Strategic Planning Questions
To many health care providers, strategic planning is still something meant only for large business enterprises, but it is equally applicable to organizations of all shapes and sizes. Strategic planning is really about the skill of matching the strengths of the organization’s operations to available opportunities. To do this effectively, top managers and their teams will need to set about collecting, screening and analyzing information about the current health care environment. This will help top management team’s in defining a clearer understanding of their businesses strengths and weaknesses and assist in developing a clear sense of mission, goals and objectives. Understanding the complexities of strategic planning usually involves finding the correct answers to complex problems by carefully researching and analyzing changes to the health environment first.
Strategic Planning Questions should involve the following considerations:
- With the government focus on reducing double digit price increases, maintaining proper patient safety standards and the use of Internet data, how will your organization handle these future shifts in funding?
- Knowing the demands of patients for transparent communications what action steps can management undertake to assure 3rd party payers that patient’s are receiving quality care?
Managing Disease Categories
- To better control costs of services we know care will be aggressively managed with HMO-type models, so do we have the infrastructure developed to respond effectively?
- Assumptions should include behavioral health services having to face greater pressures from managed care, receiving greater scrutiny from 3rd party payers and assuming more financial risk associated with patient outcomes. So, how should organizations expect to repond to these outside pressures? The question for 3rd Party payers is; “How can we effectively treat patients with chronic diseases; become much more efficient, reduce Inpatient stays, all while utilizing less resources?”
- Given the new Importance placed on standardization of care, where patients receive high quality services based on standard measures of appropriate medical care, will our programs be capable of meeting these revised, new standards of care?
- What action steps can we initiate now to assure that “Transparent Communications” will become one of the normative measures in patient satisfaction.
- Do we have in place both external & internal accountability criteria in evaluating patient services?
No Separate System for Substance Abuse
- From all indications, treatment of substance abuse disorders will no longer occur predominantly in a specialty services sector. Because patients in the future will find their care through primary medical care settings, how can we assure ongoing Patient referrals to our programs?
- Does the operations administrative and infrastructure support systems currently meet the equivalent standards required of mainstream medicine
- Dos the facility have the necessary infrastructure in place to accept private insurance, Medicaid or both?
Residential substance abuse treatment Changes
- As a residential Facility how do we remain successful when we’re going to be asked to continuously reduce admissions rather than continuously increasing them?
- With future reimbursements be targeted toward low cost outpatient service levels what operational changes will be required to tap into this new marketplace?
- While expanded funding for substance abuse services could increase in the short run, how will they become integrated into the mainstream medical health care system?
Consolidation vs. Expansion
- With Community Mental Health Centers actively gearing up to become FQHC accredited & expanding their SUD services, and survival of Stand-Alone” Treatment Centers threatened, what competitive strategies can substance abuse providers employ?
- In the short run does the ACA encourage financial opportunities for larger, better operated programs to move into the market, through acquisition of weaker players?
- If expansion of revenues is only possible through more efficient services and increased caseloads is this an opportunity for smaller programs to become better organized, more efficient multi-service organizations?
Move to a Medical Orientation
- If Patients must first find their care through primary medical care settings, then how will they find the necessary referrals through all the red tape?
- For rural treatment programs is it possible to meet Medicaid policy guidelines requiring substance abuse be covered as a clinic service be under direction of a physician directly affiliated with a clinic?
- With the impetus for development of Medical Homes, Community mental health centers may be motivated to provide more substance abuse services and integrated care, what is the best response to unbridled competition.
- Many Providers seeking to reduce costs and improve quality are building new relationships with payers to create payment models that reward value, how is your organization doing in this area?
- What new delivery models are being utilized to align incentives for lowering cost, and building higher quality systems of delivery?
- Can you effectively utilize collaborative care models such as ACO’s Health Co-op’s, FQHC’s and Primary Care services to build co-operative relationships between hospitals, primary care physicians, and payers?
Dependence on Government Funding
- In the future, will there be an increased reliance of the organization placed on Medicaid as the major funding source for health services?
- Realistically will the role of residential programs within the system of care be significantly reduced by the Affordable Care Act’s ACA’s) mandates? Maintaining existing public treatment programs at current levels would require continuing support from state’s reduced general revenue funds. Is this something programs can count on in the future?
- What are the effects of Medicaid programs on substance abuse treatment and how will the Affordable Care Act (ACA’s) requirements reimburse these types of services at parity?