Health Organization Evaluation Paper

Health Organization Evaluation Paper

Introduction

UnitedHealth Group Incorporated is a for-profit organization headquartered in Minnesota, United States of America. The firm offers both insurance services and healthcare products to Americans in different states. By 2020, United Health Group had grown to become the second-largest healthcare provider in the United States behind CVS Health.

However, the company has also had numerous challenges that have negatively impacted its operations. The company serves millions of people not just in America, but also outside America, in particular, the Americas (UnitedHealthCare, 2021). In 1998, United Healthcare group realigned its business operations to incorporate a collection of five independent subsidiaries. The purpose of this paper is to assess the organization’s preparation and readiness to meet the healthcare needs of the population it serves.

United Health Group Readiness to Meet People’s Healthcare Needs in the Future.

Different contemporary organizations operating in the healthcare space tend to employ varied techniques and strategies to meet their service delivery objectives. Business diversification is the strategy used by United Health Group to stay afloat while meeting the needs of the customers. The conglomerate serves over 6 million clients within the United States and over 130 million customers across the world. Through diversification, the company has two divisions that run its businesses.

Optum is the branch that deals with different lines of businesses, and UnitedHealthCare is the branch that deals with benefits (Che, & Liebenberg, 2017). Under Optum, UnitedHealth Group has several lines of business such as mail-order pharmacy, health savings account, and a payment processor service for healthcare providers. These business divisions ensure that United Healthcare does not only stay afloat businesswise but can cater to the needs of its customers even in the future.

United Healthcare’s business model that is forward-looking and supports its existing streams of income does seem to prepare it to meet the needs of the citizen in the future. The company uses a mixture of value proposition and revenue models to meet its business objectives (Gyan et al., 2017). In the case of the revenue model, the company identifies viable sources of revenue to pursue. For instance, the company has two subsidiaries that deal with different lines of businesses.

United Healthcare is a branch that deals with benefits for example health insurance. Optum is the new branch that has three lines of business-Optimum Insight which is a service that processes payments for other healthcare providers. OptumRx is a mail-order pharmacy branch while Optum health is a branch that deals with health savings. UnitedHealthCare accounts for about 80% of the group’s total revenue (Gyan et al., 2017).

UnitedHealthCare also uses a value proposition model to ensure that it keeps its customers while attracting new ones. The value proposition model is a business model in which a firm finds a way of making its products/services attractive to customers (Gebauer et al, 2017). Through strategies such as pocket-friendly pricing and quality services, UnitedHealthCare can attract more customers while retaining their current ones. Through relevancy, quantified value, and differentiation, UnitedHealthCare has been able to withstand pressure from its competitors. These are the same strategies that the firm will continue to leverage and remodel to make the business adaptable for ensured business continuity and to ready itself its clients’ future healthcare needs.

Strategic Plan to Address its Health Issues

Nursing Staff Issues

America, like most developed countries, has been hit by a shortage of qualified nursing personnel that negatively affects the quality of care delivered by healthcare providers. To address the issue of the nursing staff shortage, UnitedHealthCare is involved in numerous programs to help increase the number of nurses in the country to plug the deficit.

An excellent example of a program that UnitedHealthCare is involved with concerning the shortage of nursing staff is sponsorship programs so that more students take up a nursing course to fill the shortages. Such an approach of guaranteed incentive, as Park and Yu (2019) observe, can create a long-term solution to the problem by ensuring a steady supply of trained workforce, though it must be complimented strategies to ensure long-term retention. Nonetheless, the organization’s intervention to solve nursing workforce shortage compliments the government’s multidimensional approach to solving the problem.

UnitedHealthCare works with healthcare facilities to improve the working conditions of health practitioners across the country and beyond. Today, many nurses work long hours under stressful conditions that create a high turnover. Many others quit nursing because of poor remuneration, fatigue, stress, and the excessive nurse-patient ratio. To encourage nurses to stay in their jobs, the network works closely with hospitals to bring change to the nurses’ working environment.

Through educational programs, the network sensitizes healthcare facilities about the importance of improving the working conditions of nurses. For those facilities that are in dire need of nurses, the network works with hospitals to sensitize them about outsourcing nursing staff from other parts of the world. For example, the network has deep roots in the Americas and is involved in the training and facilitating the transfer of nurses where the shortage is acute.

Patient Satisfaction

UnitedHealthCare works closely with hospitals to ensure that these facilities meet key parameters about patient satisfaction. One of the critical issues that the network addresses with hospitals is the provision of quality care. A critical factor in the improvement of quality care is the availability of highly trained nursing staff. The network works with healthcare facilities to ensure that hospitals acquire highly trained personnel to improve the quality of care given to patients. Further, the network has resource centers that nurses and other medical professionals can use to expand their knowledge and skills.

Potential Issues within the Organizational Culture

UnitedHealthCare has had a troubled past concerning its management that impacted negatively on its corporate culture. Unfortunately, the network has been one of the firms previously investigated by authorities in America for client fraud. The company was accused of creating an elaborate scheme to defraud customers through inflating customary rates and manipulating rates.

