Executive Summary

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Executive Summary

  1. 1. Strategic Business Planning Report Executive Summary Bon Secours Baltimore Health System Urban Medical Institute (UMI) May 2001
  2. 2. Executive Summary Table of Contents Introduction………………….…………………………….………………………..……………………….4 § Scope of Engagement § Key Findings § Conclusions § Business Strategy Approach Business Strategy and Objectives………………………………….………………………………….……..10 § Recommendations § Benefits § Expansion of Mission § Continuum of Care Opportunity UMI Programs and Financial Impact……………………….………………………………………………18 § New Programs and Services § Financial Impact § Grant Funding Sources § Existing Programs and Services Marketing Strategy………………………………………………………………….………………………27 § Marketing and Community Outreach § Target Market Segments § Internal Marketing Strategy § External Marketing Strategy Plan of Action………………………………………………………………………………………..……..31 § Critical Success Factors § Integration of UMI § Recommended Next Steps Appendix……………………………………………………………………….…………………..…...…..34 § UMI Community Service Area Map § UMI Community Health Needs 2 2
  3. 3. Executive Summary Contents UMI Business Marketing Plan of Programs & Introduction Strategy & Strategy Action Financial Objectives Impact §Scope of §New Programs & §Marketing and §Critical Success §Recommendations Engagement Services Community Outreach Factors §Benefits §Key Findings §Financial Impact §Target Market §Integration of UMI §Expansion of Segments §Conclusions §Grant Funding §Recommended Mission §Internal Market Sources Next Steps §Business Strategy §Continuum of Care Strategy §Existing Programs Approach Opportunity §External Market & Services Strategy 3 3
  4. 4. Introduction Scope of Engagement Since its inception in 1996, the UMI’s operating expenses have exceeded Introduction •Scope of Engagement revenue. Programs and services have been underutilized and service volumes •Key Findings appear to be on a downward trend. Many of the services initially planned •Conclusions •Business Strategy have either been consolidated or were never developed due to lack of Approach Business Strategy & funding. Objectives UMI Programs & Financial Impact § TLTsolutions was engaged by the leadership of UMI to Marketing Strategy Plan of Action accomplish the following: – Develop a business strategy for the UMI to enable it to become financially self sufficient while meeting the community’s healthcare needs – Develop a plan of action 4 4
  5. 5. Introduction Key Findings The UMI is not fully integrated into the Bon Secours Baltimore Health Introduction •Scope of Engagement System (BSBHS), and has essentially been operating as a stand-alone facility. •Key Findings •Conclusions •Business Strategy § Approach Many of the physicians and other clinicians at Bon Secours Hospital are Business Strategy & unaware of, or have limited knowledge about the UMI. Objectives UMI Programs & Financial § The UMI has consistently had operating losses; in FY ’01 losses are Impact Marketing Strategy expected to exceed $1.0 M. Plan of Action § Of the 11 initial programs offered at UMI only 5 are currently operational and only one program is revenue generating. § The UMI has not been successful in obtaining grant funding to cover all of its programs. – minimal fundingàminimal programsàminimal programsàlow volumeàlow volumeàminimal to no grant funding § Services offered by the UMI are preventive in nature serving a population that is high risk with chronic health illnesses. § The BSBHS has minimal post acute care services. 5 5
  6. 6. Introduction Conclusions With a preventive care mission, the UMI will not be able to achieve financial Introduction •Scope of Engagement self-sufficiency if it continues to operate as a stand-alone facility. •Key Findings •Conclusions •Business Strategy § TLT Solutions explored the development of several preventive programs Approach Business Strategy & that could help further the mission of the UMI, however, these programs Objectives would not make the UMI financially solvent due to their limited to no level UMI Programs & Financial Impact of reimbursement. Marketing Strategy Plan of Action § Existing UMI services can be operationally improved to reduce expenses. Nevertheless, if the UMI is to obtain financial self sufficiency a focused integrated approach with the BSBHS is imperative. § Preventive care models similar to the UMI that are successful are generally integrated into and supported financially by parent organizations, or they are largely dependent upon grant funding. § The greatest potential to turnaround the financial situation is to leverage the UMI to provide post-acute care services to strengthen the continuum of care for the BSBHS. This strategy will reap financial benefits for the entire BSBHS. 6 6
