This course is based on previous courses taken in the MSHA program.
In general, there will be no additional new readings, but rather the course will be based on the reading materials required in program core courses.
The program core courses are listed below. Please refer to the lists of readings as they appear on their respective course syllabus pages.
Again, these readings should refresh your memory on the course topics, and serve you in responding to the Case, SLP, and Discussion assignments.
In the modular Background materials pages, the instructor has identified the course readings most relevant to the Capstone modular topic(s).
Module 1
Module 2
Module 3
Module 4
MHA506 - Health Care System Organization
X
X
X
MHA507 - Health Care Delivery Systems
X
X
X
MHM525 - Marketing in Healthcare
X
MHM502 - Health Care Finance
X
MHM514 - Health Information Systems
X
MHM522 - Legal Aspects of Health Administration
X
Running Head: MARKETING PLAN1
MARKETING PLAN 4
Marketing Plan
Shaneya Acker
Dr. Eric Oestmann
MHM 525
Trident University International
April 27, 2019
Contents
Cover Letter3
Introduction4
Geographical location4
Historical background4
Marketing Goals and Objectives5
Market Analysis6
Environmental Analysis7
Political and Legal7
Social and Cultural7
Consumer Analysis8
SWOT8
Strengths8
Weaknesses9
Opportunities10
Threats10
Marketing and Promotion strategies10
Marketing and Promotion Strategies13
References16
Cover Letter
This paper presents a marketing plan for Continuum health partners. Continuum health partners is an organization based in the metropolitan area of New York US. The main aim of the organization is to coordinate the operations of its members to keep the organization financially solvent by controlling costs in the highly competitive industry (Pronk et al., 2015). The plan outlines various goals and objectives which will help the organization succeed. Goals are used as a road map for the organization to achieve its vision. The plan also presents a market analysis for the healthcare industry.
The plan also presents an environmental analysis of political and social issues affecting the organization. Politics and policy issues affect the healthcare industry in a big way. For instance, the Affordable Healthcare Act has been used in the US for a while. However, the new incumbent government has promised that they will replace this Act. Social and cultural factors significantly affect the quality of healthcare for a community. Most people in the US are educated and this helps them to understand the importance of staying healthy. The paper also presents a consumer analysis of the healthcare sector.
Various strengths, weakness, opportunities and threats facing the organization are also discussed in details. One of the main strengths of the organization is its geographical location which ensures that consumers can easily access health care services within the city. Finally, the paper explores ...
Call Girls in Dwarka Mor Delhi Contact Us 9654467111
This course is based on previous courses taken in the MSHA program.docx
1. This course is based on previous courses taken in
the MSHA program.
In general, there will be no additional new readings, but rather
the course will be based on the reading materials required in
program core courses.
The program core courses are listed below. Please refer to the
lists of readings as they appear on their respective course
syllabus pages.
Again, these readings should refresh your memory on the course
topics, and serve you in responding to the Case, SLP, and
Discussion assignments.
In the modular Background materials pages, the instructor has
identified the course readings most relevant to the Capstone
modular topic(s).
Module 1
Module 2
Module 3
Module 4
MHA506 - Health Care System Organization
X
X
X
MHA507 - Health Care Delivery Systems
X
X
X
MHM525 - Marketing in Healthcare
X
2. MHM502 - Health Care Finance
X
MHM514 - Health Information Systems
X
MHM522 - Legal Aspects of Health Administration
X
Running Head: MARKETING PLAN1
MARKETING PLAN 4
Marketing Plan
Shaneya Acker
Dr. Eric Oestmann
MHM 525
Trident University International
April 27, 2019
Contents
3. Cover Letter3
Introduction4
Geographical location4
Historical background4
Marketing Goals and Objectives5
Market Analysis6
Environmental Analysis7
Political and Legal7
Social and Cultural7
Consumer Analysis8
SWOT8
Strengths8
Weaknesses9
Opportunities10
Threats10
Marketing and Promotion strategies10
Marketing and Promotion Strategies13
References16
Cover Letter
This paper presents a marketing plan for Continuum health
partners. Continuum health partners is an organization based in
the metropolitan area of New York US. The main aim of the
organization is to coordinate the operations of its members to
keep the organization financially solvent by controlling costs in
the highly competitive industry (Pronk et al., 2015). The plan
outlines various goals and objectives which will help the
organization succeed. Goals are used as a road map for the
organization to achieve its vision. The plan also presents a
market analysis for the healthcare industry.
The plan also presents an environmental analysis of political
4. and social issues affecting the organization. Politics and policy
issues affect the healthcare industry in a big way. For instance,
the Affordable Healthcare Act has been used in the US for a
while. However, the new incumbent government has promised
that they will replace this Act. Social and cultural factors
significantly affect the quality of healthcare for a community.
Most people in the US are educated and this helps them to
understand the importance of staying healthy. The paper also
presents a consumer analysis of the healthcare sector.
Various strengths, weakness, opportunities and threats facing
the organization are also discussed in details. One of the main
strengths of the organization is its geographical location which
ensures that consumers can easily access health care services
within the city. Finally, the paper explores various marketing
and promotion strategies as well as pricing strategies. The
pricing strategies include Pricing at a premium, economy
pricing, pricing for market penetration, psychology pricing,
price skimming and bundle pricing. Implementation of these
marketing and promotion strategies will enable the organization
achieve its goals. Introduction
Healthcare prices in the US are determined by both market and
non-market factors along with many other factors. Healthcare
costs in the United States cost higher compared to other OECD
countries. The healthcare sector in the country lucks
transparency unlike other industries in the United States.
Patients are not in a position to compare healthcare prices
between different organizations because healthcare providers do
not disclose this information. Government insurance program
and mandated critical care also have significant impacts on the
U.S healthcare. Nevertheless, coming up with an appropriate
price for healthcare services in an organization is an integral
part of marketing. This paper will focus on factors affecting
healthcare pricing for Continuum health partners. Geographical
location
Continuum health partners is an organization based in the
metropolitan area of New York US. The organization is
5. headquartered at 555 west 57th street New York (Pronk et al.,
2015). The organization is made up of various partners who
work together to enable the corporation achieve their objectives.
It provides health services in areas of weight loss, urology,
stroke, women’s conditions, neck pain, asthma, infertility, heart
disease, cancer, asthma, alcoholism, addiction among many
others. The organization also engages in clinical research in the
areas of neurology, mental health, kidney, HIV/AIDS, diabetes
as well as cancer. Historical background
Founded in 1997, the organization is made up of four hospitals
namely New York Eye and Ear Infirmary, Long Island college
hospital, St. Luke's-Roosevelt Hospital Center
and Beth Israel Medical Center. The main aim of the
organization is to coordinate the operations of its members to
keep the organization financially solvent by controlling costs in
the highly competitive industry. Each of its members were
founded in different years and were operating independently
until the organization was formed bringing them together. This
was in response to the increased completion between health
payment systems by managed care organizations and
government programs (Pronk et al., 2015)..
In 1997, the merger between Beth Israel and St. Luke’s-
Roosevelt brought together Manhattan west side medical
organization with one of the east sides of the borough. This
merger eased pressure on both members since St. Luke’s-
Roosevelt had a lot of space to relieve the cramped operations
of Beth Israel while the latter shouldered financial debt of St.
Luke’s-Roosevelt. This organization was developed to control
operation of these partners although it never had its own assets.
In the initial operations, the new organization ran into financial
difficulties due to the debts associated with its members. The
organization began inviting other hospitals to join them
promising cheaper delivery and lower process. Marketing Goals
and Objectives
The main goal of the organization is to coordinate the
operations of its members to keep the organization financially
6. solvent by controlling costs in the highly competitive industry.
Healthcare industry is very competitive in the United States and
therefore it is very important to set an appropriate price for
healthcare services. The organization aims to provide a good
healing environment for patients as well as their families while
improving the quality of life in the community. Te organization
aims to provide cost effective and highly accessible healthcare
services for the community.
Continuum health partners also aims at improving patient
engagement. Good patient engagement increases repeat business
and referrals which could support the organization’s financial
goals. Increased engagement with both potential patients and
existing patients increases satisfaction. Patient review will
promote the growth of the organization. Patients will also play a
significant role in marketing the organization for the quality
services and care offered. The organization also aims to reduce
marketing expenses. Instead of using a lot of budget on
marketing, the organization is focusing on quality of their
promotional strategy. This could help the organization use the
money that could be used for advertising to improve quality of
their services (Thompson, 2017). Market Analysis
The US health care sector is now focused on financial models
that are based on value. For this reason it is important to keep
patients out of hospital and healthy. Health care organizations
are now treating patients as members rather than ordinary
patients. More health organizations are collaborating to work
together towards a particular goal due to the increased
competition in the industry. Technology is also evolving
rapidly. Healthcare organizations are using technological
developments to improve the quality of their services.
Healthcare professionals have also shifted their focus on
wellness rather than illness. This plays a significant role in
determining the quality of care offered to patients.
Exponential innovative advances, aging population and greater
chronic disease preference have significantly increased demand
for healthcare and expenditure. Healthcare organizations are
7. struggling to manage financial, clinical and operational
challenges in the industry in which new care delivery models
could help improve quality of care and solve the existing
problems in the system. Healthcare stakeholders could achieve
this goal by focusing more on a healthcare that supports early
intervention, prevention and well being. Environmental
AnalysisPolitical and Legal
Politics and policy issues affect the healthcare industry in a big
way. For instance, the Affordable Healthcare Act has been used
in the US for a while. However, the new incumbent government
has promised that they will replace this Act. Any changes in
this Act will affect the mode of healthcare delivery in the
country. Data breaches have become a major issue in the
healthcare industry. However the government has developed
various regulations to protect important patient data in
healthcare organizations. There are also various regulations
which dictate the conduct of medical professionals. These
regulations ensure that patients receive safe and quality
healthcare at affordable prices (Thompson, 2017). Social and
Cultural
Social and cultural factors significantly affect the quality of
healthcare for a community. Most people in the US are educated
and this helps them to understand the importance of staying
healthy. Most people visit the doctor regularly and engage in
healthy activities. Most people earn almost twice above the
minimum wage which ensures that they can afford quality
healthcare services. This also helps them to access healthy
foods and enough safe space for exercise. A good population in
the US lives in safe neighborhoods thanks to the affordable
housing program. This ensures that people are not exposed to
poor living conditions which could affect their health.
