Running Head: STRATEGIC PLAN

Strategic Plan
Team 1
Anita Altawan, Brian Chancellor,
Joseph Cleary, & Jessica Ehinger

A project submitted in partial fulfillment

of the requirement for the degree
Master of Arts in Leadership

Siena Heights University

Southfield, Michigan

3/27/2016

Running Head: STRATEGIC PLAN

Background and Overview of the Organization

In 1993, three Central Iowa hospitals came together to form what was known as
Iowa Health System. These organizations were: Blank Childrens Hospital, Iowa
Methodist Medical Center and Iowa Lutheran Hospital. Later that same year Iowa Health
Physicians group joined and the name was changed to Iowa Health Des Moines.
Between the years of 1995-1999 the health system saw the addition of St. Lukes
Methodist Hospital in Cedar Rapids, Allen Memorial Hospital in Waterloo, St. Lukes
Region Medical Center in Sioux City, Finley Hospital in Dubuque, Jones Regional
Medical Center in Anamosa, Trinity Regional Medical Center in Fort Dodge, and Trinity
Regional Health System in the Quad Cities. In 2009 the system saw the addition of Unity
Health Care, which would later become Trinity Muscatine. That same year Iowa Health
System launches Health Net Connect, a 3,200-mile fiber optic network from Denver to
Chicago, and e-Prescribe Iowa, the nations first statewide electronic prescribing
program. The following year Iowa Health System was rated one of the top health care
systems in the U.S. by Thomson Reuters. In 2011 Methodist Medical Center of Illinois
joins Iowa Health System and The Centers for Medicare and Medicaid Services select
Trinity Regional Medical Center and Trimark Physicians as one of the nations original
Pioneer Accountable Care Organizations. It was in 2013 that Iowa Health System would
change its name to UnityPoint Health to reflect the way its hospitals, physicians and
home care entities are transforming health care delivery through patient-centered
coordinated care (Sinnard, 2013, p. 1). This change in name was in order to symbolize
the difference between the former hospital-centered health care process to one that more

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effectively addressed the total care of all patients, whether they were at a clinic, a hospital
or home (History, 2015, p. 1).
Today, Unity Point is the 5th largest nondenominational healthcare system in the
nation with over 24,000 employees including 900 providers in over 28 clinics and 29
hospitals (History, 2015). Eric Crowell, President and CEO of Unity Point had the
following to say about UnityPoint Health:
We are dedicated to our mission of improving the health of our community
through healing, caring and teaching. Another vital part of our mission is teaching
and training the health care workers of tomorrow. Through residency programs,
clinical education programs, workshops and seminars, we provide the training
necessary to assure continuing quality healthcare in our community. Working as
caregivers, volunteers and teachers, the dedicated physicians and staff of our
hospitals and clinics continue to reach out to improve the health of our
communities and every patient we serve (Message, 2015.)
Directional Strategies
Mission
The role of a mission for an organization is to describe the organizations purpose.
The mission is a starting point in the development of the strategic vision of the
organization (Logan, 2004). The mission of UnityPoint Health is to improve the health
of the people and communities we serve (Mission and Values, 2015, p. 1).
Vision
The vision of the organization describes its ideal future. It incorporates the values
and the mission of the organization. The vision unites the members for the organization

Running Head: STRATEGIC PLAN

toward a shared strategic direction (Logan, 2004). The vision of UnityPoint Health is to
achieve the best outcome for every patient every time (Mission and Values, 2015, p. 1).
Values
An organizations values acts as guidelines for behavior and conduct in an effort
to achieve the vision. Values reflect how the organization carries out their mission
(Logan, 2004). There are five core values that UnityPoint Health emphasizes and they
include; integrity, pursuit of excellence, partnership, community stewardship and placing
the patient first. UnityPoint Healths focus on integrity is rooted in transparency of
quality and service metrics to the public. In its pursuit of excellence, UnityPoint Health
embraces innovation, creates a positive work environment for staff, and utilizes bestpractices and evidence based care. This organization is an Accountable Care Organization
(ACO) that integrates partnering to facilitate care coordination and access. Within
community stewardship, UnityPoint Health promotes wellness and prevention as well as
assesses for community needs. This organization places the patient first by the care that
they provide as well as the coordination of care throughout the patients entire
experience.
Goals
The primary goal of UnityPoint Health is to advance their Triple Aim (The
IHI, 2016). The three aims include; better value and affordable care costs for all, better
health for individual patients and better health for UnityPoints community. More specific
goals are then derived from this Triple Aim. The progress toward these goals is
measured yearly though survey data and the results of the progress are shared in the
organizations annual reports (The Journey, 2015).

