MHA FPX 5006 Assessment 3 Cost-benefit Analysis

Cost-benefit Analysis

Student name

Capella University

MHA-FPX5006

Professor Name

Submission Date

Executive Summary

This assessment has completed a cost-benefit analysis, and the agency can determine that there are three strategic long-term solutions that address the current nursing shortage that has impacted the agency as it works to meet current client load. The options were evaluated with the priority implications for finance, operations, and organization in mind. RPM can result in high-impact technological investments that significantly reduce the need for inpatient visits, increase nurse capacity, and allow RPM to continue to scale services and maintain its rate of growth without hiring more nurses.

The benefits of the model, in terms of operational efficiency, are small when the Telehealth Nurse Triage model is used as a follow-up appointment and low-acuity assessment is moved to an online model. The alternative will encourage increases in access and competitiveness for the agency in the transforming environment of the industry, and is especially beneficial to underserved clients.

Enhanced HR Benefits and Retention Programs are workforce-oriented strategies to stabilize staffing levels, foster organizational culture, and reduce turnover-related costs from certain investments in education, flexibility, and wellness provisions. This flexible, affordable model has led to higher client satisfaction, increased operational efficiencies, and is consistent with national trends in the evolution of telehealth. Conversely, the HR benefits Program holds the most promise for long-term staffing by reducing turnover and improving retention, but may not fill current capacity gaps.

Option 1: RPM System

Proposal

The agency will also use RPM to monitor the patient’s vital signs, symptoms, and adherence to care plans, but it doesn’t necessarily require the patient to be physically present with the agency. Moreover, the clinically stable, low-acuity clients transferred to the RPM-based care will significantly reduce the number of visits per week by nurses and improve the capacity of nurses (Azevedo et al., 2022). This is consistent with the organization’s funding approach, and scalable technologies are chosen to enhance the efficiency of the operations, the quality outcomes, and sustainability.

Advantages

• Low acuity clients: Allows current nurses to spend up to 40 percent more time with clients during face-to-face visits. More visits are possible.
• Facilitates earlier identification of change in clinical status, reduces unnecessary hospitalizations, and increases satisfaction.
• Increases access for homebound clients who cannot be visited on a regular basis, thereby enhancing the agency’s mission.
• It will streamline the agency’s operations because it can expand the services without an increase in full-time employees.
• Enhances market competitiveness through delivery of technology-based services valued by consumers (payers, families, and referring partners alike).

Cost

• RPM Site Performance: 350,000/year.
• Buy 200 patient kits (BP cuff, Scale, Pulse Oximeter, and integration of the app) for all 400,000.
• $50,000 Nurse and leadership training.
• IT integration, data infrastructure, cybersecurity compliance: $75,000.
• Maintenance and technical support of equipment: 25000/year.
• (Year-1 Cost Total: USD 900,000)

Opportunity Cost

This would leave the entire surplus budget amount to hire four full-time nurses to serve the organization, which would cost the organization somewhere between $320,000 and $400,000 per year as a unit. It also eliminates the possibility of investing in a less expensive telehealth system (estimated at 250,000-300,000) that would not be as comprehensive as RPM regarding workload burden. It depends on the funding RPM that is chosen. The funds that would have been used for hiring people for one-off needs could be redirected to long-term technology.

Explanation

RPM is an alternative solution directly addressing the workload limitations at scale and long-term solutions. With the current rate of 20 clients per week per nurse, this would free up enough clinical capacity to see the same number of clients with 4 full-time nurses (Tan et al., 2024), with the reduction of an in-person service for about half the number of stable clients at the agency (about 160 clients). This aligns with the agency’s mission to expand access to high-quality home-based care and its financial objective to enhance efficiency relative to staffing-based models.

The opportunity costs of recruitment-based solutions limit the application of such solutions in the short term, but RPM is a long-term thinking approach with the key benefit of productivity and workforce stabilization, and revenue-generating potential. This can be achieved by continuous monitoring that would lead to timely monitoring of clinical deterioration, reduction of unnecessary hospitalization, and improvement of long-term patient satisfaction.

The addition of remote monitoring (RPM) will also help an agency to secure itself in a competitive, technology-driven market, as more agencies are making the switch to RPM being implemented in their operations. Finally, RPM integration fosters sustainable development by creating a more resilient, scalable, and efficient care delivery system going forward.

Option 2: Telehealth Nurse Triage Program

Proposal

The Telehealth Nurse Triage Program (TNTP) is a scalable technology solution that increases nursing capacity and improves patient care quality. In this alternative, the licensed nurses would provide virtual assessments, symptom evaluation, education of the patient, and scheduled follow-ups for appropriate patients (low acuity). The agency will be able to substantially cut down on the inefficiencies associated with travel and focus efforts entirely on getting to work each day and getting the daily batch of cases done by taking a large chunk of the face-to-face interactions online (Kobeissi & Ruppert, 2021).

The model supports continuity of care, improves clinical responsiveness, and is in line with the National trend of more popular hybrid and technology-assisted care delivery. The agency will be strategically positioned to meet the growing demand for services from its telehealth Program, without an increase in staffing demand, in an increasingly competitive labor market, with a formalized telehealth triage Program.

Advantages

• Facilitates the conversion of approximately 2,535 percent of follow-ups and evaluations of lower acuity patients to telehealth, expanding nursing capacity and allowing nurses to focus on face-to-face visits with patients with higher acuity.
• Improves access for those who are home-bound, in rural areas, or otherwise limited in their usual modes of transport, thus reducing disparities in care provision.
• Provides flexibility and reduces wait times and missed and cancelled patient visits to help improve patient satisfaction.
• Enables the agency to grow, as the agency can take on more clients without necessarily having to increase the staffing level.
• In keeping with the national trend of growing telehealth, payer incentives, and demand for efficient, technology-enabled care delivery.

