The Advantages and Disadvantages to the of Working with the AMC
The major advantages of working with the AMC are based on the opportunities for the poor layers of the population to be insured on the costs of governmental funds. More importantly, AMC is premised on Medicaid reforms and provides healthcare insurance for physicians and hospitals, as well as medication for the nation’s elderly (Herzlinger and Lurding). However, there are certain disadvantages of introducing AMC reforms, such as the insufficient coverage of risks while cooperating with other hospitals outside the service area, which can lead to further losses.
Conflict Between THG Goals and Those of the AMC Regarding Hospitalization, Specialist Use, and Managed Care Experience
There is a conflict between the agendas of AMC and HMO. Specifically, the medical center seeks to fill out hospital beds, and insure lives to its experts. It also expects to increase its managed care experience. In contrast, THG’s objective is to reduce hospital patients and the personnel to reduce costs and enhance the shareholder value through the increase in long-term capital.
Incentives for PCP to Keep Costs in Control in the Capitated System
Capitation is aimed at paying fee to physicians monthly for each enrolled members. This capitation payment, which is also considered as per member/per month remains unchanged in case an enrolled members does not visit the physicians. In this respect, capitation provides a monetary incentive for physicians to advance HMO patients and sustain high quality of healthcare. In contrast, the common identity insurance reforms provide insurance with payment for each treatment or visit. This practice, therefore, is more motivating because it encouraged physicians to treat more patients, but these procedures are not always necessary. In order to avoid under-treatment, the hospital should also create penalties and greater monitoring of treatment process. At the same time, making these incentives in public is not always the option.
TriPoint has been launched to manage risks in a more effective way and create a possibility to control the service area outside the AMC. The managerial autonomy can add to the shareholding value and the overall company’s reputation. In the context of SWOT, the company can receive more opportunities in managing risks beyond the contract with AMC. However, it can discourage AMC of introducing their service, which is the major threat. The major weakness of the TriPoint includes additional costs.
Recommend a Plan of Action for Tom and Randy’s Expansion Options
Quality assurance and total quality management should become the priority in treating patients. The plan should be oriented at introducing a transparent reporting reform and holistic approaches to managing patients. These pillars will contribute to the hospital and patients’ welfare.