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Iora Strategy Project Final version (3)

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Iora Strategy Project Final version (3)

  1. 1. IORA STRATEGY PROJECT Conducted by Gates Associates, LLC, a business consulting firm composed of Jeremy Gates, Léa Serrano, Tiffanie Stamper and Zack Williford “Serving as strategic management for Iora Health’s expansion”
  2. 2. 2 TABLE OF CONTENTS Executive Summary – Gates Associates, LLC.……………………….......….…… 3 Meetour Team…………………………………………………………………... 3-5 About IORA Health……………………………………………………………...… 5 Executive Summary of IORA Health Project………………………………....... 6-7 Statement of Problem ………………………………………………………..……7-8 ProposedSolution………………………………………………………..…….…9-15 Conclusion…………………………………………………………………….…15-20 References……………………………………………………………………..…… 21
  3. 3. 3 ABOUT GATES ASSOCIATES, LLC Gates Associates, LLC, was established in 2016 in order to provide high quality professional services to businesses seeking innovative solutions that analyze, identify and address potential company issues or concerns. Our knowledgeable and passionate professionals collaborate in a synergistic environment that enables us to provide the upmost service to our clients and has caused our business model to thrive. We continue to deliver superior financial results to investors while contributing to the communities in which we live and work. Our professionals specialize in using their expertise and imagination as well as their creativity to seek ways to apply things that we, overtime, have explored in our professional experience. MEET OUR TEAM Jeremy Gates Senior executive with over 15 years of leadership and management experience in private and public sectors including, manufacturing, healthcare, government insurance and social service organizations. Developed and implemented staffing strategies and programs that improved operational outcomes and maximized the available staff resources. Extensive experience in human resource planning and operations, organizational change, team building, organizational effectiveness and facilitative leadership. Performed operational and organizational audits that aligned business requirements with staffing plans and processes to enhance
  4. 4. 4 teamwork, and team performance along with team creativity and innovation. Léa Serrano Consultant expert with over 15 years of professional experience in several countries around the globe. Fields of endeavor include but are not limited to business growth and development, marketing, advertising and branding, as well as employee management. Specialized in the restaurant and art industries, Lea Serrano brings her creative and innovative approaches to management styles to organizations all over the world. Traveling and experiencing different cultures is her biggest passion - something she puts to use during her consulting services in order to provide an international, diverse and insightful environment for any organization that seeks to be taken to the next level, all while remaining true to their brand. Tiffanie Stamper Accomplished and highly respected subject matter specialist in planning, developing and implementing customer operational strategies, contact center diagnostics, and business process reengineering efforts. Over 25 years of functional and consulting experience in the communications, defense, distribution, entertainment, financial services, health services, state government, transportation and utilities industries. Possesses excellent working knowledge of overall customer management processes, operational management processes, marketing, sales, order entry, distribution,
  5. 5. 5 collections, customer service, and face-to-face processes, as well as in recruitment, human resource development and training. Zack Williford Distinguished consultant with over 12 years of management experience in healthcare, private, not-for-profit, and international organizations. Specializes in customer service and employee participation. Previously led an organization into a profitable and stable international market business. Excited to share knowledge and gain new insight. ABOUT IORA HEALTH Iora Health is an innovative health care company that emphasizes a new team approach to primary care. Iora’s business model believes it can solve two major problems in America’s health care system: the first is misalignment of financial incentives and social issues that hamper people’s health. In their model, they provide care based on a flat fee per customer in contrast to the traditional piecework model that most providers use. They are treating the patient using a care team to ensure no one falls through the cracks and to provide not only medical care but also mental health and emotional support. They believe their rational approach can thrive off the money currently wasted in the health care system if successful expansion occurs using their current profit-making model (Sanger-Katz, 2015). EXECUTIVE SUMMARY OF IORA HEALTH PROJECT Referred by professor Mark Fitzgerald, Gates Associates, LLC and their most trusted business consultants were ask to provide an analysis concerning a specific organizational behavior problem that Iora Health is likely to face and our strategic management solution to that problem.
