Instructions
ITC Health Delivery Initiatives in Rural Catan
HCL 731 - Financial Management
Instructions
Please enter your name below.
Name:
For this assignment, assume that you are Melissa Jordan, a financial analyst for ITC's newly-formed Rural Health department. ITC is working on the financial projections for its rural health operations. You have been
ought on by Mr. Surhoff because of your expertise in full costing and background in rate structure analysis. In this assignment, you will be given a series of messages from your supervisor with related tabs to provide your responses.
This assignment will follow the general flow given below.
1. Read itcMessage1 and read the information on the "1a.Background" and "1b.Definitions" tabs (orange tabs)
2. Read itcMessage2 and complete the "2a.CostDrivers" tab (blue tabs)
3. Read itcMessage3 and complete the "3a.Step-Down" tab (green tabs)
4. Read itcMessage4 and complete the "4a.RateStructureAnalysis" and "4b.Recommendation" tab (purple tabs)
When you have finished reading these instructions, proceed to the "1. itcMessage1" tab.
Where we go from here:
Case Presenters (Melissa Jordan) and Respondents (Mr. Ripken, VP of Finance for ITC Health): After preparing your analysis of ITC's rate structure, you will record a presentation with your recommendation of rate structure, including both advantages and disadvantages.
Presenters: You are presenting your recommendation and analysis to Mr. Ripken. Record a 2-4 minute discussion of your presentation.
Respondents: You are the asking questions or seeking clarification on points discussed in Ms. Jordan's presentation. You can respond with some of your own conclusions and analysis, and you also should pose 2-3 questions in response to the presenter's analysis.
The scenario was adapted from a case study of Access Health International. All numbers are fictitious and developed for instructional purposes only.
Source: https:
www.itcportal.com
usinesses/agri-business/e-choupal.aspx
1.itcMessage1
ITC Health Delivery Initiatives in Rural Catan
HCL 731 - Financial Management
Instructions
1. Review the itcMessage from Mr. Surhoff below.
2. Proceed to the "1a. Background" tab.
itcMessage1
From: B.J. Surhoff, Director, ITC Health Delivery
Sent: Wednesday, Fe
uary 20, 20X0 12:22pm
To: Melissa Jordan, Financial Analyst, ITC Health Delivery
Subject: Rural Health Pro Forma
Melissa:
It's great to have you on board! Please review the background information on our Rural Health Initiative ("1a. Background tab) and the definitions associated with the program's projected expenses and statistics ("1b. Definitions" tab). Enjoy!
I'll send some other information along shortly.
B.J.
1a.Background
ITC Health Delivery Initiatives in Rural Catan
HCL 731 - Financial Management
Instructions
1. Read the background information about ITC's Rural Health Initiatives below. The information below is the same as the "ITCRuralHealthCase.pdf," so you can refer to that document as well.
2. After reviewing the background, proceed to the "1b. Definitions" sheet
Background
In 20X0, ITC ca
ied out a need gap analysis in Sehore1, Madhya Pradesh (a state in central Catan) to better understand the realities of providing healthcare in rural Catan. Data were collected using a survey that covered 108 respondents and 78 rural healthcare providers in 27 choupals (villages). Analysis of the survey data reaffirmed the inadequacy of public health facilities available to the villagers; it also became clear that biggest challenge in accessing quality health care at an affordable cost was for villages farther than 11 kilometers from the town. People in these areas more often sought the services of a local private practitioner. However, of the 78 health practitioners interviewed, it was found that only 16 percent were qualified to practice medicine. Villagers expressed the need for health services with a greater focus on preventive services close to their homes.
Based on the gaps identified in the survey and visits to existing health care providers, ITC felt that their existing e-Choupal kiosk infrastructure, which focuses on agriculture, could be modified to deliver a range of health services and products. The existing agriculture infrastructure creates a farm-to-market supply chain made up of three tiers: village, town, and city. The first tier consists of the village level e-Choupal kiosks with internet access, housed and managed by an ITC trained local farmer and within walking distance (1-5 kilometers) of each target farmer. The kiosks enable farmers to report crop weights locally, rather than hauling their harvest into the nearest town (10-30km). Then, ITC tractors drive from a nea
y town to the villages and collect crop batches to
ing back to the town (hub of operations). In the town, the hub is an ITC facility where the shipments are measured, stored, and shipped to cities. In the cities, ITC distributes these crops to food producers and food packaging companies. The average population of a village is 775, a town is 31,000, and a city is 1 million or more.
For the rural health care delivery model, ITC could use its agriculture infrastructure in the villages and towns as the foundation for its operations. At the village level, preventive and primary level curative services could be delivered by a trained healthcare worker (called a village health champion). These services could be supplemented by basic diagnostics support, good quality medicines and a higher level of care by a medical professional at the hub level. For more advanced needs, ITC would establish a refe
al network via a telemedicine center at the hub that would connect to external healthcare providers. Health care delivery would be facilitated by leveraging the existing hub infrastructure with internet and video conferencing (for telemedicine), partnering with providers in cities for specialist care, and introducing health insurance. The three-tiered model would be supported by a robust supply chain for pharmaceuticals, supplies, and educational materials.