  7. 7. Introduction Conclusions With effective integration with BSBHS and the development of new post Introduction •Scope of Engagement acute care services, the UMI can be leveraged to provide more than •Key Findings $400,000 in system-wide benefit to BSBHS. •Conclusions •Business Strategy Approach § Business Strategy & Development of a Comprehensive Outpatient Rehabilitation Facility Objectives (CORF) coupled with the existing services will allow the UMI to become UMI Programs & Financial Impact self sufficient realizing a profit of $160,000 within three years. Marketing Strategy § Plan of Action Services to be offered in the CORF will help meet the needs of patients with diagnosis such as CHF, COPD, and CVA which represent the highest volume of patients both internally and externally. § Development of a Disease State Management program will help bridge the gap in the BSBHS continuum of care while assisting with managing the high costs of the chronically ill patient. § The greatest potential to increase patient volume and the utilization of services at the UMI is internally through the referral of patients from physicians and other clinicians within the BSBHS. § In addition, the BSBHS could realize a 30% growth in new patient referrals from the UMI with incremental growth in UMI volume. 7 7
  8. 8. Introduction Business Strategy Approach A high involvement strategy was undertaken to develop the vision for the Introduction •Scope of Engagement UMI. We initially thought we could start with a “clean slate”; study the UMI •Key Findings community to identify their greatest health care needs, and then translate •Conclusions •Business Strategy them into opportunities for the UMI. Approach Business Strategy & Objectives § UMI Programs & Financial Conducted over 12 one-to-one interviews Impact § Facilitated one day off-site session with key stakeholders Marketing Strategy Plan of Action § Completed market analysis and health needs assessment using secondary data Initial Approach Market Analysis Financial Analysis Marketing Strategy Strategy Development External Define Internal Health care Identify Estimate Needs for Opportunities Financial Define UMI and Services Impact Market Community Segments 8 8 Key Stakeholder Input
  9. 9. Introduction Business Strategy Approach Based on pertinent findings, our initial approach had to be refined to include Introduction •Scope of Engagement the assessment of the Bon Secours Baltimore Health System (BSBHS) •Key Findings continuum of care. •Conclusions •Business Strategy Approach § Business Strategy & The UMI is not fully integrated into the Bon Secours Baltimore Health Objectives System (BSBHS), and has essentially been operating as a stand-alone UMI Programs & Financial Impact facility. Marketing Strategy § Plan of Action BSBHS has minimal post acute care services. § Many of the physicians and other clinicians at Bon Secours Hospital are unaware of the UMI. Revised Approach Market Analysis Financial Analysis Marketing Strategy Strategy Development External Define Internal Estimate Identify Health care Financial Opportunities Needs for Define Impact and Services UMI Assess Market Community BSBHS Segments Continuum of Care 9 9 Key Stakeholder Input
  10. 10. Business Strategy and Objectives Recommendations We recommend that BSBHS expand the UMI’s mission to include Introduction Business Strategy & intervention and also leverage the UMI to strengthen the continuum of care Objectives •Recommendations for the system. •Benefits •Expansion of Mission •Continuum of Care The following objectives should be adopted to achieve this strategy: Opportunity UMI Programs & Financial Impact Marketing Strategy Plan of Action § Integrate the UMI into the BSBHS § Align the UMI’s priorities with the BSBHS’s Inv est nvest strategic objectives I § Develop new post acute care services to reap Tar get get Tar system-wide benefit Dev lop § Target existing UMI services for growth and elo eve p D operational efficiencies Alig n Alig n § Invest in Marketing and Community Inte Outreach rate gra teg te In 10 10 UMI Profitability Strategy
  11. 11. Business Strategy and Objectives Benefits By implementing the business strategy outlined, we estimate that the UMI Introduction Business Strategy & can become financially sufficient by year 3 with nearly $160K in net income. Objectives Additionally, efforts to improve operational efficiencies with existing •Recommendations •Benefits services can yield even higher margins for the UMI. •Expansion of Mission •Continuum of Care Opportunity § UMI Programs & Financial If the UMI were to maintain the “status quo”, a loss of $2.6M is estimated Impact over the next three years. Marketing Strategy Plan of Action § By developing new post acute care services, the UMI can be leveraged to provide system-wide benefits in excess of $400K in year 3 to BSBHS. § Increasing Bon Secours Hospital physician and other clinician awareness of the UMI will increase the utilization of all UMI services. § Higher patient volume and utilization of UMI services will better position the UMI to obtain grant funding. 11 11
