Wishard Hospital core objective and mission is to serve the uninsured and poor of Indianapolis, Indiana in Marion County. The phenomenon has made it the only hospital in the region that can serve the vulnerable and the underserved who are termed as the indigent of the society. Most of the patients trickling into Wishard are jobless and cannot afford medical care. If they cannot be treated at the facility, they may have nowhere else to go because other hospitals concentrate more on patients with insurance and those that can afford. As such, most patients who flock into Wishard are indigent and those going to other healthcare facilities, if not an emergency, are also sent to Wishard.
Wishard ends up serving 800,000 patients per year whom 90% are from government programs with no insurance. Patients on Medicare and Medicaid are both on government programs. Medicare is a government program paying for patients over the age of 65 and under 65 if disabled. Medicaid is a program by the government for those without an income to access medical facilities. Most of the patients are also indigent and may not afford care. Apart from being there for the community, Wishard has a bed capacity of 492 while other hospitals within the county cannot match. The hospital also boasts of six community health clinics and a midtown community health center. These facilities have had the capability of serving many people in Indiana and cheaply.
Delegate your assignment to our experts and they will do the rest.
However, serving uninsured and indigent does not bring revenue to the table and Wishard has been straining for that matter. Unless it is a collaborative initiative, it may be too much for one hospital to handle (Bhatt & Bathija, 2018). The institution has been posting losses for the years 2002 to 2004 and if the predicament continues, the hospital might be forced to shut down. Therefore, the hospital may have the facilities to tend to many patients but they have not had the revenue to maintain the facilities. The facilities end up being rundown and looking old. The situation has made it possible for its direct competitors to benefit from paying patients who would have gone to Wishard but ended up going to other hospitals because Wishard facilities looked rundown.
Environmental Factors Impacting Wishard
One of the major environmental factors affecting Wishard is the physical appearance of the hospital. Wishard’s décor look old and poor while not all facilities are in working condition. The general outlook of the hospital keeps paying customers away as they would prefer going to better-looking facilities for healthcare. For instance, other hospitals have invested a lot in modern equipment and the appearance of the hospital. Patients tend to feel safe and, in an environment, that they could get better soon in such established hospitals. Without paying patients, Wishard is left in a precarious position when they do not have the revenue to maintain equipment and staff.
The situation is worsened when the government does not fully reimburse Medicare and Medicaid for the old and the poor. Also, the increasing number of patients without insurance or money to pay their bills does not help with the situation. Given the economic times, the economy around the world continues to rise and everything has to rise with it. The price of drugs, equipment, and staff wages goes up. Wishard can no longer afford to pay nurses and specialists pegged to the hospital. The result is that most of the staff and specialists would leave putting the hospital in the situation that it is not capable of serving patients. With no specialists, the special departments don't work hence face stiff competition from specialty hospitals and surgery centers because they appeal to better-paying customers. Wishard's investments in the stock market would have helped but the stock market is performing dismally too. Investment in the stock market was a better way to diversify their income but the stakes were high.
The hospital may have invested $700 million in equipment and décor but the investment was wrong because the hospital still did not receive paying customers. This is because change does not happen overnight, paying customers would have taken time to adjust. The hospital was better off starting a new facility in a different location targeting only paying customers who would have earned it revenue that could be used in the old hospital. The management somehow practised mindless competition.
Strategic Leverage at Wishard
Given Wishard’s capacity, it had strategic leverage over other hospitals and therefore could make a turnaround when the time was right. If the management were keen earlier, they would have been able to forecast their predicament and make changes early enough. The changes they would have made was to probably drop the emergency department. Wishard was a hospital with a mission to serve the uninsured and poor who could not afford medical services. Having patients not pay for essential services especially during an emergency put them back a few dollars. This is because it is not possible to compel a patient to pay when they have come in for an emergency.
If the hospital tries to compel the patients to pay before any service is offered, then they would rather not come to the hospital and have no medical care overall. The outcome goes against Wishard’s mission. In the case of emergencies, emergency cases in other hospitals can be treated. This way, the hospital is sending other hospitals emergency cases in the same manner that other hospitals send non-emergency indigent cases to Wishard. Therefore, shutting down the emergency department would help Wishard stop bleeding money.
