Assignment: Health Organization Evaluation

NRS 451 Health Organization Evaluation

Evaluation of healthcare organization involves a description of the organization, an assessment of the strategic plan, and an overall evaluation of its readiness to meet the needs of the community served. The assessment should include a review of the organization’s governance, management, and financial resources; as well as the programs and services. Finally, the evaluator should provide conclusions and recommendations to help the health organization improve its performance. There are several healthcare organizations in the United State dedicated to providing treatment services to the ever-growing population. Some of these organizations operate within a specific geographic locations while others span throughout the United States (Branch et al., 2019). The purpose of this article is to provide a review of the United Healthcare Organization as one of the organizations that spans several states and to evaluate the readiness to provide healthcare services to different populations.

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Description of Healthcare Organization (United Healthcare Organization)
United Health Care Organization is one of the largest healthcare organization in the United States. The company was founded in 1977 and has since expanded to offer health insurance coverage in several states. UHC offers a wide range of health plans and services, including dental and vision coverage, prescription drug benefits, and wellness programs (Nakagawa et al., 2018). Their customer service is highly rated, and they have a wide network of doctors and hospitals to choose from.
UnitedHealthcare Inc. operates in more than 34 states. It is the largest provider of managed care services in the country and it has more than 70 million members. The organization’s main competitors are Anthem, Aetna, and Cigna. All of these companies are large providers of health insurance and managed care services. They all offer similar products and services, so they compete mainly on price and customer service.
UnitedHealthcare reported total revenues of more than $180 billion in 2017, and employs more than 260,000 people (Molinari, 2018). The company’s core business is providing health insurance to individuals, families, and businesses. It also operates a large network of hospitals and doctors’ offices, and provides pharmacy benefits management services. The organization has been rapidly expanding its presence in the healthcare market in recent years. In 2018, the company agreed to acquire DaVita Medical Group, one of the largest providers of outpatient care in the United States, for $4.9 billion (Molinari, 2018). The move will gave it a substantial foothold in the rapidly growing market for outpatient care.
UnitedHealthcare Inc. Overall Readiness
UnitedHealthcare Inc. is a highly competent health insurance company with an elaborate structure and strong policies in place. Their team is experienced and efficient, which allows them to provide quality service to their members. Overall, they are well-prepared for any situation that may arise. UnitedHealthcare has a comprehensive emergency preparedness plan that is designed to help the company quickly and effectively respond to any event, often unexpected, that may impact its customers or operations. The plan is overseen by a corporate-level Emergency Preparedness Steering Committee, which includes representatives from across the organization (Molinari, 2018). The committee’s goal is to ensure that the company can continue to provide quality service to its customers in the event of an emergency.
UnitedHealthcare has also established detailed disaster recovery plans for each of its business units. These plans include contact information for key personnel, specific steps to take in order to minimize the impact of an emergency on customers and employees, and protocols for communicating with stakeholders during and after an incident. The UnitedHealthcare Inc. has a well-organized structure and policymakers that are involved in the development of policies and strategies to be followed.
Strategic Plan
UnitedHealthcare is planning to focus on technology and innovation to provide better healthcare services (National Academies of Sciences, Engineering, and Medicine, 2018). They are also increasing their investments in data analytics, which will help them to improve the quality of care while reducing costs. Additionally, they are focusing on expanding their health insurance offerings both domestically and internationally; this will enable them to serve more customers and create a stronger competitive advantage. Finally, they are working to develop closer relationships with health care providers in order to better understand the needs of their patients.
Mission
To be the world’s leading provider of healthcare services and decision-making assistance for bettering healthcare outcomes.
Vision
To become one of the premier healthcare organizations by providing superior insurance and medical services.
Financial Planning
UnitedHealthcare Inc. intends to increase revenues by extending its healthcare services to new countries and states. Already, the organization’s strong financial performance is reflected in its healthy balance sheet and solid financial position. The company has a low debt-to-equity ratio and generates ample cash flows to cover its expenses and dividend payments. Additionally, UnitedHealthcare enjoys a high degree of liquidity and has access to capital markets should it need to raise funds.
Network Growth
UnitedHealthcare plans its network growth through mergers and acquisitions, expansion to other states, and going international. For example, in 2009 UnitedHealthcare completed the purchase of Sierra Health Services Inc., which expanded their presence in Nevada and added over 1 million members. They plan to acquire more companies to enhance their network growth In 2015, they announced their intention to acquire Catamaran Corporation for $12.8 billion, which would make them one of the largest health insurers in the world with approximately 140 million members.
Nurse and Staffing
UnitedHealthcare’s staffing model is composed of three tiers. The first tier includes corporate staff who work in areas such as finance, human resources, information technology, and marketing (National Academies of Sciences, Engineering, and Medicine, 2018). The second tier includes operational staff who work in contact centers and clinics. The third tier includes clinical staff who work directly with patients. Each tier has its own unique set of responsibilities and functions within the company. Corporate staff are responsible for developing and implementing strategy, while operational staff are responsible for delivering services to members. Clinical staff provide healthcare services to all the members.
Resource Management
UnitedHealthcare is working on measures to improve resource allocation and usage through its subsidiary Optum. The company has been able to identify certain areas where it can save money, including reducing the number of unnecessary hospital admissions and improving care coordination. As part of its continued service expansion, UnitedHealthcare Inc. expects to build additional offices and healthcare facilities in a number of states. Moreover, the company plans to extend its IT services.
Patient Satisfaction
UnitedHealthcare offers a variety of channels through which patients can reach customer service, including phone, email, and social media. Additionally, UnitedHealthcare has a website specifically for patients that provides information about their coverage and how to use it. UnitedHealthcare also surveys patients periodically to gauge their satisfaction with the company’s customer service and overall care. The results of these surveys help the company identify areas in which it can improve and ensure that its patients are satisfied with their coverage.
Current Issues with the Organizational Culture
There are a number of issues with the organizational culture at UnitedHealthcare, including a lack of transparency, poor communication, and a top-down management style that stifles creativity and innovation. Employees at all levels of the company have complained about feeling belittled and disregarded, and there is a high rate of turnover among both managers and employees. In addition, the company has been criticized for its low level of customer service and for putting profits ahead of patients’ needs (Molinari, 2018). United Health Company has robust and well established cultural standards that enable healthcare employees to favorably influence healthcare operations. In other words, the organization’s cultural values drive employees to cooperate toward a single purpose.

