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PubMedDate not supplied

The IT system that couldn't deliver.

Diana Sullivan, CIO of Lenox Insurance, thought she had done her job when, after three years of hard work, she had delivered Lifexpress on time and on budget. A sophisticated computer-aided system, it enabled Lenox's 10,000-plus agents to do everything from establish a prospect's financial profile, to select the most appropriate products from the company's myriad policies, to generate all the paperwork needed to close a sale. But now Sullivan's boss, CFO Clay Fontana, seemed to be holding her accountable not only for the creation and implementation of the system but for realizing its business goals as well. And Lenox's CEO, James Bennett, appeared to concur. Two of Lenox's competitors had launched similar systems and were training their agents on them at a faster clip. Fontana and Bennett made it clear they believed it to be Sullivan's problem that Lifexpress wasn't boosting sales productivity as much as management had expected. "It's your system," Fontana had said. "We made this tremendous investment based on your recommendations." A 20-year veteran information systems executive, Sullivan knew going into this job that computers had never been one of Lenox's strengths. And she had taken what she felt were the appropriate steps to bring the company up to speed. In this hypothetical case study, Sullivan and the other top executives at Lenox must decide who should be responsible for realizing the business goals of information technology projects. Should Sullivan have gone about the project in another way? Should Fontana and Bennett be playing more active roles? Five experts weigh in with their advice for Sullivan and for Lenox's management.

Administrative Personnel↗
PubMedDate not supplied

An emerging niche market opportunity. Part I.

Society is split between a desire for access to quality health care and a reluctance, by some, to pay for it. Looking at this cost/access dichotomy historically enables one to recognize an emerging niche market--discriminating, affluent consumers willing to pay for better health care.

Consumer Behavior↗
PubMed1997

Building the dream team: don't make it a nightmare.

This article covers the often overlooked area of team management concepts through a discussion of what many companies have done to implement these new concepts successfully. It describes the basics of how to and also explains why people resist the process of implementation. The main topics are (1) team formation, (2) pitfalls to avoid, and (3) team measurement.

Conflict, Psychological↗
PubMedDate not supplied

The promise--and peril--of integrated cost systems.

Recent advances in managerial accounting have helped executives get the information they need to make good strategic decisions. But today's enterprise resource planning systems promise even greater benefits--the chance to integrate activity-based costing, operational-control, and financial reporting systems. But managers need to approach integration very thoughtfully, or they could end up with a system that drives decision making in the wrong direction. Operational-control and ABC systems have fundamentally different purposes. Their requirements for accuracy, timeliness, and aggregation are so different that no single, fully integrated approach can be adequate for both purposes. If an integrated system used real-time cost data instead of standard rates in its ABC subsystem, for example, the result would be dangerously distorted messages about individual product profitability--and that's precisely the problem ABC systems were originally designed to address. Proper linkage and feedback between the two systems is possible, however. Through activity-based budgeting, the ABC system is linked directly to operations control: managers can determine the supply and practical capacity of resources in forthcoming periods. Linking operational control to ABC is also possible. The activity-based portion of an operational control system collects information that, while it mustn't be fed directly into the activity-based strategic cost system, can be extremely useful once it's been properly analyzed. Finally, ABC and operational control can be linked to financial reporting to generate cost of goods sold and inventory valuations--but again, with precautions.

Budgets↗
PubMed1988

Standard planning for new programs.

Health-care executives need to eliminate "gut feel" decisions with a standardized approach to business planning, such as Baxter Healthcare Corp.'s Healthcare Business Planner. The author illustrates how University Hospitals of Cleveland used this model to determine the feasibility of an ambulatory center dedicated to systemic lupus erythematosus.

Decision Making, Organizational↗
PubMed1989

Analysis provides test for profitability of new services.

Breakeven analysis gives healthcare financial managers a tool for weighing the potential profitability of adding a new service. The method estimates profit or loss at various usage levels, showing at what level costs and profits meet. The analysis also lends itself to evaluating alternate courses of action, which may be compared to determine the best route to follow under various expansion proposals.

