Stevens District Hospital Strategic-Planning Scenario
Stevens District Hospital Strategic-Planning Scenario
HCS/499 v5
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Stevens District Hospital 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 in Jefferson City, which is a city of 50,000 people 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
Current Mission and Vision Statements
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
Goals and Progress Table
| Goals | Progress Toward Meeting Goals |
| Increase market share by recruiting three family practice physicians. | During the past year, the hospital was able to recruit only one family-practice physician to increase primary care market. 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
Patients
The continued growth of chronic disease will require changes to the care-management model.
Percent of Population by Age Table
| Age Ranges | % Five Years Ago | % Five Years From Now |
| Under 18 | 24% | 18% |
| 18–44 | 46% | 32% |
| 45–65 | 26% | 30% |
| Over 65 | 4% | 20% |
More than 53% of residents have at least some college education, with just over 29% having an associate’s, bachelor’s, or graduate degree. More than 90% of residents have at least a high school diploma. The average unemployment rate in the county is 9.9%:
Market Share Distribution Percentage Comparison Table
| Hospital | Market-Share Distribution % Five Years Ago | Market-Share Distribution % Last Year |
| Stevens District Hospital | 48% | 35% |
| Competitor Hospital | 30% | 43% |
| Out-of-County Hospitals | 22% | 22% |
Figure 1: Patient Origin by Zip Code
Figure 1: In the Patient Origin by Zip Code pie chart, 96101 is Stevens District Hospital zip code and 94963 is major competitor hospital zip code. 52% are from 96101, 20% are from 94963, 16% are from 92106, and 12% are from 93921.
Increases in the percent of population with chronic disease and contributing factors will change significantly over the coming five years.
Chronic Disease Predictions
Payment
There will be continued focus on pay for performance and increased wellness programs. The Affordable Care Act (ACA) is leading to more people being covered; 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 next 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.
Percentage of Population by Insurance
Figure 2: Current Payer Mix
Figure 2: The Current Payer Mix pie chart shows that 35% are covered by Medicaid, 30% are covered by Medicare, 24% are covered by commercial insurance, 9% are uninsured, and 2% are noted as “other.”
Figure 3: Projected Payer Mix in 5 Years
Figure 3: The Projected Payer Mix in 5 Years pie chart shows that 38% are covered by Medicare, 24% are covered by Medicaid, 32% are covered by commercial insurance, 4% are uninsured, and 2% are noted as “other.”
As part of your review of this data, consider the following factors:
· A portion of the population will become Medicare eligible.
· The addition of manufacturing positions that include benefits will increase commercial insurance coverage.
· Changes from the ACA 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 Analysis Table
| Competitor Name | Competitor Type | Key Areas of Competition | New Programs and Facilities | Risk to Market Share |
| Hanover County Hospital | Primary competitor | · Facility upgrade · Quality scores | · Significant renovation of core hospital to update aesthetics · Added new wide-bore MRI machine last year · Reached the 95th percentile in five of six HCAHPS categories | · Drawing patients to newer facility · Accommodating patients with a wider range of body weights · Patient perception of higher quality and patient satisfaction |
| Medical Center Located in County South of Stevens District Hospital | Primary competitor | · Physician clinics · Financial stability | · E-visits with specialists · Low debt and high cash on hand | · Drawing patients out of primary and specialty care at Stevens District Hospital · Ability to cash-flow projects |
| Retail Pharmacy Instant Clinic | Secondary competitor | · Low acuity office visits | · Pharmacy added instant clinic in north part of county 6 months ago | · Loss of patients from primary care physicians’ practices |
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 ACA has increased the number of patients with some form of insurance payment. These patients are now seeking care from a primary care physician in greater numbers. Stevens District Hospital struggles with accommodating patient scheduling requests to establish care with a primary care physician.
Planning Components Explanation
Planning Components Explanation Table
| Components | Definition | Examples | Measurement |
| Goal | Organization goals that cover broad strategic issues, such as quality, finances, and growth | · Improve HCAHPS scores by 5%. · Improve operating margin by 3%. · Increase market share in 96103 zip code by 5%. | · Percentage increase in operating margin · Percentage change in market share |
| Objective | Broad action items that address organizational goals, such as increased market share, increased use of technology, and increased physician satisfaction | · Improve emergency department patient satisfaction survey by 5%. · Grow urgent care visits by 10%. | · Percentage change in the emergency department (ED) satisfaction survey · Percentage change in urgent care visits |
| Actions | Action item that meets an objective, such as implementing EMR, renovating physician lounge, and increasing marketing for specific products | · Implement urgent care center in north zip code. · Purchase tablets for physicians for EMR rounding. | · Number of patient visits at new urgent care center · Percentage increase of EMR use |
Financial Summary
Financial Summary Table
| Revenues and Expenses | This Year (In $) | Last Year (In $) |
| Operating Revenues | n/a | n/a |
| Net revenues from services to patients | 343,737,280 | 344,726,245 |
| Other operating revenues | 16,846,309 | 20,311,534 |
| Total operating revenues | 360,583,589 | 365,037,779 |
| Operating Expenses | n/a | n/a |
| Salaries and benefits | 192,053,379 | 182,853,245 |
| Supplies and other expenses | 130,173,477 | 135,560,131 |
| Depreciation | 18,969,799 | 20,644,157 |
| Interest | 2,695,623 | 2,226,437 |
| Foundation | 628,184 | 1,182,308 |
| Total operating expenses | 344,520,462 | 342,466,278 |
| Income From Operations | 16,063,127 | 22,571,501 |
Last Year
Admission ER Visits Deliveries Surgeries 4458 20930 405 6365 This Year
Admission ER Visits Deliveries Surgeries 5147 26292 472 7284
US Age Distribution 2010
96101 94963 92106 93921 0.52 0.2 0.16 0.12
5 Years Ago Obesity Diabetes Heart Disease 0.15 0.05 0.12 5 Years Ahead Obesity Diabetes Heart Disease 0.26 0.12 0.22
US Age Distribution 2010
Medicaid Medicare Commercial Uninsured Other 0.35 0.3 0.24 0.09 0.02
US Age Distribution 2010
Medicare Medicaid Commercial Uninsured Other 0.38 0.24 0.32 0.04 0.02
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Copyright 2022 by University of Phoenix. All rights reserved.