Consumer Analysis
There is a considerable growth of consumer engagement with
healthcare from looking for care to accessing new care channels
and tracking and sharing health data. Increased consumer
engagement has significantly reduced healthcare costs and
8. improved healthcare outcomes. Patients are more informed
about their health and more involved in the process of treatment
which tends to yield better health outcomes. Many healthcare
plans, health care systems and clinicians have developed
strategies aimed at improving consumer engagement. Currently,
healthcare consumers are more open to new channels of care
and using quality ratings. Many healthcare consumers are also
willing to share their health information to improve their
health.SWOTStrengths
Continuum health partners Inc. coordinates the operations of its
members to keep the organization financially solvent by
controlling costs in the highly competitive industry. This
ensures that patients are offered the best healthcare prices by
the organization. Members of the organization are also located
in the metropolitan areas of New York. This ensures that
consumers can easily access health care services within the city.
Having merged several hospitals, the organization has a great
financial potential for expansion which has allowed them to
deliver quality healthcare over the past couple of years (Pronk
et al., 2015).
The organization provides innovative services to their
consumers. This helps them to offer affordable and quality
services to their patients. The organization has also built a
strong reputation for offering quality services. Patients want to
visit the organization and experience the greatness of their
services. The institution is well equipped with modern
healthcare facilities which ensure their services are the best.
Their professionals are also well trained and can interact with
patients positively creating a good healing environment for
them. The organization has strong cultural connections with the
community which boosts the quality of services offered. This
eases communication within the hospital between patients and
healthcare professionals which is very important in the
treatment process. Weaknesses
There are various weaknesses associated with Continuum health
partners Inc. One of them is lack of differentiation. The
9. organization has not differentiated itself from other players in
the industry. Most of the services offered by the organization
are the same services offered by their competitors. The
organization also has staff management issues. Staff members
are not offered competitive salaries and therefore there is high
rate of turnover. This is because they feel underappreciated and
not motivated. This compromised the quality of services offered
at the institution due to lose of talent and experienced
employees.
The organization is also lagging in technology. This is
contributed by the lack of talented and experienced workforce
to operate modern healthcare machines. The organization also
lacks a marketing plan. Marketing is very important for any
organization. It plays a significant role for an organization to
achieve its objectives. The organization has lost its market grip
due to the lack of a marketing plan. Most consumers learn of the
existence of an organization and the services they offer through
marketing. With the current competition in the healthcare
industry, marketing is becoming very important. There are also
gaps in the services offered by the organization. Continuum
health partners Inc does not offer all clinical services offered by
their competitors. Opportunities
There is availability of new technology that Continuum health
partners Inc can embrace to better the quality of their services.
For instance artificial intelligence technologies can be used to
better the services offered to their consumers. Their competitors
are also vulnerable to the market trends. The organization can
capitalize in these vulnerabilities to grow their market share.
There are also significant changes in the population needs.
Patients are now more concerned about their health. The
organization can use this opportunity to provide services needed
by modern healthcare consumers. There is also lack of dominant
completion in the healthcare industry. This gives them an
opportunity to grow their market share (Pronk et al., 2015).
Threats
The organization is facing various threats. One of these threats
10. is rapid innovation from their competitors. Other healthcare
organizations are innovating at a very high rate to improve the
quality of services offered to their clients. There are also
changes in insurance plan that could affect the way healthcare
services are delivers. Changing politics and regulation could
also have significant impacts on healthcare delivery. The
industry may also experience shifts in referral sources.
Marketing and Promotion strategies
The following are six pricing strategies ranked in the order of
their effectiveness in healthcare industry.
1. Pricing at a premium
2. Economy pricing
3. Pricing for market penetration
4. Psychology pricing
5. Price skimming
6. Bundle pricing
Pricing at a premium is the most effective strategy in the
healthcare industry. This involves keeping the prices of services
high in order to influence buyers positively based on the price
only. This strategy is very effective especially if you have a
specific service offered to consumers. The organization must
work hard to influence the consumers that their services are of a
higher quality. This strategy needs serious marketing to ensure
that people understand the worth of their services. The quality
the services and products must also be of high quality. This
together with the organization reputation supports the premium
price (Belleflamme & Peitz, 2015).
Economy pricing is aimed at attracting the most cost cautious
customers. This strategy involves organizations minimizing
production and marketing costs in order to reduce the costs
associated with products and services. Consumers can purchase
the products and services they would wish to without any
struggle. This strategy could be effective in healthcare since
most consumers are price cautions. People are only interested
on services that will heal them. However, people may think that
the products and services being offered at these low prices are
11. of low quality. This will affect the organization negatively.
Healthcare organizations must create awareness of the quality
of their products.
Pricing for market penetration is used in many cases when an
organization is entering the market. It focuses on reducing the
prices of services and products. Most people are attracted to
products of low prices. This therefore attracts consumers to buy
your products and services thus growing your market share.
However, this may result to lose of initial income for the
business. This could work well in the healthcare industry so
long as the organization conducts marketing. This creates
awareness among consumers which could help the healthcare
organization to stand out in the market and improve their
products. After gaining momentum the organization can
increase price for their services to match their market position.
Psychology pricing involves marketers setting their products
and services prices slightly lower than the actual price. An
example is setting the price for an antibiotic at $29 instead of
$30. This is based on the belief that consumers do not round off
numbers but rather see these prices as lower. Consumers also
tend to focus more on the first number than the second. The
main aim of this strategy is to increase demand by creating an
illusion that the prices are lower. This strategy can also be
effective in healthcare. This could encourage consumers to
purchase products and services more base on that perception
(Belleflamme & Peitz, 2015).
Price skimming on the other hand involves setting prices high in
the introductory phase. The prices are then lowered after some
time as competitors appear in the market. At the introductory
phase there are many prospective consumers who are willing to
purchase products and services at a high price. Consumers
interpret the high prices as sign of quality. This could also be
very effective in the healthcare industry. The healthcare
organization needs to be innovative so that they have new
products or services to introduce in the market. This would help
them make a lot of prices before competition develops in the
12. market.
Bundle pricing involves selling multiple products at a lower
cost than they would be if each item was sold individually. This
improves the perception of consumers on the products since
they are being given an item for free. Bundling improves
efficiency by reducing the distribution and marketing costs.
With time, bundling can significantly increase profits from a
particular product. Many services may also be sold to one
consumer encounter. However, this strategy forces consumers to
purchase a product even if they are not in need of it. This
strategy is not effective in healthcare since many services in
healthcare are independent and cannot be offered in a bundle.
Price transparency in healthcare refers to the ability of
consumers to get enough information on healthcare quality and
prices. Prices for the same service can vary greatly depending
on the provider. In the United States it is very difficult for
consumers to access this information which can help them
compare providers in terms of quality and prices. Having
enough of this information could help consumers anticipate
their expenses and choose high quality providers. This could
also help healthcare stakeholders and policy makers accountable
for coming up with fair prices (Sinaiko & Rosenthal, 2016).
Lack of price transparency in the healthcare industry has
resulted in fluctuation of costs for healthcare services. This
problem can only be fixed by policy makers and not market
forces. However it is difficult for policy makers to understand
the unwarranted variation in healthcare prices since these prices
are treated as trade secrets. Increases price transparency in
healthcare could provide an opportunity for policy makers to
address the issues of price fluctuations. Marketing and
Promotion Strategies
There are various marketing strategies which can help
Continuum health partners Inc reach people and turn them into
customers. They include Television advertisement, printed
media, social media and radio advertisement. All these
strategies have clearly developed goals and objectives and well
13. laid out plans to implement them. The choice of these strategies
is informed by the achievement an organization needs to realize.
These strategies are highly effective in the healthcare sector.
Social media strategies offer businesses an opportunity to reach
new customers despite their geographical locations. Currently
there are many social media platforms including Facebook
twitter, instagram, Google, LinkedIn among many others. All
this platforms are suitable for healthcare marketing. However,
consistency and persistence is very important in social media
marketing. Posting regularly to these channels increases an
organization’s exposure to new customers. Most people use
smart phones to access this platforms. Therefore marketing a
healthcare organization could create awareness about the
organization, its location and the services offered at a wide
range of people. Social media marketing can allow patients to
interact with healthcare professionals in real time. It could also
help educate patients by sharing useful information with them
(Hillestad & Berkowitz, 2018).
Television advertisement is also an effective strategy for
healthcare marketing. It is possible to use a TV advertisement to
deliver a professional quality message. Tight budget control,
new media options and friendly broadcast rates makes television
a sensible consideration for healthcare organizations. Most
people view television and therefore the advertisement is likely
to reach thousands of people. Television advertisement offers
emotional connections with the viewers. Picture and visual
effects paint a picture of the brand being advertised. People will
feel emotionally connected to the organization. Every message
broadcasted trough TV advertisement should be focusing on the
brand of the healthcare organization. These advertisements are
also cost economic which helps a healthcare organization to
save on costs that they could have used in other strategies of
advertisement.
Print media advertising involves using printed media such as
newspapers and magazines to reach prospects and consumers.
This can be achieved by using digital media. Newspapers target
14. a wide range of audience. Organizations can by spaces in news
papers to display advertisements featuring illustrations, pictures
and texts. Many people also like to read trade magazines. Just
the same as news papers, advertisers can but spaces in these
magazines to advertise their contents. Print media is very
favorable for healthcare advertisements since it is an easy
medium to spread awareness about a particular service being
offered by the organization (Gilligan & Lowe,2018).
Radio advertising is also a great way of marketing in healthcare.
