HCM-FPX5314_MusiKeti_Assessment 2-1

1 Assessment 2: Alignment of a Health Organization Structure Keti Musi HCM-FPX5314: Driving Health Care Results Prof. Stocker Capella University February 6, 2022

2 NewYork-Presbyterian Overview NewYork-Presbyterian (NYP) is one of the nation’s most comprehensive, integrated academic health care delivery systems, dedicated to providing the highest quality, most compassionate care, and service to patients in the New York metropolitan area, nationally, and throughout the globe. NYP was founded nearly 250 years ago with the fundamental belief that every person deserves access to the best care. NewYork-Presbyterian encompasses 10 hospital campuses across the Greater New York area, more than 200 primary and specialty care clinics and medical groups, and an array of telemedicine services. NewYork-Presbyterian has four major divisions: (1) NewYork-Presbyterian Hospital, (2) NewYork-Presbyterian Regional Hospital Network, (3) NewYork-Presbyterian Physician Services, and (4) Community and Population Health. NewYork-Presbyterian Healthcare System’s mission is to be a leader in the provision of world class patient care (i.e., high quality, fiscally responsible healthcare services that meet the needs and expectations of the communities they serve), teaching, research, and service to local, state, national, and international communities. The communities NewYork-Presbyterian services, which spans from New York City to the counties just outside of NYC, represent a broad diversity of demographics, socioeconomics, and health service utilization needs. NewYork-Presbyterian is an 11-hospital system that experiences 2.6 million patient visits annually. The system employs 10,000-plus physicians and is equipped with 4,000-plus certified beds. Background As a senior leader of a NewYork-Presbyterian, I have been charged with performing a complete analysis of our internal organizational structure. Elements of the organizational structure that will be considered are service delivery or manufacturing process, finance, operations, human resources, supply chain, marketing, leadership, etc. My analysis will evaluate

4 external analysis is key in gaining a holistic picture of the organization's environment and developing a winning strategy. Once complete, the organization should have a clear idea of where it’s excelling, where it’s doing okay, and where its current deficits and gaps are. The analysis will arm management with the knowledge to take advantage of its strengths, expertise, and opportunities. It also enables management to develop strategies to mitigate any threats and compensate for identified weaknesses and disadvantages. An organization can be confident that they are funneling their resources, time, human capital, and focus effectively and efficiently. Organizations can choose from a variety of tools and frameworks for conducting an internal analysis and each is valuable for a certain purpose (Porter, 2004). Each uses slightly different tools, strategies, and objectives to identify key information about the internal processes, resources, and structures of the business. A few of the most common examples of internal analysis frameworks include: (1) gap analysis, (2) strategy evaluation, (3) SWOT (Strengths, Weaknesses, Opportunities and Threats) analysis, (4) VRIO (Valuable, Rare, Inimitable and Organized) analysis, (5) OCAT (Organizational Capacity Assessment Tool), (6) McKinsey 7S (strategy, structure, systems, shared values, skills, style, and staff) framework, and (7) core competencies analysis. Utilizing a VRIO analysis and a SWOT analysis to evaluate the internal structure of NewYork-Presbyterian will help break down both the strategic and operational framework. SWOT Analysis stands for – Strengths, Weaknesses, Opportunities, and Threats that NewYork-Presbyterian encounters both internally and in macro environment that it operates in (Blayney, 2008). Strengths and Weaknesses are often restricted to company’s internal –resources, skills, and limitations. Opportunities and Threats are (external) factors that are analyzed in view of the prevalent market forces and other factors such as social, health & safety, legal &

5 environmental, technological, political, and economic. The SWOT analysis allows organizations to uncover the external opportunities they have the strength to exploit while simultaneously minimizing the internal factors that cause weaknesses. It also helps to reduce the risk of impending threats. Assessing organizational strengths, weaknesses, opportunities, and threats from an unbiased perspective will ensure that the management team has a detailed holistic conversation. Area Environment Analysis Strength Internal Has strong brand reputation in the healthcare market, which has increasingly earned it stakeholders’ vote of confidence to manage patient care, including the complexities of chronic and acute care. Has a vast knowledge and expertise of healthcare delivery, alongside a vast network of highly trained physicians and staff to demonstrate its capabilities and excellence. It provides high-quality care at an affordable price. It has a wide range of quality medical services. It invests in new technology and improved access to healthcare in the community. Weaknesses Internal It is a large employer with multisite business. Faces some challenges in harmonizing the operations of 10 hospital campuses across the Greater New York area, more than 200 primary and specialty care clinics and medical groups, and an array of telemedicine services, including consistency in delivery of care, degree of customization, financial decisions, and coordination mechanisms. Faces challenges in attracting and retaining top talents to fit in its working environment socially and culturally. Opportunities External Development of new programs that can increase access to care, new technology that ensures quality services, advancements in outpatient care services, maintaining better patient relationships after discharge, improving communication across the organization, reducing costs of patient care, and potential partnerships with hospitals or other community health centers. Changes in population profile or need. Threats External The entrance of new competitors, economic and political changes, state and federal budget cuts, high demand for expensive medical equipment, insurance plan changes (in reimbursement), demographic changes, loss of key