The hospital prides itself to serving the poor, a situation that implies that the hospital is cost-effective. The matter of cost is strategic leverage against its competitors. Wishard also has the option of merging with another hospital. If Wishard's management had a clue about their strategic points, they would have had a better chance of leveraging them to turn around the position of the hospital (Putsis, 2020).
Being an old hospital, Wishard is strategically placed in Indiana. Any other facility would be lucky to merge and enjoy the access their patients can get. There is also the matter of space. A 492-bed hospital is quite huge. Lastly, Wishard could have gone into joint construction ventures with other hospitals. Location is key in targeting different kinds of demographics. A joint build on a children’s hospital or a cancer center would enter Wishard into specialization and have targeted paying or insured customers. It stands as a better move towards generating revenue to support the number that cannot afford medical care.
Societal Perception
The society is quite different. Perception by society is unique and business take advantage of society’s perception. The problem of having a stand-alone public hospital declaration that its mission is one of serving the poor has societal repercussions. For instance, most insured patients would avoid going to Wishard because they perceive it’s for the uninsured. Furthermore, paying customers would openly or unconsciously decide that the hospital l is for the poor and would not want to be treated there. A poor hospital may not have the facilities and staff to adequately handle able patients. Wishard was better of redefining its mission statement to a cost-effective hospital in order to attract paying customers. Then they can still have an under spot for Medicare and Medicaid patients. One arm should help drive the other.
Wishard’s option to change its mission statement is a strategy to change the perception of potential patients. It’s a new approach to changing people’s mindset from what they used to believe in something new (Mahmoud et al, 2019). Changing the mission statement will change the perception of staff too (Trybou et al, 2017). Therefore, Wishard could declare that they are changing operations and reflect it on the mission statement. They could say that they strive to give cost-effective treatment to their patients. The move is likely to change how patients perceive the hospital and begin attending.
Recommended Strategic Steps for Wishard
Wishard still has relevancy in the region. Closing down should not be an option. The first recommendation is to begin by redefining their mission statement then collaborating with another hospital preferably with a hospital that is nearby. Redefining their mission statement should target including everyone in the society rather than focusing on the uninsured and the poor. The objective is to imply that the hospital has changed direction and is now focused on a larger group. The collaboration will help with financial muscle whereby patients from another institution can be sent to Wishard and patients from Wishard to the other facility. This way Wishard can get more insured patients and those that are willing to pay. The move would boost revenue in the establishment.
Wishard should look for partners to build a new facility targeting demography that can afford specialized services. Once the facility is operational, Wishard can allocate a percentage of the revenue to cater to the uninsured in the old facility.
The recommended strategic steps are long term and Wishard would require a short-term solution to facilitate a faster turnaround. Firstly, the organization should incorporate a better financial analysis perspective when making an investment. Investments should be tied to the new mission and should make sense in what kind of revenue it is expected to bring. A sound approach is by benchmarking with other institutions (Ercan, 2015). Secondly, human capital management should be made to understand the hidden agenda to serve the uninsured and the poor. The hospital can also work with volunteers and non-governmental institution on the part of manpower. Thirdly, the hospital should use the power of social media to market and advertise its services.
References
Putsis, W. (2020). The carrot and the stick: Leveraging strategic control for growth . Toronto: University of Toronto Press.
Bhatt, J., & Bathija, P. (2018). Ensuring Access to Quality Health Care in Vulnerable Communities. Academic Medicine, 93 (9), 1271-1275. doi:10.1097/acm.0000000000002254
Mahmoud, A. B., Ekwere, T., Fuxman, L., & Meero, A. A. (2019). Assessing Patients’ Perception of Health Care Service Quality Offered by COHSASA-Accredited Hospitals in Nigeria. SAGE Open, 9 (2), 215824401985248. doi:10.1177/2158244019852480
Trybou, J., Gemmel, P., Desmidt, S., & Annemans, L. (2017). Fulfillment of administrative and professional obligations of hospitals and mission motivation of physicians. BMC Health Services Research, 17 (1). doi:10.1186/s12913-017-1990-0
Ercan, T., & Koksal, A. (2015). Competitive Strategic Performance Benchmarking (CSPB) model for international construction companies. KSCE Journal of Civil Engineering, 20 (5), 1657-1668. doi:10.1007/s12205-015-0733-1
