Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments SWOT Analysis / TOWS Matrix / Weighted SWOT Analysis
Finance & Accounting
Strategy / MBA Resources
Case Study SWOT Analysis Solution
Case Study Description of Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments
Explains how managed care organizations use capitation as a payment method for providers.
Swot Analysis of "Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments" written by Regina E. Herzlinger, Thomas Nagle includes – strengths weakness that are internal strategic factors of the organization, and opportunities and threats that Capitation Care facing as an external strategic factors. Some of the topics covered in Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments case study are - Strategic Management Strategies, Corporate governance, Financial management, Health and Finance & Accounting.
Some of the macro environment factors that can be used to understand the Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments casestudy better are - – competitive advantages are harder to sustain because of technology dispersion, increasing household debt because of falling income levels, banking and financial system is disrupted by Bitcoin and other crypto currencies, increasing transportation and logistics costs, customer relationship management is fast transforming because of increasing concerns over data privacy, increasing commodity prices, there is increasing trade war between United States & China,
technology disruption, increasing energy prices, etc
Introduction to SWOT Analysis of Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments
SWOT stands for an organization’s Strengths, Weaknesses, Opportunities and Threats . At Oak Spring University , we believe that protagonist in Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments case study can use SWOT analysis as a strategic management tool to assess the current internal strengths and weaknesses of the Capitation Care, and to figure out the opportunities and threats in the macro environment – technological, environmental, political, economic, social, demographic, etc in which Capitation Care operates in.
According to Harvard Business Review, 75% of the managers use SWOT analysis for various purposes such as – evaluating current scenario, strategic planning, new venture feasibility, personal growth goals, new market entry, Go To market strategies, portfolio management and strategic trade-off assessment, organizational restructuring, etc.
SWOT Objectives / Importance of SWOT Analysis and SWOT Matrix
SWOT analysis of Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments can be done for the following purposes –
1. Strategic planning using facts provided in Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments case study
2. Improving business portfolio management of Capitation Care
3. Assessing feasibility of the new initiative in Finance & Accounting field.
4. Making a Finance & Accounting topic specific business decision
5. Set goals for the organization
6. Organizational restructuring of Capitation Care
Strengths Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments | Internal Strategic Factors
What are Strengths in SWOT Analysis / TOWS Matrix / Weighted SWOT Analysis
The strengths of Capitation Care in Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments Harvard Business Review case study are -
Ability to lead change in Finance & Accounting field
– Capitation Care is one of the leading players in its industry. Over the years it has not only transformed the business landscape in its segment but also across the whole industry. The ability to lead change has enabled Capitation Care in – penetrating new markets, reaching out to new customers, and providing different value propositions to different customers in the international markets.
Learning organization
- Capitation Care is a learning organization. It has inculcated three key characters of learning organization in its processes and operations – exploration, creativity, and expansiveness. The work place at Capitation Care is open place that encourages instructiveness, ideation, open minded discussions, and creativity. Employees and leaders in Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments Harvard Business Review case study emphasize – knowledge, initiative, and innovation.
High brand equity
– Capitation Care has strong brand awareness and brand recognition among both - the exiting customers and potential new customers. Strong brand equity has enabled Capitation Care to keep acquiring new customers and building profitable relationship with both the new and loyal customers.
Ability to recruit top talent
– Capitation Care is one of the leading recruiters in the industry. Managers in the Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments are in a position to attract the best talent available. The firm has a robust talent identification program that helps in identifying the brightest.
Highly skilled collaborators
– Capitation Care has highly efficient outsourcing and offshoring strategy. It has resulted in greater operational flexibility and bringing down the costs in highly price sensitive segment. Secondly the value chain collaborators of the firm in Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments HBR case study have helped the firm to develop new products and bring them quickly to the marketplace.
Successful track record of launching new products
– Capitation Care has launched numerous new products in last few years, keeping in mind evolving customer preferences and competitive pressures. Capitation Care has effective processes in place that helps in exploring new product needs, doing quick pilot testing, and then launching the products quickly using its extensive distribution network.
High switching costs
– The high switching costs that Capitation Care has built up over years in its products and services combo offer has resulted in high retention of customers, lower marketing costs, and greater ability of the firm to focus on its customers.
Organizational Resilience of Capitation Care
– The covid-19 pandemic has put organizational resilience at the centre of everthing that Capitation Care does. Organizational resilience comprises - Financial Resilience, Operational Resilience, Technological Resilience, Organizational Resilience, Business Model Resilience, and Reputation Resilience.
Strong track record of project management
– Capitation Care is known for sticking to its project targets. This enables the firm to manage – time, project costs, and have sustainable margins on the projects.