Regular advertisements can attract new consumers. It is also
important to repeat the advertisement since people tend to
forget what was advertised. Radio advertisement yields great
results if repeated regularly. Radio advertisement has the ability
tom stand out. Most people listen to the radio while driving
alone or while at a lonely place. This allows them to listen
carefully at what is being said in the radio. It allows healthcare
advertisements to stir emotions of the listeners and encourage
them to find healthcare services from the organization.
References
Pronk, N. P., Baase, C., Noyce, J., & Stevens, D. E. (2015).
Corporate America and community health: exploring the
business case for investment. Journal of occupational and
environmental medicine, 57(5), 493-500.
Thompson, G. (2017). Affordable and Accessible Hearing
Healthcare Interventions in the United States: A Literature
Review and Prospective Analysis.
Belleflamme, P., & Peitz, M. (2015). Industrial organization:
markets and strategies. Cambridge University Press.
Hillestad, S. G., & Berkowitz, E. N. (2018). Health care market
strategy. Jones & Bartlett Learning.
Gilligan, C., & Lowe, R. (2018). Marketing and healthcare
15. organizations. CRC Press.
Sinaiko, A. D., & Rosenthal, M. B. (2016). Examining a health
care price transparency tool: who uses it, and how they shop for
care. Health Affairs, 35(4), 662-670.
Running Head: PRICING STRATEGIES1
PRICING STRATEGIES6
Pricing strategies
Shaneya Acker
Dr. Eric Oestmann
MHM 525
Trident University International
April 27, 2019
Pricing Strategies
This paper discusses pricing strategies for Continuum health
partners. Continuum health partners is an organization based in
the metropolitan area of New York US. The main aim of the
organization is to coordinate the operations of its members to
keep the organization financially solvent by controlling costs in
the highly competitive industry (Pronk et al., 2015). The
organization is made up of various partners who work together
to enable the corporation to achieve their objectives. It provides
health services in areas of weight loss, urology, stroke,
women’s conditions, neck pain, asthma, infertility, heart
16. disease, cancer, asthma, alcoholism, addiction among many
others.
The following are six pricing strategies ranked in the order of
their effectiveness in healthcare industry.
1. Pricing at a premium
2. Economy pricing
3. Pricing for market penetration
4. Psychology pricing
5. Price skimming
6. Bundle pricing (Gilligan & Lowe, 2018).
Pricing at a premium is the most effective strategy in the
healthcare industry. This involves keeping the prices of services
high in order to influence buyers positively based on the price
only. This strategy is very effective especially if you have a
specific service offered to consumers. The organization must
work hard to influence the consumers that their services are of a
higher quality. This strategy needs serious marketing to ensure
that people understand the worth of their services. The quality
the services and products must also be of high quality. This
together with the organization reputation supports the premium
price (Belleflamme & Peitz, 2015).
Economy pricing is aimed at attracting the most cost cautious
customers. This strategy involves organizations minimizing
production and marketing costs in order to reduce the costs
associated with products and services. Consumers can purchase
the products and services they would wish to without any
struggle. This strategy could be effective in healthcare since
most consumers are price cautions. People are only interested
on services that will heal them. However, people may think that
the products and services being offered at these low prices are
of low quality. This will affect the organization negatively.
Healthcare organizations must create awareness of the quality
of their products.
Pricing for market penetration is used in many cases when an
organization is entering the market. It focuses on reducing the
prices of services and products. Most people are attracted to
17. products of low prices. This therefore attracts consumers to buy
your products and services thus growing your market share.
However, this may result to lose of initial income for the
business. This could work well in the healthcare industry so
long as the organization conducts marketing. This creates
awareness among consumers which could help the healthcare
organization to stand out in the market and improve their
products. After gaining momentum the organization can
increase price for their services to match their market position
(Hillestad & Berkowitz, 2018).
Psychology pricing involves marketers setting their products
and services prices slightly lower than the actual price. An
example is setting the price for an antibiotic at $29 instead of
$30. This is based on the belief that consumers do not round off
numbers but rather see these prices as lower. Consumers also
tend to focus more on the first number than the second. The
main aim of this strategy is to increase demand by creating an
illusion that the prices are lower. This strategy can also be
effective in healthcare. This could encourage consumers to
purchase products and services more based on that perception
(Belleflamme & Peitz, 2015).
Price skimming on the other hand involves setting prices high in
the introductory phase. The prices are then lowered after some
time as competitors appear in the market. At the introductory
phase there are many prospective consumers who are willing to
purchase products and services at a high price. Consumers
interpret the high prices as sign of quality. This could also be
very effective in the healthcare industry. The healthcare
organization needs to be innovative so that they have new
products or services to introduce in the market. This would help
them make a lot of prices before competition develops in the
market.
Bundle pricing involves selling multiple products at a lower
cost than they would be if each item was sold individually. This
improves the perception of consumers on the products since
they are being given an item for free. Bundling improves
18. efficiency by reducing the distribution and marketing costs.
With time, bundling can significantly increase profits from a
particular product. Many services may also be sold to one
consumer encounter. However, this strategy forces consumers to
purchase a product even if they are not in need of it. This
strategy is not effective in healthcare since many services in
healthcare are independent and cannot be offered in a bundle.
Price transparency in healthcare refers to the ability of
consumers to get enough information on healthcare quality and
prices. Prices for the same service can vary greatly depending
on the provider. In the United States it is very difficult for
consumers to access this information which can help them
compare providers in terms of quality and prices. Having
enough of this information could help consumers anticipate
their expenses and choose high quality providers. This could
also help healthcare stakeholders and policy makers accountable
for coming up with fair prices (Sinaiko & Rosenthal, 2016).
Lack of price transparency in the healthcare industry has
resulted in fluctuation of costs for healthcare services. This
problem can only be fixed by policy makers and not market
forces. However, it is difficult for policy makers to understand
the unwarranted variation in healthcare prices since these prices
are treated as trade secrets. Increases price transparency in
healthcare could provide an opportunity for policy makers to
address the issues of price fluctuations.
References
19. Belleflamme, P., & Peitz, M. (2015). Industrial organization:
markets and strategies. Cambridge University Press.
Hillestad, S. G., & Berkowitz, E. N. (2018). Health care market
strategy. Jones & Bartlett Learning.
Gilligan, C., & Lowe, R. (2018). Marketing and healthcare
organizations. CRC Press.
Sinaiko, A. D., & Rosenthal, M. B. (2016). Examining a health
care price transparency tool: who uses it, and how they shop for
care. Health Affairs, 35(4), 662-670.
Running head: SWOT ANALYSIS OF UNITEDHEALTH
GROUP1
SWOT ANALYSIS OF UNITEDHEALTH GROUP5
SWOT Analysis of UnitedHealth Group
Shaneya Acker
Dr. Eric Oestmann
MHM 525
Trident University International
April 5, 2019
SWOT Analysis of UnitedHealth Group
Introduction
SWOT (Strengths-Weaknesses-Opportunities-Threats) is a tool
that is used by organizations as well as auditing companies
among others to conduct situational analyses of the company. It
provides top management as well as prospective investors
internal and external strategic factors. With UnitedHealth Group
20. being one of the largest companies in the industry it has several
strengths and opportunities that allow it to maintain its market
position. However, I also experience weaknesses and threats.
Strengths
Among the leading strengths that UnitedHealth exhibits are its
high level of consumer satisfaction that is attributed to the
company’s dedicated consumer relations department. Through
this department, the company can respond to various customers’
nationwide thereby creating good brand equity for potential
clients. The second strength of the company is the strong
portfolio, the company’s long reputation in the industry, as well
as investments, have made the company a brand name ("About
UnitedHealth Group", 2019). This has allowed the company to
expand in various sectors as well as offer its shareholders
varied products. The third strength is strong distribution
networks; the company has been able to develop a strong
distribution market through its various acquisitions as well as
the increased market base. These distribution channels have
allowed the company to reach to various communities of
different socio-economic classes making the company diverse in
its activities and products ("About UnitedHealth Group", 2019).
The final strength the company has to offer is the strong
integration strategy for firms that compliments its operations.
This factor is the main contributor after a large number of
policyholders, which has allowed the company to grow to its
current state and offer professional services to its over 100
million clients.
Weaknesses
Though many people including analysts view the company as
being generally successful, there are attributes concerning the
company that limits its efficiency as well as effectiveness. The
first is the company’s poor product demand forecasting; this
results in the company having high in-house inventory. The
second weakness is high employee turnover; this is associated
with the high consumer base. This forces the company to spend
millions in training new employees compared to its competitors.
21. The poor marketing strategies are the third weakness; even
though the company has registered high success rates in a
variety of its products, the poor marketing strategy allows for
other companies to take advantage of the factor (Trefis, 2015).
The fourth weakness is the rigid culture the company has
adopted. This limits other cultures from newly acquired
companies to integrate easily. This results in frequent
breakdowns in communication. Finally, the company has low
profitability and Net contribution ratio and percentage
respectively (Trefis, 2015).
Opportunities
With the strengths and weaknesses of UnitedHealth Group
offering internal strategic factors that affect the company, the
opportunities and threats offer the external strategic factors that
influence the company. Among the first opportunities is the
recent economic growth taking place (Japsen, 2018). With more
people having disposable incomes the organization is expected
to appeal to the new markets thereby increasing its market
share. Another opportunity is the new markets that have
developed because of government agreements with regards to
technology. The government recently added new free trade
agreements that have opened the new markets for UnitedHealth
Group to explore (Japsen, 2018). The third opportunity is the
recent decrement of shipping costs. This has allowed
UnitedHealth Group to increase the quantity of imported
material thereby having a direct impact on the company’s
profitability. Finally, the scope of the company has resulted in
the dilution of various competitor advantages thereby allowing
UnitedHealth Group to have an increased stake in the medical
and insurance industry.