  12. 12. Business Strategy and Objectives Expansion of Mission Key Stakeholders said the mission should include: Introduction Business Strategy & §“significantly improve the health and well-being of community residents in West Baltimore” Objectives •Recommendations §“provide the tools that will improve health now and into the future” •Benefits §“culturally appropriate strategies” •Expansion of Mission §“health promotion and maintenance” •Continuum of Care Opportunity §“collaboration and partnerships” UMI Programs & Financial Impact Marketing Strategy Why Expand the Mission? Plan of Action § The UMI serves a community that is high risk with chronic health conditions that are beyond prevention. § Intervention and disease management type services are needed to improve the quality of life for those suffering with disease and disability. § Prevention services alone will not provide enough revenue to make the UMI financially self-sufficient. Potential Mission Statement To significantly improve the health and well-being of community residents in West Baltimore through the delivery of health promotion and wellness, disease prevention and intervention programs and 12 services; and by leading culturally appropriate health outcomes research. 12
  13. 13. Business Strategy and Objectives Continuum of Care Opportunity An effective Integrated Delivery Network is a partnership in which each part Introduction Business Strategy & along the continuum of care plays a distinctive role that contributes to the Objectives •Recommendations overall success of the whole system. •Benefits •Expansion of Mission •Continuum of Care Opportunity UMI Programs & Financial Impact Marketing Strategy Plan of Action Home Care Acute Care Outpatient Prevention Rehab 13 13
  14. 14. Business Strategy and Objectives Continuum of Care Opportunity The premise behind integration, particularly vertical integration is to provide the Introduction Business Strategy & communities served with a strong continuum of care. By utilizing the UMI to Objectives •Recommendations provide post-acute care services that keep patients in the system while reducing •Benefits inpatient lengths of stay, BSBHS can realize system-wide benefits. •Expansion of Mission •Continuum of Care Opportunity UMI Programs & Financial Impact Bon Secours Hospital Marketing Strategy Plan of Action • Cost Avoidance • Increase post acute care volume • Decreasing ALOS Continuum of Care • Creating lower • Patients stay within cost venues of the Bon Secours care Health System • Lowering health • Improve patient and Urban Medical Institute disparities w/in physician satisfaction the community 14 14
  15. 15. Business Strategy and Objectives Continuum of Care Opportunity Bon Secours Hospital could realize a $162,000 cost saving for Medicare Introduction Business Strategy & CVA (stroke) patients alone by reducing its length of stay by 1.5 days. Objectives •Recommendations •Benefits $Opportunity: 540,478-378,560=$161,918 •Expansion of Mission •Continuum of Care Opportunity Medicare DRG 14 Patient UMI Programs & Financial Impact Marketing Strategy Benchmark Plan of Action DRG 14 CVA BSH LOS Medicare LOS 5.98 4.50 Annual Medicare Cases1 364 364 Inpatient Charges $2,710,344 $2,710,344 Avoidable Cost - $161,616 Inpatient Costs $1,933,932 $1,772,316 Medicare Reimbursement $2,312,492 $2,312,492 Profit/(Loss) Per Case $378,560 $540,478 Source: 1 BSBHS CHF Cases HSCRC 2000 15 15
  16. 16. Business Strategy and Objectives Continuum of Care Opportunity Bon Secours Baltimore Health System (BSBHS) has made a great effort of Introduction Business Strategy & developing services and treatments to meet the needs of the communities Objectives •Recommendations they serve. •Benefits •Expansion of Mission •Continuum of Care Current Environment: BSBHS Network Opportunity UMI Programs & Financial Impact Marketing Strategy UMI Plan of Action Preve ntive Care tal ospi urs H e Seco Car Bon e Acut Co C m Beh IBS He mun alth it av Ne Car y Hea ioral two e lth rk Village Liberty g Housin Senior Pri ma ry Ca re 16 16
  17. 17. Business Strategy and Objectives Continuum of Care Opportunity However, new services and programs that address the post-acute care needs Introduction Business Strategy & of patients within the BSBHS are needed. (Future service recommendations Objectives •Recommendations are highlighted in color below.) •Benefits •Expansion of Mission •Continuum of Care Future State: BSBHS Network Opportunity UMI Programs & Financial Impact Marketing Strategy Plan of Action UMI Bon Secours Hospital Partner CIBS Acute Home Care Services Behavioral Health Care UMI Community UMI HealthCare Network Disease State Management CORF Primary Care UMI UMI Future Program/Service Preventive Care Liberty Village Senior Housing 17 17
