The Wall Street Journal exposed the business history of Carilion Health System through an article composed by John Carreyrou. The journal warned of a possible monopoly over medical care services by Carilion Clinic in the region. The journal claimed that the cost of health care in Roanoke Valley has been rising cumulatively in the last few years. In addition, the health insurance in the region had shifted from being the cheapest to the highest in Virginia State (Carver & Jessie, 2011). This rise has been attributed to the market domination in the Roanoke Valley’s economy by Carilion Health System through lots of its holdings in the region. In response to these views, Carilion Health System acknowledged its influence over the inhabitants of the area, and it dismissed monopoly claims over the Roanoke Valley health care system. The hospital claimed that it only charges more for specific medical processes since it has to promote emergency operations and treatment service for uninsured patients (Carver & Jessie, 2011).

Carilion had a plan to integrate health system into a new clinic model. Through this model, the doctors will work together in a well harmonized health care delivery model in an attempt to cut down avoidable procedures and checks (Hayes & Gregory, 2012). However, a group of non-Carilion physicians in the region have impeded the implementation since they claim that the Carilion plan is essentially designed to suppress competition. In addition, the non- Carilion and Health insurance brokers claim that the move is aimed at eliminating any hospital competition, thus enabling Carilion to hike health service prices as well as insurance rates in the area (Hayes & Gregory, 2012).

The two main external market challenges include an ever-increasing cost of health care delivery, which makes it difficult to maintain an adequate workforce and contain the cost incurred. Another challenge is meeting the needs of ever-increasing chronic care, especially to the growing and aging population (Riha, Martin & Burks, 2011). These challenges are faced by health care providers in the primary care. This makes it difficult for the Carilion Clinic to face these challenges with its initial model. Therefore, it was forced to adopt a patient-centered medical care model in order to provide well-coordinated and comprehensive care that is rooted in strong collaborative relationship (Riha, Martin & Burks, 2011).

There is a potential conflict of interest in the Carilion Executive Board. This is as a result of multi-million construction tender awarded to a company owned by one of the director member’s of the Board. Turner & Co. Inc. company is co-owned by Jay Turner, who is a member of Carilion Executive Board. However, according to the reports from the Carilion, Jay Turner has never influenced the decision-making process leading to hiring of the Firm. Another potential conflict of interest arises from the influence of Dr. Ed Murphy in the board and the Roanoke community. Dr. Murphy is influential due to many positions he held previously in the region. He also held a senior position in Virginia Council that aimed at structuring growth and progress in the Virginia State. In order to evade conflict in the Board, the Policy that protects conflict of interest in the Carilion Clinic needs to be followed to the latter. The policy will ensure that members of the Board do not benefit improperly due to position they hold in the organization.

The vertically integrated clinic model that is intended to promote teamwork and patient-focused care is well positioned for participation in health exchanges. This is because the new model will make the Carilion Clinic cease from being an independent entity and become ancillary services to the doctor’s practice (Lubell, 2011).  As a result, the Clinic will provide cost-effective and better health services. The Carilion is also in a position to enhance the exchange program. This will be enhanced by the Clinic’s initial plan to partner with Virginian Tech University in order to institute medical school and a non-profit clinical research facility. This partnership will facilitate the exchange program (Lubell, 2011).

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