Superior customer experience
– The customer experience strategy of Capitation Care in the segment is based on four key concepts – personalization, simplification of complex needs, prompt response, and continuous engagement.
Operational resilience
– The operational resilience strategy in the Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments Harvard Business Review case study comprises – understanding the underlying the factors in the industry, building diversified operations across different geographies so that disruption in one part of the world doesn’t impact the overall performance of the firm, and integrating the various business operations and processes through its digital transformation drive.
Diverse revenue streams
– Capitation Care is present in almost all the verticals within the industry. This has provided firm in Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments case study a diverse revenue stream that has helped it to survive disruptions such as global pandemic in Covid-19, financial disruption of 2008, and supply chain disruption of 2021.
Weaknesses Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments | Internal Strategic Factors
What are Weaknesses in SWOT Analysis / TOWS Matrix / Weighted SWOT Analysis
The weaknesses of Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments are -
No frontier risks strategy
– After analyzing the HBR case study Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments, it seems that company is thinking about the frontier risks that can impact Finance & Accounting strategy. But it has very little resources allocation to manage the risks emerging from events such as natural disasters, climate change, melting of permafrost, tacking the rise of artificial intelligence, opportunities and threats emerging from commercialization of space etc.
Slow to strategic competitive environment developments
– As Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments HBR case study mentions - Capitation Care takes time to assess the upcoming competitions. This has led to missing out on atleast 2-3 big opportunities in the industry in last five years.
Ability to respond to the competition
– As the decision making is very deliberative, highlighted in the case study Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments, in the dynamic environment Capitation Care has struggled to respond to the nimble upstart competition. Capitation Care has reasonably good record with similar level competitors but it has struggled with new entrants taking away niches of its business.
High dependence on existing supply chain
– The disruption in the global supply chains because of the Covid-19 pandemic and blockage of the Suez Canal illustrated the fragile nature of Capitation Care supply chain. Even after few cautionary changes mentioned in the HBR case study - Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments, it is still heavily dependent upon the existing supply chain. The existing supply chain though brings in cost efficiencies but it has left Capitation Care vulnerable to further global disruptions in South East Asia.
Employees’ incomplete understanding of strategy
– From the instances in the HBR case study Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments, it seems that the employees of Capitation Care don’t have comprehensive understanding of the firm’s strategy. This is reflected in number of promotional campaigns over the last few years that had mixed messaging and competing priorities. Some of the strategic activities and services promoted in the promotional campaigns were not consistent with the organization’s strategy.
Aligning sales with marketing
– It come across in the case study Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments that the firm needs to have more collaboration between its sales team and marketing team. Sales professionals in the industry have deep experience in developing customer relationships. Marketing department in the case Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments can leverage the sales team experience to cultivate customer relationships as Capitation Care is planning to shift buying processes online.
Products dominated business model
– Even though Capitation Care has some of the most successful products in the industry, this business model has made each new product launch extremely critical for continuous financial growth of the organization. firm in the HBR case study - Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments should strive to include more intangible value offerings along with its core products and services.
High bargaining power of channel partners
– Because of the regulatory requirements, Regina E. Herzlinger, Thomas Nagle suggests that, Capitation Care is facing high bargaining power of the channel partners. So far it has not able to streamline the operations to reduce the bargaining power of the value chain partners in the industry.
Slow to harness new channels of communication
– Even though competitors are using new communication channels such as Instagram, Tiktok, and Snap, Capitation Care is slow explore the new channels of communication. These new channels of communication mentioned in marketing section of case study Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments can help to provide better information regarding products and services. It can also build an online community to further reach out to potential customers.
Slow decision making process
– As mentioned earlier in the report, Capitation Care has a very deliberative decision making approach. This approach has resulted in prudent decisions, but it has also resulted in missing opportunities in the industry over the last five years. Capitation Care even though has strong showing on digital transformation primary two stages, it has struggled to capitalize the power of digital transformation in marketing efforts and new venture efforts.
Lack of clear differentiation of Capitation Care products
– To increase the profitability and margins on the products, Capitation Care needs to provide more differentiated products than what it is currently offering in the marketplace.
Opportunities Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments | External Strategic Factors
What are Opportunities in the SWOT Analysis / TOWS Matrix / Weighted SWOT Analysis
The opportunities highlighted in the Harvard Business Review case study Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments are -
Finding new ways to collaborate
– Covid-19 has not only transformed business models of companies in Finance & Accounting industry, but it has also influenced the consumer preferences. Capitation Care can tie-up with other value chain partners to explore new opportunities regarding meeting customer demands and building a rewarding and engaging relationship.
