HADM 6370: 2020 Integrated Business Case Analysis and Grading Rubric

“A business case document is a formal, written argument intended to convince a decision maker to approve some kind of action. A well-crafted business case explores all feasible approaches to a given problem and enables business owners to select the option that best serves the organization. A business case for a health care improvement intervention exists if the entity that invests in the intervention realizes a financial return on its investment in a reasonable time frame, using a reasonable rate of discounting. This may be realized as “bankable dollars” (profit), a reduction in losses for a given program or population, or avoided costs. In addition, a business case may exist if the investing entity believes that a positive indirect effect on organizational function and sustainability will accrue within a reasonable time frame.”  (Source: http://content.healthaffairs.org/content/22/2/17.full)

Primary Task: You have been hired by the Jasper Gardens Nursing Home’s administrator to complete a comprehensive analysis of Jasper Gardens’ current situation and provide a business case analysis (BCA) that supports the accomplishment of its mission and long-term viability. Additionally, she is looking for recommendations regarding the many issues facing her organization. You are to utilize the information provided in Case 1, Case 8 and the Appendixes of The Middleboro Case Book and conduct further outside research as needed to complete this task.

The Situation: Intermediate care facilities are finding it increasingly more difficult to sustain institutional profitability due to changes in Medicaid reimbursement rates. Consequently, Jefferson Partners, the parent company of Jasper Gardens, is planning to pursue one of two possible product development strategies for Jasper Gardens to ensure future viability and profitability. The two primary investment projects under consideration are (1) building an assisted living facility and retirement housing (houses and senior apartments) community adjacent to Jasper Gardens, or (2) building an additional wing on the existing facility to support the Alzheimer’s/Dementia target market.  You have been tasked to prepare a business case analysis for the two associated investment opportunities and to make a recommendation regarding which one would most benefit the organization and its community.

Business Case Analysis Format: Provide a 4-7 page narrative (1.15 to 1.5 spacing is acceptable; 12 pitch font, 1” margins) indicating your findings and your substantiated recommendations. Use APA format for citing in-text references and include a reference page (not included in the page count).  Note, you do not need to provide in-text citations for information obtained from the Middleboro Casebook but you must cite all references you used from outside of the book. You may include tables, figures, calculations, etc. in an appendix that is not part of this page count. State any assumptions you make that are not provided in the cases (you can include those in an appendix if needed). Include with your submission, an Excel spreadsheet to show your financial analyses and any other quantitative analyses you may have conducted. The Casebook does not provide all the information you will need to complete this analysis. Therefore, you should plan on allocating research time to better inform yourself about the nursing home/assisted living/Alzhiemer’s/dementia care market. For example, you may be interested in delving into what insurance/ payment models, if any, pay for the various types of care/services that would be required; what the current trends are in delivering these types of services for this population; what  the costs may be to build and staff such facilities; what regulatory issues may impact the pursuit of these options;  just to name a few.

BCA Content (minimum, but not limited to):

1. SWOT Analysis: Discuss Jasper Gardens’ key strengths, weaknesses, opportunities, and threats. In doing so, you need to address the healthcare environment in which Jasper Gardens operates. Also incorporate findings from select data provided in the two cases’ tables. You do not need to assess all the data, only the data that you believe is most relevant to your task at hand.  You do need to consider the quality measures provided in Table 8.7. Note, this section needs to be in narrative format. While you may provide the information in a SWOT table format, you still need to discuss each section.
2. Market Analysis of each proposal. This includes, but is not limited to, identifying the target market populations and specific needs of each market that would be addressed by the respective expansions, evaluating the level of competition, determining the effective market size, determining the cost associated with the facility expansions, and identifying reimbursement sources and proposed pricing.
3. Financial Analysis of Jasper Gardens and the capital investment proposals.

Task 1: Assess Jasper Gardens’ current financial position, applying analytical tools you learned in Finance I and II. Describe the strengths and weakness of their current position.

Task 2: Evaluate the financial feasibility of the two capital investment proposals, using tools you learned in Finance II. You can assume Jasper Gardens’ corporate cost of capital is 10%.

4. Recommendation with Supporting Arguments: Based upon your analysis, make a recommendation on which investment opportunity Jefferson Partners should pursue (you must select one, not both). Provide support for your recommendation. Discuss the benefits and risks associated with implementation of your proposal. Fully describe the changes Jasper Gardens (organizational plans) would have to make to implement this proposal.

Grading Rubric aligned with MHA Program Competencies:

Strategic Orientation (6).  Ability to consider the business, demographic, ethno-cultural, political, and regulatory implications of decisions and develop strategies that continually improve the long-term success and viability of the organization.

BCA Learning Outcomes:  Demonstrates ability to develop organizational goals/plans that take advantage of its strengths, addresses its shortcomings, builds on opportunities, and attempts to minimize environmental threats. Analyzes the forces that are shaping health over the next 5 to 10 years (market, social, cultural, economic, and political) as it relates to their organization and the community it serves; and bases organizational changes/plans on his/her findings.

Grading Rubric:

1. Identifies and discusses Jasper Gardens’ strengths, weaknesses, threats, and opportunities, including the multiple key elements of the situation facing Jasper Gardens.
2. Analyzes the forces that are shaping Jasper Gardens’ health care environment over the next 5 years (e.g., market, social, cultural, economic, legal and political) as it applies to the case scenario.
3. Recommends organizational changes that are based upon the case scenario and analysis findings.

Healthcare Environment (1).  Ability to explain issues and advancements in the healthcare industry.