Threats
Similar to weaknesses, these are the factors that limit the
progression of the company within the industry. The first threat
is related to the high turnover the company experienced, it is
experiencing a shortage of skilled workforce, and this threatens
the company’s profit generation. The second threat is the
22. intense competition from various organizations operating in
either of the two industries. In the past half-decade, the number
of companies offering similar products and services as
UnitedHealth has increased by a significant number (Trefis,
2015). Additionally, the varying state laws have resulted in the
company taking up several litigations from its various
subsidiaries. This limits the company’s operative capabilities
thereby limiting its overall revenue generation. Finally, the
growing strength of local distributors has the potential to limit
the market share of the company.
References
About UnitedHealth Group. (2019). Retrieved from
https://www.unitedhealthgroup.com/about.html
Japsen, B. (2018). UnitedHealth Group: 50M To Access New
Personal Health Record In 2019. Retrieved from
https://www.forbes.com/sites/brucejapsen/2018/11/27/unitedhea
lth-50m-to-access-new-personal-health-record-in-
2019/#168a67f13a19
Trefis. (2015). Key Factors Driving UnitedHealth Group's
Medicaid Managed Care Business. Retrieved from
https://www.forbes.com/sites/greatspeculations/2015/04/01/key-
factors-driving-unitedhealth-groups-medicaid-managed-care-
business/#27e3ac95512d
23. Running head: BRAND AUDIT OF UNITEDHEALTH GROUP1
BRAND AUDIT OF UNITEDHEALTH GROUP 3
Brand Audit of UnitedHealth Group
Shaneya Acker
Dr. Eric Oestmann
MHM 525
Trident University International
April 5, 2019
Brand Audit of UnitedHealth Group
There are hundreds of medical organizations in the United
States (U.S.), but for this brand audit, the organization selected
is UnitedHealth Group Inc. The company is a for-profit
organization; this means that the activities it conducts are
mainly driven by profit. Nevertheless, the company has its
headquarters in Minnetonka, in the state of Minnesota. As of the
end of the financial year of 2018, the company was ranked fifth
in the nation’s fortune 500, which is a list of the country’s
highest revenue generating companies ("Our History", 2019).
The company’s operations are mainly medical as they offer
healthcare products to its client market as well as insurance
services. These services made the company be ranked as the
global leader when it came to revenue generation for a medical
organization. Data from the company identified that in the year
2016 the company had over 110 million clients relying on their
services. The company was formed in the late-1970s by Richard
Taylor Burke, through Charter Med Incorporated ("Our
History", 2019). The main purpose of creating the
UnitedHealthcare Corporation was to reorganize the company
making it the parent of Charter Med. The top management
24. intended to take the management position of the newly
developed Physicians Health Plan, among the first health
management organizations in Minnesota ("Our History", 2019).
Regardless, through numerous acquisition of various other
health-related organizations, the company the commonly
accepted healthcare giant (Dine & Hurd, 2016).
The company’s financial records were hard to attain, but its
records showed that from 2005 the company’s income was
constantly rising to average at a net income of approximately $4
billion between 2005 and 2007 (Dine & Hurd, 2016). However,
during the great recession of 2007 and 2008, the economic
downturn also affected its revenue generation. But after the
market settled, the company regained its initial continuous
revenue generation to that of 2018 ("Our History", 2019).
Moreover, with the company’s increased acquisitions its
workforce also increased from just over 150,000 in 2013 to over
300,000 by the end of 2018. The same progression could be
identified with the company’s stock prices, in 2005 they had an
average value of $45.25, but by the end of the 2018 financial
year, they were valued at an average of $246.12 ("Our History",
2019). This advancement was a notion that the company was
successful in its activities thereby gaining market attention.
From the inception of the company in the 1970s, the company’s
logo has seen minimalistic changes with the only addition being
the emblem compared to its initial logo compromising of the
abbreviation of the company name. Nevertheless, the company’s
current logo contains a minimalistic font, and the most
recognizable aspects of the logo include the sizes of the letters.
Emphasis is stressed on the “United” as well as “Group”
identifying the activities of the company with relation to health.
The company’s slogan “Helping People Live Healthier Lives,”
also promotes the company’s products and services. Similar to
its logo, it is short and noteworthy easily identifying the
company’s objectives as well as intentions. When it comes to
products and services, the company offers a diverse number of
commodities for various socio-economic classes. The company
25. offers premium insurance and health-related products to
products that appeal to those of low income. This attribute
makes the company favorable to many clients as they offer
products relevant to the income generated by the potential
client.
In terms of competition, it can be stated that the organization
has no monopoly over the market. With organizations such as
Humana, they offer stiff competition to UnitedHealth Group in
the insurance sector for various reasons. When compared to
UnitedHealth Group, Humana under several occurrences has
been identified as the best company when it comes to insurance
plans. Humana offers robust healthcare coverage, but in various
regions within the U.S. UnitedHealth Group is deemed the
cheapest and health plan (Ginter, Duncan, & Swayne, 2018).
Moreover, UnitedHealth offers Health Savings plans that are
non-existent in Humana making the company even more
attractive to the public. In terms of coverage, UnitedHealth is
deemed to have the most expansive coverage area. The company
offers not only insurance covers but also a multitude of doctors,
hospitals and other medical facilities secured with the
contractual agreement with the policyholder (Hernandez, 2013).
From retrospect, it can be assumed that UnitedHealth takes
advantage of markets that are either ignored by other
organizations. This increases not only its market share but also
its public acceptance. In comparison, UnitedHealth has
coverage that can be deemed as being equally spaced globally if
adjustments in data are made for the region. However, the
majority of Humana’s market share is concentrated in the
southeast region of the U.S (Ginter, Duncan, & Swayne, 2018).
The analysis has identified that UnitedHealth Group is not only
a considerate of its market income but also offers more services
to its policyholders thereby making them industry leaders.
Additionally, it can be identified that UnitedHealth’s vast
network of clients can be attributed to the number of
acquisitions it made from its inception in the late 1970s. By
addressing common issues mostly ignored by other
26. organizations in the same industry, the company has been able
to register continuous growth that has propelled it to its current
position.
References
Dine, E. E., & Hurd, M. (2016). Health Insurer Merger Frenzy:
How the Continued Arms Race Will Disrupt Traditional Market
Roles. Annals Health L., 25, 98.
Ginter, P. M., Duncan, W. J., & Swayne, L. E. (2018). The
strategic management of health care organizations. John Wiley
& Sons.
Hernandez, L. M. (Ed.). (2013). Health literacy: Improving
health, health systems, and health policy around the world:
Workshop summary. National Academies Press.
Our History. (2019). Retrieved from
https://www.unitedhealthgroup.com/about/history.html
Running Head: SEGMENTATION, TARGETING,
POSITIONING &ANALYSIS 1
SEGMENTATION, TARGETING, POSITIONING
&ANALYSIS 3
Shaneya Acker
Dr. Eric Oestmann
MHM 525
Trident University International
27. March 17, 2019
Segmentation, targeting, positioning, and analysis
Market analysis
The industry of offering long term care for the aged is a
growing industry in the Richmond area. According to the
statistics of Richmond County, close to 22% of the dwellers of
the county is between 22years and 45 years, 4% are between 45
and 55 years and close to 13% are over 65 years of age. With
the above statistics, it is safe to assume that those who are 65
years and above are the current target clients for long term care
services and facilities and those who are between 45years and
55 years will be the target clients in the next ten years. It is in
the best interest of the organization that we not only come up
with a marketing strategy that targets the current target clients
but also targets the future target clients.
An analysis of the target market place reveals that half of the
population is of African American descent and that only 40%
are white Americans. The nature of the organization is likely to
attract white Americans over African Americans and this is
because of the family values differences. The best case scenario
for the organization would be to attract as many people from all
the races living in the Richmond area however that is not going
to be the case unless specific measures are taken up.
The organization can frame the services they offer the aged of
the African American descent with the intention of attracting
them. For example, the organization can offer to have dance
incorporated in their facilities and this is because of the love
28. African American regardless of age have for music. Not only
will the strategy attract more customers from the African
American decent but it will also put the organization ahead of
its competition.
Unlike other areas, Richmond County has a huge population of
African Americans and as mentioned in the above paragraph
African Americans rarely consider having their elderly in long
term care services. The other areas in the US have lesser
numbers of African Americans and for that reason are likely to
have more elders in long term care facilities. Local
organizations in the Richmond area that offer long term care
services have a small pool of clients as compared to other parts
of the country and it is for that reason that the marketing
strategies for the Richmond area are more advanced compared
to the marketing strategies of other places.
Environmental analysis
The Richmond area for a long time was known as one of the
most dangerous parts of the US and this was because of the high
rates of poverty which contributed significantly to high rates of
criminal activity. With high crime rates, the county has a poor
economy compared to other counties and it is for that reason
that the area receives reduced consumer activity for all sectors
including the hospitality and health sector.
Political/legal
At the moment, the policies in place do not really advocate or
push for the operations of the organization. The elderly and
veterans are covered well by the medical policies in place;
healthcare for the elderly is an entitlement that is protected by
the law. With policies that cover the elderly, few people want or
are willing to incur extra costs to take care of the elderly and
this by itself reduces the potential customers that the
organization can attract to their facility. It is for the above
reason that the organization should market itself more using the
selling point that they take away the extra burden of caring for
the aged.
Social/cultural
29. Bearing in mind that the target population for the organization
is majorly African Americans, It would be best for the
organization to carry our marketing strategies that target on the
close-knit culture of African Americans (Ernst & Dolnicar,
2018). The organization can have a selling proposal that states
that the organization offers long term care services that can be
equated to homely care. Such a mantra would appeal more to the
African American population. Using such a mantra will also
help retain the white American target population as well since
everybody loves homely care services.
Consumer analysis
The immediate target population for the organization is the
elderly who are 55 years and above while the secondary target
population is for the people who are between the ages of 45 and
55 years. The primary target population requires personalized
care because of their frail age. They also need to have all
possible chores that one can think of, performed for them. In
order to meet the needs of the target population better than any
organization that offers the same services that we offer, the
organization will use two strategies. The first strategy will
involve having facilities and equipment that offer advanced
recreational services to the target population (Schlegelmilch,
2016). The second strategy will involve having facilities and
equipment that make it possible to deal with chronic diseases as
well as diseases and conditions that come with age.