  18. 18. UMI Programs and Financial Impact New Programs and Services In order to effectively leverage the UMI to strengthen the Continuum of Introduction Business Strategy & Care at BSBHS, new post-acute services will need to be developed. Objectives UMI Programs & Financial Programs and services developed should be integrated into BSBHS and Impact aligned with the system’s strategic initiatives. •New Programs and Services •Financial Impact •Grant Funding Sources § Many services were evaluated but the following offer the greatest •Existing Programs and Services potential to improve the UMI’s financial position within three years, while Marketing Strategy meeting the needs of the West Baltimore community. Plan of Action ü Comprehensive Outpatient Rehabilitation Facility (CORF) A moderate intensity, multidisciplinary therapeutic program which provides Inv est nvest diagnostic, therapeutic, and restorative outpatient services for the rehabilitation I of injured, disabled, or sick persons. ü Disease State Management Program as a link between higher Tar get get Tar cost and lower cost venues of care to help manage the cost of the chronically ill patient. Dev p elo elo » Congestive Heart Failure Dev p » Diabetes Mellitus ü Strengthen relationship for home care services with Alig n Alig n existing freestanding agency to maintain patients in the Inte te BSBHS. gra gra nte te I 18 18 UMI Profitability Strategy
  19. 19. UMI Programs and Financial Impact New Programs and Services An added benefit to the development of these proposed programs Introduction Business Strategy & and services at the UMI is their strategic compatibility with the Objectives UMI Programs & Financial proposed Screening and Testing Center of Maryland. Impact •New Programs and Services •Financial Impact •Grant Funding Sources •Existing Programs and Screening and Testing Center of Maryland Services Marketing Strategy Plan of Action ü Disease State Management Programs in congestive heart failure and diabetes mellitus will necessitate Inv est nvest periodic and extensive screening and education I services that adhere to clinical protocols. Tar get get Tar Dev ü In addition, the screening and testing center can be p elo elo Dev p leveraged to increase the patient volume for all UMI Alig services including the CORF. n Alig n Inte te gra gra nte te I 19 19 UMI Profitability Strategy
  20. 20. UMI Programs and Financial Impact New Programs and Services Introduction The UMI may also want to explore other programs and services Business Strategy & Objectives after financial stability is achieved. UMI Programs & Financial Impact •New Programs and The following were also identified by key stakeholders as programs and Services services with high UMI community need. •Financial Impact •Grant Funding Sources ü Weight Management Program (Bariatrics)- With over 55% of the population classified •Existing Programs and Services as overweight1, there is a significant need for this health service. Currently, financial risk exist Marketing Strategy since all services are not insured. Third party reimbursement is likely to be legislated in the Plan of Action future. ü Maternal and Child Health Program-The infant mortality rate in Maryland is 16.7% greater than the Health People 2010 goal of 4.5 death per 1,000 live births2. The infant mortality rate among African Americans in the state, regardless of economic group, is Inv est nvest significantly greater. This suggest that the existing programs have yet to adequately improve I the health status of the community for this condition. Moreover, reimbursement for these services by state programs is well established. Tar get ü Adolescent and Pediatric Program- These programs are still relatively new and get Tar represent an untapped market in the UMI community. Pediatric sports medicine is a growing field. These services could also provide a vehicle for treating and studying injury, the primary Dev p elo cause of death in this population. Furthermore, the CDC provides grant funds to programs elo Dev p dealing with homicide and violence prevention3. ü Adult Day Care-The UMI sold its license and may want to explore buying it back or Alig n Alig n obtaining another one. Inte te gra gra nte te I 1Maryland Health Care Commission. “Financial, Social, and Medical Impact of Proposed Mandated Benefits.” William M. Mercer, Inc, 1999. 2Maryland Health Improvement Plan, 2000-2010. 20 3www.cdc.gov 20 UMI Profitability Strategy