Other corporate malpractices such as overbilling, denial of treatment, backdating lawsuits, and compliance issues are some of the problems that have bedeviled the firm in the past and which has impacted negatively on its corporate culture and standing. For example, in 2018, UnitedHealthCare was fined $2.5 million by the New Jersey Department of Banking and Insurance (2018) for issues concerning compliance. All these ill practices committed by top directors have made both employees and external customers have a negative perception of the company.

Theory or Model That Could Be Used To Support Implementation of the Strategic Plan

The best model that can help UnitedHealthCare to support the implementation of its strategic plan is the issue-based Strategic planning model. This model is the best for the network because it compels the stakeholders to identify the major issues as well as realign its goals. Besides, this model allows the firm to review and re-evaluate its values, mission, and vision. A review of the company’s values will help the firm to create a strong and positive culture that will in turn positively influence its employees and customers.

Most importantly, the issue-based Strategic planning model contains the SWOT analysis (Ginter et al., 2017) through which the firm can re-examine its weaknesses, strengths, the opportunities available to it, and the threats to the business. One of the critical weaknesses is bad governance over the past years. Poor governance has caused UnitedHealthCare millions of dollars in needless lawsuits and compensations/settlements. Through SWOT analysis, the company has the opportunity to rectify these blunders/mistakes. Lastly, through SWOT analysis, UnitedHealthCare has the chance to evaluate its current position and what to do to ready itself to meet people’s healthcare needs in the future.

Conclusion

UnitedHealthCare is a conglomerate headquartered in Minnesota that provides health care services and products to millions of clients in the Americas. In the United States alone, UnitedHealthCare serves over six million customers while across the world, the firm serves over 130 million people. In terms of revenue, UnitedHealthCare is only second to CVS health that occupies the top spot in terms of profitability.

Through diversification, the company has two divisions that run its businesses namely Optum, which runs different lines of businesses, and UnitedHealthCare, which handles client benefits. Based on this analysis of the organization’s needs, the best model for UnitedHealthCare to support the implementation of its strategic plan is the issue-based Strategic planning model. This model emerges as the best for the organization as it compels the stakeholders to identify the major issues as well as realign its goals.

References

Che, X., & Liebenberg, A. P. (2017). Effects of business diversification on asset risk-taking: Evidence from the US property-liability insurance industry. Journal of Banking & Finance, 77, 122-136. DOI: 10.1016/j.jbankfin.2017.01.004

Gebauer, H., Haldimann, M., & Saul, C. J. (2017). Business model innovations for overcoming barriers in the base-of-the-pyramid market. Industry and Innovation, 24(5), 543-568. https://doi.org/10.1080/13662716.2017.1310033

Ginter, P. M., Duncan, W. J., & Swayne, L. E. (2018). The strategic management of health care organizations. John Wiley & Sons.

Gyan, A. K., Brahmana, R., & Bakri, A. K. (2017). Diversification strategy, efficiency, and firm performance: Insight from emerging market. Research in International Business and Finance, 42, 1103-1114. https://doi.org/10.1016/j.ribaf.2017.07.045

New Jersey Department of Banking and Insurance. (2018). New Jersey Department of Banking and Insurance Announces $12.5 Million in Consumer Recoveries and Fines for First and Second Quarter of 2018. Accessed April 7th from https://www.state.nj.us/dobi/pressreleases/180723.html

Park, H. Yu, S. (2019). Effective policies for eliminating nursing workforce shortages: A systematic review. Health Policy and Technology, 8(3), 296–303. doi:10.1016/j.hlpt.2019.08.003

UnitedHealthCare. (2021). About us. Uhc.com. Retrieved 7 April 2021, from https://www.uhc.com/about-us.

Health Organization Evaluation Paper Instructions

Research a health care organization or network that spans several states with in the United States (United Healthcare, Vanguard, Banner Health, etc.). Assess the readiness of the health care organization or network you chose in regard to meeting the health care needs of citizens in the next decade.

Prepare a 1,000-1,250 word paper that presents your assessment and proposes a strategic plan to ensure readiness. Include the following:

  • Describe the health care organization or network.
  • Describe the organization’s overall readiness based on your findings.
  • Prepare a strategic plan to address issues pertaining to network growth, nurse staffing, resource management, and patient satisfaction.
  • Identify any current or potential issues within the organizational culture and discuss how these issues may affect aspects of the strategic plan.
  • Propose a theory or model that could be used to support implementation of the strategic plan for this organization. Explain why this theory or model is best.

You are required to cite a minimum of three sources to complete this assignment. Sources must be appropriate for the assignment and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Rubric Criteria

Expand All Rubric CriteriaExpand All

Health Care Organization or Network

27 points

Assessment of Overall Organizational Readiness

27 points

Strategic Plan

36 points

Identification of Issues in Organizational Culture

27 points

Theory or Model to Support Implementation of Strategic Plan

27 points

Thesis Development and Purpose

9 points

Argument Logic and Construction

9 points

Mechanics of Writing (includes spelling, punctuation, grammar, language use)

9 points

Paper Format (use of appropriate style for the major and assignment)

3.6 points

Documentation of Sources

5.4 points

Total180 points