The first strategy will come in handy in pinning down the
competition because most long term care facilities around the
area and all over America do not offer recreational facilities to
the age. They instead offer the basics which include; having
green lawns which they can walk and exercise, offer good food
and good shelter. By our organization offering recreational
facilities and activities such as board games, saunas, and
Jacuzzis the organization will offer services that appeal to the
elderly as well as to their sponsors. The second strategy will
offer advanced medical services that are not offered by most
long term care facilities but are really needed by the target
30. population.
The biggest beneficiary of the organization is the elderly as
they get access to full-time care. The secondary beneficiaries of
the organizations are the sponsors or the children of the elderly
as they get to free themselves the burden of taking care of the
elderly. The market segmentation that will benefit the most
from the services offered by the organization is the
demographic segmentation (Cross, Belich & Rudelius, 2015).
References
Cross, J. C., Belich, T. J., & Rudelius, W. (2015). How
marketing managers use market segmentation: An exploratory
study. In Proceedings of the 1990 Academy of Marketing
Science (AMS) Annual Conference (pp. 531-536). Springer,
Cham.
Ernst, D., & Dolnicar, S. (2018). How to avoid random market
segmentation solutions. Journal of Travel Research, 57(1), 69-
82.
Schlegelmilch, B. B. (2016). Segmenting Targeting and
Positioning in Global Markets. In Global Marketing
Strategy(pp. 63-82). Springer, Cham.
Running Head: MARKETING PLAN
1
MARKETING PLAN
4
31. Marketing Plan
Shaneya Acker
Dr. Eric Oestmann
MHM 525
Trident University International
March 17, 2019
Marketing plan
Lakewood Manor long term care facility
Lakewood Manor is one of the long term care facility in the
Richmond area in the state of Virginia. It specializes in offering
nursing facilities to the elderly of the area. The facility can
house up to a maximum of 200 residents and the facility is well-
taken care off with good lawns. The facility offers assisted
living and for that reason offers nursing facilities to its
residents; the facility has 96 Medicaid beds. In addition, the
facility is a non-profit church-affiliated facility. It is affiliated
with the Baptist church.
The facilities geographical location
Richmond is the fourth most populated city in the state of
Virginia with a population of almost 230,000 people. More than
half the population of Richmond is African American while
white Americans are 40% of the total population of the area
(Kanagy, Ramos & Prieto, 2017). Asians make up 5% of
Richmond’s population while pacific islanders, Native
Americans, and mixed race make up 0.1%, 0.3%, and 2.3% of
the areas total population. a look at the demographics of the
area indicates that close to 22% of Richmond’s population is
32. under 18 years, those between the ages of 25 and 45 are 32% of
the area’s total population and those who are above 65 years are
13% of the area’s total population. According to the statistics,
approximately 21% of residents of Richmond live below the
federal poverty line.
The historical background of the facility
The facility was established for the sole purpose of caring for
the elderly in the Richmond area. Looking at the population of
the Richmond area it is possible to note that more than 13% of
the population is over 65 years. In addition, another 4% of the
population is between the age of 55 and 65 years and for that
reason can as well be classified as elderly. The organization
houses Christian elders specifically those who are affiliated
with the Baptist denomination. As much as the organization is
non-profit organization its charges are high due to the advanced
amenities that the organization offers to the residents.
The amenities offered by the organization have been one of the
biggest selling points for the facility. The facility offers
assisted living services, memory care services, skinned nursing
services, and rehabilitation services. The facility has a 24 hour
experienced care team that offers housekeeping, medical
management and personalized care to the residents. The
Lakewood Manor targets the elderly who are suffering from
dementia and the Alzheimer diseases and through their memory
care service provides care and love to the elderly.
The facility has a 5-star rating CMS and this is because the
center is known for its prioritization on the well-being of the
residents of the facility. The facility offers treatment and
management services for chronic diseases that come with old
age and in addition, the facility has registered nurses, certified
nursing assistants and licensed practical nurses to provide
seniors with specialized care for any health condition that they
may have. The facility assures of personalized care and quality
care to all its residents.
33. As part of the organization’s rehabilitation package, the facility
enables senior citizens that have suffered strokes, illness, and
injuries to recover. The facility has as well packaged its three
meals per day program to resemble restaurant packages. All the
above is geared to better the experience of the residents of the
long term facility.
Marketing goals and objectives
Lakewood’s mission statement acts as a guide for its marketing
goals and objectives. The statement identifies Lakewood senior
living community is a place where state-of-the-art innovation
meets excellent service, and where the spirit of hospitality,
vibrant living, and commitment to exceptional healthcare are
the highest priorities. It is the top priority for the facility to
offer exceptional healthcare as well as other senior residents
preferences in a hospitable manner.
Most long term care facilities in the US are understaffed, have
poor amenities and this makes most elderly hate or dislike being
put up in such facilities. The Lakewood Manor senior resident
home can capitalize on this market by continuing to offer the
specialized services that they offer as well as ensuring that their
amenities are good enough to attract as many people as
possible. In order to ensure that the facility maintains its
already existing client base while at the same time attracts a
new client base, the organization can offer a discounted price.
The discount will keep the existing clients while at the same
time attract potential clients (Weinstein, 2016).
In order to ensure that the quality of services offered by the
facility is maintained, the organization can have service level
agreements which will dictate how the organization’s processes
will happen. The marketing strategy of the organization will
follow the guidelines of brand marketing. The facility is already
known to offer good services for the aged and it is for that
reason that brand marketing will come in handy. Brand
marketing will allow the facility to leverage on its good brand
image and reputable name (Armstrong et al., 2015).
34. References
Armstrong, G., Kotler, P., Buchwitz, L. A., Trifts, V., &
Gaudet, D. (2015). Marketing: an introduction.
Kanagy, K., Ramos, V., & Prieto, I. (2017). Planning for the
Future: A Basic Needs Assessment of the Mixteco Population
Near Richmond, Virginia.
Weinstein, A. (2016). Superior customer value: Strategies for
winning and retaining customers. CRC Press.
Running Head: MARKETING
1
MARKETING
7
Marketing
Shaneya Acker
Dr. Eric Oestmann
MHM 525
Trident University International
March 17, 2019
35. Healthcare Marketing
Challenges in healthcare marketing
There are several challenges associated with healthcare
marketing; however, there are two that can be stated to be
universal. One of those challenges is it is hard to collect data
and use data for marketing purposes in the health sector without
coming close to breaching privacy right if not breaching them
(Orchard, 2015). For effective marketing more so in this era, the
more data a marketer has on a potential customer, the more
likely they are to convert the potential customer or client to an
actual customer; data mining is part and parcel of effective
marketing. However, with restricted access to patient data
healthcare marketers are put in a tight fix that is really hard to
wiggle out of. Healthcare markets are unable to come up with
products or effective channels through which they can carry out
personalized marketing to attract as many customers as
possible.
To make matters worse, data in the healthcare sector is highly
fragmented; there is no single data housing point for healthcare
data more so data on patients. The healthcare sector is lagging
behind when compared to other sectors as far as offering joined
up data and this is also linked to the data privacy concerns
mentioned in the first paragraph (Jaworski, Malcolm & Morgan,
2016). Very few health institutions are willing to join other
health institutions to share data on their patients and as a result,
there happens to be a lot of data on patients that can be vital for
health marketing, however, the data is spread all over the place.
Just as mentioned earlier, the lack of such data makes
personalized healthcare marketing close to impossible.
The second challenge that healthcare markets face is pegged on
the fact that healthcare are “grudge purchases” or unwanted
purchase. It is normally easy to market products are services
36. that are desired by people but hard if not impossible to market
unwanted products or services (Thomas, 2014). Most of the time
until recently people went to hospitals and healthcare
institutions when and only there was a need; only when their
health status was jeopardized. Dealing with such a hand played,
health marketers find it extremely difficult to market healthcare
products and services unless to unhealthy people of society.
The relationship of the identified challenges in health care
marketing and the 4 Ps and the 4 Cs of marketing
The first challenge mentioned in healthcare marketing is greatly
affected by one of the 4Ps of marketing. It is greatly affected
when it comes to promotion. Within the framework of 4Ps of
marketing, promotion refers mainly to marketing
communications and in this case, marketing communication
refers to the use of communication channels such as email
marketing, social media marketing, direct marketing and
advertising amongst other channels. Bearing in mind healthcare
marketers have limited access to potential customers data
collected from healthcare centers it is very hard for them to use
effective promotional strategies that will yield the best results
for a healthcare organization; attract as many customers as
possible.
For the second challenge, the P that greatly affects it is the
place P of 4 Ps of marketing. in relation to the limited access to
patient data without breach of privacy rights it is close to
impossible for healthcare markets to answer the three main
questions that guide the Place P of the 4ps of marketing; where
are the target customers shopping? How are they identifying
places that they can get the services that they need? Are they
shopping for similar services in different places?
The health sector offers many products and services however
with limited access to customer data it is impossible to come up
with an effective marketing strategy that meets the consumer
needs and wants, one of the 4 Cs of marketing. Just as
mentioned in promotion P of the 4 Ps of marketing the
communication C of 4cs of marketing is greatly affected by the
37. lack of access of data to make effective communication about
the products offered by a health institution (Whats and Hows,
2016).
Trends that will help in dealing with challenges in healthcare
marketing
There are three trends in healthcare marketing that may help the
identified challenges in healthcare marketing. One of those
trends is the use of social media and the internet by potential
customers to gather as much information as possible on health
conditions and health facilities. For the issue of not having a
proper promotion or communication model to customers due to
data constraints, the use of social media platforms offers a way
out of the challenge.
Social media platforms like Twitter, Facebook, Whatsapp, and
LinkedIn offer various ways through which healthcare
marketers can collect as much data as possible on potential or
target customers without breaching privacy rules. One way
through which health care markets can leverage on social media
to data mine as much as possible is the launching of interesting
health surveys (Lim, 2016). The surveys will help to lock down
potential customers, identifying services that are in great
demand and identifying ways through which services can be
administered in a manner that best appeals to the target market.
