Hospital Comparisons Understanding the Marketplace

1. Hospital Comparisons Understanding the Marketplace HCA 399 November 1, 2005

2. Hospitals Comparison Assignment • Introductory paragraph on hospitals visited. List names and titles of hosts. Give separate paragraph for each hospital to include other participants in the meetings. • Go on-line and get additional information: • Mission statements • Ownership information (e.g., HCA) • Where is headquarters to organization. • Describe similarities and differences. Analyze primary, secondary and tertiary service areas. Make sure to include any major affiliations that they may have. • Include the following table on the landscape chart on next page. You may attach additional pages as necessary. If you do not know the information requested, you may have to make some phone calls.

3. Hospitals Comparison Assignment • Summarize your table findings. • Other pertinent information you would like to include about the hospital. Among some of the topics you might want to address in this area are availability of emergency rooms, trauma centers, specialty areas, new construction activities, nursing shortage issues, etc. • Conclusions • Which, if any, of the hospitals interested you the most.

4. Service Area Competitor Analysis Define the Service Categories Define the Service Area and Create Service Area Profile Conduct Structure Analysis Conduct Competitor Analysis and Map Strategic Groups Synthesize Analyses

5. Consumer Determinants Service Type Usage Rates Brand Predisposition Preferred Image Personal Values Social Values Epistemic Values Past Experiences Personal State of Health Service Area • Location • Drive Time • Transportation • Parking Ease/Access • Convenience • Hours of Operation • Safety • Way-finding • Price Level • Image • Services Available • Service • Friendliness • Caring • Wait Time • Quality of Information • Phone Consults • Brochures • Instructions Market/Organization Determinants

6. Understanding Geographic Boundaries • Services may be in an entire area or region • May depend on the type of services provided to determine boundaries • Opportunities and threats may differ because of this • Service areas will be different for different organizations • Geographic boundaries may be subjective and based on several factors • Available technology • Patient history • Physician recognition

7. Structural Analysis: Forces Driving Service Area Competition Potential Entrants Threat of new entrants Bargaining power of buyers Service Area Competition Rivalry Among Existing Firms Suppliers Buyers Bargaining power of suppliers Threat of substitute products or services Substitutes

8. Potential Strengths Distinctive Competence Financial resources Competitive skills Image Acknowledged market leader Proprietary technology Proven management Ahead on experience curve Potential Weaknesses Lack of strategic direction Deteriorating competitive position Obsolete facilities Sub-par profitability Lack of managerial depth and talent Vulnerability to competition Weak market image Below-average marketing skills Unable to finance needed changes High overall costs relative to competition Vegas Area Competitor Strengths and Weaknesses

9. Role of Community Health Care Management Partners in Evaluating the Health Care Administration Practicum Chris Cochran, Ph.D. Associate Professor University of Nevada Las Vegas School of Public Health Department of Health Care Administration and Policy Nevada Public Health Association 2005 Conference October 13-14, 2005

10. Student Practicum Sites

11. St. Rose Dominican Hospital Market Development Plan for San Martin Preceptor: Vice President of Business Development University Medical Center Point of Service Policy for utilization of Emergency Department Preceptor: Chief Operations Officer UMC Fitness and Wellness Program Preceptors: Senior Associate Administrator; Manager, Workmen’s Compensation and Benefits Improving the Staffing Process Preceptor: Chief Nursing Officer NevadaCare Federal and State Legislation Tracking Preceptor: Director of Public Affairs Data Transfer Corruption Prevention Preceptor: System Administration Dir Boulder City Hospital Multi-Task Management Project: HIPAA Security Compliance and Physician Recruitment Preceptor: Chief Executive Officer Las Vegas Anesthesiologists Project Title: Developing a Risk Retention Group Kindred Healthcare Quality Improvement Activities and Quality Award ProjectPreceptor: Executive Director Sierra Health Services Quality Improvement and Research Developing the Baseline Assessment Tool for HEDIS Preceptor: QIR Manager Corporate Credentialing Project Preceptor: Dir. Of Credentialing MSN, RN Medicaid Dental “Insourcing” Preceptor: Senior Project Coordinator, Provider Services Veterans Administration Quality Improvement Research for the VHA Geriatric ClinicPreceptor: Martha Shaffer, Clinic Director Sunrise Medical Center Employee Retention Project Translation of Forms into Spanish Preceptor: Chief Operations Officer Westcare Nevada, Inc. Marketing the Community Triage American Cancer Society Project Title: Relay for Life Preceptor: Executive Director Dr. John Wechsler, Internal Medicine Financial Reconciliation of a Group PracticePreceptor: Practice Administrator Spring 2005 Student Roster and Assignments

12. Participants by Ownership Type • One of the unique characteristics about the Las Vegas environment is the large number of for-profit health care organizations compared to non-profit or government organizations. As the figure above describes, most of the student projects were in for-profit organizations.

13. Types of Projects

14. Program Requirements • Pre-Practicum Course • Introduction to the practicum through site visits. • Practicum Requirements • Daily and Weekly Diaries • Major Project Proposal • Environmental Assessment • Organizational Assessment • Major Project • Design a website Two Sierra Health Services HEDIS auditors are flanked by UNLV practicum students Erica Kanda (left) and Johanna Paderna (right) as the prepare their presentation.

15. Student Preceptor Course Each of the participants involved in the practicum experience participate in the evaluation process. Students are evaluated by their preceptor using a 10 measure job performance assessment. This evaluation is similar to many job performance evaluations. Faculty assesses the student’s performance using weighted scales to examine their work including the organizational and environmental assessments, the project write-up, meeting deadlines, and the maintenance of weekly progress reports. Students assess the practicum course, their preceptor, and the health care administration department. Evaluation Process

16. Frequency distribution of Preceptor Evaluations of Students, 2000-2005

17. Frequency distribution of Preceptor Evaluations of Students, 2000-2005

18. Preceptor Evaluation of Student Performance p<.05 N=92. Results based on 4-item scale (4=Excellent, 3=Good, 2=Fair, 1=Poor).

19. Jobs Offered to Students • One outcome measurement of a quality practicum is the assessment of how many students were offered jobs at their project sights. A comparison was made of students who completed a full-time practicum (those without prior health care administration experience). The analysis shows that the majority of students were offered a job at their practicum site. Only includes students completing full-time practicum, 2000-2005. n=64

20. University Medical Center Sierra Health Services St. Rose Dominican Hospitals NevadaCare Sunrise Hospital and Medical Center Boulder City Hospital Veterans Admin.of Southern NV Kindred Healthcare Lifecare Health Strategies Trans Health, Inc. American Cancer Society MountainView Hospital Insight Diagnositics Valley Medical Center Southern Nevada AHEC Nevada State Health Division Sultanate of Oman Health Ministry Mississippi State Health Department John Goodman and Associates Goldring Sleep Center Prison Health Services Pahrump Family Medical Center Lake Mead Medical Center Pacificare Westcare Nevada Incorporated Clark County Health District Nevada Anesthesiologists Southwest Medical Associates Nevada ENT, Associates Practicum Partnerships

21. Conclusions • Preceptor evaluations rate students high. • High performance evaluations are consistent with literature on employee performance. • Experience provides students with very good opportunity to secure employment with practicum sites.