Everyone is; should healthcare? Outsourcing: Issues in strategic planning, organizational culture, and organizational ethics

Expenditures for personal health services in the United States have doubled over the last decade. They continue to outpace the growth rate of the gross national product. Costs for medical care have steadily increased at an annual rate well above the rate of inflation and have gradually outstripped payers' ability to meet their premiums. This limitation of resources justifies the ongoing healthcare reform strategies to maximize utilization and minimize costs. The majority of the cost-containment effort has focused on hospitals, as they account for about 40 percent of total health expenditures. Although good patient outcomes have long been identified as healthcare's central concern, continuing cost pressures from both regulatory reforms and the restructuring of healthcare financing have recently made improving fiscal performance an essential goal for healthcare organizations. ^ The search for financial performance, quality improvement, and fiscal accountability has led to outsourcing, which is the hiring of a third party to perform a task previously and traditionally done in-house. The incomparable nature and overwhelming dissimilarities between health and other commodities raise numerous administrative, organizational, policy and ethical issues for administrators who contemplate outsourcing. This evaluation of the outsourcing phenomenon, how it has developed and is currently practiced in healthcare, will explore the reasons that healthcare organizations gravitate toward outsourcing as a strategic management tool to cut costs in an environment of continuing escalating spending. ^ This dissertation has four major findings. First, it suggests that U.S. hospitals in FY2000 spent an estimated $61 billion in outsourcing. Second, it finds that the proportion of healthcare outsourcing highly correlates with several types of hospital controlling authorities and specialties. Third, it argues that healthcare outsourcing has implications in strategic organizational issues, professionalism, and organizational ethics that warrant further public policy discussions before expanding its limited use beyond hospital “hotel functions” and back office business processes. Finally, it devises an outsourcing suitability scale that organizations can utilize to ensure the most strategic option for outsourcing and concludes with some public policy implications and recommendations for its limited use. ^

Strategic planning tools for European negotiators to defend their national interests in the Council of the European Union. EIPA Working Paper 2013/W/02

Summary. Negotiating in the Council of the European Union poses some challenges that are common to most international negotiations but there are other dimensions that are a lot more specific. In order to understand better the specific nature of negotiations on a European level and to develop some practical guidelines for European negotiators, it is important to situate European negotiations in the more general context of the theory on international relations and to remember that European negotiations are governed by the general principles which characterise the negotiation theory. This working document has three objectives; after having reminded ourselves of the fundamental principles that govern European negotiations, it aims to provide a general foundation, which in turn will be useful for preparing most negotiations within the Council. A series of practical recommendations will then be made in order to contribute to the strategic thinking of the negotiator responsible for defending the interests of his or her Member State within the Council.

Outils de réflexion stratégique du négociateur européen pour la défense de ses intérêts nationaux au sein du Conseil de l’UE = Strategic planning tools for European negotiators to defend their national interests in the Council of the European Union. EIPA Working Paper 2013/W/01

No abstract.

The Strategic Planning of EU Military Operations - The Case of EUFOR TCHAD / RCA. IES WORKING PAPER 5/2008

On 28 January 2008 the European Union launched the military operation EUFOR in Chad and the Central African Republic. Its mandate was to contribute to the security of the civilian population, the numerous refugees from neighboring Darfur and the local presence of the United Nations. This paper describes and analyses the planning process of this operation at the political-strategic and military-strategic levels with the aim of understanding how the military instrument was intended to generate the desired political effects. The paper argues that, from a military perspective, the EUFOR operation is based on the concept of humanitarian deterrence: the threat of military force is used to discourage potential spoilers from targeting the civilian population. As with any military operation, the planning of EUFOR was plagued by various elements of friction. At least some of this friction seems to flow from the mismatch in expectations between the political-strategic and military-strategic levels. The various political and military-technical constraints within which the operation was planned resulted in an operational posture that is less decisive than what the political ambitions would have suggested.

OECD seminar on strategic planning for road research programs. Conference proceedings.

Federal Highway Administration, Office of Safety and Traffic Operations Research Development, McLean, Va.

Toward equality of well-being : strategies for improving minority health : strategic planning and coordination process.

S/N 037017-024-01504-1 (GPO).

Performance measurement : toward more effective government : hearing before the Committee on Governmental Affairs, United States Senate, One Hundred Second Congress, second session, on S. 20, to provide for the establishment, testing, and evaluation of strategic planning and performance measurement in the federal government, and for other purposes, May 5, 1992.

Shipping list no.: 93-0182-P.

Report on the Ecological Risk Assessment Guidelines Strategic Planning Workshop.

Mode of access: Internet.

2005 - 2007 suicide prevention report : Illinois Suicide Prevention Strategic Planning Committee.

"December 2007"

Addendum to Strategic planning study for flood control : Crystal Creek, Villages of Franklin Park & Schiller Park, Cook County, Illinois.

"OWR/SPS/99-003."

Farmers/Prairie Creek strategic planning study : Cook County, Illinois /

CD contains full text of the study and appendices.

Strategic planning study for flood control : Bensonville Ditch, Bensenville, Illinois, DuPage County.

"December, 1987."

Strategic planning study for flood control : Fargo Creek, Dixon, Illinois, Lee County.

"February, 1989."

Strategic planning study for flood control : Addison Creek, Cook and Du Page Counties.

Volume 2 is Executive summary.

Strategic planning study for flood control : Village of Lyons, Cech Terrace Subdivision, Cook County, Illinois.

"DOWR/SPS/90-003."