Abstract
Process improvement helps businesses review the different aspects of their work and make changes that will help provide a better quality of services, increase profits, and achieve the mission and vision of this company. United Healthcare is an insurance provider that has declared the decision to promote the population’s health as a part of its mission and vision. Moreover, United Healthcare places emphasis on addressing the care needs of the vulnerable populations who have diminished access to care services. This paper analyzes the balanced scorecard elements pertaining to United Healthcare’s operations and offers to invest in the development of community health programs, such as the aging population program that targets older adults. Additionally, United Healthcare should integrate mobile applications and services for health monitoring as part of its services since it helps reduce the number of visits to the care provider. This paper details the specific elements of United Healthcare’s strategic direction.
Introduction
Process Improvement allows us to examine the organization’s current operations, such as its financial statements, customer focus, internal processes, and a strategy for growth and compare these to its mission and values. For this paper, the analysis will be based on a healthcare insurer United Healthcare. United Healthcare is an insurance organization operating from Minnesota, which provides healthcare insurance services to U.S. citizens across the states. This paper will analyze United healthcare’s organizational structure, macro-level indicators, mission and values and offer a process improvement strategy.
Existing Organizational Structure, Mission, Vision Analysis
The organizational structure of United Healthcare is a matrix organization, which is defined as an organizational structure where there is a dual managerial responsibility and accountability (IntroBooks, 2018). With this, there are two lines of command that govern the operations of the organization. United Healthcare’s structure is the closest to that of a matrix since this organization has begun to incorporate other business models and brands into its structure. Apart from being an insurer, this organization has acquired several emergency care clinics under the brand name MedExpress. This company has a separate line of authority, although United Healthcare still defines the strategic direction and development targets for it. According to IntoBooks (2018), the definitive characteristic of this structure is that the employees report to two managers rather than one, which may be viewed as a negative aspect of this organizational structure because of the potential confusion and communication problems that might arise. However, the benefits of this structure are optimized resource utilization and enhanced motivation and better cooperation between the employees.
The factor of resource optimization is especially important for United Healthcare because of the continuously increasing cost of care in the United States and the considering the mission of this business to address the healthcare needs of the underprivileged populations. Moreover, according to some experts, the goal of the current healthcare providers and insurers is in “controlling costs and standardizing care” (“United Healthcare and U.S. healthcare business models: A tradition of change,” n.d.). Hence, from a financial viewpoint of the balanced scorecard, United healthcare is properly managing its resources by using the most resource-efficient strategy.
Mission and vision statements are important determinants of the strategic direction that a company has selected. Currently, United Healthcare (n.d.) defines its vision as “redefining access and addressing social determinants of health” (para. 1). Hence, the priority is placed on the health of the population in general and on making the citizens healthier. The mission of this organization consists of two parts, one of which is to address the immediate health care needs of the underserved communities, and the second is to actively promote the recognition and working with the social determinants of health. From the mission and vision statements, this organization has moved beyond the promotion of health for one customer and instead decided to address the nation’s pressing healthcare needs. Notably, although United Healthcare (n.d.) is a for-profit organization, they emphasize in their vision statement and explanations to it that they are committed to helping the uninsured populations that have restricted access to healthcare services.
Finances, Internal Process, Learning & Growth, Customer Satisfaction
The macro-level of analysis is best completed using the balanced scorecard created by Norton and Kaplan. Table 1 is an adaptation of the balanced scorecard by Kaplan and Norton, which represents the current strategy and strategy of development for United Healthcare. In terms of finances United Healthcare, the general goal for United Healthcare is to generate revenue for the stakeholders. However, considering the increasing cost of healthcare services and issues with the shortage of qualified medical professionals and the cost of medications, the organization should be concerned with its profit margins. By reducing the costs and increasing the profit margins, this company will be able to keep up with the changing environment in the United States. Moreover, considering that United Healthcare has already invested in purchasing companies that provide healthcare services directly to consumers, one can argue that the financial strategy of this organization is reducing costs by vertically integrating providers of varied care services, which will help substantially reduce the resource utilization and costs.
Table 1. Balanced scorecard
In terms of the Internal Business processes, considering the mission of United Health, the company aims to integrate community and population health services into its process structure. Hence, having community health programs will be beneficial for United health because the organization will improve the health of the insured and uninsured populations, indirectly impacting the profits as people will need fewer services from health providers. Here, the focus of the internal processes management is one facilitating the shift from the standard insurance provider model towards a fuller and universal model of a company that improves the health and wellbeing of the entire population.
For the Learning and Growth element o the scorecard, United Health should invest in the research and development of programs that target population and community health. This is needed to achieve the mission of this business and to enable the effective use of the company’s resources to establish programs that are directed at improving the population’s health. To change and improve, which are the main goals of the Learning and Growth element of the Balanced Scorecard, United Health has to invest in practices that are analyzing the innovation within the healthcare market and the ones that test out population health improvement programs to implement the most effective solutions into its operations.
