Strategic Plan Presentation

Background
Stevens District Hospital is a 162-bed acute care hospital that is qualified as a not for profit facility. The hospital was originally a county-owned facility and its status was transferred to an independent facility three years ago. The hospital receives no external funding from government agencies for operations. The hospital is accredited by The Joint Commission and received reaccreditation during their triannual survey last year. The hospital has an aggressive quality management program and a low volume of medical malpractice claims. The hospital is located in Jefferson City, which is a city of 50,000 with 80,000 in the regional market. The hospital provides a general range of acute care services, including medical/surgical, rehab, and emergency care.

Current Performance Analysis
Mission and Vision
Our mission: To improve health by providing high-quality care, a comprehensive range of services, and exceptional service.

Our vision: Stevens District Hospital and its affiliates will be the health care provider of choice for physicians and patients. Our five year vision is to create a large, multispecialty physician practice system that would include at least six family practice physicians and specialists in cardiology, oncology, and women’s services. Currently, the hospital employs three family practice physicians, one obstetrician, one medical oncologist, and one non-invasive cardiologist.

Previous Strategic Plan Review
Goal

Accomplishments

Increase market share by recruiting three family practice physicians.

The hospital was able to recruit only one family practice physician to increase primary care market this past year. The limited number of state medical school graduates makes local recruitment difficult.

Improve quality HCAPS scores in all six criteria to a baseline of the 85th percentile.

The hospital improved HCAPS scores in four of six criteria. Lagging elements in HCAPS scores are inpatient patient satisfaction and primary care patient satisfaction.

Market Forces Affecting the Hospital
Volumes
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44582093040563655147262924727284050001000015000200002500030000AdmissionER visitsDeliveriesSurgeriesVolume changes last year versus this yearLast yearThis year

Patients
The continued growth of chronic disease will require changes to the care management model.

Percent of Population by Age

Five Years Ago

Five Years From Now

Under 18

24

18

18 to 44

46

32

45 to 65

26

30

Over 65

4

20

More than 53 percent of residents have at least some college education, with just over 29 percent having an associate, bachelor’s, or graduate degree. More than 90 percent of residents have at least a high school diploma.

The average unemployment rate in the county is 9.9 percent:

Market share distribution percentage with a major competitor.

Five Years Ago

Last Year

Stevens District Hospital

48

35

Competitor

30

43

Out of County Hospitals

22

22

Patient Origin by Zip Code

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Increases in the percent of population with chronic disease and contributing factors will change significantly over the coming five years.

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Payment
There will be continued focus on pay for performance and increased wellness programs. The Affordable Care Act is creating more covered lives; however, there are often high deductibles.

The median household income for county residents is $59,548. On average, households in the county earn more than the state median household income of $44,446 and more than the national average of $53,650. The addition of a new automotive manufacturing plant to the local market this coming year is projected to add 1,500 production line jobs and 300 administrative jobs by year end. Median income for the production positions is estimated at $45,000 and will provide health, vision, and dental insurance benefits.

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Medicaid, 35%Medicare, 30%Commercial, 24%Uninsured, 9%Other, 2%

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As part of your review of this data, consider that a portion of the population will become Medicare eligible, the addition of manufacturing positions that include benefits will increase commercial insurance coverage, and changes from the Affordable Care Act will increase the number of patients in the market with insurance coverage.

Employers
There is expected growth in large employers with the addition of the automotive factory in the northwest sector of the county.

Physicians
The continued shortage of medical staff, especially in orthopedics, oncology, and primary care, will require increased recruitment efforts.

Competitors
Hanover County Hospital, which is the other hospital in the county, has an updated facility that has drawn more market share to its facility.

Competitor

Key Areas of Competition

New Programs and Facilities

Risk to Market Share

Primary Competitors

Hanover County Hospital

Facility upgrade

Quality scores

Significant renovation of core hospital to update aesthetics

Added new wide-bore MRI machine last year

Reaches the 95th percentile in five of six HCAPS categories

Drawing patients to newer facility

Accommodates heavier patients

Patient perception of higher quality and patient satisfaction

Medical Center in County South of Stevens

Physician clinics

Financial stability

E-visits with specialists

Low debt and high cash on hand

Drawing patients out of primary and specialty care at Stevens

Ability to cash flow projects

Secondary Competitors

Retail Pharmacy Instant Clinic

Low acuity office visits

Pharmacy added instant clinic in north end of county 6 months ago

Loss of patients from primary care physicians’ practices

Technology
A competing hospital has added e-visits for physician practices, which is causing a shift of patients to the competitor hospital’s physician practices.

Regulatory Changes
Health care reform through the Affordable Care Act has increased the number of patients with some form of insurance payment. These patients are now seeking care in greater numbers from a primary care physician. Stevens District Hospital struggles with accommodating patient scheduling requests to establish care with a primary care physician.

Plan
Planning Components Explanation
Goal

Objective

Actions

Definition

Organization goals that cover broad strategic issues, such as quality, finances, growth

Broad action items that address organizational goals, such as increasing market share, increased use of technology, increased physician satisfaction

Action item that meets an objective, such as implementing EMR, renovating physician lounge, increasing marketing for specific products

Examples

– Improve HCAPS scores by 5%

– Improve operating margin by 3%

– Increase market share in 96103 zip code by 5%

– Improve emergency department patient satisfaction survey by 5%

– Grow urgent care visits by 10%

– Implement urgent care center in north zip code

– Purchase tablets for physicians for EMR rounding

Measurement

– % increase in operating margin

– % change in market share

– % change in ED satisfaction survey

– % change in urgent care visits

– Number of patient visits at new urgent care center

– % increased use of EMR

Financial Summary

This year

Last year

Operating Revenues

Net revenues from services to patients

343,737,280

344,726,245

Other operating revenues

16,846,309

20,311,534

Total operating revenues

360,583,589

365,037,779

Operating Expenses

Salaries and benefits

192,053,379

182,853,245

Supplies and other expenses

130,173,477

135,560,131

Depreciation

18,969,799

20,644,157

Interest

2,695,623

2,226,437

Foundation

628,184

1,182,308

Total operating expenses

344,520,462

342,466,278

Income from operations

16,063,127

22,571,501

96101 is Stevens District Hospital zip code

94963 is major competitor hospital zip code

Projected Payer Mix 5-years

Current Payer Mix

Percentage of Population by Insurance

Copyright © 2017 by University of Phoenix. All rights reserved.

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96101 42%
93921 12%
92106 16%
94963 20%
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4458 5147
20930 26292
405 472
6365 7284
Last year
This year
Volume changes last year versus this year
Sheet1
Last year This year
Admission 4458 5147
ER visits 20930 26292
Deliveries 405 472
Surgeries 6365 7284
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0.35
0.3
0.24
0.09
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US Age Distribution 2010
Sheet1
US Age Distribution 2010
Medicaid 35%
Medicare 30%
Commercial 24%
Uninsured 9%
Other 2%
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0.15 0.26
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5 yrs ago
5 yrs ahead
Chronic Disease Predictions
Sheet1
5 yrs ago 5 yrs ahead
Obesity 15% 26%
Diabetes 5% 12%
Heart Disease 12% 22%