  6. 6. 6 Iora Health has retained our services in order to identify any potential organizational behavior problems within its company and to provide strategic management solutions to that problem. They have requested that we include clear action steps that can be taken by management to resolve this problem. Iora Health desires to expand all while keeping customer satisfaction in addition to profits at an all-time high. Iora’s expansion plan’s mission is to develop a standard formula and to allow its professionals to experiment and adapt to local conditions. They have requested that the company’s proprietary electronic medical records, the design of the consultation rooms and the daily huddle itself are not subject to change. Gates Associates created and managed a synergistic team in which all members played a significant role and made worthy contributions. Our synergistic team, gained insight into motivation, goals, values, personality, communication and work habits. We collectively identified useful tools such as useful assessments for employee selection, training, motivation, productivity and/or job assignment, and identified effective management tools to solve the specific business problem faced by the company in the case study: Iora Primary Care. Gates Associates, LLC. • Syngergistic team consisted of experienced professionals Corporate Analysis and Insight • Motiv ation • Goals • Values • Personality • Communication • Work Habits IORA Health • Will be provided a Performance Management System that will be useful for the following • Employee Selection • Training • Motivation • Productivity • Job Assignment/Transfer • These usefool tools will solve corporate problems and guarantee safe and successful development and expansion
  7. 7. 7 STATEMENT OF PROBLEM Iora has set organizational goals that it hopes to achieve in the medium-to-long-term future (Raymond, 2013). A main goal is to disrupt the current model of primary care delivery and to reduce health care spending by placing a greater emphasis on primary care which prevents costly emergency room visits and hospital admission along with fixing the inefficiencies that occur in traditional health care practices here in the United States. The founder Dr. Fernandopulle’s strategy is to take something small and effective and reproduce it in office after office (Sanger-Katz,2015) but in order to accomplish this you must seek to gain a competitive advantage through your employees and must be able to manage the behavior and results of all employees (Raymond A. Noe, 2013). Doing so will ensure that Iora’s current expansion strategy effectively and successfully transform the health care system throughout the United States in the ideas of its founder. After careful analysis and with extensive collaborations with human resources, our business consultants, as requested, have determined that Iora’s great ideals are feasible. However, implementing an unconventional practice throughout the United States will require strategic management. In today's competitive markets, organizations must engage in strategic planning to survive and prosper (Raymond A. Noe, 2013). Desire to expand • Pressure from corporate to comply to fixed and replicated rules Problems faced along the way • Disassociation betw een corporate desires and actuality of local environment and individuals at each IORA medial office location • Employees’ misalignment w ith organizationalgoals and objectives Decreased productivity
  8. 8. 8 We as your business consultants have thoroughly performed an SWOTanalysis and have foreseen a problem that will need to be address in order for Iora to transform health care. We will clearly address both the problem and the steps to liberate the foreseen problem. Here is what our research has shown. There have been several innovative and successful new primary care models, but few have grown beyond 1-2 clinics (Sanger-Katz, 2015). However, we see a key distinction that separates Iora from the rest. You have fundamentally changed your operating models. Your operating model is aligned with your business model, and that is – the “triple aim” of improving patient experience, clinical outcomes, and affordability of care – through its unique delivery model. Since you have provided such beautiful architectural work, we feel only right to provide you with a solution to get the best out of your constructors. IORA faces productivity issues that arise as expansion occurs in regards to the disassociation between corporate desires and the actuality of local environment and individuals at each IORA medial office location. More specifically, in order to solve the problem of the employees’ misalignment with organizational goals and objectives, Gates Associates, will organize and implement a performance management system favoring strategic congruency. Strategic management is a process, an approach to addressing the competitive challenges an organization faces. It can be thought of as managing the “pattern or plan that integrates an organization's major goals, policies, and action sequences into a cohesive whole” (Raymond A. Noe, 2013). In order to accomplish realignment, Gates Associates performance management system will provide a clear understanding of job responsibilities and expectations, which will result in increased productivity and better information available to corporate to use for training, job experiences, and developmental activities, thus allowing desired effective corporate expansion. It can also be used as a basis for compensation, pay increases, promotions, transfers, and assignments. It is imperative that corporate executives understand and apply this performance management system thoroughly in order to for it to be effective. This system will be overseen and managed by a corporate liaison who will be in direct contact with both corporate executives and employees at all IORA medical offices locations.