Social media platforms offer an avenue through which users can
offer a lot of their private information with little to nil pushing.
If healthcare marketers can know how to best push for
information from potential users without seeming intrusive then
they can collect as much data as possible to help in their
marketing strategies. For example, healthcare marketers and
even healthcare institutions can start hashtags using their social
media platforms. The hashtags will give an opportunity to
potential clients to share their views on certain health issues
and through that data which can be used for targeting potential
customers can be collected.
The last fifteen years have seen a lot of changes in the typical
patient or health care consumer. People are moving from just
38. visiting healthcare institutions just for health issues but are
visiting health care institutions for wellness desires or issues
(Resnick, 2017). Unlike in the past, people are going to
healthcare centers and hospitals to seek information on
practices that can ensure that they live longer and healthier. The
above-mentioned trend is a trend that can really come in handy
in assisting to market healthcare services and this is because
healthcare services are moving from “unwanted services” or
“grudge purchases” to desired purchases and even luxurious
purchases or services.
Healthcare marketers can leverage on the trend by identifying
the services that are in great demand and this is also pegged to
another trend in the healthcare sector; customers are willing to
spend a lot on value (Smith & Jones, 2017). Customers of all
industries of our era are ever willing to spend extra on services
and products that they find valuable and the healthcare sector is
not an exception. It is common knowledge that healthcare
centers and hospitals that offer good customer experience more
often than not have more customers lining up to get services
from the centers as compared to healthcare centers and hospitals
that do not offer exceptional customer service. Healthcare
marketers can leverage the above trends by using marketing
strategies that sell healthcare services as desirable and
luxurious services instead of grudge purchases.
39. References
Jaworski, B., Malcolm, R., & Morgan, N. (2016). 7 big
problems in the marketing industry. American Marketing
Association. Retrieved from
https://www.ama.org/publications/MarketingNews/Pages/7-big-
problems-marketing.aspx
Lim, W. M. (2016). Social media in medical and health care:
opportunities and challenges. Marketing intelligence &
planning, 34(7), 964-976.
Orchard, C. (2015). 8 challenges to customer-driven healthcare.
Harvard T.H. Chan School of Public Health. Retrieved from
https://www.hsph.harvard.edu/ecpe/8-challenges-to-customer-
driven-health-care/
Resnick. L.R. (2017). Six healthcare marketing trends for 2018.
Managed Healthcare Executive. Retrieved from
http://managedhealthcareexecutive.modernmedicine.com/manag
ed-healthcare-executive/news/six-healthcare-marketing-trends-
2018
Smith & Jones. (2017). 2018 healthcare marketing trends and
playbook: Eight emerging trends and how you can leverage
them now. Retrieved from https://smithandjones.com/wp-
content/uploads/2017/10/SJ-1390-2018-Trends-Playbook_lres-
1.pdf
Thomas, R. K. (2014). Marketing Healthcare Services. Chicago:
Health Administration Press.
Whats and Hows. (2016). What is the Marketing Mix – The 4Ps
& 4Cs. [Video]. Retrieved from
https://www.youtube.com/watch?v=9MQS-75K2ZM
Targeting in Marketing
Shaneya Acker
Dr. Eric Oestmann
MHM 525
40. Trident University International
March 29, 2019
Targeting in Marketing
For a company in any industry to be successful in the selling of
its products or services including the health sector, the company
or organization must
Segment its market
Target its best clients or customers
Position its offering in a way that will appeal best to the target
customer or client
Any organization, company or business regardless of the
industry it operates interested in successfully selling of its
products or services including the health sector, the company or
organization must segment its target market, target its best
clients or customers and position its offering in a way that will
appeal best to the target customer or client.
2
Segmenting Market
Products and services cannot appeal to everybody
Dividing clients into groups that they share similar
characteristics with e.g. elderly patients
Segmenting/ dividing customers into groups makes it easy for
the identification of an effective approach to increases the
chances of scoring a client or customer (Kubacki, Dietrich &
Rundle-Thiele, 2017).
Segmenting a market refers to the dividing of clients into
groups that they share similar characteristics with. For example,
the elderly can be segmented to demographics segment. The
41. dividing of customers into groups makes it easy for the
identification of an effective approach to increases the chances
of scoring a client or customer.
3
Ways of segmenting markets
There are many ways of segmenting markets depending on the
industry.
For the healthcare industry, there are three main ways of
segmenting the market
Demographic-age, gender, race or ethnicity (Christia & Ard,
2016).
Psychographic-lifestyles, value or personality
Behavioural or trait-brand loyalty, luxury etc.
There are three main ways of segmenting the healthcare
industry. It can either be according to demographics,
psychographic or behavioural. In demographics target customers
can be divided according to age, gender, race or even ethnicity.
In Psychographic segmentation, target customers can be divided
according to their value or personality or even lifestyle. In trait
segmentation, target customers can be divided according to their
personal preferences or habits.
4
Demographic segmentation
Segmenting markets using demographics is the easiest form of
segmentation.
In demographic segmentation potential clients or customers are
divided in reference to demographics e.g. target markets might
be divided according to age.
For example, a health institution that specializes in handling
chronic diseases may target their services at elderly people
42. (Vogenberg & Santilli, 2018).
Demographics segmentation is the easiest form of segmentation
because most preference sand buyer characteristics are dictated
a lot by demographics such as age and gender. An example of
demographics segmentation is when a health institution that
specializes in handling chronic diseases targets their services at
elderly people.
5
Psychographic segmentation
In this type of segmentation, potential clients are grouped
according to their shared values, attitudes, lifestyles or even
personality traits.
This type of segmentation is effective in the targeting of
heterogeneous customers with the same product.
In the health sector patients who prefer certain procedures such
as cosmetic surgeries can be segmented using the
psychographic segmentation with the aim of having them take
on more forms of cosmetic treatments (Serrat, 2017)
As earlier stated in the psychographic segmentation, potential
clients are grouped according to their shared values, attitudes,
lifestyles or even personality traits. It is important to note that
psychographic segmentation is effective in the targeting of
heterogeneous customers with the same product.
6
Behavioural or trait segmentation
In trait segmentation, potential customers are grouped according
to three main parameters
brand loyalty
43. usage frequency-
Occasion oriented
For example, In the health sector, there are patients who like
getting spectacles from a particular brand. such clients can be
targeted to push the sale of spectacles and other optician related
devices.
In trait segmentation, target customers are divided according to
three main parameters; brand loyalty, usage frequency and
occasion oriented. An example of trait segmentation where the
brand loyalty parameter is in play is the targeting of clients who
like particular brand names when it comes to the purchase of
spectacles. With such clients, the clients can be targeted to push
the sale of spectacles and other optician related devices.
7
Targeting
After the segmenting of customers, the next step is to come up
with approaches of targeting customers or clients effectively.
In coming up with the best markets to target three things must
be considered
The profitability of the segment.
The size of the segment as well as the potential growth of the
segment.
The factors likely to affect the identified market segmentation
After the segmentation stage is done the next stage involves
coming up with approaches to targeting customers or clients
effectively. In order to come up with the best markets to target,
there are things that must be considered; the profitability of the
44. segment, the size of the segment as well as the potential growth
of the segment and the factors likely to affect the identified
market segmentation.
8
Profitability of segment
It is important that a profitable segment is targeted- a segment
that brings the most profit to an organization
Profitable segments are identified by the segments that have
many potential customers
for example, since the number of children is high coming with
approaches that target paediatrics customers might be very
profitable for a health institution.
In marketing, it is best that a profitable segment is targeted. A
profitable segment can be identified by the number of potential
customers that are present in a segment; the higher the number
of potential customers is in a segment, the higher the
probability that the segment will be profitable. An example of a
potentially profitable segment in health care centres is the
paediatric wing. Since the number of children is high coming
with approaches that target paediatrics customers might be very
profitable for a health institution.
9
Size and potential growth
When it comes to targeting an identified segment, it is
important to establish whether the segment is big enough and
whether the segment will grow in the future.
Segments with potential growth offer a better brighter future
than segments that do not have the potential to grow.
For example, targeting paediatric customers offers a guarantee
that there is repeat business for a health organization.
45. As mentioned in the previous slide, the size of a segment
influences whether a segment is targeted. Other than the size of
the other area that should be looked at when identifying a target
segment is the potential growth of the segment. Segments with
potential growth offer a better brighter future than segments
that do not have the potential to grow.
10
Factors likely to affect identified segment market
There are various factors that can affect how an identified and
targeted market reacts to a product or service. The factors
include
Political- policies and government regulations
Economic-state of the economy
Social or cultural-cultural beliefs and taboos
Technological- advanced services and products
There are four main factors that influence whether a target
market will be chosen and the factors include political factors,
economic factors, social factors and technological factors.
Political factors refer to the policies and government
regulations that may affect how an organization operates.
Economic factors can either reduce or increase the buying
powers of consumers. Social factors refer to the beliefs and
practice that may cause potential customers to participate in a
trade or not.
11
A unique selling proposition
In the coming up with a unique selling proposition a position
map is used- through this marketers know how to position their
46. offering.
More gentle
Less effective
More effective
Less gentle
Laser surgery
spectacles
Contact lenses
In the coming up with a unique selling proposition a position
map is used and through this marketers know how to position
their offering. A look at the position map in the slide shows the
selling propositions that can be adopted in the selling of
spectacles, contacts or laser surgery. For example, one marketer
can opt to sell laser surgery by claiming that it is effective
despite it being less gentle on the human eye.
12
Positioning proposal or offer
In the last stage, marketers identify the methods or strategies
that they want to use to sell their offer to their target market.
Two main things happen in this stage
Coming up with a unique selling proposition
Identify the best marketing matrix that will yield the best
results.
