Health Organization Evaluation

Organization evaluation is an important tool for improving management with a focus on change. Conducting an organization evaluation presents an awareness of the organization’s effectiveness in terms of achievements, problems and functioning from social and behavioral system points of view. Readiness for change is considered a critical precursor for ensuring that the organization successfully implements complex changes within a health care setting in response to the evaluation. Failure to establish sufficient readiness strategies could result in unsuccessful organizational change efforts. Drawing on models of change, such as Lewin’s three stage model of change, organizations can prescribe strategies for creating readiness for change and creating motivation for change (Schmets, Rajan & Kadandale, 2016). The present paper presents the results of an organization evaluation for United Healthcare.

Describe the health care organization or network.

United Healthcare (UHC) is an organization that is dedicated to modernizing health care with a view to driving distinct returns for the society. It focuses on developing a more effective, progressive and modern health system that provides significant value to the society by improving the quality of life and building healthier communities. This includes transforming health care by applying distinctive competencies in clinical excellence, technology and insights to reimagine health care on behalf of the communities that the organization serves. A key objective of the organization is to improve the value that health care consumers receiving by simplifying the health care experience, improving wellness and health, enhancing the quality of care received, and reducing the total cost of care (UnitedHealth Group, 2021).  Health Organization Evaluation Discussion Paper

UHC has adopted a unique business model that sees it act as a middleman to improve health care cost-effectiveness and efficiency. The organization generates its incomes from investment, sales on health care services and products, fees from various services, and premiums on risk-based products. Formed in 1974 as Minnesota-based charter Med Incorporated before changing its name to United HealthCare Corporation, the organization has made a name for itself by acquiring other competing healthcare providers, such as the online patient platform PatientsLikeMe that was acquired in 2019. Operating primarily as an insurer that provides health care coverage and benefits services, the organization serves more than 130 million clients spread across the world. In addition, it presents a range of products and services to include health care tools and equipment delivered via wholesale agents, direct sales or consultants (McFarlane, 2019).

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Describe the organization’s overall readiness based on your findings.

UHC is an organization that focuses on providing premium business services to all stakeholders in the health care ecosystem. It has introduced multiple innovations in its service and product portfolio to generate sustainable revenue sources. The strategic objectives that guide its revenue generating and diversification approaches are to improve the quality of care and reduce the cost of providing health benefits. In its more than 40 years of operations, the organization has had significant expansion and growth as a business entity. Over the four decades, the organization has expanded its business portfolio and reported increasing profits (UnitedHealth Group, 2021). Still, there are opportunities for the organization to grow and report higher revenues and profits. These opportunities are in the face of ongoing reforms in health care systems, especially those concerning adoption of medical technologies and increasing access to high quality health care at competitive costs. This is particularly true for the US health insurance industry that has seen substantial reforms seeking to increase the numbers of Americans with health insurance. In addition, there are health industry trends that can be turned into business strengths for the organization to include spreading out its business portfolio to cushion against market shocks, integrating care networks, growth opportunities, and an attractive health care market. The organization is targeting these opportunities for growth thereby indicating its overall readiness (DeNisco, 2020).

Prepare a strategic plan to address issues pertaining to network growth, nurse staffing, resource management, and patient satisfaction.

An evaluation of the business model applied by UHC reveals it is effective since the organization continues to grow its portfolio and report higher revenues and profits. However, UHC is facing significant competition from other health care organizations. The increasing competition makes a case for UHC business model and strategic plan to be revised and improved. One direction in which the organization can revise and improve its strategic plan is capacity building with a focus on appropriately assessing, planning and evaluating business activities. This includes assessing the existing health care needs that the organization can meet, and impact of its interventions on communities. This strategic plan would allow the organization to increase its portfolio and experience network growth, while improving resource management (Borkowski, 2016).

Identify any current or potential issues within the organizational culture and discuss how these issues may affect aspects of the strategic plan.

The business model applied by UHC is focused on making health care more accessible at competitive prices. This has seen the organization acquire and merge with other business entities. The acquisitions and mergers occur at the organization level to include management approaches and organizational cultures thereby enhancing trust and cooperation, and reducing disagreements. However, there is always a possibility of the mergers achieving less than ideal results. This occurs when the different management approaches and organizational cultures are unable to be merged thereby resulting in a dysfunctional business entity whose earnings and profits would reduce even as relations with the stakeholders and investors deteriorate. In addition, a dysfunctional merger would act as an indication of limited management control over operations and activities, causing the stakeholders to identify less with UHC and lack a shared awareness that would be necessary to identify what is important (Borkowski, 2016).

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.

Lewin’s three-step change management model is appropriate for implementing the strategy plan for UHC. The model simplifies change into three steps. The first step is unfreezing in which the problem is identified as a problem with the current strategic management approaches. Identifying the shortcoming helps to make the stakeholders aware that the existing management approach has failed and change is necessary. The second step is change in which the problem identified in the first step is addressed. This step leverages the available resources to make the change while engaging the stakeholders in contributing to the change by suggesting changes. The third step is refreezing in which the change is turned into new standard management practice for the organization. This final step is intended to stabilize the change (Zaccagnini & White, 2017).

References

Borkowsi, N. (2016). Organizational Behavior, Theory, and Design in Health Care. Jones & Bartlett Learning, LLC.

DeNisco, S. M. (2020). Advanced Practice Nursing: Essential Knowledge for the Profession (4^th ed.). Jones & Bartlett Learning, LLC.

McFarlane, G. (2019, Sept. 25). How UnitedHealth Group Makes Money. https://www.investopedia.com/articles/markets/043015/how-unitedhealth-group-makes-its-money-unh.asp

Schmets, G., Rajan, D., & Kadandale, S. (2016). Strategizing National Health in the 21st Century: A Handbook. World Health Organization.

UnitedHealth Group (2021). About UnitedHealthcare. https://www.unitedhealthgroup.com/who-we-are/businesses/unitedhealthcare.html

Zaccagnini, M., & White, K. (Eds.) (2017). The Doctor of Nursing Practice Essentials: A New Model for Advanced Practice Nursing (3^rd ed.). Jones & Bartlett Learning, LLC.

Research a health care organization or network that spans several states within 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:

1. this paragraph will have an Introduction. Be explicitly what you will be talking about.
2. Describe the UNITED HEALTHCARE organization or network.:Provide a clear description of the organization.
3. Describe the organization’s overall readiness based on your findings: In this section, you will provide an assessment of overall organizational readiness. This assessment needs to be very detailed and you need to use strong evidence and rationale to support the assessment.
4. Prepare a strategic plan to address issues pertaining to network growth, nurse staffing, resource management, and patient satisfaction: In this section, you will include a well-developed strategic plan.  Network growth, nurse staffing, resource management, and patient satisfaction are to be addressed in detail. The plan needs to be supported with strong evidence and rationale.
5. Identify any current or potential issues within the organizational culture and discuss how these issues may affect aspects of the strategic plan: In this section, you will address current or potential issues in the organizational culture. The potential impact of these on the strategic plan must be thoroughly described and supported with evidence and rationale.
6. Propose a theory or model that could be used to support the implementation of the strategic plan for this organization. Explain why this theory or model is best: In this section, you will propose a theory or model to support strategic plan implementation. The theory or model will demonstrate strong support for the implementation of the strategic plan for the organization. You must provide a compelling rationale that supports why the theory or model is the best choice.
7. Conclusion    .Health Organization Evaluation Discussion Paper