BCA Learning Outcome: Identifies current healthcare industry issues and latest advancements applicable to making key decisions within the specific organizational setting.

Grading Rubric:

4. Addresses relevant issues and advancement in the healthcare industry as they apply to the case scenario.

Community Orientation (14). Ability to align one’s own and the organization’s priorities with the needs and values of the community, including its cultural and ethnocentric values and to move health forward in line with population-based wellness needs.

• Explains and measures key determinants of community/population wellness.
• Identifies and addresses health disparities within a given community
• Critically evaluates the factors that influence the wellness/health status of a community
• Develops viable alternatives to addressing community wellness/health needs.
• Effectively communicates analysis and recommendations of community/population needs assessment.

BCA Learning Outcome: Incorporates a community orientation into the organizational decision processes.

Grading Rubric:

5. Identifies the relevant community stakeholders and their health needs and addresses those needs in the organizational plans as applicable to the case scenario.

Process Management and Organizational Design (#5): The ability to analyze and design or improve an organizational process, including incorporating the principles of quality management as well as customer satisfaction.

1. Conducts Process Flow Analyses: Maps process steps, identifies key decision points, determines staffing requirements (numbers, costs and essential knowledge, skills and other attributes), cost implications, and service implications.
2. Benchmarks Good Processes and Practices: Conducts benchmarking and best practices research and interpretation to improve both clinical and non-clinical organizational practices, understands customer service and satisfaction drivers, understands continuum of care across different delivery sites (e.g., outpatient, acute care, specialty clinic), defines roles and responsibilities of different caregivers and other providers, defines roles and responsibilities of administrators and departments, understands legal, accrediting, and regulatory requirements, knows patient and information confidentiality requirements, determines costs and revenue implications.

BCA Learning Outcomes: Demonstrates ability to analyze organizational data, including existing quality and patient satisfaction indicators, and to utilize findings to drive organizational changes.

Grading Rubric:

6. Incorporates principles of quality management to improve Jasper Gardens’ internal organizational environment and to provide quality care to their target population.

Human Resources Management (10). Ability to implement staff development and other management practices that represent contemporary best practices, comply with legal and regulatory requirements, optimize the performance of the work force, including performance assessments, alternative compensation and benefit methods, and the alignment of human resource practices and processes to meet the strategic goals of the organization.

 

BCA Learning Outcome:  Considers human resource management implications and requirements in the organizational decision-making processes.

 

Grading Rubric:

7. Identifies human resource issues and requirements and provides supporting recommendations.

Financial Skills (9). Ability to understand and explain financial and accounting information, prepare and manage budgets, and make sound long-term investment decisions.

BCA Learning Outcome: Apply financial analysis tools to assess the financial health of Jasper Gardens and the financial viability of the two proposed capital investment projects.

Grading Rubric:

8. Accurately applies appropriate financial analytical tools to assess the financial condition of Jasper Gardens.
9. Accurately discusses the strengths and weakness of Jasper Gardens’ financial condition.
10. Accurately applies appropriate financial analytical tools to assess the financial feasibility (i.e. profitability and return on investment) of the two capital projects being considered.
11. Explains the results of the capital investment financial analysis, identifying the most appropriate capital investment strategy to pursue from the financial perspective.

Performance Measurement (13). The ability to understand and use statistical, economic, epidemiological, and financial methods and metrics to set goals and measure clinical as well as organizational performance; commitment to and employment of evidence-based techniques.

• Uses knowledge of customers, markets, patient populations, and financial and management accounting to track organization performance and financial results.

BCA Learning Outcomes: Makes evidence-based recommendations through the assessment of existing statistical, epidemiological, and economic performance measurements as provided in the case study.

Grading Rubric:

12. Bases recommendations on a thorough assessment of existing statistical, epidemiological, and economic performance measurements as provided in the case study.

Critical Thinking and Analysis (3). Ability to break a situation, issue or problem into smaller pieces or tracing its implications in a step-by-step way. It includes organizing the parts of a situation, issue, or problem systematically; making systematic comparisons of different features or aspects; setting priorities on a rational basis; and identifying time sequences, causal relationships, or if-then relationships.

BCA Learning Outcome: Demonstrates application of analytical skills and critical thinking in the evaluation of the situation/problem and identification of the solutions by: identifying multiple elements of the problem, breaking those elements down in detail, and showing causal relationships between them; peels back the multiple layers of the problem; uses several analytical techniques to identify potential solutions and weigh the value of each.

Grading Rubric:

13. Describes the various components and the associated risks and benefits of the two capital investment options and provides a recommendation that is justified by the full analysis undertaken.
14. Demonstrates accurate and complete presentation of facts and supports arguments presented.

Communication Skills (16).  Ability to speak and write in a clear, logical, and grammatical manner in formal and informal situations and to prepare cogent business presentations.

BCA Learning Outcomes: Demonstrates, in written response, logical presentation of thoughts and proper use of grammar and sentence structure.

15. Writing Quality Grading Rubric:

Purpose

__The student’s writing is focused upon meeting the purpose of the assignment.

__The analysis is comprehensive.

__The student stayed on topic throughout the paper.

Organization

__The student organized the material in a logical manner and used appropriate headings.

__The student used paragraphs that are fully developed, focused, and fact-based.

__The student used effective phrasing to connect ideas.

__The paper contained a title page and reference page (if needed).

Grammar / Mechanics

__The student proofread for grammar, mechanics, spelling, and word usage.

__When appropriate, the student used the appropriate method of citing sources, and writing style (i.e. APA)

__The student displayed good writing logic, clarity of thoughts, and the paper flows well.