Business Case for Chronic Diseases Control and Prevention Center (CDC)
Before deciding whether to embark on a project in healthcare, cost and benefit analysis (CBA) should be conducted to evaluate the total anticipated costs versus total expected benefit to ascertain whether the implementation is worth the investment(Masters et al., 2017). Where benefits outweigh the costs, then the project could be recommended for implementation. In cases where the costs outweigh the benefits, the project should not be recommended for implementation (CDC,n.d-b). This paper will carry out CBA for the CDCP project and provide recommendations based on the results.
Part 1: Risk and Mitigation Analysis for the CDCP Project
Opportunities and associated Benefits to the clinic
To begin with, this project provides an opportunity to the community members to access self-management support including self-help resources, one-on-one coaching, other learning opportunities and remote patient monitoring services. Secondly, there will be additional physicians, trainers and instructors who will be able to handle the surging number of chronic disease patients. Thirdly, the implementation of the CDCP project will improve healthcare outcomes of society by reducing chronic disease risks such as diabetes, overweight, and high blood pressure. Lastly, there will easy monitoring and follow-ups administered to patients admitted in the Marshfield Clinic because data on vulnerable patients will be available through the established chronic disease management registry.
These opportunities will have several benefits to Marshfield Clinic. To begin with, there will be improved decongestion of the emergency and primary treatment centers within Marshfield Clinic. That will ensure efficient and effective services with better health outcomes and improved hospital ratings and referrals. Secondly, there will be an overall increase in Marshfield Clinic’s total revenue by the implementation of the CDCP project from the consultation fees and fitness training. Thirdly, there will be enhanced health literacy among society members who will improve society’s involvement in healthcare and support for the Marshfield Clinic’s initiatives. Lastly, there will be increased accountability, efficiency, and communication following the use of chronic disease registry among health care providers within the clinic.
Risks and associated Threats to the Clinic
To begin with, due to the high initial cost for a project set up, additional designs and adjustments sue to changes in scope may lead to a withdrawal of sponsors from the project. Secondly, funding delay may cause the extension of project completion as work schedule may be reviewed and extended. Thirdly, materials and labor used in the estimate of the project may increase due to other market factors outside the control of the project management hence inflating the costs. Lastly, there is a possibility that some interventions may collide with cultural and socio-economic norms of some members of the society and therefore may resist to buy-in part of the entire project.It includes poverty levels that may hinder people from paying for the services.
These threats may have some negative impact on the clinic. To begin with, the withdrawal of sponsors as a result of a change in project scope may result in delays of the project, which may cause losses associated with costs incurred. Secondly, delay in funding may extend the lifecycle of the project, which may lead to additional costs incurred by the clinic. Thirdly, changes in the costs of materials and labor may affect the completion of the project and may lead to stalling and related financial losses. Lastly, resistant by the community due to conflicting cultural and social norms may lead to delay in approval and extended payback period (CDC,n.d-a).
Summary
The potential economic opportunities of CDCP project are much higher than the potential risks created. The reason is that the savings that the opportunities brought about by the project will be higher than the costs(Rabarison, Bish, Massoudi,& Giles, 2015). For instance, health literacy created by the implementation of the project will have higher benefits to the society compared to the costs that may be incurred, for example, by delay in approving the project. Also, economic benefits as a result of reduced hospitalization and emergency room congestion are higher than the economic costs incurred an increase in material and labor costs as the former will involve the entire society and far-reaching than the latter(Rabarison et al., 2015). Therefore, the potential economic opportunities in implementing the CDCP project are much higher compared to potential financial risks.
Ethical and Culturally-Oriented Solutions
The most problematic risk is the community resistance towards the proposed initiative. Community members the main stakeholderswhose participation is key to the success of the entire project. The second risk is the withdrawal of sponsors. That will impact the financial and administrative operations of the clinic. The third risk is funding delay. That will impact on the completion of the project as well as additional costs.