Position proposal is the lasts stage of target marketing. In this
47. last stage, marketers identify the methods or strategies that they
want to use to sell their offer to their target market. There are
two main things that happen in this stage; the coming up with a
unique selling proposition and the identifying of the best
marketing matrix that will yield the best results.
13
Marketing mix
In this process, the best approach on how to market a product or
service is identified.
The marketing mix has seven main elements
Price-amount that customers should pay
Promotion
People
Physical environment
Process
Product
place
In the marketing mix part, the best approach on how to market a
product or service is identified. The marketing matrix has seven
main elements and all the elements look at the best way to
market products or services. For example, the price element
concentrates on the best price that a product or service should
be changed to attract more customers.
14
References
Christia, J., & Ard, A. (2016). The Influence of Demographic
Characteristics on Service Quality Perceptions. Journal of
Marketing Management, 4(2), 57-62.
Kubacki, K., Dietrich, T., & Rundle-Thiele, S. (2017).
Segmentation in social marketing: why we should do it more
48. often that we currently do. In Segmentation in Social
Marketing (pp. 1-6). Springer, Singapore.
Serrat, O. (2017). Marketing in the public sector. In Knowledge
Solution
s (pp. 111-118). Springer, Singapore.
Vogenberg, F. R., & Santilli, J. (2018). Healthcare trends for
2018. American health & drug benefits, 11(1), 48.
BAY CLINIC
Health Care Delivery in Hawaii
Shaneya Acker
MHA507
Dr. Sharon Nazarchuk
Trident University
August 22, 2018
BACKGROUND OF BAY CLINIC
Founded in 1983 as the Hilo Bay Clinic
49. Registered as a non-profit facility in 1986
The Clinic has developed to add more specialized community
centres across Hawaii.
The Clinic operates the only 340B Pharmacy in Hawaii that
supports federal discount program since 2015.
The Clinic also introduced a roaming Health Unit that
incorporates dental care and medical care services launched in
2016.
TARGET POPULATION
This is the biggest community health center in Hawaii island
Targets 1,392,400 Hawaii Residents
Employs approximately 150 medical professionals and support
50. staff
Serves a population of 22096 residents in East Hawaii
This accounts to 80,000 visits in year.
CONDITIONS/DISEASES TARGETED
Cancer Services
Behavioral Health
Pharmacy
Diabetes Management
53. Hawaii CHIP
Uninsured
INSURANCE PRODUCTS OFFERED
Health Maintenance Organization
Medicare
Preferred Provider Organization
Maternity Coverage
Special Enrollment Period(SOP)
54. Healthcare Insurance.
PARTICIPATING PROVIDERS
Women's Health Center in Hilo
Dental Center in Hilo
Pahoa Family Health Center
Family Health & Dental Center in Kaū
Mobile Clinic
Keaau Family Health and Dental Center
55. Women & Children's Health Center in Pāhoa
REIMBURSEMENT APPROACHES
Prospective Payment System (PPS) used by Medicare
Capitation
Fee for Service
Reimbursement based on cost of service
Prospective payment
Reimbursement based on Charge
56. Recommendations
Advancing from the fee-for-service model a holistic patient-
centered medical model.
1
Improve relationship between patients and doctors
2
Focus on Health and not Sicknesses
3
Organize providers into specialized teams in meeting a patients
multiple health requirements
4
Educating and fostering patient centered health initiatives as
opposed to addressing illness.
5
57. Ambulatory Care
This refers to all medical procedures and treatment performed in
an outpatient facility.
01
Ambulatory care is one of the essential health benefits
02
The treatment is geared towards improved wellbeing, diagnosis,
rehabilitation and treatment of patients
03
This thus covers nutrition and preventive campaigns, drug and
substance abuse rehabilitation, diagnosing and treating diseases.
04
Complementary And Alternative Medicine
This refers to the practice of treating a disease using
complementary drugs and techniques or alternate drugs.
58. Complementary treatment initiatives include the use of one drug
or procedure to lessen severe side effects of another drug or
procedure.
Alternative medicine onto the contrary refers to the use of
supplement medical procedure or drug to meet the same desired
results.
Mental Health (SLP)
This refers to a set of activities aimed at diagnosing, assessing
and treating cognitive disorders or diseases.
1
This disorders may affect speech, swallowing, speech and
digestion among adults and children.
2
Mental health care programs also serve to address emotional
and psychological disorders through counselling, training and
59. medication.
3
References
Bay Clinic Inc - Serving the health care needs of East and South
Hawai'i Island families. (2018). Retrieved from
http://www.bayclinic.org/
1
Diamond, W. (2001). The clinical practice of complementary,
alternative, and Western medicine. Boca Raton, FL: CRC Press.
2
American Academy of Ambulatory Care Nursing. (2018).
Retrieved from https://www.aaacn.org/
3
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61. Part one: Insurance
The health insurance is a kind of insurance that tends to cover
the entire or a segment of the individual that is incurring the
medical expense, through spreading the risk over a large
population of individuals (Schroeder, 2014). The insurer may
create a routine funding framework such as a monthly premium
to be able to provide the finances to pay for the specified health
care benefits outlined in the insurance agreement.
Insurance product
My health insurance plan is the HMO (Health Maintenance
Organization). This kind of insurance product tends to limit the
coverage care from the health providers who work or are
contracted by the HMO. Basically, this insurance plan does not
cover the out of network care except in times when an
emergency arises. The holder of this kind of insurance plan is
required to work or live in areas where the services of this
insurance plan coverage (Baker, 2010). The insurance plan
offers the integrated car as well as it focuses on prevention and
the patient’s wellness.
Source
My employer is the source of my insurance and the company
decides on the insurance plan that we as the employees need to
take. The company agrees with the insurance company on how
62. the funding structure of every employee is going to be settled
based on the income of the employee (Baker, 2010). The
company that I work for deducts from my salary the financing
required for me to enjoy the benefits provided by my insurance
provider. A particular percentage of my salary is deducted every
month and also the insurance service company provides me and
my fellow employees with a listing of the health facilities where
we would acquire health services under the insurance plan
provided.
Out-of-pocket costs
The out of pocket costs are the costs which I incur as a health
insurance holder because the insurance cover does cover
particular services that I might receive in the health care
(Baker, 2010). As a holder of my health insurance plan from
time to time, I always incur some extra cost when I visit the
health facility recommended by the health organization. Some
of the extra costs that I incur in my health insurance plan are
buying the prescribed and seeing a specialist.
Level of coverage
The insurance plan that I use covers about 100% of my health
expenses and in that case, it tends to reduce the out of pocket
expense. Some of the coverage’s that my insurance plan covers
are wellness, preventive, surgical as well as hospital services
(Baker, 2010).
Self-pay
63. A self-pay patient is a term that is used to provide a
description of an individual who opts to independently pay for
his or her medical bill without the assistance of a health
insurance (Limb, 2015). Self-pay patient avoids the monthly
premium which is often paid b individuals who use insurance
policies to pay for their medical expenses. Also it an individual
may opt to self-pay for his or her medical expenses if his or her
condition falls under the exclusion list of the insurance
provider. For a self-pay patient, he or she may face difficulty
choosing a primary health provider to whom he will be visiting
for his or her medical checkups. Also for self-pay, the patient
some most health care providers not allow them to receive
treatment. The major limitation of the self-pay patient is that
his or her medical bill may be higher than he or she expected.
Part 2
MEMO
To: Healthcare Lobbyist
From:
Cc:
Date:
Subject: LIMITATIONS OF SELF PAY
As a United States citizen, I have noticed that our healthcare
systems do not entirely support the self-pay patients. The
healthcare systems tend to be much more supportive to patients
who are covered by the private or the public insurance. Most of
64. the people who opt to use the self-pay method to settle their
medical expenses mostly their health conditions are often
excluded in the insurance coverage list. As a citizen of the
United States, I would love for the self-pay method to be
reviewed and the patients who opt to use this kind of method
should be treated the same as those patients using an insurance
cover to settle their bills.
The self-pay patient tends to receive medical services which
are at some point escalated us a way to limit the self-pay
method. Due to this most people are forced to seek other
alternative treatment methods which are cheap and affordable.
Some of these alternative medications may not be as effective
as the treatment that the patient would have received in a health
care facility and it may lead to their health condition
deteriorating.
As the healthcare lobbyist, I would request you to push the
health care system to come with new ways that would see the
individuals opting to use the self-pay method to settle their
medical expenses be provided with equal chances as those using
the insurance cover. Some of the recommendations that I would
provide would be the health the cost of the services it provides
to it patients and also the health insurance companies to be
pushed to incorporate most of the health needs in their
insurance plan. By doing this health would no longer be
regarded as a luxurious need but as a basic need (Schroeder,
65. 2014).
Yours Sincere
References
Baker, L. C. (2010). HMO Coverage Reduces Variations In The
Use Of Health Care Among
Patients Under Age Sixty-Five. NCBI.
Limb, M. (2015). Self pay patients are likely to increase in the
UK as waiting lists lengthen and
medical insurance prices rise. BMJ.
Schroeder, S. A. (2014). Physicians, politics, and health
insurance expansion. Journal of General
Internal Medicine.
66. 1
Running head: QUALITY MEASURES IN HEALTH CARE
FACILITIES1
1
QUALITY MEASURES IN HEALTH CARE FACILITIES
QUALITY MEASURES IN HEALTH CARE FACILITIES
Dr. Sharon Nazarchuk
MHA 507
67. Trident University International
August 26, 2018
Introduction
To ensure that patients and medical caregivers have the
knowledge and skills to prescribe medicine safely and
effectively, it is vital for them to understand what quality
measures entail. Quality basically necessitates all the medicinal
precautions and the general way staff reacts toward their
patients. The definition of quality also relates equally to
decisions about medicine used by individuals and how the
decisions they make affect the health of the population. In this
paper, I researched, analyzed and evaluated the aspect of
quality. For the research, I used questionnaires to carry out the
68. experiment. This experiment was done in different regions, a
total of seven people were used in the experiment.
