middleboro business plan
DESCRIPTION
The Health Systems Administration program at Georgetown has its students complete case projects for a fictional community, Middleboro. Throughout the program we created several deliverables: Community Profile, Community Health Assessment, Strategic Plan, Marketing Plan, and Business Plan.TRANSCRIPT
Medical Associates
Jess i ca Jacobs . Karen Jose . Er in Lenhardt .
Veron ica Locke. Dan ie l Lynn.
Middleboro Ambulatory Surgery Center Business Plan FY 2010
Middleboro ASC
• Duplication of Jasper ASC
• Located within our Middleboro facility
• Satisfy community demand and organizational needs
Rationale: Progression of Organizational Goals
•Return to nurse-dominate staffing structure (as opposed to medical assistants)
CPI #1: Staffing Care Model
•EHR implementation to bill wider payer audience and compliance with Medicare reimbursement guidelines
CPI #2: Payor Mix •Clarify organizational structure of the surgical department: hierarchy and decision-making
CPI#3: Organizational Management
•Increase profitability and market share
CPI#4: Financial Growth
Rationale: Successful Jasper ASC
Rationale: Significant Increases in Demand
Demand: The Base Case
Base Case Calculations
% of Uptake
Total Current
Procedures
Total Uptake
Procedures
Middleboro Community Hospital
23% 3455 781.5
MA Jasper ASC 20% 3046 609.2
Total Procedures 6501 1390.7•Limit the initial base case from our Jasper ASC to 20% of existing cases
•60% of our 37.7% market share, for a total of 23% of MCH’s ambulatory surgery market
Demand: Projections and Utilization
Finance: Debt, Staffing, and IT
Debt Financing
• Borrow debt in two stages, once in 2010 and once in 2011.
• 8% Interest Rate
• This debt will cover: • Facility Modernization• Pre, Post, and Operative Suites• Recruitment Costs • IT Investments – including mobile
devices and imaging
Human Resources & IT
Human Resources: • HR structure will remain primarily the
same• Hire, in conjunction with our Jasper ASC:
– 9 RNs by 2013– 6 Surgeons by 2014
Information Technology: • Implement EHR approved by MA• Purchase flat screens and mobile
devices for all staff members
Finance: Expected Returns
Break Even Analysis
Time Breakeven 4.37 Years
Net Present Value
$ 102,900Horizon Value (2015)
$ 2,063,377Present Value (including Horizon)
$ 2,711,571
Internal Rate of Return 25%
Modified IRR 23%
Finance: Profit and Loss
Risk Management
External• Legal Risks
– Stark Laws– Anti-Kickback Laws– Anti-Trust Laws
• Ethical Risks– Middleboro Community
Hospital– Community Impact
Internal• Technology
– Interoperability– EHR in an ASC
• Personnel & Management– Staff Competency
• Patient Care– Infection Control– Sentinel Events
Risk Management
Probability of
Occurrenc
e
•Ethical risk – Relationship with Middleboro Community Hospital
•Cultural risk: phase-in of nursing model
•Interoperability of newer technology systems (iPad, flat screens, etc)•Personnel issues (hiring competent staff)
•ASC-tailored EHR system
•Inadequate patient care•Legal compliance•Financial – demand projections not realized
Impact of Risk
Implementation Timeline
Renovation and Investment of Suite A
Seek CMS Accreditation
Electronic Health Record Implementation
Organizational Restructuring
Recruitment of RNs
Recruitment of Physicians
Labor Investments
Investment of Suite B
Opening of Suite A
Opening of Suite B
2010 2011 2012 2013 2014 2015
Rationale: SWOT Analysis
Strengths• T
echnological advancement
• Community benefit
• Internal stakeholder benefit
• Debt financing
• Strong market position
Weaknesses• L
iquid capital
• Staff communication, ambiguous authority, and decision making
• Organizational management and need for knowledge, skills, and expansion management
Opportunities• N
ew and/or expanded service lines (orthopedics, cardiac services, and family practice)
• Market growth – expanded insurance coverage
• New payment & reimbursement opportunities
• Meaningful Use Incentive Payments
Threats• A
dversely impacted relationship with Middleboro Community Hospital
• Increased risk – debt, higher fixed, and variable costs
SWOT Analysis
Middleboro ASC
• Questions & Answers