To begin with, the community resistance could be mitigated through consultation and involving the community throughout the entire project. Community members should be included in the planning, implementation, evaluation and monitoring stages of the project. Also, the formation of a multi-disciplinary team should be involved in assessing the specific cultural needs of the community through a consultative approach. Again, the project team should review the ethical implication and legal frameworks engaged in setting up preventive care center to ensure that the center meets ethical and legal requirements. Secondly, the problem of sponsor withdrawal should be addressed through sponsor communication and contingency planning. According to Rabarison et al. (2015), proper planning should consider contingencies and budget for them. These include sponsor withdrawal and scope creep contingency planning. Lastly, funding delay should be addressed by negotiating with the sponsors and identify the role of each sponsor in the project. Other initiatives that could be undertaken involve the five-stage process by Turner (2016). That include reviewing causes and control, developing risk treatment options, assessing risk options against the cost, selecting risk treatment option with optimum effect, and developing a risk treatment plan.
Part 2: Cost-Benefit Analysis
Analysis of Costs and Benefits and Implications
The cost-benefit analysis (CBA) was completed for the proposed project as shown as Appendix A. The cost analysis template completed represents various costs and benefits that will run from the base year to year 1, year 2, year 3, year 4, and year 5. Salaries will be increasing because, in the base year, the center will employ two nurses earning about $ 68,450 per year. Every year, the center will employ an additional two nurses to build capacity depending on the projected patient number. As seen in the CBA, the center will be obtaining revenue from consultation fees and gym services. Also, savings from a reduction in re-hospitalization and savings on drugs will translate to the benefits of the center.
As represented in the CBA analysis template, the Net benefit is $ 13,034,010.21. It shows that the project is viable because its benefit outweighs costs by a considerable margin. Therefore, this CBA must be taken into consideration when deciding as to whether to embark on the project or not. As seen, it is highly recommended that the management of the Marshfield Clinic should embark on this project.The spreadsheet shows that the costs in employees’ salary increase each year with accompanying training recruitment and training costs. It shows that the center should be ready to incur additional costs in employee training and salaries.
In incorporating the findings of this CBA, the decision making process must factor in opportunity cost. That is the consideration of alternative benefits that could have been obtained by selecting one alternative over another. That is a missed opportunity by choosing this project over others. The management of Marshfield Clinic in factoring opportunity cost will be able to assess the benefits of the alternative course of action in their decision making rather than limiting themselves in the current choice being recommended by the CBA.
Controlling Costs and Maximizing Benefits
One cost that could be controlled or reduced is the recruitment and training costs. Reducing this cost involves coming up with employee retention and motivation strategies. That will prevent employee turnover, which will trigger costly hiring and training. Also, the human resource department will ensure that they employ highly, educated and trained personnel to reduce time and costs in training. Retaining employees will lead to highly experienced employees who are also motivated to work. A highly motivated employee will be highly productive and efficient in providing the proposed services(Kossivi, Xu,&Kalgora, 2016). In order to ensure ethical and equitable recruitment and retention, this project proposes equal pay and equal opportunity for all applicants. No employee will be discriminated against in terms of remuneration and hiring based on ethnicity, religious, race, gender, age, or sexual orientation (Kossivi et al., 2016).
References
Centers for Disease Control and Prevention (CDC). (n.d.-a). Part III: Programmatic costanalysis. Retrieved from http://www.cdc.gov/dhdsp/programs/spha/economic_evaluation/docs/podcast_iii.pdf
Centers for Disease Control and Prevention (CDC). (n.d.-b). Part IV: Benefit-costanalysis. Retrieved from http://www.cdc.gov/dhdsp/programs/spha/economic_evaluation/docs/podcast_iv.pdf
Kossivi, B., Xu, M., &Kalgora, B. (2016). Study on determining factors of employee retention. Open Journal of Social Science, 4(5), 261-268. doi:10.4236/jss.2016.45029
Masters, R., Anwar, E., Collins, B., Cookson, R., &Capewell, S. (2017). Return on investmentof public health interventions: A systematic review. Journal of Epidemiology & Community Health, 71(8), 827-834. Retrieved from https://jech.bmj.com/content/jech/71/8/827.full.pdf
Rabarison, K. M., Bish, C. L., Massoudi, M. S., & Giles, W. H. (2015). Economic evaluationenhances public health decision making. Frontiers in Public Health, 24(3), 164. doi:10.3389/fpubh.2015.00164
Turner, R., (2016). Gower handbook of project management. New York, NY: Routledge.
Appendix A: Cost-benefit Table
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