Running Head: STRATEGIC PLAN

One of these goals is that UnityPoint Health strives to increase transparency.

Performance results are being made accessible to the general public and shared with
employees. Transparency of performance results will hopefully drive performance. In
2016, they will begin to share quality, patient experience, and cost of care data so that
patients can make a conscious decision as to which site of care they should choose (The
Journey, 2015).
In an effort to remove uncertainty and fragmentation from the current healthcare
journey, UnityPoint Health strives to improve coordination of care between members of
its ACO. This fluid movement through the patient experience is further aided by clinical
care pathways. These clinical care pathways sequence interventions and provide
timeframes as well as expected outcomes for standardizing treatment of certain diagnoses
(The Journey, 2015).
The organization is advancing itself in the use of telehealth as well to improve
access. Along with being an ACO, it has an EpicCare program that sends notifications to
the patient providers when they come to the hospital (The Journey, 2015). A
recommended goal for UnityPoint Health would be to advance itself further in the use of
telehealth. Since much the community in which is provided for is in rural settings, the use
of telehealth can greatly improve access.
External Environmental Analysis
General
Social. Many large social changes in the general environment are readily apparent
including that the population of the United States is becoming more diverse, pursuing
more education (and student loans), and our aging population is expanding. The

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expansion of the ageing population is discussed further in the industry-specific section

below.
The population of the United States is trending toward becoming more racially
and culturally diverse. Projections predict that by 2043, the white population will fall
below a majority and the US population will become a minority majority. While currently
the minorities represent 37% of the population, it is projected that they will make up 57%
in 2060 ("U.S. Census," 2012). This will have implications to healthcare in that there will
be an increased need for cultural competency. Hopefully there will be a diversification of
healthcare leadership to advocate for and represent the population to which it cares.
Although the minority population comprises 35% of the population, it only comprises
17% of nurses and 12.3% of medical school graduates (Betancourt, Beiter, & Landry,
2013).
The trend of education over the past few generations has been to receive higher
levels of education. Although this is definitely positive for the education of the average
American, it has great implications on the financial status of families. As of 2012, thirtyseven million individuals and an astonishing 15.4% of households owe on student loans.
The average 2010 college graduate from a four-year university owed over $25,250 in
student loans. Studies show that approximately 21% of student loans are either delinquent
or in default (Daniel, 2013). As our American population incurs more debt and increasing
monthly payments for student loans, they will have less means by which to pay other
bills, such as medical expenses.

Running Head: STRATEGIC PLAN

Economic. The 2008 recession marked an increase in unemployment and for

many a loss of healthcare coverage. The economic picture at the time of the ACA passage
was very different than it is today. The following is a reflection of the past five years:

Since the passage of the ACA in 2010, 13.4 mission more Americans have
found employment. In 2014 and 2015 an average of 200,000 jobs per
month were added, which is the largest increase of jobs in a single year
since the 1990s (Schoen, 2016).

Unemployment has decreased from 9.9 percent to a mere five percent over
the last five years. However, these gains are in the private sector, and
employment in the public sector is actually down since 2010. All of the
job growth has been though full-time jobs, despite fears that the ACA
would cause employers to transition those to part-time jobs to avoid
paying benefits (Schoen, 2016).

There has also been a decline of 3 million in those who are working parttime but would rather be working full-time (Schoen, 2016).

Over the past five years, healthcare spending growth per person has
slowed (Schoen, 2016).

The expansion of Medicaid by some states also has large economic implications.
Many factors impact whether Medicaid expansion will be beneficial to the state and the
impact that it will have on the healthcare economics of that state. Important variables that
impact these effects include the number of Medicaid eligible candidates, the medical
spending burden, and the state costs of Medicaid expansion (Caswell, Waidmann, &

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Blumberg, 2013). So far 30 states and the District of Columbia have chosen to expand
their Medicaid programs (Coverage, 2015).
Industry-Specific
Social. There are social changes that have large implications in the healthcare
industry. The baby boomer generation is aging as well as our life expectancy and our
ability to extend life through multiple comorbidities. In 2012 the estimated population
over the age of 65 was 43.1 million. By the year 2050 the expected population of this age
is 83.7 million. In the year of 2050, those baby boomers who are still alive will be over
the age of 85 (Ortman, Velkoff, & Hogan, 2014). The prevalence of comorbidities in
those over the age of 85 is higher compared to other populations over 65 (Ahluwalia er
al., 2011). This emphasizes the importance of coordination of care between the services
that manage these comorbidities. Healthcare organizations will have to adjust to having a
large population that is moving into an age category that increases healthcare demand.
This increase of demand will be coinciding with a decrease in supply of healthcare
workers. The aging population will also mean the retirement of a large portion of the
healthcare workforce. As our society has a larger class of higher aged individuals and less
of us to care for their needs, a problem emerges. On the side of supply, the population of
nursing is aging. A 2010 study reveals that the average age for the working nurse is 46.8
years old more than half of those intended to retire by 2020 (Mullenbach, 2010). By
2020, it is estimated that there will be a shortage of 800,000 nurses (Ginter, Duncan, &
Swayne, 2013). Another large strain for nursing demand that is often not talked about is
the decrease in the lengths of stay and the increase of acuity over the course of the stay

