Strategic Quality Management and Customer Satisfaction
MGT449
February 28, 2011
Rich Wagner
Strategic Quality Management and Customer Satisfaction
Strategic planning, as noted in our text, “is the process whereby organizations develop a vision, a mission, guiding principles, broad objectives, and specific strategies for achieving the broad objectives.” (Goetsch & Davis, 2010). Without strategic planning, it is unlikely that an organization will be successful. This is especially important because of the global competition that exists in most industries. Because each step of the strategic planning process builds on the last, it is important to complete the steps in the order listed above. Learning Team A will go through the strategic planning process for Blue Cross/Blue Shield.
SWOT Analysis of BlueCross/BlueShield Health insurance is something that all Americans should think about before buying. There are many health insurance companies; some larger than others. When buying health insurance, consumers may want to consider the type of coverage needed, and the price of the coverage. As the cost of health care increases, health insurance rates increase also. BlueCross/BlueShield is one of the leading health insurance companies in America. Even though Blue Cross/Blue Shield is one of the leading health insurance companies, the company must offer affordable healthcare insurance policies and a variety of benefits and coverage to accommodate every individual’s needs. When talking benefits and coverage, this company must consider their members: whether the members are employed, self-employed, or retired and the benefits and coverage should be made to fit their needs. Higher healthcare rates can cause Blue Cross/Blue Shield to increase their insurance rates, which poses higher rates for the members. Because of the service Blue Cross/Blue Shield offers to many individuals, a SWOT analysis will be conducted to analyze the organization. “SWOT is the acronym for strengths, weaknesses, opportunities, and threats. A SWOT analysis answers the following questions: What are this organization’s strengths? What are this organization’s weaknesses? What opportunities exist in this organization’s business environment? What threats exist in this organization’s business environment? (Goetsch & Davis (2010). p. 50). Blue Cross/Blue Shield offers a variety of flexible health insurance policies. By providing flexible policies the members can choose the plan and the coverage that best fits their healthcare needs. When members choose the plan and coverage desired, the members are expected to continue to pay the same price for the coverage as time goes on. There are cases in which a member has questioned the organization about a price increase on his or her coverage without first informing him or her of the price increase. By informing members there will be a price increase, members have the options to choose another plan, keep the plan they have and pay the increase, or just drop the plan. When there is an increase in a healthcare policy, this increase creates a problem for some Blue Cross members, especially retired members and other members, on a fixed income. When higher healthcare cost forces Blue Cross to increase their rates on their healthcare policies, this type of mishap creates opportunities for an organization to re-evaluate their healthcare insurance policy coverage, benefits, and prices. By re-evaluating the rates of their services, it shows that the members are important to the organization. During the re-evaluation, the organization comes up with more affordable healthcare insurance policies with some of the same benefits but at lower rates to accommodate retired members on a fixed income. The threats existing in this organization is competition with other leading healthcare insurance companies. Blue Cross policies must offer better coverage and prices to their members or members may choose to go to one of its competitors. Other companies such as Aetna can pose a threat if their rates, benefits, and coverage are better than Blue Cross.
Vision Statement and Mission Statement
Once the SWOT analysis has been completed, the organization is able to create the mission and vision statements. According to our text, “Everything about the organization – its structure, policies, procedures, and allocation of resources – should support the realization of the vision.” (Goetsch & Davis, 2010). The vision of the company represents the ideal trying to be achieved and the mission statement goes further and “describes who the organization is, what it does, and where it is going.” (Goetsch & Davis, 2010).
The vision statement should be easily understood, clear and concise, present a challenge that is achievable, create excitement and unity among all stakeholders, and set the tone for the entire organization. Using the SWOT analysis, the vision statement for Blue Cross/Blue Shield could be as follows:
To provide affordable healthcare by offering a variety of coverage’s at reasonable rates to the public while maintaining fairness and integrity.
The mission statement encompasses the “three W’s – who, what, and where – as the criteria.” (Goetsch & Davis, 2010). The “who” refers to the organization, Blue Cross/Blue Shield. The “what” describes specifically the goals the organization hopes to accomplish. The “where” refers to what population will be served. After reviewing the results of the SWOT analysis, the mission statement may be constructed as the following:
To be the most trusted, convenient, and competitive provider of health insurance products in the United States while striving to provide quality and superior customer service.
Once the vision and mission statements are in place, the organization needs to put in place processes that ensure that the vision and mission are upheld through quality customer service. This could take the form of an 800 number that policyholders can call with any problems or issues. Providing a website that allows the policyholder to search out the information he or she requires is also a good way to provide quality service and ensure customer satisfaction.
Strategic Plan and Strategic Objectives Blue Cross Blue Shield has undergone extremely difficult financial changes and challenges over the past decade. Their effort to regain business composure and stature as an honest medical insurance organization was fueled by its conversion from nonprofit to for-profit licensees. In developing a strategic plan that defines quality as Blue Cross’s core principles it is best to improve the weaknesses of the organization and strengthen the allegiance to its customers and stakeholders. The once national Empire is now represented and regulated by each state and the laws that govern the medical insurance industry. Empire Blue Cross Blue Shield is WellPoint, which is a Blue Cross Blue Shield licensee in 14 states. First in the strategic plan is to define measures that will give the customer reduced rates and discounts, especially for those retired customers or members under fixed incomes. Next would be to developed notification measures to notify members of medical adjustment rates. Next, is to draw from the qualities of other Blue Firms nationwide so that there may be a universal Blue philosophy through WellPoint that encourages sensitivity to customer concerns regarding rates and medical investments. Robinson (2003) “ Use of Empire's assets for wage increases represents only one among many financial and regulatory supports, which include special funding for graduate medical education, regulatory barriers to competition from freestanding ambulatory care centers, and impediments to entry by investor-owned hospital chains.” Building a process of improvement that would merge and build relationships with medical affiliates to provide support networks, would help continue efforts to offer a wide variety of Flexible Health Insurance Policies, which is the equivalent of member choices. Blue Cross Blue Shield is a company continuing to grow in the health care industry and has a strategic objective to be the leading company in the industry. Blue Cross/Blue Shield strives to meet their business needs as well as the client’s needs and taking the clients satisfaction is consideration. Blue Cross/Blue Shield became aware that to remain competitive the company must make some organizational changes. In the changing times today’s health care is reworking their leaderships style.

