Twin Pines Medical Center Affiliation Recommendation

Note: Responses should align with both the rubric aspects and task requirements.

1. Goals and Rationale

1. Explain key goals for the affiliation and specific criteria a candidate affiliate must meet.

The most important aims of TPMC’s affiliation involve expansion of specialty care service, financial sustainability, and expansion of access to care via telemedicine. TPMC sees a high level of uninsured and Medicaid-dependent patient volumes, and financial burden and access restrictions to important specialties such as disease management, endocrinology, and cardiology occur, therefore: Twin Pines Medical Center Affiliation Recommendation.

By affiliating with a seasoned care system, TPMC will curtail overuse in its EDs, implement preventive care programs, and transition towards a value model with increased financial viability. In addition, technological advancement, workforce development, and operational efficiencies will be supported through affiliation, and TPMC will improve patient outcomes and its role as a community-based care leader.

An ideal affiliate will have qualifications in terms of its purpose and success in a strategic affiliation. Ideally, a not-for-profit with a strong commitment to taking care of underprivileged communities and a background in disease management and preventive care is best situated to become an ideal TPMC affiliate.

Besides, an ideal affiliate will have strong competencies in telemedicine in an attempt to extend access to care for rural patients, a successful track record in financial viability, and a shared model of decision-making in a way that will allow TPMC to preserve its community orientation. All these qualifications will allow TPMC to have a strong affiliation in offering high-value, accessible, and cost-effective care for its patients.

2. Identify three specific advantages a well-aligned affiliation would provide for TPMC.
3. Increased access to Specialty care and High-tech Clinical Services

One of the key benefits of affiliation is increased access to specialty care services. TPMC is not yet in a position to have access to enough specialists, and therefore, its patients have to go out of region for care, and for long-term ailments, have to use emergency care (Haleem et al., 2021). Affiliation with a larger medical system will enable TPMC to have access to specialists including cardiologists, pulmonologists, and endocrinologists, and therefore, will enhance access to expert care for its patients.

2.Increased financial solidity and cost-effectiveness

The financial uncertainty in TPMC arises out of its high level of uninsured and Medicaid-dependent cases. Affiliation with a well-matched entity will yield financial capabilities and cost-saving potential in economies of scales, shared administration, and access to grant funding sources (Mitchell & Kohlhammer, 2021). In addition, its value-based care model expertise will allow TPMC to transition to an outcome-based reimbursement model, with a view towards having a more sustainable financial performance.

3.Increased Telemedicine and Integration of Technologies

Another key benefit of affiliation is an expansion of telehealth capabilities. With TPMC’s rural patient base, many face difficulty in accessing timely medical care through transportation constraints. Affiliation with a technology-intensive care entity will allow TPMC to use telehealth platforms for virtual consultation, disease management, and virtual specialist consultation referrals (Haleem et al., 2021). It will reduce unnecessary travel, reduce patient waits, and overall improve access to care.

3. Analyze the current state of TPMC and the projected market segmentation for TPMC anticipated from the proposed affiliation. Your analysis must be supported by demographic data and include the following elements:

• the current state of TPMC, including anticipated market segmentation

The TPMC is a small community medical center with a high uninsured and low-income patient base. It suffers significant financial strains, with limited access to specialist care, outdated infrastructure, and high uncompensated care volumes. Most of its patients utilize the Emergency Department (ED) for non-emergency care, burdening hospital operations and producing poor patient outcomes. TPMC’s most critical target areas include preventive care, maternal care, disease management, and behavior care.

The TPMC marketplace will expand with affiliation, with a larger patient base having access to an increased range of service options. Targeted segments include: The uninsured and Medicaid beneficiaries, who will have increased access to preventive and specialist care. The rural citizens, who will have access to extended telehealth care and virtual consultation (Flaubert, 2021).

Long-term disease suffers, including cardiovascular disease and diabetes, will have an increased disease management program benefit. Older adults with increased long-term care service and programs specifically designed for them

• location-specific demographics

The TPMC is located in rural northern Louisiana, with a population base consisting of urban and rural communities, many of whom have transportation barriers and limited access to medical providers. 33% of its citizens have no medical insurance, and 36% utilize Medicaid, a strong indicator of a demand for accessible, affordable medical care options. 17.9% of adults have diabetes, and cardiovascular disease is high in terms of admissions, a strong indicator of a demand for additional specialty care and disease management programs for long-term disease.