  21. 21. New Programs and Services Comprehensive Outpatient Rehabilitation Facility (CORF) Developing a CORF would strengthen BSBHS continuum of care by Introduction Business Strategy & providing a moderate intensity level of therapy, which is a natural transition Objectives UMI Programs & Financial for patients recovering from an acute incident. In addition, there is significant Impact opportunity to grow patient volume at the UMI through the addition of the •New Programs and Services CORF. •Financial Impact •Grant Funding Sources •Existing Programs and § A certified CORF includes physical therapy, physician services, and psychology or Services social services. Other core components include occupational therapy and Marketing Strategy Plan of Action speech/language pathology. § The current UMI physical therapy therapy services will be integrated into the CORF. § A large number of Bon Secours Hospital patients are CORF appropriate including CVA, CHF, COPD, and Trauma (see appendix II). § Developing a CORF is aligned with BSBHS strategic initiative to develop orthopedic surgery into a Center of Excellence. § Certification will expand source of revenues from Medicare and Medicaid population. § Effective October 1, 2001 Prospective Payment will impact how inpatient rehabilitation is reimbursed. § The start-up cost associated with the CORF are minimal. The “Connection” fitness center provides required exercise space for the CORF. § The CORF can be a natural feeder of referrals to the Connection as the patient stabilizes and requires less intensive therapy. 21 21
  22. 22. Financial Impact Comprehensive Outpatient Rehabilitation Facility (CORF) Introduction With a modest 10% increase in revenue from existing services and the Business Strategy & development of a CORF, the UMI can become financially self-sufficient. Objectives UMI Programs & Financial Impact •New Programs and Services •Financial Impact •Grant Funding Sources •Existing Programs and Services Marketing Strategy Plan of Action Year 1 Year 2 Year 3 CORF & Existing UMI Services 781,170 1,499,535 1,801,956 NET REVENUE OPERATING EXPENSES: Direct Caregiving Costs 398,785 713,588 783,209 CORF Start-up Costs 200,000 - - UMI Indirect Costs 1,000,000 1,020,000 1,040,400 1,598,785 1,733,588 1,823,609 TOTAL EXPENSES 170,521 174,784 179,154 NON-OPERATING INCOME GAIN/(LOSS) FROM OPERATIONS (647,094) (59,269) 157,501 Note: 1 Model assumes only 1/3 of UMI’s existing direct care giving costs will be needed once combined; this is due primarily to sharing staff, increased volume, increased staff productivity, and operational improvements 22 22
  23. 23. New Programs and Services Disease State Management Program Introduction Disease State Management programs have a strong outreach and education Business Strategy & component that will further enhance the UMI’s visibility both internally and Objectives UMI Programs & Financial externally. Additionally, management of the chronically ill patient can help Impact •New Programs and to reap system wide benefits through cost avoidance by significantly Services •Financial Impact reducing readmission rates. •Grant Funding Sources •Existing Programs and Services § Marketing Strategy Begin the Disease State Management program with Congestive Heart Failure and Plan of Action Diabetes Mellitus, two of the UMI community’s greatest health care needs. – CHF represents the 2nd highest volume DRG for BSH and the 3rd largest DRG for the UMI community. § Increasing physician and other clinician awareness of the UMI’s Disease State Management Program will increase the utilization of all UMI services. § Reduction in CHF readmissions enhances the Bon Secours’ CHF Center of Excellence. § Positions Bon Secours Baltimore Health System to increase contracting relationships with managed care organizations. § Based on the success of chronic care management in the Medicare+ Choice sector, HCFA is exploring widespread implementation and reimbursement for such services. 23 23
  24. 24. Financial Impact Disease State Management Program Introduction Although the Disease State Management Program in itself is not revenue Business Strategy & generating, effectively managing BSH’s CHF population through a Disease Objectives UMI Programs & Financial State Management program will help decrease readmissions avoiding Impact additional inpatient costs of $130,000. •New Programs and Services •Financial Impact •Grant Funding Sources •Existing Programs and Services Marketing Strategy Plan of Action BSBHS Readmitted Elim ination of DRG 127 w ithin 30 Days Readm ission Variance Annual Medicare Cases 30 30 30 Combined ALOS 10.3 4.9 -5.4 Inpatient Costs $ 282,955 $ 153,840 $ (129,115) Medicare Reimbursement 172,080 172,080 - Profit / (Loss) $ (110,875) $ 18,240 $ 129,115 Source: Avg. cost of ($5,128) & Medicare reimbursement of ($5,736) per the HCIA ’00 handbook for the State of Maryland 24 24