Blue Cross/Blue Shield’s goals is to break down the barriers, promote leadership, enhance communications from within and outside the company, focus on the business goals and services, and execute a positive business plan. Creating a new business and customer satisfaction measurement can enable the company to obtain a better hold on future improvements.

Measuring patient satisfaction plays an important role growing toward accountability with the health care field. According to Role of Patient Satisfaction (2003), “Overshadowed by measures of clinical processes and outcomes in the quality care equation patient satisfaction measurement has traditionally been relegated to service improvement efforts by hospitals and larger physicians practices, and to fulfilling accreditation requirements of health plans” (Role of patient satisfaction, para. 1).

Blue Cross/Blue Shield collects data on patient satisfaction by various entities for multiple purposes and at different levels. Blue Cross/Blue Shield sends out surveys to their clients looking for feedback to make their clients happier and ways to improve their customer care level. According to Role of Patient Satisfaction (2003),” Given the push toward increased provider accountability and health care quality improvement initiatives, there is no question that the attention and weight given to patient satisfaction is going to increase” (Role of patient satisfaction, para. 1).

As we can see, the SWOT analysis completed on Blue Cross/Blue Shield has identified the strengths and the weaknesses of the company. The vision and mission statements identify what the organization strives to be and how it endeavors to achieve the goals set forth. The strategic plan and strategic objectives listed also help to create the atmosphere that will ensure customer satisfaction. This process is important for any organization to pursue as it will help ensure success in the global economy.

References
Goetsch, D. L., & Davis, S. B. (2010). Quality Management for Organizational

Excellence. Introduction to Total Quality (6th ed.). Upper Saddle River, NJ: Pearson Prentice

Hall.

Role of Patient Satisfaction. (2003). Physicians news Digest. Retrieved from http://www.physiciansnews.com/2003/12/23/role-of-patient-satisfaction/

Robinson, J. (2003). The curious conversion of Empire Blue Cross. Health Affairs (Project

Hope), 22(4), 100-118. Retrieved from EBSCOhost.