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for patients (Upenieks, 2005). This means an increase in the number of FTEs per floor
and more skilled nursing to care for these patients.
Economic. The economic environment has greatly changed since the
institution of the Affordable Care Act. Healthcare coverage and cost is constantly
growing and changing to adapt to the implications of the ACA. Some insurers have
proposed increases exceeding 40 percent for 2016 because of the impact of not having the
young (under 26) healthy population paying for their healthcare (Battersby, 2015). It is
never really discussed that having individuals under the age of 26 stay on their parents
healthcare may actually have a negative effect in driving up healthcare costs in the
chance that they are deferring their own insurance and not paying in while their usage is
minimal.
Along with the changes that happened on a large scale with the ACA, there were
changes at the organizational level such as the establishment of accountable care
organizations (ACO). As discussed at the ACO summit, the goals of these ACOs are to
improve access, reform payment practices, provide better population health, and improve
physician alignment (Koury et al., 2014). The reform to the current payment system has
led many ACOs to large profits when the savings are spit with the Medicaid Shared
Savings Program (MSSP). In a study of 32 ACOs that began the program in 2012, 12 of
the ACOs received a total of $76 million in combined savings. This was part of the shared
savings of $147 million from these organizations. There was only one organization that
shared in losses through the program (Petersen & Muhlestein, 2014). As these
organizations become accountable for their care and the financial incentive is present to
reduce costs they will look for means to reduce waste. This would assuredly include tools

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10

like Six Sigma or activity-based costing (ABC). Much of the waste of previously divided
entities will be reduced as these ACOs become responsible for the entire coordination of
care and treatment of the patient. As we discussed above, there will be a flux in the older
population who are living with comorbidities so coordination of this populations care
will become ever increasingly important.
Service Area Competitor Analysis
The Service Area
The outreach of UnityPoint Health extends through the populations of Iowa,
Illinois, and Wisconsin ranging through the geographical regions of nine large areas. The
pertinent demographic communities include Anamosa (Iowa), Cedar Rapids (Iowa), Des
Moines (Iowa), Dubuque (Iowa), Fort Dodge (Iowa), Meriter (Madison, WI), Peoria
(Illinois), Quad Cities/Muscatine (Iowa, Illinois), Sioux City (Iowa), and Waterloo
(Iowa). With the
current location of
our university we
have decided to
locally refer to the
Meriter (Madison,
WI) location in
reference with our
location in
Michigan.

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11

Meriter (Madison, WI) is home to the location of UnityPoint Health. The

population of Madison is considered on the urban end, with a population of 245,691
(population estimates, 2014, para. 1). The Meriter UnityPoint health system has a
discharge rate of 21,457 a year (Reports Detail, 2016, para. 1). Per the United States
Census, Madison Wisconsin the health information provided included with a disability,
under age 65 years, percent, 2010-2014 = 6.5% and persons without health insurance,
under age 65 years, percent = 8.3% (US Census, 2010-2014). With the service area of
Madison, WI the total health care and social assistance receipts/revenue, 2012 ($1,000)
= 4,054,428 (US Census, 2010-2014). The health system of UnityPoint directly serves
the community providing adult intensive care, alcohol/chemical dependency,
cardiovascular, emergency, gynecology, hospice/palliative care, neonatal intensive care,
neurology, obstetrics, oncology, orthopedics, pediatrics, psychiatry, pulmonary,
rehabilitation/physical medicine, trauma, urology/nephrology (Reports Detail, 2016,
para. 1). The wide variety of healthcare possibilities is what allows for healthcare
acceptance across the demographical board. Per the Kaiser Family Foundation:
Individuals who have newly gained coverage in the Marketplace are beginning to
interact with their new health plans and seek care. By preserving its limited
Medicaid expansion, Wisconsin continues to forgo significant federal funding
available for coverage of adults. However, there is no gap in coverage for adults
in Wisconsin unlike other states that have not implemented the Medicaid
expansion and Wisconsin could elect to move forward with the full expansion in
the future. Meanwhile, the health care system and providers in Wisconsin, as in all
states, is evolving in response to new demands, changing health care markets, and

