SWOT and Gap analyses are often used to assess organizational operations and performance improvement opportunities. Explain how a SWOT analysis is used in the strategic planning process and provide examples of how a gap analysis can be used to improve the quality of healthcare services.
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Essentials of Strategic Planning in Healthcare, Third Edition
Chapter 4
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Strategic Healthcare Management: Planning and Execution, Second Edition
Chapters 8 and 10
CASE STUDIES
1. Move to a Concierge Model or a Direct Primary Care–
Medicine Business Model?
Michael Glen runs the General Medical Clinic, a group of 22 primary care physicians in a
prosperous suburb of Philadelphia, Pennsylvania. He has held this position for just over ten
years and has seen many changes to the healthcare sector. The clinic includes a spectrum of
primary care providers, with six general internal medicine, six pediatricians, and ten family
practitioners. The clinic has prospered, and almost all the physicians have full or near-full
practices. However, in the past five years, expenses have continued to increase, while
revenues remained stagnant. Although compared to national standards the physicians appear
to make good salaries, their take-home pay has been flat over the past three years, and they
are concerned that it may decrease if healthcare reform proceeds. Currently, General Medical
Clinic’s primary care practitioners make about $190,000 per year, with some variation for
age, practice intensity, and other factors.
The clinic has billed insurance and sought to collect the difference from the patient or, if
the patient was uninsured, would seek to set up a payment plan. Its patient load consists of 25
percent Medicaid, 40 percent Medicare, 5 percent bad debt, and 30 percent commercial
insurance. Currently, it did not have any capitated contracts.
Michael recently attended a conference where he learned about concierge medicine and
direct primary care (DPC). The presenter noted that more and more physicians feel
overworked, revenues and salaries are flat, and many doctors spend more and more time on
nonclinical paperwork. Many primary care physicians, she reported, have begun to look for
practice options with alternative financial arrangements. Capitation has been one option, but
it has not been very successful for most primary care practices.
Concierge medicine and direct primary care (DPC) are two relatively new options that
could solve these problems, the presenter said. In concierge medicine, practices charge their
patients a flat fee (monthly or annually) for enhanced services and greater access. These
“enhanced” services usually include same-day access to the doctor, which might be done via
cellular phone or text messaging. Such practices often also provide online consultations;
unlimited office visits with no copayments; and free prescription refills, house calls, and
preventive care services. Most concierge medicine services also bill patients’ insurance.
The woman also described DPC, which, like concierge medicine, charges a monthly or
Walston, Stephen. Strategic Healthcare Management: Planning and Execution, Second Edition, Health Administration Press, 2018. ProQuest Ebook Central,
http://ebookcentral.proquest.com/lib/apus/detail.action?docID=6452271.
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L e a r n i n g O b j e c t i v e s
After you have studied this chapter, you should be able to
➤➤ integrate the various disciplines into a comprehensive framework to assess problems in
healthcare strategic planning,
➤➤ exercise strong managerial problem-solving skills using SWOT analysis,
➤➤ formulate strategy and implement change using gap analysis and force-field analysis, and
➤➤ discuss the multidisciplinary teamwork required to enable an organization’s leaders and
team members to efficiently implement change.
C H A P T E R 4
S W O T A N A LY S I S
I skate where the puck is going to be, not where it has been.
—Wayne Gretzky
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Harrison, Jeffrey P.. Essentials of Strategic Planning in Healthcare, Third Edition, Health Administration Press, 2020. ProQuest Ebook Central,
http://ebookcentral.proquest.com/lib/apus/detail.action?docID=6349384.
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K e y t e r m s a n d c O n c e p t s
➤➤ Bundled payment
➤➤ Churn rate
➤➤ Downstream value
➤➤ Force-field analysis
➤➤ Freestanding emergency department
➤➤ Opportunities
➤➤ Strengths
➤➤ SWOT analysis
➤➤ Threats
➤➤ Weaknesses
in t r O d u c t i O n
Healthcare organizations must continually adjust to ensure optimal performance. The rapid,
continuous, and unpredictable changes in the field accelerate the speed at which strategic
planning must happen for healthcare organizations that are adapting to these changes
(Johnson 2017). These organizations believe that strategic planning is critical and requires
the short- and long-term allocation of resources, the integration of geographically separated
organizations, and a team that can focus on a clear strategy. As a result, strategic planning
is evolving into a more continuous and integrated process. Strategic teams can use a variety
of techniques to determine where adjustments are needed. One essential technique involves
a discussion of an organization’s strengths, weaknesses, opportunities, and threats (SWOT
analysis). Originally designed for use in other industries, SWOT analysis is increasingly
being used in the healthcare industry (Gurel and Tat 2017).
To get the most out of its planning efforts, an organization, before beginning its
strategic planning, should have a panel of experts who can assess the organization from a
critical perspective and conduct a SWOT analysis. This panel could comprise senior lead-
ers, board members, employees, medical staff, patients, community leaders, and technical
experts. The panel members would base their assessment on utilization rates, outcome
measure
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