HCS/499 v4
Strategic Planning Scenario
Background
Stevens District Hospital is a 162-bed acute care hospital that is qualified as a not for profit facility. The hospital was originally a county-owned facility and
its status was transferred to an independent facility three years ago. The hospital receives no external funding from government agencies for operations.
The hospital is accredited by The Joint Commission and received reaccreditation during their triannual survey last year. The hospital has an aggressive
quality management program and a low volume of medical malpractice claims. The hospital is located in Jefferson City, which is a city of 50,000 with
80,000 in the regional market. The hospital provides a general range of acute care services, including medical/surgical, rehab, and emergency care.
Current Performance Analysis
Mission and Vision
Our mission: To improve health by providing high-quality care, a comprehensive range of services, and exceptional service.
Our vision: Stevens District Hospital and its affiliates will be the health care provider of choice for physicians and patients. Our five year vision is to create
a large, multispecialty physician practice system that would include at least six family practice physicians and specialists in cardiology, oncology, and
women’s services. Currently, the hospital employs three family practice physicians, one obstetrician, one medical oncologist, and one non-invasive
cardiologist.
Previous Strategic Plan Review
Goal
Accomplishments
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Stevens District Hospital Plan
HCS/499 v4
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Increase market share by recruiting three family practice
physicians.
The hospital was able to recruit only one family practice physician to increase
primary care market this past year. The limited number of state medical school
graduates makes local recruitment difficult.
Improve quality HCAHPS scores in all six criteria to a
baseline of the 85th percentile.
The hospital improved HCAHPS scores in four of six criteria. Lagging elements
in HCAHPS scores are inpatient patient satisfaction and primary care patient
satisfaction.
Market Forces Affecting the Hospital
Volumes
Volume changes last year versus this year
30000
26292
20930
22500
15000
7500
6365 7284
4458 5147
405 472
0
Admission
ER visits
Last year Deliveries
This year
Surgeries
Patients
The continued growth of chronic disease will require changes to the care management model.
Percent of Population by Age
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Stevens District Hospital Plan
HCS/499 v4
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Five Years Ago
Five Years From Now
Under 18
24
18
18 to 44
46
32
45 to 65
26
30
Over 65
4
20
More than 53 percent of residents have at least some college education, with just over 29 percent having an associate, bachelor’s, or graduate degree.
More than 90 percent of residents have at least a high school diploma.
The average unemployment rate in the county is 9.9 percent:
Market Share Distribution Percentage With a Major Competitor
Five Years Ago
Last Year
Stevens District Hospital
48
35
Competitor
30
43
Out of County Hospitals
22
22
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Stevens District Hospital Plan
HCS/499 v4
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Patient Origin by Zip Code
22%
96101 is Stevens District Hospital zip
code
18%
94963 is major competitor hospital zip
code
47%
13%
Increases in the percent of population with chronic disease and contributing factors will change significantly over the coming five years.
Chronic Disease Predictions
5 yrs ago
26%
5 yrs ahead
22%
15%
12%
12%
5%
Obesity
Diabetes
Heart Disease
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Stevens District Hospital Plan
HCS/499 v4
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Payment
There will be continued focus on pay for performance and increased wellness programs. The Affordable Care Act is creating more covered lives; however,
there are often high deductibles.
The median household income for county residents is $59,548. On average, households in the county earn more than the state median household income
of $44,446 and more than the national average of $53,650. The addition of a new automotive manufacturing plant to the local market this coming year is
projected to add 1,500 production line jobs and 300 administrative jobs by year end. Median income for the production positions is estimated at $45,000
and will provide health, vision, and dental insurance benefits.
Current Payer Mix
Projected Payer Mix 5-years
Uninsured
9%
Other
2%
Medicaid
35%
Commercial
24%
Medicare
30%
Percentage of Population by Insurance
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Stevens District Hospital Plan
HCS/499 v4
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As part of your review of this data, consider that a portion of the population will become Medicare eligible, the addition of manufacturing positions that
include benefits will increase commercial insurance coverage, and changes from the Affordable Care Act will increase the number of patients in the market
with insurance coverage.
Employers
There is expected growth in large employers with the addition of the automotive factory in the northwest sector of the county.
Physicians
The continued shortage of medical staff, especially in orthopedics, oncology, and primary care, will require increased recruitment efforts.
Competitors
Hanover County Hospital, which is the other hospital in the county, has an updated facility that has drawn more market share to its facility.
Competitor
Key Areas of Competition
New Programs and Facilities
Risk to Market Share
•
Facility upgrade
•
Significant renovation of core
hospital to update aesthetics
•
Drawing patients to newer facility
•
Quality scores
•
•
Accommodates heavier patients
Added new wide-bore MRI
machine last year
•
Patient perception of higher quality and
patient satisfaction
•
Drawing patients out of primary and
specialty care at Stevens
•
Ability to cash flow projects
Primary Competitors
Hanover County
Hospital
Medical Center in
County South of
Stevens
•
Reaches the 95th percentile in
five of six HCAHPS categories
•
Physician clinics
•
E-visits with specialists
•
Financial stability
•
Low debt and high cash on hand
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Stevens District Hospital Plan
HCS/499 v4
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Secondary Competitors
Retail Pharmacy Instant
Clinic
•
Low acuity office visits
•
Pharmacy added instant clinic in •
north end of county 6 months
ago
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Loss of patients from primary care
physicians’ practices
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HCS/499 v4
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Technology
A competing hospital has added e-visits for physician practices, which is causing a shift of patients to the competitor hospital's physician practices.
Regulatory Changes
Health care reform through the Affordable Care Act has increased the number of patients with some form of insurance payment. These patients are now
seeking care in greater numbers from a primary care physician. Stevens District Hospital struggles with accommodating patient scheduling requests to
establish care with a primary care physician.
Plan
Planning Components Explanation
Goal
Objective
Actions
Defini Organization goals that cover broad
tion
strategic issues, such as quality,
finances, growth
Broad action items that address
organizational goals, such as increasing
market share, increased use of
technology, increased physician
satisfaction
Action item that meets an objective, such as
implementing EMR, renovating physician
lounge, increasing marketing for specific
products
Exam •
ples
•
•
Improve emergency department
patient satisfaction survey by 5%
•
Implement urgent care center in north zip
code
•
Grow urgent care visits by 10%
•
Purchase tablets for physicians for EMR
rounding
•
Improve HCAHPS scores by 5%
Improve operating margin by 3%
Increase market share in 96103 zip
code by 5%
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Stevens District Hospital Plan
HCS/499 v4
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Meas
urem
ent
•
% increase in operating margin
•
% change in ED satisfaction survey
•
% change in market share
•
% change in urgent care visits
•
Number of patient visits at new urgent care
center
•
% increased use of EMR
Financial Summary
This year
Last year
343,737,280
344,726,245
16,846,309
20,311,534
360,583,589
365,037,779
Salaries and benefits
192,053,379
182,853,245
Supplies and other expenses
130,173,477
135,560,131
18,969,799
20,644,157
2,695,623
2,226,437
Operating Revenues
Net revenues from services to patients
Other operating revenues
Total operating revenues
Operating Expenses
Depreciation
Interest
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Stevens District Hospital Plan
HCS/499 v4
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Foundation
Total operating expenses
Income from operations
628,184
1,182,308
344,520,462
342,466,278
16,063,127
22,571,501
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