  9. 9. 9 PROPOSED SOLUTION With no other elaboration, Gates Associates is concerned about some productivity issues that may occur with regards to you expanding. We see this all the time. A company has great ideas. It works within their current chain of stores, so they seek to expand. Attempting to manage the additional store or facility they lose sight of their original ideas because it’s a lot tougher communicating and tracking nonnegotiable job requirements in facilities in an expansion mode than in your current state. Thus, as Professor Milstein points out, running one unconventional practice and keeping it great is very different from running 100 (Sanger-Katz, 2015). In continuation, by this being an unconventional practice, our business consultants are concerned that a dissociation between corporate desires and actuality of local environments and individuals will eventually occur as Iora expands into new territories and opens new medical offices. We are proposing a solution in the form of a strategic congruence plan that will increase productivity and prevent this dissociation from occurring. A strategic congruence is the extent to which a performance management system elicits jobs performance that is congruent with the organizations strategy, goals and culture (Raymond A. Noe, 2013). Since Iora’s emphasis is on its unique delivery model that is centered on monthly fees as opposed to the conventional way of billing patients, we have put together a plan that focuses on those important elements. Our plan encourages workers to positively view those elements by implementing a reward plan that encourages those behaviors. Our plan increases productivity, prevents employee misalignment, and could save you money because our performance management system provides for clear understanding of job responsibilities and expectation that can be implemented on a large scale. Our plan facilitates Iora’s ability to transfer something small and effective and reproduce it in office after office. In addition our plan can also be a basis for pay increases, promotions, transfers, and individual assignment rewards. We have laid out the particulars, and it is imperative that corporate executives understand and apply this performance management system thoroughly. In order for
  10. 10. 10 this performance management system to be effective, this system will be overseen and managed by a corporate liaison who will be in direct contract with both corporate executives and employees at all lora medical offices locations. Our plan is centered on Iora’s care teams’ expectations. A team of a doctor or nurse practitioner, nurse, behavioral health specialist and a health coach works with each person. They set goals with the patients, enabling them to become active participants in their own well-being. They should know people by name, but more importantly by their dreams, fears and challenges (Iora Health, 2016). “We believe it’s easier for patients to manage their lives when mental health is also prioritized and seen as integral to one’s overall health. At Iora, our patients can access their own behavioral health specialist in the comfort and privacy of their doctors’ office (Iora Health, 2016). Individual team members also have goals:  Doctor/ Nurse practitioner: Individual clinical assessments of each patient through examination and communication to provide medical health goals.  Nurse: Cares for patients, administers medicine and supports communication between doctors and patients.  Behavioral health specialist: Provide short-term counseling, assessments and referrals, as well as consultation to other team members.  Health coach: Build relationships between the patients and their care teams by connecting deeply with patients by becoming their confidants, cheerleaders, and friends (Iora Health, 2016). Care Team Doctor/Nurse Practitioner Nurse Behavioral Health Specialist Health Coach
  11. 11. 11 CARE TEAM PLAN Patient satisfaction is determined based on three factors: How the patient rated their provider, how much time they felt the provider spent on them, and how well their health care goals were discussed. If a team exceeds the patient satisfaction (average of three percentages on website) IORA’s average of 80%, then the patient care team will receive a team dinner within one week of the quarterly Elements of Strategic Congruency Plan to be oustandingly met by Care Team Patient experience and satisfaction Reward>80%= Team Dinner Iora Avg > Performance = Corrective actions Industry Standard > Performance= Termination, Job Transfer, Assighnments, reduced Engagement Reward>25%= Non-Financial Iora Avg > Performance = Corrective actions Industry Standard > Performance= Termination, Job Transfer, Assighnments, reduced Access Reward> Iora's standards Non-Financial Iora Avg > Performance = Corrective actions Industry Standard > Performance= Termination, Job Transfer, Assighnments, reduced Clinical outcomes Reward> Iora's Standards Non-Financial Iora Avg > Performance = Corrective actions Industry Standard > Performance= Termination, Job Transfer, Assighnments, reduced Coordination of care Reward> Iora's Standards Non-Financial Iora Avg > Performance = Corrective actions Industry Standard > Performance= Termination, Job Transfer, Assighnments, reduced PROV IDER RA TING OF 9 OR 1 0 SA ID PROV IDER A L WAYS S PENT ENOUGH TIME DISSCUSED HEA L TH CA RE GOA L S 18% 35% 21% 75% 89% 77% PATIENT SATISFACTION Industry Standards Iora Averages