Issue-Based Strategic Planning Model

United Health Company often use an issue-based planning strategy to aid in the execution of their strategic plan. Most recently, they have focused on the following key issues: Providing quality and affordable health coverage for all Americans, developing innovative health care models that improve quality and lower costs, reinforcing their commitment to prevention and wellness, and promoting a better understanding of the role of preventive health care in keeping people healthy.
Conclusion
UnitedHealthcare Inc. is one of the largest health insurance companies in the United States. It was founded in 1977 as United Healthcare Corp., a joint venture of the nonprofit Health Maintenance Organization (HMO) and the Mutual Benefit Association (MBA). UnitedHealthcare’s primary goal is to provide high-quality, affordable healthcare coverage to as many people as possible. UnitedHealthcare is planning to focus on technology and innovation to provide better healthcare services. They are also increasing their investments in data analytics, which will help them to improve the quality of care while reducing costs.

References
Baker, W., Heinzl, R., Migliori, R., Gruber, D., & Gusmano, M. K. (2018). Telehealth Policy Debate: There is Greater Financial Value in Telehealth for Consumers than for Providers. Telehealth and Medicine Today. https://telehealthandmedicinetoday.com/index.php/journal/article/view/105
Branch, L., Eller, W., Bias, T., McCawley, M., Myers, D., Gerber, B., & Bassler, J. (2019). Trends in malware attacks against United States healthcare organizations, 2016-2017. Global Biosecurity, 1(1). https://jglobalbiosecurity.com/articles/10.31646/gbio.7/
Molinari, A. (2018). Healthcare Mergers and Acquisitions in an Era of Consolidation: Review of Health Insurance Mergers and a Call for Agency Collaboration in Antitrust Information. Pepp. L. Rev., 45, 405. https://heinonline.org/HOL/LandingPage?handle=hein.journals/pepplr45&div=12&id=&page=
Nakagawa, K., Kvedar, J., & Yellowlees, P. (2018). Retail outlets using telehealth pose significant policy questions for health care. Health Affairs, 37(12), 2069-2075. https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2018.05098
National Academies of Sciences, Engineering, and Medicine. (2018, July). Adopting Health Literacy in an Organization. In Building the Case for Health Literacy: Proceedings of a Workshop. National Academies Press (US). https://www.ncbi.nlm.nih.gov/sites/books/NBK518845/
Yabroff, K. R., Gansler, T., Wender, R. C., Cullen, K. J., & Brawley, O. W. (2019). Minimizing the burden of cancer in the United States: Goals for a high‐performing health care system. CA: a cancer journal for clinicians, 69(3), 166-183. https://acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/caac.21556

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Assessment Description

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.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

atement makes the purpose of the paper clear.

4. Good
7.65 points

Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.

3. Satisfactory
6.75 points

Thesis is apparent and appropriate to purpose.

2. Less Than Satisfactory
5.85 points

Thesis is insufficiently developed or vague. Purpose is not clear.

1. Unsatisfactory
0 points

Paper lacks any discernible overall purpose or organizing claim.

Argument Logic and Construction
9 points

Criteria Description
Argument Logic and Construction

5. Excellent
9 points

Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

4. Good
7.65 points

Argument shows logical progression. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.

3. Satisfactory
6.75 points

Argument is orderly but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.

2. Less Than Satisfactory
5.85 points

Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.

1. Unsatisfactory
0 points

Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.

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

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

5. Excellent
9 points

Writer is clearly in command of standard, written, academic English.

4. Good
7.65 points

Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.

3. Satisfactory
6.75 points

Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.

2. Less Than Satisfactory
5.85 points

Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.

1. Unsatisfactory
0 points

Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.

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

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

5. Excellent
3.6 points

All format elements are correct.

4. Good
3.06 points

Appropriate template is fully used. There are virtually no errors in formatting style.

3. Satisfactory
2.7 points

Appropriate template is used. Formatting is correct, although some minor errors may be present.

2. Less Than Satisfactory
2.34 points

Appropriate template is used, but some elements are missing or mistaken. A lack of control with formatting is apparent.

1. Unsatisfactory
0 points

Template is not used appropriately, or documentation format is rarely followed correctly.

Documentation of Sources
5.4 points

Criteria Description
Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)

5. Excellent
5.4 points

Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

4. Good
4.59 points

Sources are documented, as appropriate to assignment and style, and format is mostly correct.

3. Satisfactory
4.05 points

Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.

2. Less Than Satisfactory
3.51 points

Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.

1. Unsatisfactory
0 points

Sources are not documented.

Total

180 points