Transformation of an existing health service

Project Description:  Present a plan to transform an existing health service or service line to achieve an overall 30% improvement towards one or all through of the goals of Triple AIM; this can include cost reductions in types of services, new processes for managing better health outcomes with more care at earlier interventions and substitutions in required intensity of care and/or expertise in providing medical interventions for better outcomes, and/or new high-valued services that quality for payer value-based payments and/or are in-demand consumer care services that increase market share/quality for high-value pricing.

Moving beyond the basic costing model in the first assignment, present a plan, ie, what you are proposing with aligned strategic/tactical goals, not how, to accomplish your improvement goals.  Identify the type of care setting and identify your goals in what Triple AIM goal(s) you are addressing.  Identify the changes required to implement your plan (ie, abandoning any current practices/services, increased management of current processes, leadership in building a higher level of performance in one or more areas).

You may build off of Assignment #1 with your Cost Model or select one of the following areas for your Health Care Model (attached)

1)      Provider/Health Markets – Focus on the services provided to the markets served to change the   access and/or services provided.  Identify the target markets, assess current market needs and identify planned strategies to improve overall health (ie, illness treatment/managing risk/increasing health status/increasing health and wellness – can include physical, mental, behavioral health needs including socioeconomic factors effective populations and cultural disparities).

Address how the plan will increase access to care and increase health capacity to deliver care with sustainable resources.  Address how “market basket” total cost allocations will differ from the current system, and how the new model will contribute to cost reduction through reduced price, use of more cost-effective treatments/resources, and a higher status of health, with reduced risk.

2)      Managing Health Services/Processes – Identify core capabilities and assess the allocation of those resources in current systems and make recommendations for change to increase effectiveness.  Address who/how authority is distributed and who is accountable for results.  Address what human production systems are used (customized, standardized, mass customization, process production), and how staff skills are used in the current assignment of tasks, activities, and processes (whether they work independently or in teams, whether there are cross-domain care teams, etc.), and development of new capabilities to support staff (ie,  training, technology, autonomous teams, etc.)

Provide a plan to address existing costs of service/operations and increased effective utilization, including use of technology.  Present a strategy to deliver the right care at the right site at the right cost.  Identify how your plan will apply economies of scale internally and externally with supply chains and new partnerships, centers of excellence, where applicable.

3)     Performance of Health Systems and Delivery of Services to the Consumer – Present a plan to improve the outcomes of healthcare and increase value to patients and improve patient satisfaction.  Address the issues involved with physician behavior, staff behavior, and patient behavior with behavioral economics.  Assess the role and potential impact of fully engaged providers, patients, customers, family members, etc.

Present a management plan to improve productivity, including strategies, design, and goals, and leadership strategies to increase value for customers and all stakeholders.  Present a vision of healthcare of the future and how to increase the value of health treatment, engagement of consumers and become the provider of choice with right services, at right time, in right setting, at right price.  Present plan to achieve these goals moving from old systems to new and identify what is needed to build consumer-driven care.

Demonstrate economic literacy with your ability to explain your model and your design to improve financial performance, quality care, and customer satisfaction.  This will be accomplished through your presentation of your assumptions and rationale for your model, and the use of the economic tools you are proposing.  Identify the costs/resources used, organization of those resources in the production and distribution of your services, and how this will impact your consumers and your markets.  Apply the relevant economic concepts we have studied (ie,  supply/demand, competition, pricing, cost/benefit analysis).  Use relevant “results” data, as opposed, to the “detail” of elements in your cost model, to present a deeper understanding of your analysis and interpret the proposed results.  Present your rationale for your model and conclusions.  Present in effective format to explain your model and to gain approval and support for your proposal.

SUBMITTED MATERIALS:  Present in writing a plan, including items addressed in 1, 2, or 3. In the form of a Power Point (can use same materials used in presentation), outline, and/or narrative.

Files: Medical Office Cost Model (1).docx


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