  12. 12. 12 report, which increases corporate morale and increases employee satisfaction and motivation. If performance falls below IORA averages/standards corrective actions in the form of developmental activities and training will take place. The consequences if performance falls below industry averages/standards could be termination, job transfer, additional assignments, or reduced compensation. If a team’s patient engagement exceeds Iora’s average of 25%, a non-financial compensation such as recognition that leads to increased motivation and employee satisfaction will be rewarded. If their performance falls below Iora’s averages/standards, then corrective actions will be implemented in the form of developmental activities and training. The consequences if performance falls below industry averages/standards could be termination, job transfer, additional assignments, or reduced compensation. If as a team they provided their patients access to useful resources, produced clinical outcomes or had coordination of care that exceeds Iora’s averages or standards then a non-financial compensation such as recognition that leads to increased motivation and employee satisfaction will be rewarded. If their performance falls below Iora’s averages/standards, then corrective actions will be implemented in the form of developmental activities and training. The consequences if performance falls below industry averages/standards could be termination, job transfer, additional assignments, or reduced compensation. If a team manages to achieve the quarterly bonus reward for all 5 elements of our strategic congruency plan, across three consecutive quarters an additional bonus may be rewarded in the form of 3 extra paid days off that can be taken at the individual team member’s discretion. 2% 25% 0% 5% 10% 15% 20% 25% 30% INDUSTRY AVERAGE IORA Patient Engagement Industry Average Iora
  13. 13. 13 INDIVIDUAL TEAM MEMBER PLAN An individual team member’s performance assessment is based on provider ratings, time spent with patient, and discussed health care goals. This information is received by the corporate liaison and is provided through customer surveys. If a team member’s patients rate them a 9 or 10 for the quarter then that member will receive recognition in their practice and receive a small financial incentive such as a gift card or voucher. If the member is rated a 9 or a 10 throughout all four quarters the team member will receive an end of the year bonus according to team member’s merit. If a team member is a 6 or 7, they will receive training in order to prevent member from falling below average. If member is rated lower than a 5, member will receive warnings that can result into termination if performance does not improve over time. Individual team members will receive recognition in team huddles and entered into special drawings for financial incentives if their time spent with patient exceeds Iora’s standards. If member is at or falls below Iora’s average then they will receive training in direct relation to level of customer satisfaction concerning time spent with their patients. Meaning the higher the score the less training, the Individual Team Member Performance Assessment Provider rating Time spent with patient Discussedhealth care goals
  14. 14. 14 lower the score the more training the team member will be required to attend. Consequences if member falls below healthcare industry average is verbal warning with additional training and if continues across multiple quarters may result in termination. The reward for team members who discussed health care goals with their patients and exceeded Iora’s standards will be recognized in team huddles and entered into to win special financial incentives in the form of a drawing. If a member is at or falls below Iora’s average they will receive training in direct relation to level of customer satisfaction concerning health care goals. Meaning the higher the score the less training, the lower the score the more training the team member will be required to attend. Consequences if member falls below healthcare industry average is verbal warning with additional training and if continues across multiple quarters may result in termination. CORPORATE LIAISON We also more clearly defined the corporate liaison’s responsibility within and outside the organization. The corporate liaison will work from Iora’s existing headquarters where they will provide technical, staffing, and operations support to practices across the country. The liaison will go into branches when there are specific problems to be dealt with that have been consistently reported to corporate and resolve them, as well as evaluate corporate performance standards. Based on these standards, they will be able to enforce the rules of the congruency plan. CONCLUSION Interpretation of Findings In supposition, Iora an innovative health care company that emphasizes a new team approach to primary care seeks our expert advice as they expand. Moreover, Iora’s goal is to disrupt the current models of primary care delivery and reduce health care spending by placing a greater emphasis on primary care to prevent costly emergency room visits and hospital admission. Iora seeks to accomplish this by aligning