Developing new processes and practices
– Capitation Care can develop new processes and procedures in Finance & Accounting industry using technology such as automation using artificial intelligence, real time transportation and products tracking, 3D modeling for concept development and new products pilot testing etc.
Lowering marketing communication costs
– 5G expansion will open new opportunities for Capitation Care in the field of marketing communication. It will bring down the cost of doing business, provide technology platform to build new products in the Finance & Accounting segment, and it will provide faster access to the consumers.
Identify volunteer opportunities
– Covid-19 has impacted working population in two ways – it has led to people soul searching about their professional choices, resulting in mass resignation. Secondly it has encouraged people to do things that they are passionate about. This has opened opportunities for businesses to build volunteer oriented socially driven projects. Capitation Care can explore opportunities that can attract volunteers and are consistent with its mission and vision.
Buying journey improvements
– Capitation Care can improve the customer journey of consumers in the industry by using analytics and artificial intelligence. Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments suggest that firm can provide automated chats to help consumers solve their own problems, provide online suggestions to get maximum out of the products and services, and help consumers to build a community where they can interact with each other to develop new features and uses.
Leveraging digital technologies
– Capitation Care can leverage digital technologies such as artificial intelligence and machine learning to automate the production process, customer analytics to get better insights into consumer behavior, realtime digital dashboards to get better sales tracking, logistics and transportation, product tracking, etc.
Harnessing reconfiguration of the global supply chains
– As the trade war between US and China heats up in the coming years, Capitation Care can build a diversified supply chain model across various countries in - South East Asia, India, and other parts of the world. This reconfiguration of global supply chain can help, as suggested in case study, Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments, to buy more products closer to the markets, and it can leverage its size and influence to get better deal from the local markets.
Loyalty marketing
– Capitation Care has focused on building a highly responsive customer relationship management platform. This platform is built on in-house data and driven by analytics and artificial intelligence. The customer analytics can help the organization to fine tune its loyalty marketing efforts, increase the wallet share of the organization, reduce wastage on mainstream advertising spending, build better pricing strategies using personalization, etc.
Changes in consumer behavior post Covid-19
– Consumer behavior has changed in the Finance & Accounting industry because of Covid-19 restrictions. Some of this behavior will stay once things get back to normal. Capitation Care can take advantage of these changes in consumer behavior to build a far more efficient business model. For example consumer regular ordering of products can reduce both last mile delivery costs and market penetration costs. Capitation Care can further use this consumer data to build better customer loyalty, provide better products and service collection, and improve the value proposition in inflationary times.
Manufacturing automation
– Capitation Care can use the latest technology developments to improve its manufacturing and designing process in Finance & Accounting segment. It can use CAD and 3D printing to build a quick prototype and pilot testing products. It can leverage automation using machine learning and artificial intelligence to do faster production at lowers costs, and it can leverage the growth in satellite and tracking technologies to improve inventory management, transportation, and shipping.
Creating value in data economy
– The success of analytics program of Capitation Care has opened avenues for new revenue streams for the organization in the industry. This can help Capitation Care to build a more holistic ecosystem as suggested in the Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments case study. Capitation Care can build new products and services such as - data insight services, data privacy related products, data based consulting services, etc.
Reconfiguring business model
– The expansion of digital payment system, the bringing down of international transactions costs using Bitcoin and other blockchain based currencies, etc can help Capitation Care to reconfigure its entire business model. For example it can used blockchain based technologies to reduce piracy of its products in the big markets such as China. Secondly it can use the popularity of e-commerce in various developing markets to build a Direct to Customer business model rather than the current Channel Heavy distribution network.
Better consumer reach
– The expansion of the 5G network will help Capitation Care to increase its market reach. Capitation Care will be able to reach out to new customers. Secondly 5G will also provide technology framework to build new tools and products that can help more immersive consumer experience and faster consumer journey.
Threats Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments External Strategic Factors
What are Threats in the SWOT Analysis / TOWS Matrix / Weighted SWOT Analysis
The threats mentioned in the HBR case study Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments are -
Consumer confidence and its impact on Capitation Care demand
– There is a high probability of declining consumer confidence, given – high inflammation rate, rise of gig economy, lower job stability, increasing cost of living, higher interest rates, and aging demography. All the factors contribute to people saving higher rate of their income, resulting in lower consumer demand in the industry and other sectors.
Technology acceleration in Forth Industrial Revolution
– Capitation Care has witnessed rapid integration of technology during Covid-19 in the Finance & Accounting industry. As one of the leading players in the industry, Capitation Care needs to keep up with the evolution of technology in the Finance & Accounting sector. According to Mckinsey study top managers believe that the adoption of technology in operations, communications is 20-25 times faster than what they planned in the beginning of 2019.
