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Final Project Submission

I. Introduction
A. What are the major forces affecting the delivery of healthcare today? Discuss these
forces and their corresponding impacts on today’s healthcare environment.
The healthcare industry is undergoing a number of changes in practice that are creating the
need for a shift in leadership paradigm. A majority of these changes are related to the ongoing
revolution in payment, population diversity, varying relationships, technology, and opposing
service models. Each theme of change presents opportunities and challenges that compel leaders
to adopt new ways of thinking. The major forces impacting healthcare delivery as well as
opportunities and challenges that appear in the leadership domain.
One of the most significant forces that are reshaping the face of healthcare is rising costs.
The implementation of the Affordable Care Act implies that Americans who were previously
uninsured now have access to healthcare services (Barati & Fariditavana, 2019). Although this is
a positive outcome, a higher number of insured individuals leads to greater demands on the part
of providers. Indeed, the rising cost of healthcare is a central issue in healthcare debates today.
Americans are expected to spend $3 trillion on healthcare annually despite the lack of a single-
payer model, as seen in other developed countries. Healthcare costs in the United States are also
some of the highest in the developed world.
Another significant force affecting the manner in which healthcare leaders approach the
concept of care is the aging population. The current generation of baby boomers is estimated to
account for a larger proportion of the American population. Additionally, baby boomers are
expected to live longer than previous generations due to the rising quality of care. However,

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since older people use a disproportionately larger share of healthcare resources, the American
healthcare sector will experience a larger demand for services and providers. The aging problem
is complicated further by the changing nature of relationships. As patients take a more active role
in their care experiences and wellbeing, healthcare providers will encounter the inflated need for
personalized services (Shukla & Shukla, 2016). In fact, patients are expected to adopt behaviors
of consumers as a result of the ongoing trend of consumerism.
Technology and opposing service models are also instrumental forces in the evolution of
healthcare. Advancing innovations in medical technology such as colonoscopies, brain implants,
robotic surgery, and electronic health records, are constantly putting pressure on facilities that
are still operating on the conventional model of healthcare. The technology revolution affects not
only healthcare recruitment but also employee education and resource allocation.
B. Impact of Forces: What healthcare service and delivery opportunities and
challenges exist because of the forces discussed above? Define the challenges and
opportunities that exist for today’s healthcare leaders.
The use of advanced health equipment creates new opportunities for vendors and
manufacturers who produce and retune healthcare equipment as well as for providers who want
to venture into safer methods of treatment. Electronic health records are particularly valuable for
facilities that want to digitize services and create better opportunities for collaboration with
clients, specialists, and hospitals. The assimilation of modern payment methods and refined
models of insurance with digital technologies could also enable leaders to traverse barriers that
plagued the conventional healthcare model. Although the high initial costs of medical equipment
is a possible challenge, it can be affordable through leasing. Capital leases are attractive to

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facilities that want to own their own equipment over time, while operational leases are fitting for
providers that want to avoid high operating and maintenance costs. In conclusion, the main
forces that are driving changes in the field of healthcare also present new opportunities and the
chance for transforming healthcare into a more desirable state.
C. Opportunities: Based on your analysis of the major forces, impacts, and
opportunities provided, consider the specific organization that you selected. What
opportunities exist for this organization, and how do these opportunities relate to
the big-picture view of healthcare?
The organization that I selected for this assignment is the University of Florida Health
Shands. It is named after William Shands, a Florida state senator in the 1940s who led efforts to
have the health facility established in Gainesville, Florida (Shands Teaching Hospital and
Clinics, 2018). It is a not-for-profit hospital with multiple hospitals for various specialties. They
include psychiatry, neuro medicine, heart, and vascular medicine, cancer, and children’s hospital.
It has consistently ranked among the best hospitals not just in the state of Florida but in the
whole of the USA. Some of its specialties such as nephrology, cancer, urology, diabetes, and
gastroenterology have been ranked among the top 50 in the USA (Shands Teaching Hospital and
Clinics, 2018). The hospital is part of the University of Florida Health which is a constellation of
hospitals, health colleges, and multiple learning and health institutes and centers in Florida.
Like the hospital, the mission of the parent company is to promote health through quality
patient care, high impact research, rigorous education, and innovation. The hospital also serves
as a teaching facility. It is among the few health teaching facilities with almost all major

