Introduction
Oakville Open MRI Clinic aims to make sure that the patients receive the safest, along with the most sophisticated medical imaging services, to make sure that every diagnosis is completed accurately and promptly. The business is dedicated to delivering exceptional service in the Oakville county region by incorporating the most up-to-date technologies in diagnostic imaging. The organization’s operations are in line with the Oakville Hospital’s vision, which adequately explains the radiology department’s as well as the general hospital’s important aims. In this scenario, the focus is on informing community people and physicians about the radiological services that will be given by the Clinic. The establishment of the new department is centered on linking the Open MRI scanning services, which are the first of their type in Oakville County, to meet the community’s requirements. The goal statement, strategic plan, and SWOT analysis have already been developed, as indicated in the scenario; the focus of this business plan will be on economic analysis, financial analysis, and budgeting. These analyses are critical before providing Open MRI scanning services to the patients. These evaluations will help determine whether or not it is feasible to create a new department and provide Open MRI scanning services.
Economic Analysis
Oakville Hospital is a well-known healthcare facility among the community members because it has very good neurology and radiology departments. The Oakville Open MRI Clinic, which the group is contemplating building, will benefit from these departments. Furthermore, the other hospitals in the county do not offer Open MRI services, but instead focus on providing Closed MRI services to the community. As a result, Oakville Hospital will be the first healthcare facility to provide Open MRI services. This hospital project will help the organization to be in the forefront of Oakville County’s healthcare business. Furthermore, with the help of providing MRI scanning services to the community members, the organization will expand its services within the community.
Thirdly, Oakville Hospital has necessarily qualified radiologists who can serve the market demand of the county comfortably. Fourth, the Open MRI clinic is a high-field performance machine that offers patients comfort and anxiety reduction, This is substantially less expensive than other imaging services currently available on the market (Williams & Wilkens, 2009). Finally, scanning time is decreased to roughly 30 minutes for each area of the body, compared to Closed MRI machines, which typically take approximately 80 minutes.
Newmarket niche’s availability; claustrophobic patients, could view their surroundings while the scanning procedure is on a roll, therefore, canceling out any of their fears for closed spaces. Secondly, large-bodied individuals can now have access to MRI services because they can now fit in the open MRI unit compared to the traditional tube-like fast MRI units. The Open MRI unit has a gantry design that is accessible from any side, allowing patients to be comfortable instead of the closed MRI diameter of between 24 and 28 with a closed-end. Thirdly, the population of Oakville County, Tennessee, is relatively made up of millennials making accessibility to healthcare services a go-to proponent for people of this community. These numbers could easily translate to patients seeking neurological and spine diagnosis, which requires MRI imaging services. Getting results after an MRI scan is what patients look forward to at all times; open MRI units take fewer times for scanning and make it possible for products available within the shortest timeframes (Casson, 1996). Lastly, with the technology of Open MRI systems, results can be accessed through online collaborations between radiologists and physicians, thus ensuring excellent service delivery.
The Open MRI machines provide better care for patients in contradiction of closed MRI machines. There is a high comfort level in an open MRI machine, reducing patients’ concerns and the claustrophobic feeling. Along with this, there is a high easiness level in the case of available MRI machines when critical parts of the body of patients are directly placed under the magnet (Weaver, Ball, Kim, & Kiel, 2015).
It can be safely mentioned by considering the above discussion that the open MRI services’ demand at Oakville County will be inelastic relatively. Therefore, it can be said that the open MRI’s demand’s proportional change will be below the proportional change in the available MRI services’ price.
For the demand’s comparatively inelastic nature, the critical cause here is that the open MRI will be preferred by the patients rather than for low-cost services of closed MRI. For this reason, open MRI assists in providing high comfort levels and satisfying the patients. Furthermore, MRI scan costs are covered by Medicare, exceptionally if the physician orders a patient to rule out a condition or an illness. Thus, the insured patients will have to suffer charges toward deductibles and copayments.
It is expected that managed care like Open MRI is turning out to be the primary financial payment means for healthcare. Consequently, there will be more minor shifting of opportunity costs, the processes of improving charge to cost proportions specific to the payer. As Oakville Hospital is the pioneer in providing open MRI services within the community, more substantial financial savings will be seen. Consequently, there would be improvements in the revenues compared to other healthcare facilities within the county that are providing closed MRI services to the patients. Furthermore, as Oakville Hospital will be more cost-efficient in providing Open MRI service, it will be successful in bidding on and obtaining the populations for Open MRI patients due to their quality and documented cost.