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emerging models of health care delivery and payment. It remains to be seen how
these and other changes under the ACA will affect the health, health care access,
and health care utilization of Wisconsinites in the long term (The Wisconsin,
2015, para. 33).
The demographics and logistics of the Madison, Wisconsin health area is wide
and various in the demands it meeting and exceeding. The provisions of UnityPoint help
to move these developments forward in the expansion of covering a vast demographic of
individuals and their care needs. The Kaiser Family Foundation (The Wisconsin, 2015)
provided a plethora of pertinent information specifically describing the logistics of the
Wisconsin population stating Wisconsin has long been a leader among states in
expanding coverage to its low-income residents since even before the major coverage
provisions of the Affordable Care Act (ACA) took effect on January 1, 2014. While
Governor Scott Walker decided not to adopt the Medicaid expansion, thousands of
previously uninsured Wisconsinites have enrolled in health coverage through the states
broad BadgerCare Medicaid waiver, which increases coverage to low-income
populations, and through
the new Health Insurance
Marketplace. (The
Wisconsin, 2015, para. 1).
Sharing this information

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13

lays the environmental picture of UnityPoints Healthcare system as a whole and the
demographics it reaches.
Competitor Analysis
Upon research of the UnityPoint Health demographical area and span throughout
the communities the competitor analysis elaborated on several networks. For the logistics
of this plan, the information provided will be from Mercy Health Network Inc., The
University of Iowa, and Genesis Health System.
To begin the Genesis Health System, is an institute operating three acute care
hospitals in the Iowa and Illinois areas. The Davenport, Iowa Genesis Health System
allows for 502 beds and this hospital provides general, surgical, and specialist health
services and employs over 450 physicians and staffs up to 3,100 employees with the
added benefit of 1,000 volunteers at any one time. A strength of the Genesis Health
System is in October of 2005, Genesis Medical Center Davenport became one of the
three percent of roughly 6000 hospitals in the United States to achieve the highest honor
in nursing; Magnet status (Genesis Health, n.d.). The benefit of a recognition such as this,
it allows for the public to feel confident and aware of their own healthcare. The
procurement of a safe atmosphere provides trust between patient and care provider.
The establishment of Genesis Health System was rated on a scale of five stars,
receiving a point value of three stars. Patients surveys reported 49 percent strongly
agree they understood their care when they left the hospital (Hospital Compare, n.d.).
Additionally it was found that 74 percent of patients reported that their nurses always
communicated well (Hospital Compare, n.d.). As a comparative section the definitive
differences between the strengths and weaknesses of the Genesis Health System is

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evident. Being they were recognized for an excellence in nursing but patients report a
lack of communication. Both accounts are taken into consideration when weighing the
competitor analysis of these health establishments.
Secondly, The University of Iowa Hospital and Clinic employs 1,617 physicians,
residents, and fellows. Currently employing 6,730 non-physician individuals and 1,904
educated nurses, and overall allowing 1,500 volunteers to influence the care and comfort
of their patients. The main and strongest impact The Iowa University Health system has
been able to implement is that of a recognition from Forbes magazine presenting Forbes
Magazine named University of Iowa Health Care as the Number 1 employer in the Health
Care industry category and Number 7 employer overall (2016) (Forbes, 2016, para. 1).
Having the ability to be recognized for such a feat is a true testament to a healthcare work
environment dedicated to the future of its employees. The Iowa University Health System
is developing an organization that individuals can be proud to work for allowing for them
to thrive and provide excellent, uninterrupted care.
Although the University of Iowa was recognized for the excellent employment
opportunities and work environment: with every strength there comes some apparent
weaknesses. Information provided via hospital compare, Medicare.gov University of
Iowa Hospital and Clinics received a three of five star rating. Patients who reported that
staff always explained about medicines before giving it to them was reported at only
59% (Hospital Compare, n.d.). Aspects of communication were also evaluated where
patients who strongly agree they understood their care when they left the hospital was
only at 50% (Hospital Compare, n.d.). The variance between excellent work environment
and the safety of their patients regarding patient education and medication reconciliation