Increasing international competition and downward pressure on margins
– Apart from technology driven competitive advantage dilution, Capitation Care can face downward pressure on margins from increasing competition from international players. The international players have stable revenue in their home market and can use those resources to penetrate prominent markets illustrated in HBR case study Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments .
High level of anxiety and lack of motivation
– the Great Resignation in United States is the sign of broader dissatisfaction among the workforce in United States. Capitation Care needs to understand the core reasons impacting the Finance & Accounting industry. This will help it in building a better workplace.
Regulatory challenges
– Capitation Care needs to prepare for regulatory challenges as consumer protection groups and other pressure groups are vigorously advocating for more regulations on big business - to reduce inequality, to create a level playing field, to product data privacy and consumer privacy, to reduce the influence of big money on democratic institutions, etc. This can lead to significant changes in the Finance & Accounting industry regulations.
Technology disruption because of hacks, piracy etc
– The colonial pipeline illustrated, how vulnerable modern organization are to international hackers, miscreants, and disruptors. The cyber security interruption, data leaks, etc can seriously jeopardize the future growth of the organization.
Learning curve for new practices
– As the technology based on artificial intelligence and machine learning platform is getting complex, as highlighted in case study Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments, Capitation Care may face longer learning curve for training and development of existing employees. This can open space for more nimble competitors in the field of Finance & Accounting .
Increasing wage structure of Capitation Care
– Post Covid-19 there is a sharp increase in the wages especially in the jobs that require interaction with people. The increasing wages can put downward pressure on the margins of Capitation Care.
Capital market disruption
– During the Covid-19, Dow Jones has touched record high. The valuations of a number of companies are way beyond their existing business model potential. This can lead to capital market correction which can put a number of suppliers, collaborators, value chain partners in great financial difficulty. It will directly impact the business of Capitation Care.
New competition
– After the dotcom bust of 2001, financial crisis of 2008-09, the business formation in US economy had declined. But in 2020 alone, there are more than 1.5 million new business applications in United States. This can lead to greater competition for Capitation Care in the Finance & Accounting sector and impact the bottomline of the organization.
Aging population
– As the populations of most advanced economies are aging, it will lead to high social security costs, higher savings among population, and lower demand for goods and services in the economy. The household savings in US, France, UK, Germany, and Japan are growing faster than predicted because of uncertainty caused by pandemic.
Instability in the European markets
– European Union markets are facing three big challenges post Covid – expanded balance sheets, Brexit related business disruption, and aggressive Russia looking to distract the existing security mechanism. Capitation Care will face different problems in different parts of Europe. For example it will face inflationary pressures in UK, France, and Germany, balance sheet expansion and demand challenges in Southern European countries, and geopolitical instability in the Eastern Europe.
Environmental challenges
– Capitation Care needs to have a robust strategy against the disruptions arising from climate change and energy requirements. EU has identified it as key priority area and spending 30% of its 880 billion Euros European post Covid-19 recovery funds on green technology. Capitation Care can take advantage of this fund but it will also bring new competitors in the Finance & Accounting industry.
Weighted SWOT Analysis of Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments Template, Example
Not all factors mentioned under the Strengths, Weakness, Opportunities, and Threats quadrants in the SWOT Analysis are equal. Managers in the HBR case study Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments needs to zero down on the relative importance of each factor mentioned in the Strengths, Weakness, Opportunities, and Threats quadrants.
We can provide the relative importance to each factor by assigning relative weights. Weighted SWOT analysis process is a three stage process –
First stage for doing weighted SWOT analysis of the case study Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments is to rank the strengths and weaknesses of the organization. This will help you to assess the most important strengths and weaknesses of the firm and which one of the strengths and weaknesses mentioned in the initial lists are marginal and can be left out.
Second stage for conducting weighted SWOT analysis of the Harvard case study Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments is to give probabilities to the external strategic factors thus better understanding the opportunities and threats arising out of macro environment changes and developments.
Third stage of constructing weighted SWOT analysis of Note on Managed Care Reimbursement of Health Care Providers: Case-Based, Per Diem, and Capitation Payments is to provide strategic recommendations includes – joining likelihood of external strategic factors such as opportunities and threats to the internal strategic factors – strengths and weaknesses. You should start with external factors as they will provide the direction of the overall industry. Secondly by joining probabilities with internal strategic factors can help the company not only strategic fit but also the most probably strategic trade-off that Capitation Care needs to make to build a sustainable competitive advantage.
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