TO: Dr. Spencer Foreman
SUBJECT: Montefiore Medical Center Analysis
DATE: May 5, 2011
Background: Montefiore Medical Center (MMC), developed from the consolidation of two hospitals in the Bronx, New York, consists of two acute care hospitals, 31 primary care centers, a home care agency, and a physician/medical joint venture with an annual operating budget of over $1 billion. By 1995, from a combination of lower payment arrangements, increased competition, and unsatisfied patients, MMC was running a $57 million budget shortfall. In response, consolidation of operations was performed leading to almost immediate cost savings of $15 million. However, with consolidation came a reduction in staff, an increase in individual responsibility, and concerns about a reduction in the quality of care. Business strategy development lead to the creation of two care streams including a population-based approach for residents of the Bronx, and specialty care centers to deliver high quality subspecialty care to local patients and patients from outside the Bronx. The strategy, termed GRIP (page 3), provided four imperatives to be utilized in the development of the two streams of care. The implementation of the Balanced Scorecard developed at Harvard was used to measure and manage performance, with scorecard development to be performed for each section of the organization.
Issues and Analysis: Despite some success in meeting envisioned targets for MMC, financial, organizational and strategic challenges remain. This memo will make recommendations in key areas upon which MMC may further improve upon what has been achieved to date.
Financial Performance: Application of an external analysis including a service-client/sponsor matrix and a PEST analysis (Appendices 1 and 2) identifies areas where MMC may target portions of the GRIP strategy in order to improve financial performance. The population-based approach to care delivery for the people of