With more than 70,000 admissions per year, Montefiore Medical Center is one of the largest healthcare institutions in the United States and is the most dominant hospital in the Bronx borough of New York City, which is apparently one of the country's poorest neighborhoods. It has two major campuses, 29 outpatient centers, a home healthcare agency, two nursing homes and a growing number of community centers. The Center's mission is to provide health care services to the public that meet the needs of its diverse communities.
Despite the pressure of escalating costs, uncertain insurance restrictions and severe nursing shortage, Montefiore Medical Center was able to implement more cost cutting to focus on customer care by increasing its revenue and investing in new programs and technology.
This case study outlines Montefiore's use of the Balanced Scorecard to create and implement a new business strategy aimed at balancing population-based health care services with centers of excellence specialized in cancer, cardiovascular diseases, HIV and women's and children's health care.
First of all, we will introduce Montefiore Medical Center by developing the problems it faced over the years and the different objectives it had. Then, we will look at the importance of developing a management system that will support a new organizational structure and strategy by describing its major tool which is the Balance Scorecard. Finally, we will focus our report on the BSC's implementation thanks to its development, its advantages, its limits and its results in order to find some recommendations for the future.
Montefiore Medical Center, in the Bronx, New York, is the university hospital of the Albert Einstein College of Medicine. The hospital named after Moses Montefiore, is one of the 50 largest employers in New York State. It is located in the Bronx, a very poor neighborhood of NYC, where the standard of living is very low. This is the reason why a major part of inhabitants benefits from social healthcare programs such as Medicare and Medicaid.
Medicare is the name of a health insurance system implemented by the American government in order to help 65 year olds and above considering certain specific criteria. In 2005, 42.5 million Americans were eligible for Medicare. However this system doesn't finance the total costs of care and people will have to put in a little sum of money. In addition, other healthcare programs like Medicaid were created to help poor people. Moreover, all around the world, the US healthcare system is considered very unfair, because the contribution system is mostly private and therefore unattainable for most people. This is why it is difficult for Montefiore to generate large profits.
[...] You have to explain to each employee how they can contribute to the performances of the Montefiore Acute Care Center, and what will be the benefits for them to involve. But this was not completely the case at Montefiore. In fact, some people were excluded. Indeed, even when Elaine Brennan deployed a wide range of communication to make the staff aware of the new strategy and the BSC's implementation, she faced some problems with Physicians because they had not been members of the strategic management team that developed the BSC. [...]
[...] Montefiore Medical Center by developing the problems it faced over the years and the different objectives it had. Then, we will look at the importance of developing a management system that will support a new organizational structure and strategy by describing its major tool which is the Balance Scorecard. Finally, we will focus our report on the BSC's implementation thanks to its development, its advantages, its limits and its results in order to find some recommendations for the future. I. [...]
[...] So we can single out the fact that Montefiore had understood that the system had no future if all people working at the Medical Center don't understand and use it. And to understand and to use it, they had to be a part of the BSC's building. But this is obviously the ideal situation and Montefiore was also aware that it would have to face some reluctant people Advantages of this new strategy The BSC helps to describe, implement and manage strategy at all levels of the Montefiore Medical Center by linking objectives, initiatives and measures to the organization's strategy. [...]
[...] The Montefiore Medical Center has to grow and become more customer-focused. The development of a population-based approach focuses on providing a full spectrum of health care services to specific population as children, women or seniors. The goal is to adopt a coherent long term strategic vision. The organization of Montefiore must be developed in accordance with these objectives. II. The importance of developing a management system that will support a new organizational structure and strategy 1. Description and objectives of the new strategy Two strategies from the strategic management team formed by Brennan: Develop a population based approach, which means provide all health services for the patients. [...]
[...] Another problem Montefiore Medical Center faced during that period was the occupancy rate which was about 90%. It would be difficult to increase the number of patients and specific services since there was not enough space for all services. Until 1998, the power-sharing arrangement to get resources was skewed. Physicians met often with M. Conaty and M. Foreman asking for resources. With the new system coming in , it had become easier to handle, as physicians started working with care center executives first and only then demanded the creation of a budget. [...]
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