  25. 25. Financial Impact Strengthen Home care relationship with existing freestanding agency Introduction Through an effective partnership with a home care agency, BSH will be Business Strategy & more capable of keeping its patients in the system post discharge and Objectives UMI Programs & Financial discharged home care patients can be referred to the UMI for services. Impact •New Programs and Additionally, stronger integration with home based services can significantly Services •Financial Impact reduce BSBHS’s length of stay. For the top ten Medicare DRGs alone, •Grant Funding Sources •Existing Programs and BSBHS could realize a cost savings of $116,000. Services Marketing Strategy Plan of Action Top Ten Medicare DRGs AVOIDABLE VARIABLE AVOIDABLE DRG DESCRIPTION CASES DAYS ALOS B-MARK DAYS DAYS COST 124 867 7.0 5.3 210.8 $ 300 $ 63,240 14 Specific Cerebrovascular Dis. 65 304 4.7 4.6 6.5 $ 300 $ 1,950 88 Chronic Obstructive Pulmonary Dis. 141 774 5.5 5.8 0 $ 300 $ - 89 Simple Pneumonia 369 1,687 4.6 4.9 0 $ 300 $ - 127 Heart Failure & Shock 85 428 5.0 4.8 17 $ 300 $ 5,100 144 Other Circulatory System Diagnosis 69 383 5.6 4.4 82.8 $ 300 $ 24,840 174 G.I. Hemorrhage 68 293 4.3 3.6 47.6 $ 300 $ 14,280 182 Esophagitis, Gastroent & Misc. 73 356 4.9 4.6 21.9 $ 300 $ 6,570 296 Nutritional & Misc. Metabolic Dis. 72 377 5.2 5.7 0 $ 300 $ - 316 Renal Failure 97 641 6.6 6.8 0 $ 300 $ - 416 Septicem ia 1,163 6,110 5.3 386.6 $ 115,980 Source: 1 Average variable cost per day Estimated at $300 Per Day Source: 2 BSBHS FY ‘00 Inpatient Data; HCIA ALOS for Maryland 25 25
  26. 26. Financial Impact System-wide Benefit Introduction By adopting the strategy and objectives outlined, Bon Secours Baltimore Business Strategy & Health System (BSBHS) could realize an incremental system-wide financial Objectives UMI Programs & Financial opportunity of nearly $403,000 over a three year period. Impact •New Programs and Services •Financial Impact •Grant Funding Sources •Existing Programs and Services Marketing Strategy Plan of Action Year 3 System-wide Benefit Addition of a CORF to Existing UMI Services $ 157,501 Avoidable Days 115,980 CHF Readm issions Savings 129,115 BSBHS System -wide Benefit $ 402,596 26 26
  27. 27. UMI Programs and Financial Impact Grant Funding Sources Introduction As the UMI stabilizes and increases its patient volume, the potential to Business Strategy & capture additional grant funding will be more likely. The following sources Objectives UMI Programs & Financial are potential grant funding sources that the UMI may want to consider Impact •New Programs and pursuing. Services •Financial Impact •Grant Funding Sources •Existing Programs and § Robert Wood Johnson Foundation. Funds programs concerning tobacco, Services community health, health behavior, population studies, and health policy; a grant Marketing Strategy Plan of Action relevant to the UMI strategic plan is: ü Take Care to Learn: Teaching Clinical Care Management § Agency for Healthcare Quality and Research. Supports research of health services and health care quality; one grant this organization funds that is relevant to UMI mission is: ü Economic studies in Cancer Prevention, Screening, and Care § Centers for Disease Control and Prevention. Supports programs and research in a number of health and disease disciplines with a focus upon prevention; the grant below supporting injury prevention may work well in conjunction with a newly planned CORF: ü Program to Prevent Injuries Among Older Adults Additional Grant Information and Resources § 27 The NIH Guide for Grants and Contracts 27 § The new NIH Center for Healthcare Disparities
  28. 28. UMI Programs and Financial Impact Existing Programs and Services Introduction The following existing services offer the greatest potential for growth and Business Strategy & profitability and therefore should be priorities for operational improvement Objectives UMI Programs & Financial and marketing investments. Impact •New Programs and Services •Financial Impact § Cardiac Rehabilitation services can be expanded when coupled •Grant Funding Sources with the level of intensity provided within the structure of the CORF. •Existing Programs and Services Marketing Strategy Plan of Action § Diabetes Care Management will be enhanced and formalized as a chronic illness managed under the recommended Disease State Management Program. Inv est nvest I § Physical Therapy will be enhanced by incorporating it into the Tar get Comprehensive Outpatient Rehabilitation Center as one of the core get Tar services. Dev p elo elo Dev p § The Connection Fitness Center provides the next level of therapeutic services once the patient has improved under the care Alig n Alig n of the CORF. Inte te gra gra nte te I 28 28 UMI Profitability Strategy
