Health care case study

Leadership and management in nursing

United Health Care is a healthcare service provider in the United States. The organization serves close to 85 million among the 50 states in the U.S. Its headquarters is based in Minnetonka a town in Minnesota. The group was formed in 1977 and later went public in 1984. It is known as a center of excellence when it comes to providing comprehensive health care benefits to various organizations and plan members nationwide. With its subsequent growth over the years, the organization has managed to improve health and wellness by Motivating Health Ownership (Borkowski, 2015).The group has managed to build on its ideologies of consumer empowerment and accountability enabling members to have individual health ownership. Through its approach of combining various clinical programs, rewards, and technology in a way that is specific to clients’ needs and goals, the organization has managed to provide the best comprehensive care which contributes to its outstanding performance in health care sector. However, the company’s tremendous growth owing to its numerous acquisitions and demographic changes has created the need to rethink its strategic plan, and address issues such as nurse staffing, resource management, patient satisfaction, and network growth.

According to a report compiled by Centers for Medicare & Medicaid Services (2013), the United Health Care group provides insurance services and plans such as the ‘Medicare Advantage’ employer-sponsored insurance and managed Medicaid. Its services across these segments are performing quite well making it able to venture and expand to close than 125 countries. The organization can serve huge populations as well as provide extensive services by the help of its professional medics. Beside this, it aims at providing service care and innovations to attend to evolving needs of its customers across the globe. The United Healthcare group has a well laid out structure and platform that is used to serve its clients, namely; the United Health Care and Optum services. The United Healthcare is a service provider platform that offers health care and benefits services. On the other hand, Optum is designed to provide information technology and health services to its clientele. This enables patients to be at ease to access health information as well as be attended to by qualified personnel at their convenience.

Patient Satisfaction

Patient satisfaction is a top priority for the organization and striving to achieve that is the organization’s goal. Just as in the case of Singapore Airlines, United Health Care Organization is committed to providing the best health care services at a less cost but still maintain utmost patient satisfaction. As indicated in its commission statement, the organization undertakes to improve health care and enhance the performance of the health system. By addressing customer needs and working to ensure community well-being, the group has set itself as a center of comprehensive care. Some of the programs such as cancer payment model, ensure that patients can access an innovative system that provides the option of payment in bundles to meet the requirements and treatment of its cancer patients (Harrington, & Estes, 2008).Such a system ensures that continued monitoring of patients during diagnosis is possible.

Additionally, the organization has managed to provide and set up a diagnosis programs, prevention and control alliance whereby through its partnership with the YMCA, the organization can provide service to diabetic and obesity patients. Consequently, the program offers education to the public by asking people to break notorious habits, maintain active lifestyles, and engage in nutritional therapy. Moreover, the implementation of Electronic Medical Records (EMR) has improved customer satisfaction since it enables physicians to provide excellent care. EMR ensures appropriate information is delivered on time. Also, the records are an improvement over paper records since more than one physician can access the records at a time. Also, the records make the patient feel safer. EMR enable the storage of more information and ease the management of chronic illnesses.  (Wolf et al., 2011). Furthermore, the organization ensures that the staff and employers maintain exceptional standards of patient care by advocating for values such as compassion, innovation, integrity, performance, and healthy relationships. This improves overall patient satisfaction. 

Resource management in health care

Resource management is essential in any organization. Every organization should strive to manage its resources through efficient allocation and maintaining transparency in the process. Investing in technology has eased the process of resource allocation in many organizations. For instance, in the case of Singapore Airlines, technology has facilitated the process of accounting for resources and funds as well as creating a detailed budget plan. United Health Care group is striving to achieve this through programs such as Optum. The program is resourceful in that patients can access medical information and communicate with physicians through an online system. Optum provides an integrated platform whereby, care providers can analyze health conditions of patients, take necessary action depending on their state of health as well as synchronize all the information needed for future diagnosis. This helps to save time and resources since patients from all over the globe can access health information as well receive their diagnosis on time. Moreover, the program helps to create an easy time for care providers to monitor their patients even after they have been discharged. Furthermore, the program eases the billing of patients’ records and creates transparency in the health administration. Transparency is a great aspect in resource management since it builds confidence in patients and other stakeholders who deal directly with the United Healthcare Group. Patients can know how their savings have been utilized and how the organization is performing. 

Also, United Health Care group has also launched ‘my Healthcare cost estimator,’ which helps patients to know the cost of medication when they visit health centers. The program provides estimates that one may encounter during their hospital visits. By doing this, United Health Care Group creates transparency and accountability as well as enable patients; budget wisely for their health matters. United Healthcare group has also been able to establish ;Now Clinic,’ an online clinic where physicians directly attend to their patients especially during emergencies. So far, it has been a great life saver. 

United healthcare strategic plan for network growth

Over the past few years, United Health Care Group has been facing several challenges and significant competition from other health care providers. To curb the challenges and survive the competition, United Health Care Group is heavily investing in networking to be able to provide better services to their customers. It is also venturing through promotions on billboards, radio, and social media for the masses to know of its ventures. Just as in the case of Singapore Airlines, United Health Care Group is focused on providing quality services at affordable costs. Networking is important when it comes to offering this kind of service. It ensures exceptional administrative standards and helps the organization to connect with and unify patients, health benefit plans, health care providers, and health care sector.  

Nurse Staffing

Due to its extensive nature, the United Heath Group has many staff members who can prove difficult to manage. However, the organization through its Center for Nursing Advancement (CFNA) has established an External Nurse Advisory Board (ENAB) to create, inform, and evolve nursing practices. Through ENAB, CFNA can create strong alliances across the nursing fraternity and health care industry in general, improve the nursing profession, and influence nursing policy (Checkley et al. 2014).  ENAB advances the objectives of CFNA such as preparing the nurses to tackle problems in health care and expanding roles in the system. ENAB is tasked with creating a program that can help resolve nurse staffing shortage by ensuring that nurses undergo regular training. Frequent training helps them be up-to-date as well offer better services to the customers. Also, the program ensures that nurses are equally distributed in all departments to attend to patients.

Conclusion

United health care group is non-profit health organizations that are aimed at improving better health care systems and improve lives. By improving its strategic plan and initiating innovations, the group has managed to develop its values of consumer empowerment and accountability. Programs such as individual health ownership have improved quality of care. Professionalism, transparency, and effectiveness have enabled the group to meet patient satisfaction while maintaining affordable health costs.

References

Borkowski, N. (2015). Organizational behavior in health care. Jones & Bartlett Publishers.

Centers for Medicare & Medicaid Services. Conditions for Coverage (CfCs) & Conditions of Participations (CoPs). November 6, 2013.

Checkley, W., Ghannem, H., Irazola, V., Kimaiyo, S., Levitt, N. S., Miranda, J. J., … & Prabhakaran, D. (2014). GRAND South Network, UnitedHealth Group/National Heart, Lung, and Blood Institute Centers of Excellence, et al. Management of NCD in low-and middle-income countries. Glob Heart, 9(4), 431-43.

Harrington, C., & Estes, C. (2008). Health policy: crisis and reform in the US health care delivery system. Jones & Bartlett Publishers.

Wolf, J. A., Hanson, H., & Moir, M. J. (2011). Organization development in health care: High impact practices for a complex and changing environment. IAP.