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is alarming. Strengths and weaknesses were truly identified here and add to the definition
of competitor analysis.
Lastly the third competitor analysis of UnityPoint Health comes from the Mercy
Health Network Inc. A foundation combined of the two largest catholic, non for profit
health organizations in the United States. Mercy Health Network Inc., developed and
implemented a successful TeleHealth application. Stating Established in 1993 as a joint
development program of Mercy Medical Center - Des Moines and Mercy Medical Center
- North Iowa, the membership of the Midwest Rural Telemedicine Consortium (MRTC)
currently consists of 25 health care provider organizations (TeleHealth, 2016, para. 1).
This MRTC that was established is the largest telemedicine program in Iowa (TeleHealth,
2016). A true strength allowing for a wider patient reach using the implementation
processes of the TeleHealth technology.
The affiliated health care center to Mercy Health Network Inc. is their Des
Moines location. Mercy Medical Center-Des Moines, upon research the weaknesses
began to appear. Per the Medicare.gov website on hospital compartments Mercy Medical
Center as a partner in Mercy Health Network Inc. was rated poorly on several aspects.
When rated by a patient survey, Mercy Medical Center received a three out of a five star
rating. Sharing several individual ratings will develop an idea of where exactly the
weaknesses lay within the Mercy Health Network Inc. It was reported that patients who
reported that they always received help as soon as they wanted was a mere 56 percent
(Hospital Compare, n.d.). Another main objective to the healthcare industry is that of
communication and an open line between care provider and patient. As stated by the
hospital compare provided by Medicare.gov, patients who strongly agree they

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understood their care when they left the hospital was rated for only 53% (Hospital
Compare, n.d.). Relatively the differences between the innovations of TeleHealth and the
discrepancies of communication lack, do paint a vivid idea of Mercy Health Network
Inc.s strengths and weaknesses.
Internal Environmental Analysis
Service Delivery
At UnityPoint and other health care organizations, the moment the patient arrives,
the point-of-service activities begin to take place. When the point-of-service occurs there
are many ways in which value is created for the patient. Some items patients may look at
are wait times, if the nurse is courteous, and any important information a patient should
be notified about with their health. Almost all hospital attempt to improve their point-ofservice at one time or another. According to Ginter, Duncan, and Swayne (2013),
Numerous public and private organizations have attempted to improve point-of-service
by ensuring the delivery of higher-quality services. However, there continues to be
considerable controversy as to how effective service improvements alone can lead to
sustainable competitive advantage (p. 135).
Point of Service
Strengths
Communication

Weaknesses
Health Promotion and Education

Timely Care
Patient Physician Rating

UnityPoint Health ranked above the 50th percentile of all Medical Shared Savings
Program (MSSP) Accountable Care Organizations in eight of the ten areas surveyed. The
feedback received from the patients is vital to help direct UnityPoint with improvements

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for patient care. Good communication is a key factor in helping patients decrease their
anxiety levels and common concerns.
Point of Service
Resources Competencies Capabilities
Value (High or Low)
High
High
High
Rare (Yes or No)
Yes
Yes
Yes
Imitability (Difficult or Easy) Difficult
Difficult
Difficult
Sustainability (Yes or No)
Yes
Yes
Yes
Resources are the stocks of human and nonhuman factors that are available for use
in producing goods and services (i.e. tangible = land, labor, or capital; intangible =
intellectual property, reputation, and goodwill).
Competency the collective knowledge and skills possessed by individuals may be a
source of sustained competitive advantage for the organization.
Capabilities an organizations ability to deploy resources and competencies, usually
in combination, to produce desired services. Capabilities fall into one of the
following two categories:
The ability to make dynamic improvements to the organizations activities
through learning, renewal, and change over time; or
The ability to develop strategic insights and recognize and arrange
resources and competencies OR to develop novel strategies before or
better than competitors.
According to Ginter et al., Strengths must have value, be rare, be difficult to
imitate, and sustainable in order to create a competitive edge (p. 146). One competitive
advantage Unity Point holds is in communication. In 2015, the theme for UnityPoints
Leadership Symposium was Unity begins with you. It is when physicians, employees
and leaders across UnityPoint embrace this phrase then at that moment individuals will
do what is right for their patients, their families and everyone they serve. There were
more than 400 leaders that gathered to the first annual Own the Moment patient
experience conference in 2015. This meeting assisted leaders with understanding the
feedback gathered from patients and help recognize the need for improvement. At

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UnityPoint, their key strength is communication and that is what they are working on to
improve. They have a built infrastructure that allocates human and financial resources to
improve the experience of the patients they serve. Communication is a key strength that
UnityPoint Possesses, but they are always trying to improve.
The main weakness of UnityPoint is health promotion and education.
UnityPoints limited health literacy is a developed program to help with health promotion
and education. It is the ability for a patient to obtain, process, and understand basic
health information and services. It affects a patients entire health experience at
UnityPoint. Patients who have low health literacy are more likely to not take
preventative measures and later on require hospitalization that could have been
prevented.
Approximately 90 million individuals have difficulty understanding and using
health information. You have to have the ability to read, understand, and effectively use
basic health information. Low health literacy affects all types of individuals no matter
their background or educational level. UnityPoint Health works with hospitals,
outpatient clinics, and home health teams to develop communication tools and implement
strategies that help increase an individuals understanding and provide a better patients or
family experience. Ginter et al. says, The strategic relevancy of each weakness can be
determined by asking questions similar to those used to evaluate strengths (p. 150).
UnityPoint has a goal to increase health promotion and education and has implemented a
strategic plan to improve this weakness of theirs.
Organizational Structure