• how the population’s health needs align with the proposed affiliation

The planned affiliation will particularly address TPMC’s greatest medical concerns in terms of:

1. Expansion of programs for controlling chronic disease for heart disease, hypertension, and diabetes
2. Enhancing infant and mother care for high-risk groups
3. Adoption of telehealth technology for effectively servicing rural patients.
4. Minimizing over-dependency on acute care through offering increased preventive and out-patient care

1. Affiliate Recommendation

1. Recommend an affiliate based on your goals and rationale from part A and include key attributes of the proposed organization that support the affiliation.

The most apt affiliation with Twin Pines Medical Center (TPMC) is with Intermountain Healthcare (IHC) because it best aligns with TPMC’s purpose, financial needs, and long-term care objectives. IHC is a not-for-profit health care system with a high level of value care expertise, expansion of telemedicine, and management of disease, all of which will become integral to TPMC’s long-term success.

Because TPMC has high uninsured, Medicaid dependent patient base, its financial viability is more achievable by leveraging IHC to provide cost effective care delivery to its patients (Teisberg et al., 2020). IHC is a preventive care and population management expert who will use its expertise to confer to TPMC to reduce the unnecessary use of the E.R. for such long-term care cases as cardiovascular disease and diabetes.

One of TPMC’s key advantages is that Intermountain Healthcare’s advanced telemedicine infrastructure enables TPMC to provide virtual consultations, remote patient monitoring and digital chronic disease management programs. Improved access to care for rural, and transportation-impedance patients will be massively enhanced with this. Furthermore, the focus on workforce development and staff training will support TPMC’s employees with continuous education, leadership programs and cross specialty collaboration enabling a highly skilled workforce. With financial security, a strong patient-first model, and a proven track record of improving health performance, IHC is best positioned to enable TPMC to drive long-term growth and enhanced patient care value.

2. Identify the major benefits of affiliation with this organization and describe how these benefits strategically align with TPMC’s goals.

3. Discuss specific reasons to avoid affiliation with each of the other potential candidates. Support your reasons with sources.

1. Affiliation Plan

1. Describe your proposed affiliation structure and include justification for the selection.

The affiliation between TPMC and IHC will be in a Joint Operating Agreement (JOA) format. With a JOA, TPMC will maintain its nonprofit and financial independence but will gain access to IHC’s expertise, assets, and shared service offerings. In a model such as this, both entities will work together in terms of integration of clinical service, expansion of telemedicine, and financial planning, yet will have individual governance and financial independence.

The model of a JOA is best for TPMC and IHC because it creates flexibility, operational efficiency, and shared decision-making, allowing TPMC to maintain its prioritization of its purpose of caring for underserved communities and benefiting from IHC’s expertise in technology in healthcare, value care, and disease management for chronic disease (Haleem et al., 2021). With a model such as a JOA, TPMC will have its operations scaled, its expenses lowered, and its access to care increased, yet will have its leadership in its community and will have IHC’s best-established practice in its model.

2. Create new organizational, vision, mission, and value statements for the new proposed affiliation structure.

3. Develop a leadership plan for the proposed affiliation structure that includes the following elements:

• strategies for overall organization management

Organizational effectiveness will be achieved through a Collaborative Executive Board (CEB) comprising representatives of TPMC and IHC. CEB will exercise overall direction, operational efficiency, and financial viability with a view towards safeguarding TPMC’s purpose unharmed. TPMC’s in-area leadership will have its role in ongoing operations, but significant administration such as assurance of quality, financial planning, and training of workers will have IHC’s key capabilities at its disposal (Chelagat et al., 2021).

• strategies for the collaborative decision-making process

The shared governance model will have a governance structure in terms of shared governance councils for respective operational departments such as clinical operations, finance, expansion of telehealth, and patient care. Recommendations will then go to CEB, with both TPMC’s local leaders and IHC’s medical professionals providing input to them. Frequent leadership forums will engender transparency, stimulate free discussion, and engender shared accountability for important decisions (Wang et al., 2022).

• evidence-based principles, strategies, and tools of effective change management

Change will be accomplished through Kotter’s 8-Step Model, with an emphasis placed on creating a sense of urgency, developing a guiding coalition, and creating lasting transformation. With an integration of Lean Six Sigma, TPMC and IHC will map out inefficiencies, streamline processes, and maximize patient care. Staff will have ongoing training and educational programs in developing skill in transitioning to new workflows, integration of telemedicine, and value-based care models (Rathi et al., 2021). With an integration of data-driven decision and evidence-based practice, leadership will monitor and confirm progression and implement transition with ease and minimum disruption to patient care and morale of staff.