  29. 29. Marketing Strategy Marketing & Community Outreach Marketing and community outreach will be critical for the success of the Introduction Business Strategy & UMI to achieve its goal to be financially self-sufficient. The UMI will need Objectives UMI Programs & Financial to increase awareness internally with the BSBHS as well as externally within Impact Marketing Strategy the West Baltimore community. •Marketing & Community Outreach •Target Market Segments § Launch aggressive campaign to increase awareness and improve •Internal Marketing reputation. Strategy •External Marketing – Significant financial resources will be required with long term Strategy commitment-benefits will not come overnight Plan of Action – Develop measurable marketing objectives Inv est nvest § Define market segments internally and externally. I – Direct focused marketing will be most beneficial based on Tar get program and service priorities get Tar – Explore untapped markets, such as middle income non Dev p traditional UMI market elo elo Dev p – Develop relationships with Managed Care Organizations Alig based on program and service priorities n Alig n § Ask the Community what they would like and more importantly Inte what they are willing to pay for. te gra gra nte te I – Conduct focus groups on an ongoing basis – Continue community relationship building 29 29 UMI Profitability Strategy
  30. 30. Marketing Strategy Target Market Segments The UMI will need to define its target market segments internally and Introduction Business Strategy & externally and then focus its marketing and community outreach efforts Objectives UMI Programs & Financial directly to those segments. Each segment can be further segmented based Impact Marketing Strategy on the program or service that is being promoted. Marketing strategies will •Marketing & Community need to be specific for each defined segment. Outreach •Target Market Segments •Internal Market Growth Example: Market Segmentation Strategy •External Market Growth CORF Services Strategy Plan of Action Bon Secours Physiatrists Orthopedic Primary Care (Doctors of Rehab Orthopedic Surgeons Physicians Medicine) Surgeons BSH Community Physicians Physicians Sports Internal External BSH BSH Injury Payors Staff Payors Market Market Patients Baltimore BSH Managed Managed Community Discharge Care Plans Care Plans College CHF Patients Planners BSH Inpatients Orthopedic Patients Liberty Village CHF Patients Residents 30 CVA Patients 30
  31. 31. Marketing Strategy Internal Market Growth Strategy The greatest potential for increasing the patient volume and utilization of Introduction Business Strategy & services at the UMI will come from physician and other provider referrals Objectives UMI Programs & Financial from Bon Secours Hospital and Primary Care Practices. Impact Marketing Strategy •Marketing & Community Outreach • It was evident during one to one interviews that there was little knowledge of the •Target Market Segments UMI’s service capabilities and the programs offered. •Internal Market Growth Strategy •External Market Growth § Strategy Increase the UMI’s visibility and presence in the hospital by becoming active Plan of Action participants on significant hospital committees, i.e. clinical path development, ethics, quality/utilization review, etc. § Increase physician awareness of the UMI’s services and programs through the provision of consistent educational and in-service programs. Identify a “physician champion” to lead the efforts. § Seize opportunities to participate in physician departmental meetings providing presentations on how services provided by the UMI impacts their specialty areas. § Develop an internal “recovery” strategy to mend working relationships between the two entities. 31 31
  32. 32. Marketing Strategy External Market Growth Strategy An external marketing plan focused on increasing the awareness of the UMI Introduction Business Strategy & to the West Baltimore community as well as repairing the UMI’s reputation Objectives UMI Programs & Financial needs to be developed. Impact Marketing Strategy •Marketing & Community § Outreach Develop and implement a marketing plan which aggressively pursues •Target Market Segments relationships with community organizations, community leaders and •Internal Market Growth Strategy physician groups, utilizing the hospital affiliation as leverage. •External Market Growth Strategy Plan of Action § Develop a “recovery” strategy to improve the community’s perception of the UMI. Based on observations and interviews the community’s perception of the UMI was that of “empty promises”. § Focus on non-traditional markets in the UMI community (e.g. middle income, private pay and privately insured patients) § Hire a Marketing and Community Outreach Director exclusively for the UMI. 32 32
