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Home Health Agency Balanced Scorecard Analysis

Info: 2393 words (10 pages) Essay
Published: 8th Feb 2020 in Management

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Description of the Hillsboro County Home Health Agency

Health is an important component of government and this has seen strategies and agencies developed at National level, State or County level to ensure the efficient delivery of healthcare services. Among such organizations is the Hillsboro County Home Health Agency that was set up in 1946 to provide home health care to the residents of the area. In recent years, however, it became oriented with the general country population. The agency’s mission is to serve all people with or without disabilities by; preventing diseases, delaying the progress of already acquired diseases; lowering the effects of inevitable diseases; providing information and inspiration to patients and their families and to provide high quality nursing and therapeutic care (Hillsboro County Home Health Agency, 2018). To achieve this, the agency established several core values that guide the employees as they perform their duties. These core values aim in enhancing the integrity, teamwork and collaboration, efficiency in service delivery, innovation and compassionate interaction with patients.

The Mission

The mission of HCHHA is to serve individuals in their usual environments and is concerned with well people as well as people with illness or disabilities. We strive to prevent disease or to retard its progress and to reduce the ill effects of the unavoidable disease. We provide quality nursing and therapeutic care to the noninstitutionalized sick and disabled. We also provide information and encouragement to individuals and families, special groups, and the community as a whole for the promotion of health.”

The Vision

To improve health service delivery and become a leading institution of health care services.




HCHHA has been in operation for decades since 1946 and it’s well known among the population

The only Medicare-certified home health agency in Hillsboro County

Has accreditation from the Joint Commission


Challenges in efficiently providing Medicare home visits such as cost of gasoline

Challenge of eligibility for Medicare services and lack of sufficient resources to sensitize the   public

Financial burdens associated with the Private Duty Division of HCHHA because Medicare does not support


Availing funds to offer nutritional counselling to Medicare patients and help with disease prevention.

Developing and improving emergency response services and preparedness

Hiring more members of staff to provide improved and efficient care in all the different departments of HCHHA




Ineligibility of some of the un “homebound” elderly patients reduce the efficiency of HCHHA within the society 

Lack of funds injures the quality of services offered and private institutions are attracting sections of the population


Internal Factors

External Factors


It has been in operation for decades.

Good repute within the community.

Locations in both Hillsboro and Jasper.

It’s the only Medicare-certified home in the whole county

It is accredited by Joint Commission


Lack of sufficient resources to sensitize the public about Medicare.

Financial burdens

Decline in financial performance.

Huge numbers of unproductive elderly employees. 

Cost of gasoline


Availing funds for nutritional counseling to patients.

Insurance companies are strategizing to work with home care companies.

Improving emergency response services

Can benefit from a more robust marketing and advertising campaign


Lack of funds that injure the quality of services provided.

Increased competition in the home care field.

Ineligibility of dome elderly patients



BSC strategy map for HCHHA would be as follows implementing key objectives that are in line with the overall strategy and build upon the four perspectives of a balanced scorecard.



Correlation with Vision and Strategy


Gaining more financial resources from Federal, State and County Governments.

Development better financial management systems

Reach as many people as possible and manage their home care service.

Improve efficiency, enact an inclusive board that ensures financial efficiency


Improving the capacity of members of staff bringing more leaders and professional managers.

Focus on offering counseling based care and preventive measures to the services currently offered.

Gathering feedback and information on the causes of resistance.

Hire new youthful employees and strategize on how to legally rid of the older ineffective team members.


To equip the employees with the skills they need to adapt to the new system.

Re-evaluate the need for a different branch in Jasper

Outsourcing nurses to train the employees on improved methods of care to improve outcomes

Creating training workshops throughout the process.

Centralize the operations at the Hillsboro office and utilize the funds efficiently from one operational point.


The identified objectives are integral in the development of an improved process of management and ensuring better financial efficiency as well as maintaining the targeted customer/patient outcomes within the agency’s mission and vision (Clair & Goyal, 2015). These objectives are imperative because when it comes to organizational readiness for change, it is clear from the feedback got from the employees that they are ready for new and better systems within the agency. Due to the increasing number of residents needing healthcare, the nurses feel overwhelmed and request for more staff to be employed (Home Health Services Coverage, 2018). In addition to the field work, the nurses are required to do some paperwork which forces them to continue working at home. The fact that previous changes made by Washington simplified work for the agency, has helped in gaining votes for a change. Using this information, it is clear that the employees will not put up much resistance to change as it will work in their favor.