Cost

• Subscription to telehealth platform: 150 000 per year.
• To purchase 100 tablets/mobile devices for high-risk patients: 80000
• Trained clinical and administrative staff: 25,000
• HIPAA, Cybersecurity and Compliance Enhancement – $40,000.
• IT and maintenance support: 30000/-/per/year is still available.
• Year-1 Cost: $325K

Cost of Opportunity

With an annual budget of $325,000, allocating funds to this telehealth initiative means the organization has other competing investment options such as two more nurses ($160,000 – $200,000) or the HR benefit package to reduce turnover ($250,000 – $300,000). It can also delay resource allocation to this Program, the capacity to provide short-term financing for other, more capital-intensive Programs such as full RPM, which can cost more than $900,000 to set up initially. The opportunity costs identified here highlight the need to make trade-offs between innovation needs and short-term operational needs.

Explanation

This telehealth solution also aligns with the agency’s overall strategy to build service capacity without relying too heavily on the addition of full-time nurses, given the current shortage of full-time nurses and a competitive job market. The information on community needs shows an increasing need for home-based services, especially for older people and for groups who are not being adequately served, and who may have barriers to offline services. This makes Telehealth a relevant and suitable answer to the needs of the communities and accessibility issues.

This trend aligns with the continued growth of telehealth nationally as patients like it, payers approve of it, and it has been useful and efficient for value-based care models and delivery systems (Weiss et al., 2023). The cost-benefit analysis has shown that these options require moderate initial investments and will lead to high operational efficiency, improved patient engagement, and a scalable healthcare model, thereby enhancing the competitive edge of the agency. The long-term value of telehealth is greater than the opportunity cost of telehealth to the alternative use of the money in the long term, so telehealth is a strategically viable alternative.

Option 3: Enhanced HR Benefits and Retention Package

Proposal

This includes a focus on staff development, flexibility and well-being, and the Enhanced HR Benefits and Retention Package to increase the long-term stability of the agency’s workforce. The alternative adds to traditional compensation packages with tuition reimbursement, targeted promotions and career paths, flexible scheduling options, and more wellness amenities for nursing staff. It has two specific objectives. One is to improve job retention, and the other is to add an attractive working atmosphere to draw good candidates in a highly competitive job market (Bristol-Alagbariya et al., 2024).

These priorities of professional development and organizational support will set the agency up for a sustainable, satisfied, and high-performing workforce that is able to effectively meet the growing community needs. That’s because, as the national nursing shortage reaches a boiling point, a retention strategy will allow the agency to stabilize staffing and even plan for future growth.

Advantages

• Reduces turnover, provides for career development opportunities and improves job satisfaction.
• Appeals to qualified nurses who value training and development, work flexibility and part-time work.
• Encourages a positive culture within the organization, with participation, teamwork and improved patient outcomes.
• Denies referrals, delays service, and disrupts continuity of staffing to serve the needs of the community.
• Builds agency competitiveness for the marketplace – home care, which will lead to future credibility and growth.
  
  

  Price

• Registered nurses already in service: tuition reimbursement: 200,000 annually.
• Annual performance bonus: $150,000.
• Wellness/Mental health support (EAP): Expansion: $50,000.
• Flexible scheduling material (cross-training, per diem staffing): $100,000
• HR administration and Program implementation – 75,000.
• Year-1 Total Cost: $575,000

Cost of opportunity

A wide range of retention packages, from $575,000 to $900,000, will reduce an agency’s capacity to invest in any more quick-fix solutions such as a telehealth triage Program ($325,000) or full-blown RPM technology ($900,000). This investment also means that the organization can only afford about 3-4 more full-time nurses (320,000-400,000 per year). “You’re investing resources for the longer-term sustainability of the staff with the agency, rather than what can be done in relatively short-term capacity building, by focusing on retaining the staff rather than on recruiting new staff or on technical growth.”

Explanation

Enhanced HR Benefits and Retention Package helps to build a long-term labor strategy of labor stability rather than competing for labor in a tight market by being aggressive in recruitment. The studies have shown that good retention Programs reduce turnover, increase team cohesiveness and continuity of care, which helps to achieve improved patient outcomes. This alternative would not provide the same number of visits as an increase in staff or technological solutions, but would have a larger staffing base to draw from for the future growth of the organization (Bharath, 2021).

Reimbursement of tuition fees, career growth programs, wellness, and flexible work schedules will make it possible for the agency to retain professionals with high ability and competencies who want to work with the organization’s mission. A well-developed and stable workforce will mean good delivery of services, stable clinical quality, and most importantly, responsiveness to the needs of the community in the longer term. Moreover, retention practices save costs and resources in the long run in the recruitment and training process, increase employee satisfaction, and make the company an employer of choice. In general, retention investment provides significant long-term benefits by reducing staffing instability, promoting professional engagement, and positioning the agency on the track of sustainable development in the next decade.

Conclusion

The results for the three strategic options, RPM, the Telehealth Nurse Triage Program, and the Enhanced HR Benefits & Retention Package, show that each option has its own strengths that are consistent with the agency’s mission of providing high-quality, accessible, home-based care. The biggest long-term impact of RPM on clinical capacity will be reduced reliance on face-to-face visits and allowing for sustainable growth in capacity. The Telehealth Nurse Triage Program will be an efficient and cost-effective means of improving follow-up care and increasing access to care for underserved populations, and keep the agency connected to the national momentum towards virtual care.