MHA 520 Week 6 Stakeholder Alliance Plan Example

A Three-Year Alliance Plan for a Community Hospital Inside a Larger System: Portfolio, Governance, Resources, Safeguards and a Relationship Health Index

[Student Name]

University of Phoenix

MHA/520: Sector Stakeholders: Identifying and Cultivating Alliances

Week 6 Assignment

[Instructor Name]

[Date]

The hospital, its alliances, budget, targets and index are composites written for a model paper; research findings come from the sources cited.

Six months after the composite suburban Atlanta hospital joined a larger Georgia health system, its new chief executive asked the vice president of community relations for a plan. The hospital's alliances had survived the affiliation and a change of leadership, but largely because of the vice president's personal effort. The chief executive wanted a plan that would outlast any one person. This paper presents the three-year alliance plan the executive team adopted.

Objectives

The plan begins with what alliances must achieve for the hospital. Access: patients can reach the physicians and services they need locally. Quality: partners help deliver safer, better-coordinated care. Community health: the hospital addresses needs identified in its community health needs assessment. Financial strength: alliances bring patients, contracts and philanthropy. Influence: the hospital has a voice in local and state decisions and within its new system.

The Portfolio

Fourteen alliances are grouped into five types. Physician alliances: the orthopedic co-management group, the largest primary care group, the medical staff leadership and the system's specialists. Community alliances: the two immigrant-serving organizations, the federally qualified health center and the school district. Public sector alliances: the county health department and local elected officials. Payer and employer alliances: the largest insurer and the county's largest employer. Philanthropic alliances: the foundation board and major donors. System alliances: the parent system's leadership.

Tiers Within the Portfolio

Each alliance keeps its tier from the earlier prioritization, reviewed annually by the council with fresh data on referrals, reach and results. Tier one alliances receive an executive owner, a written strategy and monthly attention; tier two alliances receive quarterly attention; others are monitored.

Strategies by Type

Physician alliances deepen through shared governance and shared results, such as co-management. Community alliances deepen through shared programs and funding stability. Public sector alliances deepen through data sharing and joint planning. Payer and employer alliances deepen through transparent performance reporting. Philanthropic alliances deepen through honest stewardship reports.

Why Community Alliances Get Real Resources

Nonprofit hospitals vary enormously in what they give back. In a benchmark study of community benefits, hospitals in the top tenth devoted roughly 20% of operating expenses to community benefits and those in the bottom tenth about 1%, and the variation was not explained by community need (Young et al., 2013). The hospital's plan sets a target to raise its spending on direct community health improvement, delivered largely through partners.

Evidence for the Community Health Worker Alliance

The community health worker program with the two community organizations is the plan's largest community investment. The trial-based model it follows was projected to pay back $2.47 per program dollar to a typical state Medicaid budget in the same fiscal year (Kangovi et al., 2020). The strongest case for a community alliance is one where the partner does work the hospital cannot do alone.

Evidence for the Physician Alliances

Physician alliances matter for quality as well as volume. Research on joint replacement patients across nine hospitals found that better relational coordination among surgeons, nurses, therapists and others, through frequent problem-solving communication, shared goals and mutual respect, was associated with better quality, less pain and shorter stays (Gittell et al., 2000). The plan extends the co-management model's huddles and case reviews to cardiology with the system's specialists.

The Alliance Council

To make relationships belong to the organization, the plan creates an alliance council chaired by the chief executive, with each executive owner as a member and the vice president as its staff lead. The council meets quarterly to review the portfolio, resolve conflicts between partners and decide on new alliances or endings.

Two Owners for Every Vital Alliance

Each tier one alliance has a primary and a secondary executive owner, and the shared relationship log documents history, commitments and contacts.

Resources

The plan's budget is $1.4 million a year: $620,000 for the community health worker program; $300,000 for community partner grants awarded through an open process; $250,000 for staff, including a partnership manager; $150,000 for physician alliance support, such as co-management data and meetings; and $80,000 for events, stewardship and relationship health surveys. Co-management fees are paid from the service line budget.

Integrity Safeguards

The plan incorporates the hospital's conflict of interest, gift acceptance and vendor interaction policies. All partner grants go through independent review, financial arrangements with physicians receive compliance review and the council's decisions are minuted.

Working Within the System

The parent system has its own partnerships and priorities. The plan designates the chief executive as the owner of the system relationship and requires that local alliances be presented to the system's community health leaders annually, so local commitments are understood and supported.

The Relationship Health Index

Twice a year, each tier one partner rates the relationship on trust, communication, fairness, shared goals and satisfaction. The ratings are combined into an index from 0 to 100 for each alliance and for the portfolio, reviewed alongside outcome measures.

Outcome Measures

Each alliance has outcome measures tied to objectives: patients served and follow-up rates for the community health worker program, co-management quality measures, school-based asthma referrals, employer contract results and funds raised.

Risks to the Plan

The plan names its risks. System budget pressures could cut partner funding; the plan protects the community health worker program through a three-year commitment in the affiliation agreement. Physician groups could still be acquired by competitors; the co-management renewal and cardiology model aim to keep partners engaged. Partner leadership changes could weaken relationships; secondary owners and the relationship log reduce that risk.

Communicating the Plan

The plan is shared in summary with partners, so they understand how the hospital manages alliances and what they can expect: an owner, regular contact, honest feedback through the health index and fair processes for grants and decisions. Transparency about the process builds confidence even among partners in lower tiers.

Staff Roles Beyond Executives

Alliances depend on people below the executive level: nurse managers who work with community health workers, schedulers who coordinate with physician offices and foundation staff who steward donors. The plan includes training for these staff on the hospital's partnership approach and invites their reports of problems or opportunities through the relationship log.

Year-by-Year Milestones

Year one: council established, index baseline set, cardiology coordination model launched. Year two: community health improvement spending raised and school partnership expanded. Year three: full portfolio review and a new community health needs assessment built with partners.

Ending Alliances Well

Some alliances will stop serving their purpose. The plan requires the council to end them openly, with notice, gratitude and a clear explanation.

Conclusion

A plan that outlasts its author needs objectives, a portfolio, owners, a governing council, resources, safeguards and measures. Built on the course's earlier work and on evidence about community benefits, community health workers and caregiver coordination, this three-year plan turns one vice president's relationships into the hospital's lasting alliances.

References

Gittell, J. H., Fairfield, K. M., Bierbaum, B., Head, W., Jackson, R., Kelly, M., Laskin, R., Lipson, S., Siliski, J., Thornhill, T., & Zuckerman, J. (2000). Impact of relational coordination on quality of care, postoperative pain and functioning, and length of stay: A nine-hospital study of surgical patients. Medical Care, 38(8), 807-819. https://doi.org/10.1097/00005650-200008000-00005

Kangovi, S., Mitra, N., Grande, D., Long, J. A., & Asch, D. A. (2020). Evidence-based community health worker program addresses unmet social needs and generates positive return on investment. Health Affairs, 39(2), 207-213. https://doi.org/10.1377/hlthaff.2019.00981

Young, G. J., Chou, C., Alexander, J., Lee, S. D., & Raver, E. (2013). Provision of community benefits by tax-exempt U.S. hospitals. New England Journal of Medicine, 368(16), 1519-1527. https://doi.org/10.1056/NEJMsa1210239