Health Organization Evaluation Essay Paper

Organizations are expected to operate in an optimum level. Nevertheless, the definition of an optimum level for any organization is not precise given that each organization is unique in its systems, structures and characteristics. There are questions about how to ensure that an organization is always high quality as the concept of organizational effectiveness is similarly imprecise. There have been suggestions about various standards of excellence and best practices for the different organizations irrespective of their line of business and customer focus. However, there is no strong consensus about these standards and practices. Yet, it is not enough to proclaim that none exists (standards and practices) such that organization evaluation is not worth the effort. Perhaps the benefit of conducting an evaluation is to learn more about the organization. Indeed, each organization is unique and its evaluation should similarly be customized. In conducting an evaluation, the focus remains on facilitating improvement by comparing actual performance to a standard of high performance and recommending changes that should be made in order to bring the performance up to the standard (Stufflebeam & Zhang, 2017). The present paper presents an evaluation report for the organizational structure of United HealthCare (UHC) as a health organization.

About UHC

UHC is a health insurance company that serves millions of customers in America with a focus on helping them live healthier lives and customizing the health system for their use. A public company that was founded in 1977, it is the largest single health carrier in the USA. As an insurance company, it offers health plans targeted at individuals of all demographics with each customer offered an opportunity to pick a plan that best fits their needs. In addition, the organization links customers to a list of providers (medical personnel) who have been vetted with the assurance of offering the required care covered under the benefits of their insurance plans. Besides that, the plans are flexible and reflective of the changing American society, particularly with regards to job loss that has become a common feature. Towards this end, it offers coverage after a job loss to help in feeling the coverage gap (United HealthCare., 2020a). Other than offering health insurance, the organization offers hospital and doctor indemnity insurance that is presented as a fixed-benefit insurance plan to help in supplementing traditional health insurance plans by paying a preset benefit amount for unexpected common medical costs. Also, the organization offers life insurance policy that provides financial security to loved ones in the event of death to help protect a family’s financial in the event that an earner dies. The policy features an optional critical illness benefits that pays cash benefits in case of a qualifying illness diagnosis. Additionally, the organization offers international travel insurance plans to emergency medical and emergency events for persons travelling outside the USA to include travel assistance and lost passport. Moreover, the organization offers supplemental insurance plans to help in handling emergencies that exceed the current plan (United HealthCare, 2020a).

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UHC evaluation

All insurance services offered by UHC are underwritten by Golden Rule Insurance Company, an ‘A’ rated company. The financial strength rating is conducted by A.M. Best Company (United HealthCare., 2020a). This is a global independent organization that was founded in 1899 and prides itself in being the world’s first credit rating agency. The ‘A’ rating is an indication that Golden Rule Insurance Company, and by extension UHC, has an excellent ability to meet ongoing insurance obligations (A.M. Best Company, 2020).

UHC applies a hierarchical organization structure. The leadership model groups personnel based on product (different insurance services), geography (USA and global operations), and function (operations, community, business development, human resource, communication, clinical services, legal, networks, compliance and so on) (United HealthCare., 2020b).

Recommendations for improvement

The evaluation reveals that UHC has engaged an ‘A’ rated insurance company as its underwriter. While partnering with an ‘A’ rated insurance company helps in improving trust between UHC and its customers, partnering with an ‘A+’ rated insurance company would be idea. An ‘A+’ rating indicates a company with excelled about to meet its ongoing insurance obligations thereby being more secure. This is an important consideration as the stronger the rating of the underwriter, the more likely that UHC will not experience financial failure and perhaps be unable to meet the needs of its customers. Health Organization Evaluation Essay Paper   It is important to note that A.M. Best Company carefully analyzed and evaluated the underwriter’s past, present and future financial performance before issuing the rating. Some of the key factors that were considered in the rating included management style, company structure, business focus, claims payment history, and financial reserves. Although UHC’s underwriter (Golden Rule Insurance Company) had a rating of ‘A’, this is not the best rating with the best rating offered by A.M. Best Company being ‘A+’. This is an indication that although the underwriter performed well with excellent results, some of its competitors had better performance with superior ‘A+’ rating. The difference between ‘A’ and ‘A+’ rating is considerable for customers who are looking for the best value in a health insurance cover. By engaging an insurance underwriter with ‘A+’ rating, UHC would become more appealing to customers who would consider it as a best performer in creditworthiness with an assurance of being around in trying and uncertain emergencies when needed most. Of course, although engaging an underwriter with an ‘A+’ rating is important in helping UHC to attract more customers, there are other factors that must similarly be considered to include overall customer satisfaction and best value for the price (Fevurly, 2013; Mittra, Sahu & Fischer, 2016).

The evaluation reveals that UHC applies a hierarchical organizational structure. The hierarchical organizational structure applies management layers to designate authority with each layer broken down into smaller management units. The lower units report to the upper units. This organizational structure offers one main advantage to UHC. There are clear job descriptions so that there is no confusion over who does what. This improves personnel motivation as they have specific goals to achieve. However, as a large company serving millions of customers with both USA and global operations as well as many products, a hierarchical organization structure is not suited for UHC. The structure has increased the distance between the customers and the management. Besides that, there is a lack of flexibility, a serious shortcoming in an insurance market as the company must respond speedily to market changes. Approvals and communications must travel through many levels thus making organizational change a slow process. This shortcoming is best addressed by applying a network organizational structure that decentralizes decisions and allows for flexibility. This structure allows for reliable partnership, and open and rapid communication both internally and externally. In addition, the structure is more agile as it allows for more control and bottom flow of decision making as well as fewer tiers (Andersson & Holm, 2010). In this respect, the evaluation reveals that UHC is likely to perform better by engaging an underwriter with a higher rating and applying a network organizational structure.

References

A.M. Best Company (2020). About us. http://www.ambest.com/about/

Andersson, U. & Holm, U. (2010). Managing the Contemporary Multinational: The Role of Headquarters. Edward Elgar.

Fevurly, K. (2013). Plan Your Financial Future: A Comprehensive Guidebook to Growing Your Net Worth. APress.

Mittra, S., Sahu, A. & Fischer, B. (2016). Practicing Financial Planning: For Professionals and CFP® Aspirants (12^th ed.). SAGE Publications Inc.

Stufflebeam, D. & Zhang, G. (2017). The CIPP Evaluation Model: How to Evaluate for Improvement and Accountability. The Guildford Press.

United HealthCare (2020a). Home. https://www.uhc.com/

United HealthCare (2020b). Our leadership. https://www.uhc.com/about-us/leadership  .  Health Organization Evaluation Essay Paper