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professional teaching schools such as public health, veterinary medicine, pharmacy, medicine,
nursing, and dentistry.
As mentioned above there are currently many forces shaping the healthcare industry.
Some of these forces have created challenges for the organization while others have created
opportunities. Florida Health Shands, like other healthcare organizations, is certainly going to be
impacted by these forces. One of the forces that is going to have a major impact at Florida Health
Shands is rising healthcare costs. Granted, this force is likely to pose a major challenge for the
organization. However, it also presents an opportunity. As healthcare costs are going to increase
across all healthcare organizations, patients and clients are not only going to be price sensitive
but they are also going to demand quality from healthcare providers so that they get value for
their money. As a healthcare organization known for providing high quality healthcare services
at relatively low costs, Florida Health Shands stands to gain a lot from this development. They
are likely to get increasing number of customers attracted by the high quality of its services and
relatively inexpensive costs.
The forces that have been discussed also present Florida Health Shands with an
opportunity to provide people-centered care. For all Americans to enjoy optimal health, there
needs to be a well-conducted and well-coordinated health system (Omachonu & Einspruch,
2010). The organization can invest in ensuring that it addresses the healthcare needs of the
individuals within the larger community (De Maeseneer et al., 2012). The organization can help
shape healthcare policies that will, in turn, improve the health and the wellbeing of the
community that it serves.

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Another opportunity is investing in innovation. There are many diseases that the world is
battling at the moment. The University of Florida Health Shands can help solve the critical health
challenges in the world by investing in research and innovation (Omachonu & Einspruch, 2010).
The war against various diseases can only be worn if people invest in innovation and research.
Medical practitioners are still in the dark when it comes to treating a host of diseases. Patients are
forced to spend a lot when seeking treatment. The organization can help by ensuring that cheaper
and innovative strategies to deal with chronic illnesses are developed. The opportunity is in line
with the worldwide call to push down the cost of healthcare. With the advanced technology
available at the UF Shands, the organization can become the leading innovation center in the
world. The research is an opportunity that will assist health care to reduce the time they use if
finding critical data and an increase in the efficiency and effectiveness of the queries.
D. Proposal: What is your proposal for addressing identified issues or improvements
within your organization? In other words, what changes are you trying to
incorporate in your selected organization?
One of the ways through which the hospital can take advantage of the opportunities available
in the healthcare system is increasing the budget dedicated to innovation. Innovation is quickly
gaining momentum in developed and developing nations. The organization thus needs to
increase the funds allocated to research. The culture of the organization also needs to change.
The organization needs to embrace diversity. Diversity is a key factor that pushes innovation in
an organization. When people from different backgrounds are employed, they tend to be
innovative (Jarratt, 1999). The human resource department needs to ensure that the hiring
practices accommodate diversity.

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Another key proposal is investing in the community. The University of Florida Health
Shands can ensure that it invests in educating the community. When community members are
well educated about common diseases, general wellbeing and health also improve. Investing in
the community is one way of ensuring that the healthcare costs are brought down while the
quality of care is improved. It is important to address the social factors that affect patients’
health. Thinking outside the clinical setting is important (De Maeseneer et al., 2012). Research
shows that 20 percent of the factors that affect the health of a community is related to access to
quality care. On the other hand, the other 80 percent relate to socioeconomic and environmental
factors. Healthcare practitioners can help treat sick patients, but it is community initiatives that
help keep people healthy. The social needs of the patients have not been addressed sufficiently.
If social needs are addressed, then the health of the community will improve, and the
organization will achieve positive health outcomes within society.
II. Financial and Budgetary Considerations
A. Financial Statements: What financial statements will you utilize in making your
proposal, and how will you use these statements?
In making this proposal, there are a number of financial statements that I will need in
order to make the proposal effective. I will majorly need a 10-K report. However, in its absence,
there are still multiple financial statements that will just be equally useful. Chief among these are
the organization’s statement of cash flow, balance sheet, and income statement. Statement of
cash flow, also called the statement of revenue, is a brief summary of the expenses and revenues
of the organization (Gapenski & Pink, 2015). Balance sheet, on the other hand, lists the equity,
assets, and liabilities of the organization at a particular time (Gapenski & Pink, 2015). Lastly, a
statement of cash flow provides information on all the cash that gets in and out of the