Cost-Benefit Analysis↗
PubMed1999

Mental health carve-outs: effects and implications.

To control the rise in expenditures and to increase access to mental health and substance abuse (MH/SA) services, a growing number of employers and states are implementing a "carve-out." Under this arrangement, the sponsor separates insurance benefits by disease or condition, service category, or population and contracts separately for the management of care and/or associated risks. A carve-out allows a unique set of managed care techniques to be applied to a subset of particularly costly or complex benefits. This article describes various carve-out models, discusses the potential advantages and disadvantages of a full carve-out, and summarizes recent public and private sector research regarding the strategy's effects on access and use, cost savings and shifting, and quality of care. It concludes by discussing approaches to the assessment and monitoring of the processes and outcomes associated with a MH/SA carve-out.

Contract Services↗
PubMedDate not supplied

Group practices say growth good but tough.

McManis Associates, a health care consulting firm, in conjunction with MGMA, sponsored the fourth annual roundtable for executives from leading medical groups across the country. This event is structured to capture key insights related to the success of medical group, with a special focus on medical group growth strategies. This article briefly profiles the roundtable participants and their organizations, summarizes the highlights of the discussion that took place and synthesizes the information into lessons learned that are applicable to other medical groups.

Catchment Area, Health↗
PubMedDate not supplied

Global theory and the nature of risk, Part 2. Towards a choice-based model of managed care.

Orthodox managed care depends on top-down, command and control techniques to squeeze efficiency out of the system. But for every unit of economic good this approach produces, two or three bad units come as result. The key to moving to an environment where value and efficiency become self-sustaining is to structurally recognize the medicoeconomic reality of medicine: the episode of care. The episode forms a natural unit of analysis that not only renders costs and outcomes information translucent and accessible, but it also forms the natural conduit through which premium dollars can find their optimal value. By bifurcating probability risk from technical risk and allocating them in the ex ante and ex post markets, respectively, health care insurers and providers return to their rightful economic roles, and to their appropriate fiduciary duties. And patients regain some semblance of reasonable sovereignty in managing their own medical affairs.

Consumer Behavior↗
PubMed2002

Profit opportunities still exist....in the operating room.

This piece is the first in a new series focused on improving profitability in the OR. Subsequent articles will present case studies, tools and best practices to help healthcare organizations improve resource management and increase profitability. The healthcare industry is at a financial impasse. While costs have increased, reimbursement has decreased. And just when the aging baby boomers are at the cusp of needing more care, the current nursing population is retiring, with too few new nurses to fill their shoes. Furthermore, healthcare organizations are experiencing the phenomenon of "profitless growth," a situation in which beds are full and resources appear to be fully utilized, yet profits are stagnant. Where can organizations focus to help close these gaps? The OR remains the single biggest opportunity. This project is a collaboration between McKesson Information Solutions and HFMA. The series will uncover hidden profit opportunities in the OR by focusing on three key areas: streamlining workflow, improving resource standardization and utilization, and integrating information and decision-making.

Financial Management, Hospital↗
PubMed1990

Case study: quality improvement in a diversified health center.

Hospitals are beginning to apply industry models of quality improvement to their own, very different, health care settings, and some are achieving note-worthy success. Rush-Presbyterian-St. Luke's Medical Center, Chicago, is implementing the total quality management process originally developed by Minnesota Mining and Manufacturing (3M) Co., St. Paul.

Chicago↗
PubMed1992

Whose responsibility is IT (information technology) management?

Line managers are increasingly assuming responsibility for planning, building, and running information systems that affect their operations. This is forcing organizations to evaluate how they allocate IT decision-making responsibilities. This paper describes a conceptual framework and an intervention process that can help firms devise and implement an effective IT management architecture. The authors illustrate their methods with real world examples.

Administrative Personnel↗