Health and Hospital Management
Numerous organizations have taken a holistic approach to health and healthcare system management as they seek to address the common problems related to the rising health care costs, need for insurance, and promotion of healthy staff. The organizations have sought to establish and implement health care plans for thousands of employees. The plans have raised the need to have administrative competence, excellence in case management, solid network of care providers and health care institutions and departments. Common health-related problems today require a continuum of care that is built upon the collaboration of several actors and institutions. For this reason, organizations have to rely on strategic information to facilitate improved planning and decision-making which are made possible through better collection, analysis, and use of data. However, there have been challenges in relation to case management and program coordination that have been linked to unintegrated and partially integrated systems. This paper illustrates how international centralized oversight, management and reporting for a client’s health care management program will bring in considerable efficiencies with respect to case management and better coordination. The paper looks at the case of a multinational mining company in Indonesia. To run the health care plan programs for thousands of members requires competent administration, effectiveness in case management, and a solid network of doctors and health care providers.
In the health care domain, prevention and effective care services remain key considerations for corporations as they seek to mitigate the health care costs incurred by the staff and in providing medical cover for them (Lethbridge, 2011). Corporations and their respective human resource departments require a health care plan for each of their members as one way to ensure that their health care needs are adequately fulfilled. It is through the members’ health care plans that effective health care is provided. Corporations thus need to have an adequate medical program in place. As corporations take a global approach in relation to the healthcare management, there is a need to incorporate international centralized oversight and management programs through integrated and coordinated health care management systems.
Problem
BHP Billiton is a multinational mining company operating in Indonesia with its headquarters in Australia. The company has been providing medical care to its employees in Indonesia through medical aid schemes. The multinational’s human resource department has been operating based on a stand-alone health care program that has been used since the late 1990s. The stand-alone program meant that different services and operations were executed based on uncoordinated and fragmented systems. As a result, there were complaints from employees who had to wait too long to see a physician and the quality of medical care that members received was generally unsatisfying. There were various problems that the corporation experienced in relation to case management such as spiraling care costs, wrong diagnosis, long hospital stays, delays in insurance payments, and inadequacy in access to quality care. For this reason, the human resource department saw the need to change the company’s healthcare management program.
Multinationals such as BHP Billiton must be aware of the cost of medical care both in areas outside their country of operation and within the local systems. This is based on the understanding that the health of all its staff members is critical to the productivity of the corporations and also because health care is an area of global concern. In addition, corporations have a responsibility to ensure that the well-being of their staff members is taken seriously and cost saving is achieved as part of the strategies to grow the corporations (Groves, Kayyali, Knott, & Kuiken, 2011). With respect to health care delivery, there is no universal model but rather different public-private mixes exist in the reflection of the institutional arrangements. It is thus impractical to rely on a system that does not facilitate the coordination of the care services for case management of each member of a corporation.
Integrated International Centralized Systems
An integrated international centralized monitoring and management system is important and contributes to the alignment of human resource benefits management with staff health care programs with the aim of enhancing productivity and morale, increasing turnover, and improving organization safety. The integrated system is based on integration and coordination which are the key drivers of the international centralized approach as opposed to the fragmented systems used previously. Programs that can be effectively executed using the international centralized system include health insurance, occupational safety programs, focusing on domestic/work issues, compensation of workers, and employee assistance. According to Brandenburg, Gabow, Steele, Toussaint and Tyson (2015), the integrated international centralized system incorporates systems-level transformations that provide a new opportunity for consumer and provider engagement as it provides data streams that help to improve the understanding and accountability in relation to case management.
The international centralized oversight, management, and reporting for a client’s healthcare management program take a holistic approach. It integrates interventions across the continuum of care from wellness and prevention to disease management and complex case management. Integrated programs are built on the basis of a population health management focus and arise from the need to have a streamlined and better-coordinated services (Groves et al., 2011). The programs also operate in respect to the changes in medical processes due to the use of electronic health records and the introduction of human performance management systems. Multinationals, thus, need a consistent framework that can be used to evaluate clinical and financial outcomes of case management. For this reason, integrated programs are necessary for the improvement of the reliability and comparability of case management.