4. Describe how to maintain and improve employee satisfaction, engagement, and retention in a culture of positive change.

To maintain and build morale in a positive change environment, transparent communications and staff engagement will become important. Staff will at times become insecure during affiliations, and therefore, regular town hall sessions, feedback sessions, and leadership communications will make them confident that concerns will be heard and addressed in a proactive manner.

Staff will have a say in decision-making, and leadership will make a deliberate attempt at including them in such processes, and enable them to have a voice heard. On-the-job training and continuous career development programs will make them valued and transition-fit. Career development programs, mentor programs, and access to IHC’s continuous educational programs will enhance morale and make them believe in career development in the new format.

Retain strategies will include reward, compensation, and work-life integration. Salary competitiveness, performance incentives, and wellness programs will make workers appreciate working for them (Al-Qathmi & Zedan, 2021). In addition, flexible work arrangements, mental wellness programs, and burnout intervention programs will contribute towards work-life integration.

5. Describe two opportunities and two challenges for the affiliation for TPMC.

6. Discuss the impact the organizational cultures of TPMC and the affiliate organization could have on the future of the proposed affiliation.

The integration of TPMC’s community-sensitive, patient-centered culture with IHC’s value-sensitive, system-thinking model for care delivery will shape affiliation’s future. TPMC values individualized care and localized decision, but IHC values efficiency, standardization, and value care. Differences between them can cause tension, but through cultural integration programs, leadership development, and workforce integration programs, a balanced culture can be designed.

7. Discuss reasons for termination of the affiliation agreement.

An affiliation can terminate when financial, operational, and strategic mismatches arise, and cannot be resolved. In financial mismatches, when TPMC cannot deliver cost savings according to planning, and IHC’s financial model cannot confirm TPMC’s viability, termination will become a necessity.

In a fall in patient care quality through mismatches in policies and poor management, TPMC will have to reevaluate affiliation (Turner et al., 2022). Regulatory and legal barriers in TPM’s operations under IHC’s model can also make termination a necessity. Misalignment in cultures, when morale dips in terms of workforce and trust in the community erodes, can also make termination of affiliation a necessity. In case

8. Provide a potential exit strategy that is actionable and includes three action steps.

Termination will begin with a careful review and determination, in which a proper performance review will be performed by management to evaluate whether objectives of the collaboration are not being met. In case any weaknesses have been discovered, a remediation will first be initiated and then termination will be executed.

The transition will then follow a scheduled transition timeline with realignment of shared assets, migration of patient information, and alternative medical affiliations for continuity of care. Administrative, financial, and technology interfaces will have financial arrangements, technology interfaces, and administration realigned for transparent disengagement.

The final portion will include an implementation of a communications plan, notifying patients, workers, and stakeholders about transition. There will be specific guidance in terms of continuity of patient care with no service break (Ljungholm et al., 2022). Leadership will also ensure legal and regulatory compliance in exiting. With a phased approach in exiting, TPMC will preserve its financial integrity and its mission-focus service to community

9. Discuss future challenges and opportunities that could result from the affiliation in regard to the evolving community healthcare landscape.

One of the largest post-affiliation concerns will be keeping current with changing healthcare legislation, payment methodologies, and technological advancements. As funding for Medicaid, reimbursement for telehealth, and value-based care policies modify, TPMC and IHC will have to have a flexible position (VanderWerf et al., 2021). Long-term workforce development and workforce maintenance will also become an issue, with workers potentially having a challenge with new technology, altered workflows, and shifting performance requirements in an altering model for delivering care for healthcare.

Compared with these challenges, affiliation holds enormous potential for expansion and innovation. Expansion of community-based care programs, such as electronic facilitated predictive analysis, and leveraging improvements in precision medicine can expand TPMC’s capabilities for providing cost-effective, personalized care (Johnson et al., 2020). Affiliation with IHC will allow TPMC to become part of research collaborations, funding programs, and population wellness programs, strengthening its role as a model for providing fair and state-of-the-art care. By employing proactive strategies for overcoming challenge and taking advantage of opportunity, TPMC can preserve its position at the cutting edge of community-based, technology-enriched care delivery.

1. APA Sources

References

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Chelagat, T., Rice, J., Onyango, J., & Kokwaro, G. (2021). An Assessment of Impact of Leadership Training on Health System Performance in Selected Counties in Kenya. Frontiers in Public Health, 8. https://doi.org/10.3389/fpubh.2020.550796

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Task 2 TPMC Affiliation Recommendation