  15. 15. 15 their business model with their operational model, which is – the “triple aim” of improving patient experience, clinical outcomes, and affordability of care – through its unique delivery model approach. With that approach, Iora seeks to fix the inefficiencies that occur in traditional health care practices here in the united states by taking something small and effectively reproduce it in office after office, which in theory would solve two major problems in America’s health care system: the first is misalignment of financial incentives and social issues that hamper people’s health. In their unique business model, Iora provides care based on a flat fee per customer in contrast to the traditional piecework model that most providers use. Iora’s aligned business model allows its care team members to fully focus on its patient, and provide a service that is incomparable to the less stellar practices provided through traditional practices. Implementation of Findings To better understand the Iora’s expansion leading mangers and Iora’s operational managers’ ability and limitation we had all managers answer a few self-assessments which can be found in Stephen P. Robbins Self-Assessment Library “Insights into your skills, interest and abilities”. These assessments give insight on Iora’s abilities to expand while keeping their “triple aim” approach. We chose the assessments which would be the most helpful and aid our business consultants in customizing our solutions plan to the strength of Iora’s employees. Here are those assessments:  How good am I at disciplining others? (Page 62)  This test is used to provide insight into how effective a person might be in practicing discipline in the work place (Stephen P. Robbins, 2012). It contains eight disciplining practices, managers needed to read the statements and select the answer that best described them. They were asked to respond as they have or would behave and not as they think they should behave. (Stephen P. Robbins, 2012). The following scale was used to express their response: 1= Usually, 2= Sometimes, 3=Seldom.
  16. 16. 16  The ideal manager that provides effective discipline would provide ample warning, act in a timely fashion, use a calm and serious tone, be specific about the problem, keep the process impersonal, and use disciplinary action that is progressive and consider the circumstances (Stephen P. Robbins, 2012). An ideal manager would score 22 or higher, with anything below 19 possibly needed additional training.  Results: Iora managers scored an average of 18 and this means that on average managers in an Iora health care facilities do not have the best practices for disciplining its employees on a local level.  Based on these results our business consultants felt strongly that Iora needed an outside contact to provide training and support on a regular basis to branch managers. These support task would include technical, staffing, and operations support. This translated into the corporate liaison position we recommended to Iora.  How good am I at building and leading a team? (Page 64)  In this test managers used a rating scale to answer 18 questions on building and leading an effective team. The following scale was used: 1= Strongly disagree, 2= Disagree, 3=Slightly disagree, 5=Agree, 6=Strongly agree (Stephen P. Robbins, 2012).  This assessment assumes that teams develop in 5 areas: diagnosing team development, managing the forming stage, managing the conforming stage, managing the storming stage, and managing the performing stage. The results can estimate where a manager is compared to others with the top quartile being 95 or above and the bottom quartile being below 60 (Stephen P. Robbins, 2012).  Iora’s managers scored an average of 84 and this means they know how to build effective teams, which will be extremely important as Iora expand. According to Robbins & Judge, 2012 a team generates positive synergy through coordinated