The first tier at the village level would be managed by a village health champion (VHC), who usually would be a female. The primary focus here would be on wellness and disease prevention. The VHC would be the first point of contact between the patient and the e-Choupal kiosk or other health care delivery infrastructure. The VHC would help with kiosk functions for villagers with literacy issues because basic health information and awareness would be dispersed through the e-Choupal kiosk. Also, each VHC would conduct a door-to-door health survey to enable the creation of a village health profile database, eventually enabling customization of services. Along with the two VHC functions, the kiosk also could ca
y health and well-being content and allow for relevant frequently asked questions to be monitored and responded to remotely by a doctor. Regular health camps conducted by visiting doctors would further enhance access to basic services such immunizations, preventive care, and early detection of curable diseases.
The second tier would consist of a health center (hub clinic) located in a town su
ounded by e-Choupal villages. The health center would be comprised of a primary health clinic, a pathology lab, and a pharmacy. A general practitioner, a pathologist, and a licensed pharmacist would staff the center. In addition, the hub providers of ITC would assist in various activities at the village level by providing educational reference materials at the e-Choupal kiosks. The hub clinic would also have a telemedicine center for tele-consultation with specialists located in hospitals in nea
y cities, as well as online training and learning modules for the hub administrative and clinical staff.
The third tier would consist of network partners including specialist doctors, diagnostic centers, tertiary care hospitals, and insurance companies. Telemedicine consultation would be used for specialty consultation on an as-needed basis. ITC will work to set up partnerships with secondary hospitals in the immediate vicinity of the hub for services such as maternity, basic surgical requirements and diagnostics not available at the clinic including hospitalization. Partnerships with health insurance companies would address the reimbursement of healthcare delivery. ITC would work as a facilitator involved in the execution of extended coverage programs.
For the model to take off, ITC required leverage of the established community network and its own physical infrastructure. The onus of providing high quality health care and training the required personnel would be paramount. Because financial sustainability of the initiative is critical, the clinic would need to determine the reasonable rate structure for services provided. Between 20X5 and 20X9 two pilots were conducted in the states of Madhya Pradesh and Maharashtra2.
1 Sehore is a district in Madhya Pradesh, central Catan and Sehore town being the headquarters of the district. The survey was conducted in the villages of Sehore.
2 State in the western part of Catan
1b.Definitions
ITC Health Delivery Initiatives in Rural Catan
HCL 731 - Financial Management
Instructions
1. Review the definitions of the expenses and statistics below. Feel free to refer back to this sheet during later steps in this exercise. You are NOT responsible for memorizing these definitions. They are for reference in this activity.
2. After reviewing these definitions, proceed to the "2. itcMessage2" tab.
Expenses and Statistics - Definitions
Expenses Definitions
Rent and Utilities Expenses associated with renting and maintaining the physical space occupied kiosks and clinics
Administration Salaries of corporate-level executives and staff that do not work at the clinics or the villages
Information Technology (IT) Expenses linked to maintaining internet connection to villages and ca
ying out telemedicine programs that allow for information transfer between kiosks and clinics
Training and Education (T&E) Salaries for trainers of new clinical and administrative staff and development of continuing education materials
Village Kiosk Access Expenses associated with the e-Choupal kiosks and salaries of VHCs
General Medicine Salary for 0.5 FTE of a general practitioner at the hub clinic and supplies associated with general medicine visits (Roughly half of the general practitioner's visits deal with adults)
Pediatrics Salary for 0.5 FTE of a general practitioner at the hub clinic and supplies associated with pediatric visits (The other half of the GP's visits are with children)
Laboratory Salary for 1 FTE of a licensed pathologist at the hub clinic and supplies associated with testing and diagnostics
Pharmacy Salary for 1 FTE of a licensed pharmacist at the hub clinic and pharmaceutical products for adults or children
Statistics Definitions
Salary Expenses Compensation for clinical and administrative staff members, like general practitioners, VHCs, executive director, and IT managers
Other Expenses Expenses associated with property, facility rent, equipment, and supplies
Total Expenses Sum of Salary and Other Expenses
Square Footage Total square footage covered by each department's facilities, offices, or kiosks
FTEs Full-time equivalent staff members associated with a department
Visits Total visits to a department or patient log-ins at a kiosk
IT Maint Hours Hours of IT maintenance required to build or repair infrastructure and programs for a department
T&E Hours Hours spent by T&E staff on orienting new employees and teaching continuing education modules for existing employees of a department
Kiosk Hours Hours spent by villagers at a kiosk researching information on general medicine, pediatrics, pathology, or pharmacy
2.itcMessage2
ITC Health Delivery Initiatives in Rural Catan
HCL 731 - Financial Management
Instructions
1. Review the itcMessage from Mr. Surhoff below.
2. Proceed to the "2a. Cost Drivers" tab.
itcMessage2
From: B.J. Surhoff, Director, ITC Health Delivery
Sent: Wednesday, Fe
uary 20, 20X0 12:26pm
To: Melissa