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UnityPoint Health Partners have made several important changes to its

governance structure. The health care organization has added more physicians to the
board of managers, finance, and network development. UnityPoint Health has also
created an advisory team which is comprised of executive leaders of independent
physician groups across the network to help analyze and provide valuable input and
guidance on key issues such as rick model development, data sharing and network
evolution. UnityPoint has created structured governance in order to be successful.
Organizational Structure
TYPE: Matrix
Strengths

Weaknesses

Patient-Centered Leadership

None Visible

UnityPoints governance is focused on patient-centered leadership. The Board of

Directors governs the organization caringly, responsibly, choosing to adopt many best
practices so they can focus on patient care, patient concerns, and the patients health.
According to UnityPoint Health, When individuals choose a UnityPoint Health hospital,
clinic, physician, or partner, they can be confident that the organization providing the care
or service is organized and governed properly and consistent with the best practices in
nonprofit governance (Good Governance, 2015, para. 2). Their key strength is
patient-centered governance and not many nonprofit organizations can provide
governance such as this one. I did not see a weakness that UnityPoint Health possesses.
This may be due to their large organization because they have all of the key areas
covered.
Organizational Structure

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Resources Competencies Capabilities

Value (High or Low)
High
High
High
Rare (Yes or No)
Yes
Yes
Yes
Imitability (Difficult or Easy) Difficult
Difficult
Difficult
Sustainability (Yes or No)
Yes
Yes
Yes
Resources are the stocks of human and nonhuman factors that are available for use
in producing goods and services (i.e. tangible = land, labor, or capital; intangible =
intellectual property, reputation, and goodwill).
Competency the collective knowledge and skills possessed by individuals may be a
source of sustained competitive advantage for the organization.
Capabilities an organizations ability to deploy resources and competencies, usually
in combination, to produce desired services. Capabilities fall into one of the
following two categories:
The ability to make dynamic improvements to the organizations activities
through learning, renewal, and change over time; or
The ability to develop strategic insights and recognize and arrange
resources and competencies OR to develop novel strategies before or
better than competitors.
Based on the evaluation of UnityPoint Health, the point-of-service for your
organization is a competitive strength. UnityPoint Health does a monthly, quartly, and
annual review of its strengths and weaknesses. This organization has a competitive
advantage because of its structure governance. The organization has all of its bases
covered in order to keep the competitive advantage. You are looking at multiple areas
when it comes to point-of-service. Not only do the big key items in an organization
count, but the little items count too. UnityPoint Health is consistently improving the
strengths and weaknesses in order to keep the competitive advantage. Ginter et al. says,
In Todays environment, strengths can quickly become weaknesses as successful
strategies are challenged by competitors. A critical component of strategic momentum is
continuous evaluation of the organizations strengths and weaknesses relative to the

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environment (p. 136). This is why UnityPoint Health has been successful because they
watching their competitors, while analyzing and trying to make adjustments to their own
organization.
Strategy Formulation
Overview
The specific areas based upon the reaches of UnityPoint Health and the
information provided throughout this plan has lead us to interpret the best interest of this
health organization is to expand. By way of expanding UnityPoint has the ability to
influence other health organizations and to reach more of the surrounding population.
Increasing the quality of their patient care and the influence on the population. As
discussed previously in this plan, the utilization of the general area of Madison, WI at the
location of Meriter UnityPoint Health. Upon research it was discovered that a review of
UnityPoint Health provided specific information pertaining to the expansion recently
developed within the Wisconsin area. Akanksha Jayanthi discussed:
UnityPoint Health expands its presence in the Midwest through a number of
affiliations. Most recently, UnityPoint Health Waterloo signed a letter of intent
with Black Hawk Grundy Mental Health Center. One of the health system's
larger affiliations was finalized in January when UnityHealth Point announced a
strategic partnership in its affiliation with Madison, Wis.-based Meriter Health
Services. Overall, the health system has 30 affiliated clinic and home care
locations (Jayanthi, 2014, para. 12).

