Launch Plan for Provider-Based MRI Services

Vision, Planning, and Organizational Structure

As the population increases in the area, there is an opportunity to expand quality MRI services to meet the growing demand for such facilities. Using a provider-based delivery approach, the needs of the community can be met while simultaneously improving the quality of care currently offered. While provider-based clinics come with challenges regarding billing structure and leadership, the opportunity to implement new essential services outweigh the risks.

A large addition such as this would impact the management hierarchy and decision-making structure (Lewis, Packard, & Lewis, 2012). The management hierarchies will likely change as additional staff members are brought on and the mode of leadership changes from individually based in one office to being an extension of a larger practice. Good leadership, which can be defined as “the process of influencing others to understand and agree about what needs to be done and how to do it, and the process of facilitating individual and collective efforts to accomplish shared objectives” (Yukl, 2006, p. 8) is required to highlight the benefits and opportunities surrounding taking calculated risks such as this and will assist in changing the perspective of those more focused on the gambles related to starting a new service. This means that the administrator should offer guidance and influence employees on how to handle future challenges while simultaneously working on the current issues facing the expansion of the organization (American College of Health Care Administrators, 2007). The administrator should provide a clear understanding of the overall concept, goals, and outcomes of opening the facility and exemplify leadership skills, not just management.

The decision-making structure will also be altered during the implementation phase as it must be decided what choices can be made by the provider-based agency and what needs to first go through the larger practice as they have final control over the operations. These two aspects impact the overall culture of the workplace and must be taken into account in order to provide a safe and amenable working environment that is also cost-effective and efficient.

Impact of Environmental Factors

Environmental factors such as reimbursement, competition, and hiring qualified employees influence the success of implementing MRI services. Reimbursement of funds will directly impact this facility because provider-based agencies receive funding in two ways. First, the main provider (i.e. the orthopedic practice) is charged to cover staff and overhead costs. Then, the clinic is billed for physician services based on a fee schedule (Ault & Ferman, 2002). This structure creates more paperwork and is time consuming which may directly influence whether or not the practice wants to create a provider-based clinic.

Another barrier is that similar facilities are providing these services at a lower cost, which creates an obstacle to overcome as patients largely focus on the overall cost of care. In addition, the community is a mix of Medicare and privately owned insurance clients, which impacts the cost of care. However, by providing above average service the practice can overcome higher costs and ensure clients feel safe and secure when receiving critical procedures like an MRI.

An additional challenge is recruitment of highly qualified staff. Due to the tight employment situation it is imperative that a comprehensive benefit package and rewards system be in place in order to enlist only the best employees in the area. Despite there being a low number of quality candidates available, with a focus on training, fair pay with benefits, and a pleasant work environment instituted through human resource development, administration can attract new talent to the area and capitalize on those working for other organizations that are not pleased with their current employment.

Risks and Benefits in Relation to Implementation

Various risks are expected when launching any new service. In relation to opening a provider-based MRI center, overall costs are expensive, ranging well over one million dollars, and may strain the practice, especially in the initial phases of start-up. Furthermore, due to how provider-based services are paid, this will increase paperwork and put added stress on staff making it a gamble to change the current billing system (Ault & Ferman, 2002). This would impact the overall bottom line and flow of the practice and is a large barrier to overcome.

There are many benefits that make this addition of services a smart opportunity for the practice. MRIs are used to identify many potential health issues. Opening an MRI clinic helps close a gap identified in current healthcare services, which aids the surrounding community. It will also directly compete with the current model that focuses on low-cost instead of high-quality care and provides a level of service not currently seen.

By opening a provider-based facility, this will also allow the practice to expand and receive additional sources of income over the long term while providing the quality care that is expected. As overall benefits should be considered, it is forward thinking to grow the practice as the need for MRIs increases. By creating a five-year plan along the strategic plan and goals, focus should be placed on the future advantages this service will provide such as potential revenue, job development, and high-quality MRI services.

Human Resource Initiatives

The human resource plan is integral in implementing the new MRI facility. It is threefold in that qualified staff members must be hired, appropriate training must be offered to ensure employees are continuously learning and improving their skills, and a suitable rewards program must be in place that provides incentives for quality care (Grobman, 2011; Lewis, Packard, & Lewis, 2012). These three initiatives will provide the basis for a well-functioning provider-based MRI service.

In order to hire staff, job responsibilities, necessary skills required, and other favorable attributes should be distinct before job postings are available. Human resource professionals should identify the needs of the office utilizing the strategic plan, goals, and objectives, while also focusing on the work environment, quality of service, previous experience, and personality when hiring new employees (Lewis, Packard, & Lewis, 2012). Diversity should also be an important factor as this could assist with helping underserved populations in the area.

Next, a comprehensive training and development program must be created to assist staff with lifelong learning. This can be done through in-house mentorship programs and/or training opportunities (in the office, out of the office, or web-based). A focus should be placed on development specific to MRI related care as well as confidentiality, HIPAA laws, and other relevant topics (Grobman, 2011; Lewis, Packard, & Lewis, 2012).

Finally, a comprehensive benefit package and a rewards system based on performance reviews should be utilized (Grobman, 2011). This gives each employee an incentive to work hard and provide above-average care to clients. These three initiatives should be visualized and implemented prior to opening and provide the solid groundwork that will allow the best employees to be hired.

Monitoring and Evaluating the Program

In order to effectively support this new service once it is open, program evaluation will need to be ongoing. A Continuous Quality Improvement (CQI) plan should be in place that will assist with consistent assessment and improvement of services (Grobman, 2011). This should include analyzing the budgets on a quarterly basis, utilizing client feedback regarding the services they’ve been offered, and using staff feedback concerning the office and work environment. Through the use of surveys, face-to-face conversation, and data analysis, the organization can identify funding issues for proper financial management, isolate gaps in service, and implement necessary change using the overall CQI system.

Budgets

(Tables 1-3 omitted for preview. Available via download)

References

American College of Health Care Administrators. (2007). Effective leadership in long term care: The need and the opportunity. Baltimore, MD: Dana, B. and Olson, D.

Ault, T., & Ferman, J. (2002). What surgeons should know about Medicare rules for hospital based clinics. Bulletin of the American College of Surgeons, 87 (4), 10-14.

Grobman, G. (2011). An Introduction to the Nonprofit Sector: A practical approach for the twenty first century. Harrisburg, PA: White Hat Communications.

Lewis, J.A., Packard, T.R. & Lewis, M.D. (2012). Management of Human Service Programs, Fifth Edition. Belmont, CA: Brooks/Cole.

Yukl, G. (2006). Leadership in organizations, 6e. Upper Saddle River, NJ: Prentice-Hall.