Others, to maintain or gain patients, may have to provide such services with lower actual costs, projecting on to making up essential revenues on other patients’ within the community. This will only suffice for the shorter term because the dominance of managed care like Open MRI is increasing. Oakville Hospital needs to keep on improving both the cost and quality. Processes of delivery of healthcare need to continue to be redesigned or revised to meet this requirement. External and internal forces will keep on to drive this process of improvement. Case management is not new; the process of case management in a multidisciplinary environment is a challenge that has long been discussed. Managed care simplifies the expectations of payment for care. Care standardization has always been the individual practitioner’s practice; the use of documented guidelines will assist in standardizing multidisciplinary health professionals’ practice, improving communication, and optimizing client outcomes. Information systems must be made available to facilitate the case management process to utilize practitioner resources for efficient and effective patient care and to provide significant information to aid in care improvement (Braveman, 2016)
Budgeting
While an operating budget’s creation may not be the critical goal for the organization, it is the strategic planning’s integral part that necessitates radiology practices for looking forward, seeing the desired outcomes, and setting a course for achieving them.
To map out the budgeting plan comprises a setting of a goal, an action plan for achieving the goals, and monitoring systems for measuring the efforts planned for attaining those objectives. Operating budgets can substantially indicate the outcomes of several decisions made. The intent of the business plan here is to illustrate and define the essential components that Oakville Open MRI Clinic needs to think through while making the budget.
An operating budget, in simple terms, is a snapshot or a projection of the outcomes an organization hopes for achieving or considers that these outcomes will be achieved. The words “consider” and “hope” is used here for the reason that budgeting is an innate procedure that can be implemented for different objectives and executed in several manners (King, Clarkson, & Wallace, 2010).
While it is expected that hospitals are steeped in the process of budgeting, in several radiology practices, budgets often are considered wrongly unnecessary or unimportant. A general feeling that the practice’s clinical side lacks is the control over the organizational aspects of expenses and revenues because it can result in the approach that there are no reasons for projecting them. This type of approach often results in mediocrity, along with the lost opportunities for MRI services. After the organization has decided that a budget will be prepared, the entire procedure can be grounded on hopeful intuition or scientific data.
Several methods can be used to make a budget. For Oakville Open MRI Clinic, the best way for making an adequate budget is zero-based budgeting. Though this particular method of budgeting is complex and more time-consuming, this method assists in producing a better model for the operations of the organization and assists in identifying inefficiencies or wastes (Pyhrr, 2012). Using this particular budgeting method, Oakville Open MRI Clinic can individually consider each category of expense and revenue and project what it believes and hopes will be utilized in the coming years. However, the organization’s past performance might still be used in this process only as one more detailed review component that further needs to be tied to the strategic plan (Hormonzi, Sutton, McMinn, & Lucio, 2002). As Oakville Open MRI Clinic is considering opening the MRI Clinic, past performance cannot be regarded. However, the organization can view the past performance of other departments.
Three Budget Components
As mentioned above, the organization will consider the zero-based budget; it needs to divide its projections into three key components: fixed costs, variable costs, and revenues. All these components will be handled differently, and once these components are combined, they present a snapshot of the forecasted outcome.
- Revenue: These are the most challenging and usually are the most essential elements of the project. Revenues are the driving forces of the operation and the budget. The most crucial element for Oakville Open MRI Clinic would be to project the revenues accurately and determine the value of the funding for Oakville Open MRI Clinic. In the next step, it is essential to think through the competition changes analysis within the marketplace and the changes in reimbursement. Other notable elements comprise the seasonal ups and downs and the number of working days in a particular month (Penner, 2004). With the help of combining all these factors, Oakville Open MRI Clinic can instinctively predict volumes, along with matching them contrary to trends in the local market as well as the rates for projecting its revenues
If, for example, Oakville Open MRI Clinic has a 30% Medicare charge volume, and no consequence changes are expected within the marketplace, then the reimbursements can be projected by the organization for this category grounded on the correlative data. Similarly, with the installation of new MRI machines, there would be a significant increase in the volume of patients as there is no health facility in Oakville County that provides such services to the patients. This would further lead to a rise in the revenues of the organization. Several considerations must not be ignored for having a reasonable budget. While the projections of revenues might never be exact, there needs to be the idea of Oakville Open MRI Clinic regarding the expected trends. After setting the payments, the next focus of the organization needs to be on the expenses that would be included in the fixed and variable costs.