  33. 33. Plan of Action Critical Success Factors The following factors are more specific to the business strategy objectives Introduction Business Strategy & outlined in this report and are critical for the UMI to be successful in Objectives UMI Programs & Financial achieving its goal to become financially self sufficient while meeting health Impact Marketing Strategy care needs of the West Baltimore community. Plan of Action •Critical Success Factors •Integration of UMI § Recognition of the UMI as an integral part of the Bon Secours Health •Recommended Next Steps System. § Physician buy-in and commitment to the establishment of system wide benefits for the Bon Secours Health System. § The ability of the UMI to continuously and successfully develop post acute services that strengthen the continuum of care. § Key stakeholder (internal and external) buy-in and involvement in the planning process. § The UMI’s ability to improve operational efficiencies for the existing services at the UMI. § The success of the marketing and community outreach program to increase the utilization of UMI programs and services by the internal and external UMI community patients. 33 33
  34. 34. Plan of Action Integration of UMI The success of the UMI will be dependent upon full integration with Introduction Business Strategy & Bon Secours Hospital. The greatest potential for referrals lies within Objectives UMI Programs & Financial the BSBHS. Impact Marketing Strategy Plan of Action § •Critical Success Factors Develop system-wide strategic initiatives that incorporate the •Integration of UMI UMI as an integral part of the BSBHS. •Recommended Next Steps § Work through the differences developed between Liberty Medical Center and Bon Secours. § Develop strategy to foster physician buy-in and commitment to the establishment of system wide benefits for the Bon Secours Inv est nvest I Health System (e.g. align incentives with the behaviors you want to reinforce). Tar get get Tar § Educate all physicians and staff about the UMI its programs Dev p and services. elo elo Dev p Alig n Alig n Inte te gra gra nte te I 34 34 UMI Profitability Strategy
  35. 35. Plan of Action Recommended Next Steps The success of the UMI will be dependent upon its ability to Introduction Business Strategy & implement the recommended strategy and achieve all of the Objectives UMI Programs & Financial objectives outlined. Impact Marketing Strategy Plan of Action § Obtain commitment of business strategy direction from leadership •Critical Success Factors •Integration of UMI § Complete detailed business plans for CORF, Disease State •Recommended Next Steps Management, Home Care Services Partnership § Develop plan to improve integration of UMI with BSBHS § Develop strategy to repair physician relationships – Identify and cultivate physician champions § Complete operational assessment for existing services – Improve patient encounter data and statistical tracking – Improve billing and collection process – Conduct Staffing mix analysis § Develop Marketing Plans for priority services (New and Existing) § Assign responsibility and accountability for implementation – Develop measurable goals – Hire experienced project manager to facilitate efforts § Develop mechanism to measure outcomes § Develop a mechanism for ongoing input and feedback from Key 35 Stakeholders (External and Internal) 35
  36. 36. Appendix I: UMI Community Service Area 21209 21210 21208 West Baltimore Ì 21212 Pemlico 21215 83 West Arlington 21211 UMI Ì Towanda Park 21218 Arlington West Coldspring 21207 21244 21217 Forest Park 21202 21216 Forest Park Asburton Druid Hill 21201 Wallbrook Howard Park 70 ÌHillsdale Park 21223 Windsor Hills Ì 21043 BSH Ì 21229 Ì Caroll Park 21230 Caroll Park 21228 95 Miles 36 36 0.0 0.5 1.0 1.5 2.0 21227
  37. 37. Appendix II: UMI Community Major Health Care Needs A DRG Analysis was completed to identify most prevalent illness in the UMI community. FY 2000 Cases Cases in BSBHS % Market DRG 2000 DRG Description at BSBHS Service Area Share 49% 430 Psychoses 1,297 1,326 0% 373 Uncomplicated Vaginal Delivery 0 2,444 26% 127 Congestive Heart Failure 525 1,522 0% 391 Normal Newborns 0 1,998 23% 89 Pneumonia 293 981 0% 462 Rehabilitation 0 1,084 17% 14 Specific Cerebrovascular Disorder 170 856 15% 489 HIV 134 739 0% 390 Neonate with other significant complications 0 867 15% 143 Chest Pain 124 705 § During the facilitated session, Refining UMIs Vision for the 21st Century, key stakeholders brainstormed services and ranked them with respect to community needs and mission fulfillment. They highlighted the following needs that underscore their knowledge of the UMI community: § Screening and health education to prevent cancer § Health services to treat Cardiovascular Disease with a specific focus on the CHF patient and Cerebrovascular Disease – Improving patient self-management skills – Providing necessary rehabilitation after a heart attack § Health services to treat chronic pain 37 37 Source: HSCRC databases, 2000.

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