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organization (Gapenski & Pink, 2015). While these financial statements can be used to predict
the company’s future financial performance and operations and, therefore, how these finances
and operations will affect the implementation of the proposal, it would also help to get access to
the company’s own internal discussions about how various developments are likely to affect it in
future.
These statements are certainly useful in preparation of my proposal. All of these financial
statements will help me to determine the company’s current financial situation. They may also
help in assessing the likely financial situation of the company in the near future. This information
is important because it will help in understanding, for instance, whether the company can afford
to support extensive community education on healthy lifestyle and still remain financially afloat.
It will also help in determining whether the company has enough financial resources to invest in
healthcare innovation that has the potential of significantly increasing the quality of the services
that it provides to patients while simultaneously lowering costs. Such a goal requires significant
investment in research and development. Lastly, knowing the financial position of the company
will enable me to determine whether the company can increase the number of its staff needed in
carrying out the necessary research for the desired innovation. As explained earlier, diversified
groups are best placed to make groundbreaking innovations that help in the treatment and care of
all patients. Achieving such diversification may mean employing more research staff from
underrepresented groups.
B. Proposal Impact: What impact will your proposal have on the organization’s
financial statements? Articulate the impact using appropriate terminology.

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The impact of my proposal will be both short term and long term. In the short term, the
organization will have to use a significant portion of its resources in investing in research and
development and community education. Certainly, such investment will lead to reduction in
profits of the organization in the short term. However, in the long term, the investment in
innovation has the potential of dramatically changing the financial situation of the company for
the better. With the organization able to offer higher quality services due to innovative
approaches to care, the organization is likely to witness a significant increase in its revenues in
the long term.
C. Flexed Versus Fixed: How would your proposal be different if using a flexed
budget versus a fixed budget? In other words, how would the use of one type of
budget versus the other impact your proposal, and how would your proposal
impact the budget? (Evaluate the differences between a fixed and a flexed
budget.)
Before determining how the use of either of these types of budget may affect the proposal, it
is important to understand the difference between them. Fixed budget, also called static budget,
is not affected by the activity level of the organization (Zaichkin, 2018). It remains constant
regardless of the level of activity that is reached by the organization. Thus, in fixed budget the
organization’s expenditures and incomes do not change with its activity level variation. Both of
them are pre-determined. As of flexible budget, changes in activity levels may lead to changes in
the budget (Zaichkin, 2018). This type budget is most suitable for organizations that have high
levels of variability in their production and sales. It is also suitable for an organization whose
financial situation is often affected by external factors.

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The qualities of a flexible organization make it the most suitable for Florida Health Shands.
The organization is an umbrella of multiple organizations. The organization’s revenues are,
therefore, not consistent. Additionally, as a healthcare company, the organization’s finances are
usually affected by multiple external factors (Zaichkin, 2018). Chief among these factors is state
and federal legislations. For these reasons, flexible budget is the one that is most suitable for the
organization. The effect of using this budget is that the it may be changed to reflect variations of
expenditure and income resulting from the implementation of the proposal.
III. Proposal Justification
A. Ratio Selection: What ratios will you use to support your proposal and why?
Select the ratio or ratios that would be the most appropriate.
The proposal that has been suggested will likely have a significant impact on the liquidity
of the organization. Liquidity is a major concern for any manager. This concern is because
liquidity problems can prevent the organization from making various payments at the times that
they become due. These payments include salaries and payments to suppliers or other entities
that the organization is indebted to. Due to such types of problems, proposals that are likely to
lead to liquidity crises may not be adopted. It is, therefore, important to carefully examine the
current financial statements of the organization and get ratios that help in determining the
liquidity of the company.
In order to understand the firm’s liquidity position and, therefore, support my proposal I
will examine two ratios. The first one is current ratio. This ratio reveals the number of times that
an organization can pay off its debt obligations using its current assets (Kahn & Baum, 2020).
The second ratio is quick ratio. It is also called acid test. This ratio is far more stringent than