Variable costs
These costs, as implied by the name, are conditional on changes grounded on volumes. After the budgeting of revenues, the expected procedures’ books can be utilized for projecting variable costs related to those processes. As Oakville Open MRI Clinic will work with Oakville Hospital, there would already be numerous certified public accountants looking at cost accounting more closely. For instance, the expenditures related to the brain MRI with contrast could be found with the help of costing out the milliliters of contrast required against each procedure, then assessing the average time for performing the operations, along with using this for assigning the staff’s cost of. In the next step, the utilities’ cost required for performing the tasks might also be projected. The process typically is simplified for focusing only on such expenses that will not occur if no procedure is performed, like the contrast usage in the instance above.
While utilities and staffing might be a variable cost in the technical sense, these items in actual operations are usually well-thought-out more of a fixed price. Consequently, the objective in considering variable expenses is to determine the fluctuating expenses solely ground on volumes of the procedure. Though in Oakville Open MRI Clinic, the organization does not need to worry about costs; for example, in contrast, physician-staffing decisions might be affected by the volumes.
Fixed costs
These are the expenses that take place even if there are no procedures and no volume. Sometimes, the MRI procedures can blur the variable and fixed costs’ application, contingent on the sophistication level, technically variable is often listed by an organization as specified. For Oakville Open MRI Clinic, it is comparatively simple to identify the fixed costs that are most common, along with including administrative salaries, maintenance contracts, lease payments on equipment, rent, and other items like fees and licenses. The fixed and variable costs’ gray areas might comprise office supplies, legal services, and part-time staffing. Usually, these are the costs that are the budget’s most specific section. Typically these costs are the most precise as no change can be recorded in rents and additional fixed payments.
After developing several components of the budget, the administration at Oakville Open MRI Clinic can anticipate what the profitability of Oakville Open MRI Clinic will appear to be. For the Oakville Open MRI clinic team, it makes sense to confirm their calculations’ results and whether the calculated figures seem to make sense. Then, after achieving the hopes and believes to be the future results’ accurate depiction, the leaders at the organization can start to measure the actual outcomes in contradiction of anticipated outcomes (Lawrence, 2011).
Monthly comparing each category of budget and looking for variances’ explanations assist in keeping the budget on point or track out where there is a need for the adjustments. If expenses or revenue are different dramatically from the budget, it is significant to know its reasons. For a budget, the actual benefits comprise its capability to highlight the assumptions’ inaccuracy or accuracy in terms of the dollar and provide timely comprehension regarding how and where these assumptions might have been correct and how and where they might have been incorrect. This understanding will provide Oakville Open MRI Clinic an opportunity to make changes on a timely basis to its operation. Furthermore, with the help of analyzing the way the budget is aligned with the strategic plan placed during planning, Oakville Open MRI Clinic will have a supplementary report card.
Breakeven Analysis
he term break-even analysis is often used as a synonym for sensitivity analysis. However, they do not share quite the same viewpoint. The most common application of break-even analysis determines the sales volume at which a profitable operation becomes unprofitable, that is, the point at which the process breaks even. Break-even analysis is a traditional cost accounting tool that is widely used in restaurants and other industries. It would be simple to say that every service has a price and a cost and then see whether the price exceeds the cost to determine whether we will make or lose money. However, the cost per unit of service is not constant. Because generally there are fixed costs for any service, the greater the volume, the more these costs are shared, and therefore the lower the price per customer.
Chart of Break-even signifies a graphical demonstration of the total cost (variable and fixed) and sales proceeds. It is the level where a company is in no profit and no loss situation (Warren, Reeve & Duchac, 2008). In the above diagram, output units are shown on the X-axis, and cost in dollars is shown on the Y-axis. At all levels of output, the fixed fee remains constant while variable cost, on the other hand, rises with the increase in the story of the production. The Breakeven point, in the above diagram, is the point where the total cost and total sales proceeds are the same.
