Executive Summary:
One of my business plans is to set up a Behavioral Healthcare
company to focus on developing our customers' emotional and
mental health including their thoughts, feelings, and experiences. The
target would be to provide low-cost behavioral health services
alongside primary care.
The Center will focus its services and market activities on Spokane
areas which will include psychotherapy, psychopharmacology &
substance abuse/addiction services. My aim is also to introduce a
similar online healthcare application under the company to provide
instant services and consultation for people in areas other than
Spokane or for old patients. Through the online platform, patients
can access their information through unique ID and can receive
recommendations & counseling from providers. The online platform
will give them the opportunity to explore a wide variety of
treatment options suitable based on the lifestyle and symptoms.
After the selection, the members can book appointments online and
have access to a broad range of mental health services.
Target Market:
The target customers are the consumers of mental health services
(ie. Individuals, couples, families & groups). The composition
breakdown is approximately 50% adults & 50% children, adolescents
& families.
Aim & Revenue Generation:
The aim would be to support the total health and wellness of
individuals by providing collaborative care as a part of integrated
healthcare teams through consultation, counseling, education, and
advocacy.
The revenue system would follow a process called ‘Revenue Cycle’- a
process that tracks revenue from the moment the patient engages
the healthcare provider to the point when the payment is made for
specific service. Revenues are aimed to obtaine from both private and
public sources. The business will typically follow ‘Value Based Care
Model’ which ties the amount healthcare providers earn for their
services to the result they deliver for their patients such as quality,
equity, and cost of care. The reason to follow such a model is to
place more accountability on the service providers for improving
patient outcomes while also giving them greater flexibility to deliver
the right care at the right time. There will be an opportunity to
incentivize or reward the providers with various inter-related goals
and an outcome to forfeit bonuses or lose a portion of their payment
if the goals are not met. The providers may earn more or avoid
penalties if they reduce or maintain costs. No discrimination would
be made against race, gender, and income.
Employees and Gross Revenue:
The business is aimed to be started with 20 employees with 1.2 M
with a target revenue of 4.9M. The aim is to support the total health
and wellness of individuals by providing collaborative care as a part
of an integrated healthcare team through consultation, counselling,
education, and advocacy. The priority is to provide the best care at
low cost.
Expectations:
•
•
•
•
Assuring strong administration responsible for day-to-day
operations
A signed and dated commitment to maintain patient
confidentiality in accordance.
Providing the parent/guardian of adolescent or teenage patients
with written notice regarding all available treatment options.
Obtaining a signed acknowledgement by a guardian that they
receive both verbal and written notice.
Like many businesses management, the above stated field is also not
free from challenges. Some of the issues to consider here are as follows:
*Cybersecurity: It is known that how healthcare sector is at
increasing risk of cybersecurity breaches. It gives the attackers the
opportunity to reap staggering profits by selling confidential data
since a single medical record is valued at $250 on the black market.
It harms the organization's reputation, business continuity and
patients' lives. It can turn into severe lawsuits due to the inability to
comply with privacy and security requirements.
To reduce the threat of such challenges, the plan includes appointing
a Chief Information security officer (CISO) in place to make executive
decisions about the cybersecurity program. Moreover, steps such as
Backup & Restoration, encryption, Intrusion Detection & prevention
system, Mobile devise management and training awareness will be
included in administration management.
*Financing, insurance & claims management:
In the growing era of increased health cost, claim management
acquires a highlighting aspect in healthcare industry. Effective claim
management with a focus on payment and processing, also focuses
on improved strategies and better customer interactions.
The plan includes processing of claims and insurance through claim
management software aiming for simply accessing healthcare data
of patients through cost-effective automated billing. This will help to
deliver accurate bills, generate less room for administrative errors,
fewer insurance claims denials, invoice tracking, and enable speedier
payments. All these services are included to boost accuracy and
efficiency.
Event & Incident Management:
The plan includes systems to report incidents and events through fire
alarm and using incident management software. The software allows
all employees to report a near incident quickly by filling out an
online form that can also be accessed on mobile devices. The
software gives access to all kinds of incidents such as infection,
wrong medication, or aggression towards staff. The advantages of
these applications are that only relevant questions will be shown.
This way the user does not have to ponder through irrelevant
questions. It will allow anonymous reporting and no double data
entry. A draft version can be saved.
Our marketing plan is aimed to focus on the following contents:
1.Target Audience:
Our target customers of this program will be those with private
insurance and uninsured self-paid individuals and families. Inclusion
of sliding fee in the plan will help to charge patients with products,
services or taxes based on the customer’s ability to pay. Medical
services including the Substance Use Program will be available for
adults, children & families.
The plan extensively includes promotion and mention of compliance
with the laws of Drug Enforcement Administration (DEA) & the Food
& Drug Administration (FDA) to regulate the creation and distribution
of medication. It is an attempt to work in ensuring the safety and
efficacy of medications, biological products & medical devises.
Following the rules of FDA, the proposal includes the regulation of
disseminating the public with accurate and science-based
information and evidence.
2. Goals & Mission:
Our healthcare program is aimed to adopt the ‘Triple Aim’ system
with a goal to alleviate rising health care costs & pressure to deliver
more value despite aging populations & chronic mental health issues.
The framework emphasizes the interdependence of three following
goals:
*Reducing Costs: Our foremost aim to reduce costs aligns with the
Health Care Affordability Act which focuses on lowering healthcare
premiums by making advance premium tax credit more generous and
available to all citizens ensuring that no one pays more than a
certain rate (8.5%) of their household incomes on premiums.
*Improving overall health of the communities: The system will be
designed by identifying and addressing mental health risk of specific
age groups or communities. For this we aim to explore the aspects
that prompt the community members to engage with healthcare
systems. It will focus on fluidly meeting the growing needs of diverse
population by improving access to quality behavioral health care &
practice, reducing persistent disparities in mental health and
substance use services for under-resourced populations &
communities. Arrangement of on-site attorney will be established.
An outline of one of the plans is to provide legal assistance for SNAP
(Supplemental Nutrition Assistance Program) which will advise
patients about Family Medical Leave & job protection to help ensure
that her job is waiting for her after treatment. They may assist
patients with appeals if benefits are denied. We also aim to include
one-to-one consultation by arranging chat sessions that anyone in
the community can attend. The session will cover legal issues like
consumer rights or public benefits. The patient can access medical &
legal advice at the same place.
*Budgeting: We attempt to use the Rolling Forecasting Method where
it allows the organization the flexibility to use historical data to
predict future performances. It will help to answer how the previous
quarter has changed our view of the present & future. With it we are
hopeful to adjust our strategy as financial conditions may change,
will implement decisions based on current expenditure & initiatives
and make strategic decisions about future endeavors.
Compliance with Emergency Medical Treatment & Labor Act
(EMTALA) is also documented to provide treatment for anyone to an
emergency department regardless of their insurance status or ability
to pay.