Solution
Robert answered on
Dec 26 2021
Introduction
Healthcare services are provided in a very dynamic and vi
ant system that is generally complex
and operational model are multilayered. The rapid changes that have been occu
ing in
healthcare management through daily processes, functions and activities increases the level of
complexity that the healthcare system deals with. Compounded effect of the complexity and
dynamism increases the risk involved in the healthcare system. Healthcare services are going
through transformation and managing these changes require managers to lay out a clear plan for
the need and scope of the plan, and also manage the process of transition in an effective manner
leading to sustainable results. The concept of change means ' a movement from one state of
eing or understanding to another' (Lioyd et al., 2004). According to Lioyd, in healthcare
organizations there are four levels of drivers of change, namely,
a) The Individual
) The Work Team
c) The Organization
d) The environment
The managers must be able to analyze the effect of change and its implementation must be in an
effective manner to minimize the risk. There are seven factors that needs to be analyzed
according to Lioyd “, structure, system, style, staff, skills and shared values and beliefs” (2004).
For the cu
ent project we would be selecting “OPTUM” as a healthcare organization which has
announced acquisition of Surgical Care Affiliates for $ 3.3 billion. This is the largest deal of the
first quarter, 2017.
About the Organization- OPTUM
“Optum is a health services and Innovation company”. The mission statement of the company is
“To help people live healthier lives and to help make the health system work better for
everyone.”
Optum is a part of UnitedHealth Group. The healthcare services provided by the Optum is
diversified including services to employers, care providers, governments, payers, life sciences
companies, etc. It serves its customer through three verticals:
a) OptumHealth
) OptumInsight
c) OptumRx
These units have specific work segments that are dedicated to improve overall healthcare system
y optimizing costs, increasing care quality, enhancing consumer experience and managing
healthcare performance through leveraged capabilities in analytics, pharmacy care services and
health care operations.
The market for healthcare services has become very competitive. Some of the major competitors
of Optum are HMOs, Managed Healthcare Companies, Insurance Companies, Healthcare
professionals that have formed networks, specialty advantage, population health management
companies, etc. Companies like Aetna Inc., Anthem, Kaiser Permanente poses tough competition
in the market place. The competition from new entrant also increases the competitive
environment. The competition is on basis of sales, pricing, products and services, customer
satisfaction, quality of services, network development, efficient distribution system, financial
dominance and reputation in the market. The failure in any area leads to loss of business and
eventually market share. It could adversely affect the financial strength and dominant position in
the marketplace.
Reasons for Organization Changes
Some of the major driving force for the organizational change at Optum can be related to latest
developments in business trends, Pricing trends and Medical costs trends.
Business Trends
Optum has businesses in United states of America, Brazil and certain other international health
care markets. If we consider USA, the spending on healthcare has been increasing consistently
over years. Healthcare in USA contributes to approx 18% of gross domestic products. The
expectation for future of healthcare system is to increase because of inflation, advancement of
pharmaceuticals, development of newer technology, regulatory requirements, changing trends in
demographic and interest of national government in health and well-being of citizens. However,
the market growth may be hampered by changes in macro-economic scenario of the country of
operations, regulatory changes etc.
Pricing Trends
Price of healthcare products are directly related to the costs involved in the manufacturing and
overheads. This varies differently in...