For the Customer, United Healthcare aims to create a more integrated system where they provide not only insurance services but help individuals address their other needs as well. For example, the acquisition of the E.D. centres allows United Health to leverage the resource utilization and give their customers an option to use an E.D. service provider that is in direct contact with United Healthcare, leading to better efficiency and productivity. Hence, from the Customer perspective of the scorecard, United healthcare should appear as a company that is focused on ensuring the wellbeing of the entire population and as a wholesome provider of healthcare services.
Evidence-Based and Best-Practice for Monitoring & Improving
The best approach to reach the current objectives of United Healthcare is to focus on the promotion of population health, which can be done through programs and sponsorships. Currently, there are several population health models developed by theorists. Brewster et al. (2021) argue that these programs are helpful in managing chronic conditions and preventing behavioural risk factors. Hence, by investing in these programs as part of United Healthcare’s organizational strategy, the company will be able to improve the quality of its services because this additional offer will enhance the wellbeing of the patients and address the issues with frequent visits to healthcare providers that are a result of mismanaged chronic conditions.
Currently, not many for-profit organizations offer community health promotion programs. Brewster et al. (2021) state that these initiatives are usually led by community centres, and the authors’ analysis shows a 0.94% percentage point reduction in nursing home use among the population of older adults. This suggests that the health promotion programs, especially those directed at older adults and the behavioural determinants of health, help these individuals manage their health effectively outside the care facilities. Hence, the recommendation for United Healthcare is to integrate the community health promotion programs and partner with community centres that already lead these programs. This approach will help address all aspects of the scorecard since the reduction of visits to care facilities will allow the company to save costs and enhance the customer’s perceptions of their business.
Another way of improving the processes at United Health in investing in technology and the integration of technological advancements into the services that this business provides. For example, Zhao et al. (2018) suggest that the use of mobile health applications substantially reduces the health risks of the population. Moreover, these applications can be used in combination with devices that help monitor the vital signs of the individual and therefore are helpful when determining whether their health is at an adequate level or if they need to be referred to a professional. The next step is integrating data analytics since the discussed applications generate a wide range of data that can be used for research purposes and for designing methods of optimal care. One issue is that different populations view mobile health applications differently, with varied factors playing a moderating effect, based on the analysis by Zhao et al. (2018), which can influence the way these applications are perceived and how their usefulness is rated. All of this suggesting help United healthcare reach its vision and mission, which are to address the healthcare needs of the population in general and the needs of the underprivileged communities in particular.
Organization’s Values
United Health’s values can be examined through an ethical, organizational, and directional strategy, and their inclusion is necessary to impact the needed changes for quality improvement. Evidently, United Healthcare communicates its regard for the health of the population and addressing the nation’s broader healthcare needs. For example, its ethical strategy emphasizes the need to act with integrity and in accordance with the professional standards of conduct. Moreover, this organization argues that it promotes the following “integrity, compassion, relationships, innovation, and performance” (UnitedHealth Group, n.d., para. 15). Hence, apart from the regard for population health, the UnitedHealthcare company aims to ensure that its work is ethical. The inclusion of innovations as one of the five core values points to the idea that United Health is investing in the R&D practices that would help make the provision of insurance and care services easier.
Based on United Healthcare’s directions strategy, one can conclude that quality improvements should be targeting the development of an integrated system where health insurance, health services, and population health promotion are all incorporated into the business process. The goal of this business, in general, is to provide care to people who cannot access it, which helps improve the overall health of the population and reduce the burden that healthcare facilities face due to shortages of personnel. Hence, the directional strategy implies developing services and products that will be distributed or offered to the general population and specifically the vulnerable communities to help them address their health care needs.
The organizational values of United health should incorporate the inclusion of innovation since this is an important factor in reducing the costs of health services and ensuring that more people can receive the care they need. The outcome of integrating innovation into the organizational strategy is the ability to reduce the costs of these services while receiving services of high quality. Considering the review of the Balanced Scorecard, United Health is already integrating these measures into its daily work.
Conclusion
Overall, this paper is an analysis of United Healthcare’s strategic direction through mission, vision, and organizational structure. Currently, this business declares its focus on the promotion of health and wellbeing, while organizational strategy involves the incorporation of clinics and emergency department services into the services of this company. The suggestion offered in this paper is to focus on implementing the tested models of population health promotion, partnering with the community health centres to promote health, and integrating mobile technology into the service provision. Both innovation and community health needs are integral values of United Healthcare’s work, which means that these recommendations align with the company’s strategy.
References
Brewster, A., Wilson, T., Curry, L., & Kunkel, S. (2021). Achieving population health impacts through health promotion programs offered by community-based organizations. Medical Care, 59(3), 273-279.
IntroBooks. (2018). Balanced scorecard for performance measurement. Intro Books.
United Health Group. (n.d.). Organizational values. Web.
United Healthcare. (n.d.). Our vision for empowering health. Web.
United Healthcare and U.S. healthcare business models: A tradition of change. (n.d.). Web.
Zhao, Y., Ni, Q., & Zhou, R. (2018). What factors influence the mobile health service adoption? A meta-analysis and the moderating role of age. International Journal of Information Management, 43, 342-350.