The integrated systems have made it possible to offer cashless access to health care services for workers and hence eliminated the need for members to pay upfront in the case a visit to a doctor is made. The integrated system has enabled the company to incorporate locally-crafted solutions with the aim of improving access to health care (International SOS, 2017). For example, in Papua, at a mining site, the company was able to assign an administrator and a doctor who coordinated care and focused on issues that promoted a healthy workforce. The systems can also be able to keep track of diagnosis and treatment reviews as well as the verified billing details as employees seek medical care. The systems provide monthly reports on individual employee spending, nature, and situation that prompted the delivery of care so that the human resource department can identify the key health issues that affect the employees. This also enables the company to identify preventive programs for the individual members and collective groups based on the information about the health problems that employees are at risk of developing.
The systems are also be used to implement broad-population wide programs with an emphasis on health risks and biometric operations to direct individual members towards suitable programs that deal with individual health challenges. In the case of management, there are overlapping programs and responsibilities since there are different cases and situations to be handled. For example, there are programs related to insurance coverage as well as the need to include social care workers in accordance with the case’s nature and dynamics. The overlapping programs, thus, require clear rules and prioritization with regard to case management for individuals which can be provided by the integrated system. This is achieved through a universally crafted programming approach that enables rules and prioritization criteria to be streamlined and implemented consistently. This enables activities that range from specific disease management through specific individualized interventions to the facilitation of wellness programs and priority taking to support the participation of each member. It is important to highlight that case management is an ongoing process that covers a series of care and service plan revisions and updates in respect to the case at hand (Naleppa, 2006). Through integrated international centralized systems, making the revisions and updates in relation to the care plans is made possible by the streams of data and easy communication and reliance on trusted data flows. Through real-time data sharing and updates based on the prevailing conditions and needs, it is possible for the company to stay abreast with the health care needs of individuals across the areas of operation.
With the independent stand-alone systems, it has been difficult for the human resource department to establish appropriate health care plans based on assessing the client and the individual family background and to coordinate the necessary resources and services that could be beneficial to the client. However, the integration and coordination make it possible for the company to navigate the complex and unintegrated health care services as well as social service systems to meet the multiple needs of the employees. Almost a year after the commissioning of the integrated international centralized management system, the company exhibited improvement in respect to the reduction of hospital stays, employee satisfaction, and increased savings on the company’s health care budget (International SOS, 2017). This was as a result of improving diagnosis, providing quality treatment, and implementing preventive care initiatives.
Conclusion
In conclusion, it is important for companies to have integrated international centralized health care program management systems, especially when operating in the global environment and in areas where health care is paramount for a healthier workforce; controlling the situation in case management has called for effective planning, and the delineation of alternate roles and responsibilities of healthcare staff in an organized management system. The system is important as it supplies information that helps to support data-driven issues like performance, efficiency, and cost benchmarking (Groves et al., 2011). For the company, it helped in facilitating collaboration as far as health care and social programs such as insurance covers are concerned in case management. From the case of BHP Billiton, the integrated system gave room to reconcile the health care needs of employees and the human resource goals of the organization. Workers were able to access quality care, it was easy to share information with caregivers, and workers were able to access cashless access to care. Therefore, the integrated international centralized system was able to bring efficiencies in relation to information exchange, accountability, and ease of service delivery in health care programs for the company.
References
Brandenburg, L., Gabow, P., Steele, G., Toussaint, J., & Tyson, B. J. (2015). Innovation and best practices in health care scheduling. Discussion paper. Washington, DC: Institute of Medicine.
Groves, P., Kayyali, B., Knott, D. & Van Kuiken, S. (2013). The ‘big data’ revolution in healthcare: Accelerating value and innovation. Center for US Health Reform Business Technology Office.
International SOS. (2017). Improving a Healthcare Administration Programme. International SOS. Retrieved from https://www.internationalsos.com/case-studies/case-study-folder/improving-a-healthcare-administration-programme
Lethbridge, J. (2011). Understanding multinational companies in public health systems, using a competitive advantage framework. Globalization and health, 7(19), 1-10.
Naleppa, M. J. (2006). Case Management Services. In B. Berkman (Ed.), Handbook of social work in health and aging (pp. 521-528). New York: Oxford University Press.