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It is the best interest of UnityPoint Health as a healthcare organization to continue

the expansion of their methods, culture, and technologies to provide exceptional care to
the communities and populations of the Midwest regions.
Adaptive Strategy
The adaptive strategy most effective in the expansion and already in motion
direction of UnityPoint Health we feel to be that of market development, pursing an
expansion to utilize an influence of quality care in the marketplace. With the utilization of
a geographical market in the horizontal integration UnityPoint Health as described by
Akanksha Jayanthi is, with 17 acute-care hospitals, 15 community network hospitals and
more than 280 clinic locations, it is among the 15 largest nonprofit health systems in the
country and is the fourth largest nondenominational health system (Jayanthi, 2014, para.
3). The market development already in progression is providing the same exceptional
care but to new market areas such as communities, cities, and surrounding states. The
confirmation that UnityPoint Health is successfully expanding is demonstrated in that of
the information provided, reaching the status of 15th largest nonprofit health system in the
country. In the successfulness of UnityPoint Health it is also important to recognize the
factors of a focused factory strategy that could also be applied to the strategic expansion
of this healthcare organization. As stated by Ginter et al. (2013), this strategy involves
providing comprehensive services across multiple markets (horizontal integration) for
one specific disease such as diabetes, renal disease, asthma, or cardiac disease (p. 221222). Provided UnityPoint Health expanded incorporating 280 clinic locations, ranging
from dermatology, home health, and wound care just to name a few. The success of
UnityPoints expansion is truly apparent (Jayanthi, 2014).

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23

To evaluate the adaptive strategy to expand we will use the TOWS and SPACE
analysis. A TOWS analysis looks at the threats, opportunities (environment) and
weaknesses, strengths (organization).
Strengths
-skilled

workforce

Weaknesses

Opportunities

Threats

-investments in

-new acquisitions

-tax changes

-experienced

research and

-global markets

-rising cost of raw

business units

development

-growth rates and

materials

-existing

-future debt rating

profitability

-increase in labor

distribution and

-brand portfolio

costs

sales networks

-competitive market

-growing

-barriers of market

-future profitability

competition and

entry

-productivity

lower profitability

-monetary

-increasing rates of

assistance provided

interest

-high growth rate

(UnityPoint Health, para 4-8)
One of UnityPoints biggest threats is itself. As an organization begins to expand
its portfolio and cover a larger geographical area, it becomes harder to maintain the same
quality and service provided. Opportunities to expand horizontally have been plentiful
and with more clinics, CAHs, and providers looking to shift the risk away from
themselves it is a great time to continue that expansion. UnityPoints biggest strength and
asset is its 28,000 plus employees who have a vast knowledge base with many years of

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24

experience. UnityPoint has been expanding successfully and has continued to do so for
over 20 years. An organizational weakness with expansion is creating new positions and
expanding the chain of command. A SPACE analysis (Strategic Position and Action
Evaluation) looks at the environmental stability, industry attractiveness (external) and
competitive advantage, financial strength (internal). With the introduction of Obamacare
and the expansion of Medicaid services the environment in which to expand has not only
been sustainable but seen the need for growth and expansion. With the size of UnityPoint
as an organization it has allowed all affiliates to keep up with technological change that
may not otherwise be possible. This has also created industry attractiveness through
financial
stability,
resource
utilization and
allocation, and
value based
purchasing.
Through its
already
completed
expansions
UnityPoint has
gained a competitive advantage through increased market share and product lifecycle,
thus creating great financial stability.

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25

Market-Entry Strategy
Based upon the decision to utilize the adaptive strategy of market development it
is appropriate to implement the aspect of a market entry strategy pertaining to
cooperation, specifically in the action of mergers. Per Ginter et al. (2013), in mergers,
however, the two organizations combine through mutual agreement to form a single new
organization, often with a new name (p. 232). As described in the development of this
plan UnityPoint Health was established being the product of several mergers throughout
the states of Iowa, Illinois, and Wisconsin. Combining in 2013 to become UnityPoint
Health, within these mergers there are a definitive amount of positive strategies
developed for the successfulness of this healthcare organization. A merger of healthcare
providers allows for the improvement of efficiency and effectiveness and the
enhancement of the populations access in the surroundings market areas (Ginter et al.,
2013). The fit of mergers within the UnityPoint Health system is an effective strategy as
they have already seen productive and established locations all working with the
UnityPoint HealthCares reach. Jayanthi as discussed above provided exceptional
information in the cooperation of UnityPoint and other healthcare establishments to
elaborate quality care. Jayanthi (2014) states:
UnityPoint is a leader in connected health technologies. The health system created
and launched HealthNet connect, a group of healthcare institutions connected on a
private, secure fiber optic network that allows for instant provider-to-provider
communication. The Federal Communications Commission provided the initial
$7.8 million in funding for HNc as part of the Rural Healthcare Pilot Program,