Question 1
Coordination is an important element in assessing the quality
level of any health care since through coordination one can tell
how efficient healthcare systems are. Coordination usually deals
with orderly health care system as well as their commitment to
home health care and community support. According to the
above description, where can you rate the level of coordination
in the recent two visits to health care facilities? (Range from 1
to 5, five being the best-coordinated healthcare)
1. One
2. Two
3. Three
4. Four
5. Five
Question 2
How is the clinical response of staff, in ensuring that patients
and families are aware of their health and can make informed
decisions on their personal health? Take a case of the 3 health
care centers around your area. (Pick one for good, two for
average, three for poor and four for I don’t know.)
1. Good
69. 2. Average
3. Poor
4. I don’t know
Question 3
How high or low can you rate the accessibility of the three local
healthcare centers you visited? (Bear in mind how well patients
can access services if there are electronic or telephone services,
creativity, and innovations in the I.T department)
1. Poor
2. At least
3. Good
4. Very good
5. I can’t tell
Question 4
Accountability for both physical and mental health for the
patients are a key role for a care provider as well as preventing
chronic diseases. This falls under comprehensive quality
measures. Based on your knowledge of the local health care,
how many health organizations have you seen showing a high
level of comprehensive care to their patients?
1. None
2. One
3. Two
4. Three
5. Many
70. 6. I don’t know
Question 5
Safety and precaution are vital to every health practitioner
worldwide. This is so because quality measures specify that,
health providers should exercise a high level of safety. How
many healthcare centers have you visited recently are taking
precaution and safety as an important element in health?
1. One
2. Two
3. Three
4. None
5. I can’t remember
Data results and analysis
The quantitative questionnaires were given to seven anonymous
people putting in consideration the age, sex, and group so that a
fair and precise conclusion can be made from all the varying
data. The questionnaires were structured to the convenience of
many and to those that did not understand, a local translator was
71. appointed to help them.
In the issue of coordination; 4 people out of the seven people
rated them as 4 (fairly good), 1 rated them as 5 (best) while one
rated them as 1 (poor), one said that he could not tell how the
services were. Based on the results found, more effort needs to
be done by the healthcare facilities to reach as many people as
possible. Community support was totally neglected and few out
of the tallied people have ever seen this service being rendered.
On the matter of clinical response of staff and how well they
respond to their patient's problems; 2 out of the total seven
rated the service as 3 (poor), 3 of the seven rated their response
as 1 (good) while 1 rated them as 2 (at least). Staff response is
critical and crucial to the betterment of every health institution.
From our tally, it is evident that the majority of the people
responded positively about this issue. This shows that medical
facilities have taken the role of educating the society about their
health.
On accountability question, 1 out of the 7 participants said that
3 health care centers were accountable, 3 of the seven said none
was accountable, 3 said that only 4 out of the 5 they have
visited were accountable. Comprehensive quality entails so
many roles that are aimed at helping the community at large.
Most of the hospitals that the tallied people have visited are
poor at accountability. Three of the seven people tallied even
said that the medical personnel could not even tell their names
72. yet they had stayed there for a week.
On the safety and precaution issue the responses were as
follows;
3 people out of the seven visited 3 different health care centers
and found that precaution was a key element in their services, 2
could not remember whether there was any precaution taken, 1
person only visited one hospital and mentioned that no
precaution was taken at all. The seventh person visited two and
found that precaution was considered in one out of the two.
Safety of the patient comes first in every situation, (Garratt et
al., 2002) said that the health of the patient comes first. In the
case above the precaution, aspect is put into consideration by at
least three-quarter of the hospitals that the tallied people have
visited recently. Although some have not considered these
safety measures, it is safe to say that the majority of the health
facilities are well off.
Assumption
· The data was carried out in a densely populated area
· All of the tallied people have visited the hospital in the past
two years
· The survey was done for a period of two years
· The language was not a barrier to communication
· The tallied people represent the overall community.
73. Conclusion
The information obtained from the experiment is vital to many
departments in health care for Self-evaluation. That is, training
of their personnel, technological improvement, and service
improvement. Evaluating the level of performance and the
adaptability of the medical staff helps to know which areas to
perfect and which ones to put emphases on (Porter, Larsson &
Lee, 2016). Health facilities can use this data to evaluate staff
performance, if the staff members need training or not. Also, on
the same aspect of accessibility, the data can be used to identify
whether the health organization is up to date with their
communication means and how effective their adopted
technology is.
74. References
Garratt, A., Schmidt, L., Mackintosh, A., & Fitzpatrick, R.
(2002). Quality of life measurement: bibliographic study of
patient assessed health outcome measures. BMJ, 324(7351),
1417.
Porter, M. E., Larsson, S., & Lee, T. H. (2016). Standardizing
patient outcomes measurement. New England Journal of
Medicine, 374(6), 504-506.
Running head: INSURANCE 1
INSURANCE 6
75. Managed care and accountable care organizations
Dr. Sharon Nazarchuk
MHA 507
Trident University International
August 5, 2018
HMO
An HMO requires someone to select primary care physician who
acts like gatekeeper and coordinates care meaning the doctor
must refer the patient first in order to be attended by the
specialist. The HMO are normally lower compared to other
plans because it does not have deductibles. A client pays for
test, office visits and prescriptions. Seemingly, this plan is
needed when one does not have to see many specialists and they
do not need referrals often. Second, it is used when one has
76. primary care physician and when a client if comfortable with
providers in the network (Rowe, Brown-Stevenson, Downey, &
Newhouse, 2008). Most important in HMO, cost is important
than the flexibility, the drawback is HMO does not allow
someone to go outside the network for care.
PPO
This insurance health plan have preferred network of care givers
in patient area and one does not have to choice a primary care
doctor or referral in order to see specialist. If a client use
preferred provider, he or she is responsible for paying part of
the bill. The main benefit of PPO is flexibility; however, this
comes at a higher cost and deductibles. PPO is right when a
patient wants flexibility and does not need referrals and when
flexibility is more useful than paying higher premiums.
POS
This is a hybrid of PPO and HMO plan. Like in the case of
HMO, a patient need a recommendation from PCP for him or
her to be attended by expert. But like PPO, the client pay less
for him or her use doctors and hospital providers in the plan
network. In POS there is room to access out-of-network
providers at a higher cost (Wagner & Kongstvedt, 2007).
MCO
Managed Care Organization is a Family Care Program which
coordinates service from various programs and combine then
into single long-terms plan of service according to personal
77. preferences and needs of the team members.
ACO
Accountable Care Organizations are group of surgeons,
physician and specialists who manage care for patient with the
intention to improve condition of care at the same time as
reducing spending. ACOs associate imbursement for the service
to quality of healthcare provided and efficient clinical attention.
ACO clients can move within and outside integrated network.
Participants can choose PCP, hospital of choice and even the
specialist.
Difference between ACO AND HMO
HMO is a controlled healthcare and patients choose doctors and
hospitals for a minimum period of time. In HMO, if patients are
unhappy, their options are limited to doctors under HMO
network. HMO patients stay in network and doctors are no
meaning exit of doctors attending patients can disrupt care.
ACO has no enrollment lock-in provisions so patient can seek
care freely. ACO are not insurance firms, they are provider-led
companies.Difference between HMO, PPO, POS and ACO?
Choosing the right insurance plan depend on personal decision
and the situation and preferences. The issue to take into account
include flexibility, cost, coverage and convenience. If a client
needs a large groups of car e provider and does not mind paying
extra for the care, the PPO is the best option.
78. Type of plan
Require PCP?
Need referrals?
Out of network care
HMO
Yes
Yes
No
PPO
No
No
Yes
POS
No
No
Yes, but costlier
ACO
No
No
Yes
Features of a Consumer-Driven Health Care Plan (CDHP)
CDHPs are set of plans which put power and responsibility into
the hand of the clients. Typically, CDHPs involve a high
deductible health plan commonly referred to as HDHP with a
79. saving account.
Advantages
CDHP have a lower premium because they are responsible for
much of their costs on health care. Client has the same freedom
of choice which is similar to PPO plan in that the patient does
not have to choose primary care physician and get referrals.
Also, it save cost as result of taxes and it has more
responsibility over personal health cost.
For a health person, who does not frequent the doctor, one can
save a lot of funds and if something happens, he or she is
covered. However, if someone needs office visits and
prescriptions, one can end up paying more. This means that one
should weigh different scenarios and check if CHDP is worth it.
In CDHP a client pays more out-of-pocket before the medical
plan begins. For this reason, people who choose CDHP tend to
be more informed about their health, are healthier and more
cost-conscious. A person who use CDHP pay for service
through pre-tax savings referred to HSA. The HAS is funded by
employer or employee or both.
The key feature of CDHP are
1. Round the clock accessibility
2. clinical assessment
3. It has consistency, health education, accurate triage
information, and safe-care options
4. Coordination with patient primary care physicians.
80. Monthly payments, lower premiums are other advantages of
CDHP compared to the traditional benefit plans. It is argued
that people using the CDHP spend about $500 less annually on
health care compared to those using the traditional plan. In the
Consumer-Driven model, clients assume the main role of
decision-making concerning the healthcare they receive
(Goodman, 2005)
References
Goodman, J. C. (2005). Consumer Driven Health Care.
Networks Financial Institute Policy Brief, Indiana State
University. doi:10.2139/ssrn.985572
Rowe, J., Brown-Stevenson, T., Downey, R., & Newhouse, J.
(2008). The effect of consumer-directed health plans on the use
of preventive and chronic illness services. Health Affairs, 27(1),
113–20. doi:10.1377/hlthaff.27.1.113
Wagner, E. R., & Kongstvedt, P. R. (2007). TYPES OF
MANAGED CARE ORGANIZATIONS AND INTEGRATED
HEALTH CARE DELIVERY SYSTEMS. 19-25.
1
Running head: Health Care Delivery System in the United
States1
81. 1
Health Care Delivery System in the United States
Health Care Delivery System in the United States
Shaneya Acker
Dr. Sharon Nazarchuk
MHA 507
7/24/2018
Trident University International