For Oakville Open MRI Clinic, there are some assumptions for break-even analysis. Monthly revenue break-even would be $40,582 with the belief that there would be a 23% variable cost, along with a $31,248 estimated monthly fixed fee.
Financial Analysis
When it comes to developing the financial plan for Oakville Open MRI Clinic, one of the first components that must be considered is cash flow projections. Incremental cash flows should be the primary cash flows that must be considered. The focus of the total cash flows solely comes from the accepted project. One direct way for making a capital investment decision is grounded on the cash flow created throughout the project. The estimated life of the project would be one more major component (Gapenski 2013). If life’s projected amount surpasses the limit, then the value of the project will be overlooked. This is where the element of ignoring sunk costs can come into play. This includes the cost that has already occurred. Sunk costs, however, are non-incremental and are furthermore excluded from the capital investment analyses. Opportunity costs are the ones that should be comprised and not overlooked. In the study of capital investment, the opportunity cost is high. The opportunity costs are related to capital usage and are contain the discounted rates (Gapenski 2013).
One more component to think through is the effect of the current lines of the organization. In the analyses, there is also a need to consider inflation; this can impact the profitability of the project. The inflations’ effects are already comprised in the capital’s corporate cost. As inflation is also used for setting the rate of opportunity cost, it also needs to be built into the cash flow estimates of the projects (Gapenski 2013). Finally, strategic values also need to be included. These are the essential values to capital investments that are not documented in the estimates of the cash flow.
Below is the pro forma cash flow statement for the organization:
Before Oakville, Open MRI Clinic thinks through buying a new open MRI, they must look at the hospital’s strategic plan. Strategic planning will assist in establishing where the current place of the organization, where they would like to be in the coming years, and the way they intended to get that position. Strategic planning comprises five tools that are put in place:
- Statement of mission
- Statement of values
- Statement of vision
- Goals of the organization
- Objectives of the organization
All levels of management should be familiar with the organization’s strategic plan. This is to be able to set operations in motions and to be able to make judgments on where goals and objectives to proceed with. Once they have established a strategic plan, they can then begin financial planning. Most of the financial planning portion of Oakville Open MRI Clinic is done at the department level with assistance from marketing, planning, and financial staff. Financial planning is done through the operational planning portion that is essentially how Oakville Open MRI Clinic can execute the strategic plan they have in place.
Sales Forecasting
Along with the cash flow, it is also important to focus on the sales forecast of Oakville Open MRI Clinic. The sales forecast for Oakville Open MRI Clinic includes the sales for the next 12 months. The Oakville Open MRI Clinic will focus on services like X-rays, ultrasound, CAT Scan, and MRI. These are the services that would assist the organization in generating its revenues. By providing quality care services to the patients, it is obvious that the organization will see an increase in the number of patients that ultimately will result in the generation of revenues. The projected sales forecast for Oakville Open MRI Clinic is mentioned below:
General Assumption
In the financial analysis, there are also some general assumptions that must be considered. These are the assumptions related to the current rate of interest, long-term rate of interest and rate of tax. It is also assumed that the current rate of interest, long-term rate of interest and rate of tax are constant for the next 12 months. Below are some general assumptions made for financial analysis.
Personal Plan
In the financial analysis, the next thing to consider is the payroll that the organization must consider. Dr. Hughes would be the major person in the payroll of the organization. Along with Dr. Hughes, there would be other technicians also included in the payroll. The projected personal plan for Oakville Open MRI Clinic is mentioned below:
Income Statement
After analyzing the payroll, the next step would be to identify the projected profit and loss for the Oakville Open MRI Clinic. This will comprise the revenues, expenses, and tax that will be incurred throughout the year. On the revues side, the major services, as mentioned above, will include services like X-rays, ultrasound, CAT Scan, and MRI. On the other hand, the expenses will include fixed expenses like rent, taxes, insurance, along with other variable expenses like sales and marketing, depreciation, and utilities.
The pro forma incomes statement is provided below:
It is expected that the organization will face loss in the starting months, however, with the passage of time, it can be seen that the net loss of the organization is continuously decreasing that will eventually change into net profit. It is because the new facility has to face the high marketing and other expenses in starting; however, as there would be an increase in the number of satisfied patients, the revenue of the organization will increase.