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current ratio. The ratio shows how many times a company or organization can pay off its short-
term debt obligations without resorting to selling its inventory (Kahn & Baum, 2020). It is worth
noting that inventory is one of the least liquid of any asset. Even during times of good economic
performance, finding a buyer for inventory is usually very hard. Thus, it is important that a firm
does not put into consideration when looking for options to pay off its short-term debt
obligations.
B. Ratio Results: Calculate the selected ratios and articulate the results using
accurate terminology. What do the results tell you about the viability of your
proposal?
To get the required ratios I used financial information of Florida Health Shand for the
year 2018. For current ratio the required information is current assets and current liabilities. The
formula for current ratio is current assets/ current liabilities. Current assets in 2018 were worth
$499,003 while current liabilities were worth $313,681 (Shands Teaching Hospital & Clinics,
2018). Thus, current ratio=499,003/313,681=1.5908. This current ratio implies that the
organization can pay its short-term debts 1.5908 over using its current assets.
For the quick ratio, the information required is current assets, inventory, and current
liabilities. The formula for quick ratio is current ratio- inventory/ current liabilities. Quick
ratio=499,003- 22,577/313,681= 1.5188. This quick ratio shows that the organization is able to
pay off its short-term debts 1.5188 times without resorting to selling off its inventories.
My proposal involves the hospital making significant investments in community
education and research for purposes of innovation. As explained earlier, such investment may
lead to liquidity problems if all the required financial analyses are not conducted and considered

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before implementing the proposals. As these ratios reveal, the organization is in a healthy
financial position to implement the suggested proposals. The current and quick ratios show that
the organization can pay its short-term debts 1.5908 and 1.5188 times over respectively. The
proposals can, therefore, be implemented without fear of causing a liquidity crisis.
C. Short- and Long-Term Impact: Based on your calculations and financial
statement analysis, determine the short-term and long-term impact on the
organization and the organization’s financials. What is the short-term and long-
term financial impact of your proposal for the organization? How can you plan
to strategically mitigate the impact on the financials of the company, or how will
your proposal help inform strategic planning in the short and long term?
Upon my review of the organization’s financial statements and calculating the relevant
ratios, I am convinced that my proposal is unlikely to have any negative effects in the short-term
while it is going to have mainly positive impact in the long term. In the short-term, the biggest
fear when implementing a proposal such as mine is the danger that it might cause cash flow
problems. As the current and quick ratios have shown, this is unlikely to be the case. The firm is
in a healthy position to take on more debt, if need be, without causing any liquidity problems. It
can also use some of its revenues to implement the proposals without resulting in any financial
problems.
In the long-term, the proposals are likely to increase the revenues of the organization. The
proposals will help the organization to become more innovative in its approach to provision of
healthcare services to patients. With such an approach, it likely to have more satisfied patients
and clients. With better health outcomes, the organization will not only receive more

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reimbursements but will also have more patients and clients thus increasing its revenues
significantly.
IV. Closing Statement/ Conclusion
A. Added Value: What value will your proposal add to the organization? Justify
the value or improvement your proposal will add for the organization, in
consideration of trends in healthcare.
My proposal seeks to have Florida Hospital Shands invest more resources in community
education and research and development. Given the current healthcare crisis which has seen
healthcare costs for patients significantly increase, taking a preventive approach to patient care
will help in reduction of healthcare costs. Educating the community about healthy living is
among the preventive measures that have the potential of improving overall community health
and reducing the number of times that members of the community seek treatment for various
ailments. Such an approach also improves the reputation of the hospital as one concerned not just
with making money but also helping the community become healthy.
As for research, the investment is likely to yield multiple innovations which the hospital
will use when providing care for patients. Through applications of the inventions and innovations
got from the research, the hospital will manage to provide better quality care to patients. The
benefits of such type of care both the hospital’s financial position and reputation cannot be
underestimated.
B. Justification of Proposal: How appropriate is your proposal based on your
financial analysis? Justify your proposal based on the financials and budgetary

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considerations. If you feel that your proposal is not appropriate given your
analysis, explain why, with support of your reasoning.
Based on the analysis of financial statements of the organization, I believe that my
proposal is appropriate. It does not have any negative effects both in the short-term and long-
term. In the short-term its effect is largely neutral. In the long-term, the effect of the proposals on
the organization are likely to be effective.

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References

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the US. Applied Economics Letters, 1-4.
De Maeseneer, J., Van Weel, C., Daeren, L., Leyns, C., Decat, P., Boeckxstaens, P.,. & Willems,
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efault/files/media/PDF/shands-FY18-audited-financial-report.pdf&ved=2ahUKEwi8jM-
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