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26

which provides funding for broadband networks to bring telehealth services to

rural areas of the country. The fiber optic network runs a 3,200-mile stretch from
Denver to Chicago (para. 7).
Presenting all the information it is established that UnityPoint has done a
successful implementation of growth and strategic placement within the healthcare
markets of Iowa, Illinois, and Wisconsin.
The evaluation of the market entry strategy of cooperation to achieve market
development was evaluated by analyzing the appropriate external conditions, internal
resources, competencies and capabilities, and organizational goals. The external
conditions have culminated into the perfect storm to merge and or affiliate for those
externally as well as UnityPoint. With the decrease in reimbursement, increase in cost
and the focus on providers and organization to shift the risk elsewhere, UnityPoint has
been successful in achieving the best outcome for every patient every time. UnityPoint
has been successful in all of its mergers and affiliations and has competent people and the
financial capabilities to continue to achieve market development.
Competitive Strategies
Strategic Posture.
UnityPoint is the nations fifth largest non-denomination health system. The
formally known Iowa Health System, reflects the way hospitals, physicians, and home
care entities are transforming health care services through patient-centered coordinated
care. Over the last several years UnityPoint has developed a team-based approach. They
have expanded their services in order to become a point of unity for patient care. The
UnityPoint Health brand is an expression of their promise to patients. The employees of

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27

UnityPoint Health work together as a team to create a full continuum of care. It is to

meet the health needs of individuals before they become patients. UnityPoint also wants
to serve their patients in a timely, convenient, and coordinated manner. UnityPoint Health
stays up to date on the new products. According to Ginter et al. (2103), Strategic
posture concerns the organizations fundamental behavior within a market defending
market position, prospecting for new products and markets, or balancing market defense
with careful entry into selected new product areas and markets (p. 239). UnityPoint
Health has the internal and external conditions necessary to be successful in the future.
UnityPoint is fit based on its resources, competencies, and capabilities.
UnityPoint uses a combination of strategic postures. UnityPoint Health is an analyzer in
terms of strategic posture. An organization that is analyzer strategic posture uses a
combination of defender and prospector strategic postures. The analyzer tries to balance
all aspects of the organization. Ginter et al. (2013) quotes, Characteristically they watch
competitors and rapidly adopt those strategic ideas that appear to have the greatest
potential (p. 240-241). In any organization not just UnityPoint Health, you must watch
every area in order to continue to be successful. You cant just become successful and
keep that current label without strategy. If you do not have the proper strategy aligned
for the future, your organization will truly fail. UnityPoint Health is currently an analyzer,
but if large scale shifts occur in the competitive market, legislator or direction of the
organization, the strategic posture could be revisited.
Strategic Position.
UnityPoint strives to provide the best outcome for every patient every time. In order
to meet these goals, the leaders who govern UnityPoint Health provide the caring

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28

leadership to the community-based organization. When a patient chooses UnityPoint,

they should be confident that the organization providing the care or service is organized
and governed the successful way. With their governing body leaders they are able to have
a successful future. Focus is the current strategic position for UnityPoint Health. It
succeeds in creating this focus through its goal of achieving the best outcome for every
patient everytime.
. Their future outlook looks positive. The governance board is very involved within
the health system. The Board of Directors of UnityPoint Health meets at least five times
per year and provides overall strategy and direction for the System. According to
UnityPoint Health, the board-established directives relating to:

Strategic planning
Operating budgets
Capital budgets
Incurrence of indebtedness
Managed care strategies of the System
Transfers of assets between affiliates and other affiliates, other affiliates of
UnityPoint Health, or UnityPoint Health (except to for-profit or other entities
unrelated to UnityPoint Health)
Business plans

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Figure 1 - UnityPoint Healths Structure

UnityPoint is structure properly and with the strong foundation. These items are
crucial to the future success of UnityPoint Health. UnityPoint Healths strategy
formulation is logical and fits together. The organization is structured to have a future
and be successful, even with the weaknesses of the organization. This organization will
definitely have a future with their strategic planning.
Summary and Conclusion
UnityPoint Health has chosen taken part in many initiatives that further cements
its strategic posture of focus and separates itself from its competitors. Such initiatives
as becoming an accountable care organization, its integration of telehealth, and its
incorporation of transparency of performance, quality, patient experience, and cost data.
UnityPoint Health separates itself through timely service, a theme of patient/family
centered care, and programs such as EpicCare which improves communication.

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30

UnityPoint Health could further expand its focus posture through working toward
becoming a Magnet Hospital and continuing to expand its programs in telehealth.
Through the analysis provided, the expansion of the UnityPoint Health provides
its strength but also can be a threat, so an important element to future strategy must be to
manage expansion as successfully as they have for 20 years.

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31
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