  17. 17. 17 efforts. The individual efforts result in a level of performance greater than the sum of those individuals inputs making it extreme important that Iora continues to increase its abilities to build such great teams as they lead and build new established care teams throughout the expansion process.  Based on these results Gates associates wanted to encourage the teams to continue to work with excellence and strive to be better as a whole. We built into our congruency plan specific rewards and consequences to the patient care team based on their team performances.  How confident am I in my abilities to succeed? (Page 102)  Managers were to indicate the extent in which they agreed or disagreed to 8 different statements. The following scale was used: 1=strongly disagree, 2=disagree, 3= neutral, 4=agree, 5=strongly agree (Stephen P. Robbins, 2012).  People who are confident have high-self efficacy that generalizes across a variety of situations (Stephen P. Robbins, 2012). Confidence or lack of it can have influence on many things we do (Stephen P. Robbins, 2012). The scores on this assessment can range from 8 to 40, higher the score, high the confidence you have in yourself to be successful.  Iora’s managers scored an average of 34. Meaning although you have some outliers the group as a whole are confident individuals.  The goal of Iora to expand means it needs confident individuals to make up their patient care teams. A confident individual will set goals for themselves and push harder in the face of failure. One other key feature of a confident person is even when they receive negative feedback they respond by increasing their effort and self-motivate to do better (Stephen P. Robbins, 2012). If an individual is not confident it doesn’t mean they
  18. 18. 18 cannot become more confident. Managers can use trainings and tasks to increase confidence in a team member.  Using information gathered through this assessment about Iora’s existing managers and about the role confidence plays in an individual’s ability to succeed we came up with our congruency plan concerning the individual members of each patient care team. Recommendation from Findings Strategic Congruency Plan • Rewards and punishes care team based on their perf ormance in core areas of IORA's expectations and high standards: • Patient experience and satisf action • Engagement • Access • Clinical outcomes • Coordination of care Implementation • Encourages workers to positiv ely v iew the abov e-mentioned key elements by implementing a rewards plan that encourage those behav iors • Indiv idual perf ormance rating will be based on: • Prov ider rating • Time spent with patients • Discussed healthcare goals Increased Productivity • Prev ents employ ee misalignment • Increase corporate morale • Sav es money
  19. 19. 19  Strategic congruency plan- the extent to which a performance management system elicits jobs performance that is congruent with the organizations strategy, goals and culture (Raymond A. Noe, 2013).  It rewards and punishes a care team based on their performance in core areas of Iora’s expectations and high standards: o Patient experience and satisfaction o Engagement o Access o Clinical outcomes o Coordination of care  Individual performance rating will be based on: o Provider rating o Time spent with patients o Discussed healthcare goals the appropriate actions Rewards/consequences.  Implementation of the corporate liaison - Because Iora’s managers on average scored less than what we would have liked to have seen, we have determined that one of the requirements for the corporate liaison position is to have scored a 22 or more on “-How good am I at disciplining others”? Assessment because he or she is to oversee and manage our entire congruency plan. The corporate liaisons will be in direct contact with both corporate executives and employees at all Iora health locations.  Reward system-is a strategic tool that will motivate Iora’s employees to willingly meet Iora standards. According to Robbins & Judge, 2012, motivation is the process that accounts for an individual’s intensity, direction, and persistence of effort towards attaining
  20. 20. 20 a goal. Our rewards plan was implemented to incentivize employees that met or exceeded company standards, which eludes any misalignment between corporate desire and individuals as you seek to expand.  It highly favors representative participation. According to Robbins & Judge, 2012 representative participative is goal that redistributes power within an organization, putting labor on a more equal footing. Thus, ensuring that your doctors continue their rolls as intended by you and ensuring they don’t become too dominate. We recommend that every detail in the above-mentioned plan be followed as laid out. Following our strategic congruence plan will lead Iora to competitive advantages such as:  Prevention of employee misalignment (Resulting in increased productivity)  Increase corporate morale  Saving of money REFERENCES Iora Health. (2016, March 10). Retrieved from Restoring Humanity to Health Care- Iora Health: http://www.iorahealth.com/ Raymond A. Noe, J. R. (2013). Human Resource Management: Gaining a competitive advantage. New York: The McGraw-Hill Companies. Sanger-Katz, M. (2015). Company Thinks It Has Answer for Lower Health. The New York Times, 9. Stephen P. Robbins, T. A. (2012). Essentials of Organizational Behavior. New Jersey: Pearson.
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