Performance Measures

Strategic Objective

Performance Measure

Employee training, Financial Inclusivity

Conduct a variance analysis twice a year.

Gaining more financial resources from Federal, State and County Governments.

Quarter Annual Budgetary reviews

Development better financial management systems

System audits on a monthly basis to determine the effectiveness of the system

Improving the capacity of members of staff bringing more leaders and professional managers

Measure medical outcomes, how are the success rates? Are there more subscriptions after the new training program?

Focus on offering counseling based care and preventive measures to the services currently offered.

Variance analysis on patient outcomes, work with psychiatrists at the point of diagnostics and at the point of release to see the mental progress of more so the elderly patients

Re-evaluate the need for a different branch in Jasper

Budgetary analysis, appropriations vs. the actualizations, does the extra branch improve financial efficiency other than increasing patient access?

The two imperative measures are the patient outcome variance analysis and the review and analysis of budgetary allocations and appropriations. The formers directly correlate with the missions and vision for what good is the agency if the patient medical outcomes are not consistent and patients don’t draw utility from their Medicaid and Medicare covers (Torppa & Smith, 2015). On the other hand, financial efficiency is key to all the processes involved, getting this wrong will have a trickled down effect more so on the quality of care provided through the agency and will also reflect on the general implementation of government funds meant for healthcare (Cox, 2018).

Making the BSC Impactful

The agency can as well perform annual staff appraisals so as to monitor the performance of the staff. One of the ways the agency can improve this is by developing standards of performance. To ensure the employees are aware of these standards, they should be established in operational guides, job descriptions and employee guidebooks (Wooding, 2013). The agency should also communicate about them with the employees occasionally. Establishing these standards ensures that a professional culture is nurtured within the agency. The division managers should then measure the performance of their employees by developing individual goals and evaluating their performance towards these goals. By doing this, the manager can recognize which nurse is not delivering services efficiently and rectifies the problem immediately by having a discussion with the employee. The managers can also collect information from the patients’ feedback and include it to the appraisal.

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For efficient and impartial evaluation, the agency should make use of external bodies. This can be most applicable in the finance, administration and home care divisions. In the finance division, external financial auditing is important since the employees will not be able to manipulate the auditor to collect and record information in their favor. As a result, the finances of the agency will be safe and secure as embezzlement will be eradicated (Wooding, 2013). In the administration division, external bodies can be used to evaluate how employees such as receptionists or human resource managers handle certain cases such as complaints from the patients, as well as how they keep and maintain agency records.

The agency should include incentives on top of implementing a change in the management plan. This will help in reducing resistance and motivating the employees, even after the process is complete. One of the ways to accomplish this is by giving bonus payments to the employees for their roles in the process once it is complete. Acknowledging employees who worked harder using individual bonuses is another incentive the agency should use. Using the two types of incentives, the employees will be motivated to implement the change successfully and will cause minimal, if any, disruptions (Clair & Goyal, 2015). A promise to better working conditions and hours is a further incentive for the employees as they will look forward to the new system that will make their burden lessen.


  • Clair, B., & Goyal, P. (2015). What does Medicare pay rhinologists? An analysis of Medicare payment data. International Forum Of Allergy & Rhinology, 5(6), 481-486. doi: 10.1002/alr.21461
  • Cox, C. (2018). Lobbying for Government Appropriations. SSRN Electronic Journal. doi:  10.2139/ssrn.3203661
  • Hillsboro County Home Health Agency. (2018). Retrieved from https://prezi.com/uaocu68zxcwd/hillsboro-county-home-health-agency/
  • Home Health Services Coverage. (2018). Retrieved from https://www.medicare.gov/coverage/home-health-services (2018).
  • Torppa, C., & Smith, K. (2015). Organizational Change Management: A Test of the Effectiveness of a Communication Plan. Communication Research Reports, 28(1), 62-73. doi: 10.1080/08824096.2011.541364
  • Wooding, S. (2013). A Psychodynamic Approach to Change Resistance. Change Management: An International Journal, 12(1), 17-22. doi: 10.18848/2327-798x/cgp/v12i01/50769


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