7 execution an industry where there is frequent cost overrun the segment that it operates in competitors so far have been able to imitate this expertise it competitive advantage Brand awareness Yes Yes, has one of the leading brands in the industry No Has utilized its leading brand position in various segments Sustainable competitive advantage Pricing strategies Yes No Pricing strategies are regularly imitated in the industry Yes, it has a pricing analytics engine Temporary competitive advantage Ability to attract talent in various local & global markets Yes, it’s strategy is built on successful innovation and localization of products Yes, as talent is critical to firm’s growth Difficult to imitate Yes (to a large extent) Providing strong competitive advantage Track record of leadership team Yes Yes Can’t be imitated by competitors Yes Can't be imitated by competitors Talent to manage regulatory and legal obligations Yes No Can be imitated by competitors Yes Not critical factor Supply chain network flexibility Yes Yes Near competitors also have flexible supply chain and share some of the suppliers Fully utilized Keeps the business running Recommendations

8 In order to defend against competition and to improve their market positions relative, healthcare organizations form strategic partnerships or alliances. Strategic partnerships or alliances offer Healthcare organizations, like NewYork-Presbyterian, opportunities to expand their network, access and leverage expanded benefits of scale, access essential industry resources, offer excellent value for consumers as they shop for health care services, expand access to advanced medical care to improve patient outcomes, streamline processes, reduce costs, lead to innovation, and improve patient care (McCue et al., 1999). I have identified several options for NewYork-Presbyterian to best address its short-term and long-term strategic objectives – mergers, acquisitions, partnerships, or joint ventures (JV). Based on the synthesis of all the information, my recommendation is for NewYork-Presbyterian to pursue merger and acquisition (M&A) activity. Specifically, NewYork-Presbyterian should make strategic investments and focus on ambulatory care and their traditional role as teaching hospitals. From a practical perspective, NewYork-Presbyterian would need to employ a structured, purposeful, and integrated approach to merger and acquisition—one that included developing a strong long-term strategic vision and setting explicit financial and non-financial goals. The success or failure of each merger and acquisition will hinge upon the ability to implement an integration strategy. This will enable NewYork-Presbyterian to best align the organizational structure to: (1) drive customer-focused results, (2) address its organizational challenges and opportunities in a dynamic environment, (3) exploit all opportunities and mitigate the threats or challenges it may face, and (4) fulfill its strategic initiatives to provide its patients and communities more access to services, high quality of care, and cost-effective care. Historically, NewYork-Presbyterian has effectively pursued merger and acquisition activity that resulted in better financial, operational, and quality performance (i.e., maximize post-transaction value realization) – decreased expenses,

10 References Blayney, D. W. (2008). Strengths, weaknesses, opportunities, and threats. Journal of oncology practice, 4(2), 53. Retrieved from https://doi.org/10.1200/JOP.0820501 Heeringa, J., Mutti, A., Furukawa, M. F., Lechner, A., Maurer, K. A., & Rich, E. (2020). Horizontal and vertical integration of health care providers: a framework for understanding various provider organizational structures. International journal of integrated care, 20(1). Retrieved from https://pearlbrill.com/quality-healthcare-internal- and-external-factors-affecting-quality-and-total-quality-management Hussey, P. S., Wertheimer, S., & Mehrotra, A. (2013). The association between health care quality and cost: a systematic review. Annals of internal medicine, 158(1), 27–34. Retrieved from https://doi.org/10.7326/0003-4819-158-1-201301010-00006 McCue, M.J., Clement, J.P., Luke, R.D. (1999). ‘‘Strategic Hospital Alliances: Do the Type and Market Structure of Strategic Hospital Alliances Matter?’’ MedicalCare 37 (10): 1013– 22. Retrieved from https://faculty.wharton.upenn.edu/wp- content/uploads/2014/09/20_Managed_Care_and_Hospital_Consolidation.pdf Noh, J., Kwon, Y., Yoon, S., & Hwang, J. (2011). Internal and external environmental factors affecting the performance of hospital-based home nursing care. International Nursing Review, 58(2), 263-269. Retrieved from https://www.researchgate.net/publication/51109525_Internal_and_external_environmenta l_factors_affecting_the_performance_of_hospital-based_home_nursing_care Porter, M.E. (2004). Competitive strategy: techniques for analyzing industries and competitors. New York; London: Free Press. Retrieved from https://www.researchgate.net/publication/321007042_Competitive_Strategy_Techniques_ for_Analyzing_Industries_and_Competitors

11 Rothaermel, F. (2019). Strategic management concepts (4th ed.). New York, NY: McGraw-Hill . Retrieved https://capella.vitalsource.com/#/books/9781260141931/ Shafritz, J. M., & Ott, J. S. (2005). Classics of organization theory. Belmont, CA: Thomson/Wadsworth. Retrieved from https://www.scribd.com/document/489955128/Classics-of-Organization-Theory-by-Jay- M-Shafritz-Author-J-Steven-Ott-Author-Yong-Suk-Jang-Author-z-lib-org-pdf