1. Business Planning for Health Organizations ID 536 Spring Term, 2009 Paul Campbell, MPA, ScD Harvard School of Public Health

2. 2 Agenda for First Session Course goals and organizational issues; Entrepreneurial Management; Business Plan Outline; and, “Quali-Care” Case.

3. 3 Course Learning Objectives Students will be able to draft a business plan that will: Provide evidence of the need for and economic feasibility of the project, including plans to address potential risks; Identify the financial and other resource needs and the potential sources to meet those needs; and, Effectively communicate benefits as well as economic feasibility to potential financial supporters, partners, employees and ultimately customers.

4. 4 Student Responsibilities Reading and homework assignments; Preparation of draft written business plans, which are due at class, Friday, May 22 (2 hard copies). Plan presentations (for those selected) May 15 and 22. Written and oral feedback on presentations.

5. 5 Grading 20%Class Participation 20%Homework Assignments 10%Business Plan Feedback 50%Written Business Plan 100%Total

6. 6 Student Business Plans Not expected to be “Fortune 500” in form or content; Expected to be easily readable draft; Content more important than polish; Expected to contain information related to all elements of the Business Plan Outline.

7. 7 Contact Information Paul Campbell Phone: 617-429-6614 *Email: pcampbel@hsph.harvard.edupcampbel@hsph.harvard.edu John Quattrochi *Email: jquattro@hsph.harvard.edujquattro@hsph.harvard.edu Discussions about case development: By email appointment

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9. 9 Poland Traditional Health System MOHMOF Med. Schools Voivodships (49) ZOZsHospitals Specialists HospitalsPHC Clinics

10. 10 Decentralization Central Government Legislated Transfer of Authority Regional & Local Governments

11. 11 Separation of Payer and Provider Government Payers Contracts with Providers “Independent Units”

12. 12 Transformation of Polish Health System System Bureaucracy Quasi-Market Institutions Bureaucratic Competing UnitsOrganizations Managers Administrators Entrepreneurial Managers Performance Quality Efficiency

13. 13 The Transition Entrepreneurial Administrator Manager Low Autonomy High Little Accountability Great Little Mgr. Competence Substantial

14. 14 Advantages of Shift to Markets and Entrepreneurial Management

15. 15 Disadvantages of Shift to Markets and Entrepreneurial Management

16. 16 International Evidence on Contracting for PHC “Contracting for the delivery of primary care can be very effective and that improvements can be rapid.” Loevinsohn, Harding Lancet, August 20, 2005 Study of 10 Contracting Programs

17. 17 Entrepreneur Webster’s Dictionary Definition: 1.An organizer or promoter of an activity. 2.One that manages and assumes the risk of a business.

18. 18 Social Entrepreneurs Skills include: Leadership Strategy Marketing Financial

19. 19 A Delicate Balance MissionEconomics

20. 20 Business Planning

21. 21 Business Plan Defined: “A detailed plan for a proposed program, project or service including information to be used to assess financial feasibility.“ Steven Finkler, PhD, CPA 2002

22. 22 Purposes of Business Plans External –Equity investment –Loan Internal –Organizational assessment –Individual (Personal) assessment Joseph Mancuso, 1985

23. 23 Reasons for Developing Business Plans 1.Process forces objective critical assessment of project; 2.Completed plan helps you manage; and, 3.Completed plan provides a means of communicating with others. Joseph Mancuso, 1992

24. 24 Business Plan Outline 1.Table of Contents 2.Executive Summary 3.The Business 4.Finance 5.Marketing 6.Supporting Documents

25. QUALI-CARE A Business Plan Damascus, Syria

26. 26 Positive Attributes of the Plan Being first can be an advantage There appears to be an unfulfilled demand for quality/coordinated and comprehensive care in Syria

27. 27 Positive Attributes of the Plan The key initiator appears to have the personal/family financial resources to launch the new venture The high cost of facility, equipment and working capital pose barriers to potential competitors

28. 28 Negative Attributes of the Plan Three important skills are required: Yet the individuals to manage facilities, actuarial projections, and financial issues are not identified Plan design provides for very limited control over quality of in-patient care

29. 29 Negative Attributes of the Plan Plan design requires partnership with physicians who may be threatened by Quali-Care. Plan targets small wealthy segment of the population that can already afford all services they need (without Quali-Care). Why should they opt for HMO-limited services?

30. 30 Additional Info Needed and Recommendations Management structure – who will be accountable? Who are the key individuals implementing the plan and what are their relevant skills? Budget assumptions and justifications Information regarding financing structure and ownership

31. 31 Important External Factors Strength of the economy: Will the potential market expand for Quali-Care or contract? Cooperation by medical association and individual physicians: Will the necessary providers partner with Quali-Care?

32. Will You Make the Investment?

33. 33 Remember There is no one “right” way to organize and write a business plan. The first business plan you write is perhaps the hardest.