Balance Sheet
The balance sheet include the assets, liabilities and equity. For the Oakville Open MRI Clinic, the asset side would include the cash, accounts receivable, long term assets, and fixed assets. On the other hand, the liabilities side include the accounts payable, current borrowing and long term liabilities.
Recommendation
Bearing in mind the information provided in the above budgeting, financial and economic analysis, it is recommended that Oakville Hospital should go for the Open MRI Clinic and purchase the MRI machine. The cost of the business and engine, along with other expenses, are discussed above, which shows that an organization can start generating revenues in one year. Furthermore, the opening of the Open MRI Clinic will provide the first-mover advantage to Oakville Hospital. This first-mover advantage will assist the organization in leading the competition in the healthcare industry within the community (Elllis & Hartley, 2007).
It is also essential to consider the effects of inflation while determining the cost of opening a new Open MRI Clinic. The organization needs to quickly generate the money back compared to how it was calculated; therefore, it provides room for unforeseen disruptions. Considering all the abovementioned facts, this project is deemed profitable in the long run, and this project is very feasible. Though the figures in the pro forma statements are harmful in the starting months, the organization will see extraordinary revenues in the long run because there is no such facility in the entire community that can provide Open MRI services to the patients. The project will assist the organization in generating revenues, but it also will satisfy the patients’ needs by providing them high-quality care.
Open MRI Clinic establishing itself as a market leader within Oakville County starts with undertaking a rigorous analysis of the market. The market analysis begins with finding out about research and reports on the market in question regarding the demographics and market demand for imaging services. Capitalizing on the existing business of Oakville Hospital is an ideal way for the Open MRI Clinic to kick start its operations in full swing and further seek to make any expansions with ease. This is achieved through reflection on existing referrals to the radiology department, thus making it possible for Oakville Open MRI Clinic to establish where their business is coming from and equally employ necessary marketing strategies and efforts on specific practices that have the capability of driving business to them. Nonetheless, it is critical to analyze the Tennessee region demographics and economic viability to help determine or structure an ideal plan for service delivery.
Secondly, to ensure that the new Oakville Open MRI clinic’s operations, developing and presenting itself as a unique brand will be a great initiative towards pulling new customers looking for imaging services. An ideal way of conceptualizing itself as a unique brand different from other medical facilities in Oakville is by simply offering exceptional services in the market geography. This fantastic set of service skills could be coupled with a collaborative, communicative system that makes referrals to physicians simpler and ensures that the processing of image results is speedy. Once again, obese and claustrophobic patients have always been left out when it comes to the development of MRI machines that are considerate of their body weight or fears; catering for these two needs is the first step towards the attraction of this group of customers, and what better way to do so than an implementation for the use of Open MRI units.
Conclusion
Oakville Open MRI Clinic aims to make sure that the patients receive the safest, along with the most sophisticated medical imaging services, to make sure that every diagnosis is completed accurately and promptly. Oakville Hospital is a well-known healthcare facility among the community members because it has very good neurology and radiology departments. Newmarket niche’s availability; claustrophobic patients, could view their surroundings while the scanning procedure is on a roll, therefore, canceling out any of their fears for closed spaces. The Open MRI machines provide better care for patients in contradiction of fast MRI machines. It is expected that managed care like Open MRI is turning out to be the primary financial payment means for healthcare.
While an operating budget’s creation may not be the critical goal for the organization, it is the strategic planning’s integral part that necessitates radiology practices for looking forward, seeing the desired outcomes, along trying to set a course for achieving them. For Oakville Open MRI Clinic, the best method for making an adequate budget is zero-based budgeting. As mentioned above, the organization will consider the zero-based budget; it needs to divide its projections into three key components: fixed costs, variable costs, and revenues. When it comes to developing the financial plan for Oakville Open MRI Clinic, one of the first components that must be considered is cash flow projections. Along with the cash flow, it is also essential to focus on the sales forecast of Oakville Open MRI Clinic. Bearing in mind the information provided in the above budgeting, financial and economic analysis, it is recommended that Oakville Hospital should go for the Open MRI Clinic and purchase the MRI machine.