TayganPoint has provided strategy development, deployment and strategic execution capabilities support over the last five years for a large and rapidly growing Federally Qualified Health Center organization (FQHC) in Southern California. Over the last five years, the organization has continuously improved its annual Strategic Planning Process (SPP) in order to face the challenges of a highly regulated but dynamic healthcare environment, increasing competition and the changes brought about by the Affordable Care Act (ACA). During the course of this journey, the organization twice applied for – and won – the California Performance Excellence Award (CAPE) in the silver category.
The client is a non-profit Community Health Center originally incorporated as East LA Barrio Free Clinic in 1969 in East Los Angeles, California by a group of Latino community activists to provide access to basic medical care. These early leaders were inspired to build an organization whose mission was “to eliminate disparities in health care access and outcomes by providing superior quality health and human services through an integrated world class delivery system.” This mission came from the belief that healthcare is a basic right and not a privilege, and that in providing access high quality healthcare, society, and in particular the local Latino communities, would be better served.
From these early origins, over four decades of significant growth, the client has distinguished itself to become one of the nation’s largest Federally Qualified Health Centers, transitioning from a “donations only” organization in 1969 to a current $503 million operating budget. In 2014 more than 180,000 low-income, marginalized, multi-ethnic people living in Los Angeles and Orange Counties accessed integrated and affordable medical care through a continuum of multilingual, culturally competent health and preventive care services. With 43 service delivery sites, the client provides more than 1 million ambulatory patient visits and employs over 2300 employees.
CHALLENGE + OPPORTUNITY
Market shifts brought about by the Affordable Care Act (ACA) are bringing major changes for the client and their patients. Since January 2014, many patients who were previously uninsured now have coverage, requiring a new strategic shift to health insurance education, and a sharper focus on transitioning away from fee-for-service/volume revenues to a value-based managed care model. Other strategic challenges included:
- Competing with much larger organizations with greater resources and brand recognition.
- Increasing demand for highly qualified, bilingual health care providers.
- Transitioning from a “FFS” mentality to a managed care focus as health care
reform is enacted.
- Accelerating need for improved performance measurement and improvement
- Managing delivery/costs risks associated with serving an aging, senior and
low income, high morbidity population.
- Strengthening workforce engagement and driving accountability, including health care practitioners.
- Overcoming cultural silos with lines of business built and operating as independent profit centers, not integrated across services to provide seamless care.
The challenges for the TayganPoint team were:
- To partner with the client’s Executive Leadership, Medical Leadership and functional and business unit teams to assist in building an integrated short- (1 year) and longer-term (5-year) strategic plan aligned with the annual budgeting and resourcing processes.
- To lead the organization in conducting external and internal assessments of both its own capabilities and those of its competitors.
- To lead the identification and prioritization of strategic initiatives with well-defined business cases in support of organizational goals.
- To engage a large number (100+) of key stakeholders across varying levels of the organization in order to enhance communication and to ensure buy-in of the final plan.
- To support a number of “Pillar” teams focused on cross-functional intersections in areas related to quality, service, and growth, mediating across a variety of different agendas and priorities.
- To facilitate effective knowledge transfer so that the organization builds its own capability to execute the annual SPP efficiently and effectively in the future.
APPROACH + SOLUTION
With TayganPoint’s guidance and support, over the years, the client’s Strategic Planning Process matured to include such perspectives as “Balanced Scorecard,” “Strategy Maps,” “Strategy Statements,” SWOT and competitive analyses. Leveraging best practices in strategy development by a variety of reknown experts, TayganPoint successfully facilitated the leadership team through deliberate, disciplined processes and facilitated a large number of strategic retreats. In collaboration with the Senior Executives and CEO, the planning process became increasingly robust and data-driven. TayganPoint’s respect for the organizational culture and climate enabled the implementation of “customized” approaches to planning that fueled cycles of improvement. In the last fiscal year, the client received significant kudos from the California Performance Excellence Program for its systematic approach to achieving organizational objectives. Throughout the years, TayganPoint partnered with the client team to build an integrated and well-documented process that would ultimately enable the client team to lead the most recent SPP cycle.
Many times the TayganPoint team had to find ways to accommodate competing priorities, and engaged a broad group of executives to build greater trust and engagement. The TayganPoint team operated collaboratively across the organization, often identifying potential gaps and/or overlaps between departments or functions before the rest of the organization could see them. Managing and nurturing key relationships with functional and business leads enabled the team to build partnerships and seamlessly integrate into the client’s organization.
RESULTS + IMPACT
- Resulted in the implementation of a comprehensive monthly measurement tool aligning strategic objectives to annual improvement goals, creating clear accountabilities throughout the organization related to levels of performance.
- Implemented a monthly Executive Review process to track progress against strategic initiatives, including costs, risks, and progress against plans.
- Delivered improvements in quality which enabled the client to achieve a higher tier of performance in key metrics related to health screenings.
- Expanded the organization’s geographic ‘footprint’ through targeted development efforts aimed at growth in key demographic areas.
- Integrated elements of Knowledge Transfer & Change Management as part of a comprehensive communications strategy targeted at driving organizational understanding, buy-in and alignment.
- Developed annual collateral materials – fully documented Strategic Plans, a Strategy Playbook, metrics, initiatives, etc. that enable knowledge transfer critical to building cycles of improvement.
- Prepared key internal team members to lead the annual SPP cycle.
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