A strategy for third-party logistics systems: A case analysis using the blue ocean strategy

One of today's most frequently discussed topics in the business world is how to escape from the intense Red Ocean and how to create an uncontested Blue Ocean. However, because there are few practical guidelines available on this topic, we will introduce a case study of a third-party logistics (3PL) provider, CJ-Global Logistics Service (CJ-GLS), to show how it aspires to be a leader in the newly introduced 3PL industry in South Korea. CJ-GLS is a latecomer in the logistics industry, and its resources, such as the number of trucks and warehouses, are relatively small in comparison to those of established companies. But, it has achieved a distinct competitive advantage through innovative information technology (i.e., RFID—radio frequency identification), which has enabled it to create an uncontested market space, electronic logistics business. One remarkable fact about CJ-GLS is that its swift growth comes not from attracting competitors’ customers from the existing Red Ocean market but from creating a Blue Ocean market (3PL market), which previously existing incumbents ignored, and also from constructing a new business model founded on a RFID-based, ubiquitous-oriented 3PL system. Analyzed through a Four Actions Framework and characterized as Blue Ocean, this case study provides valuable information on how a company reinforces its competitive advantage from the Red Ocean while it transitions into a Blue Ocean by utilizing advanced information communication technologies.     

Reinventing a medical specialty. Using anesthesiology as a model for change

In only a decade, anesthesiology has reversed its fortunes from an underrepresented specialty in the 1980 Graduate Medical Education National Advisory Committee report to "a specialty in trouble" featured in The Wall Street Journal. This article focuses on anesthesiology and its work force dilemma as an evolving specialist model for change. What is happening to anesthesiology will not be unique--managed care competition will affect all physicians. Most specialties will have to reshape curricula and redesign education programs and academic delivery systems concentrating on fewer trainees. What are the options for coping with physicians grieving over lost dreams, such as autonomy and solo practice, while redesigning a medical specialty? The authors untangle fact from fear, mission from myth, and offer strategic thinking and solutions.     

Physician buy-in is essential for pay for performance

Blue Cross and Blue Shield of Florida is counting on voluntary participation as it rolls out its innovative pay-for-performance program throughout the state.     

Coordination of benefits reduces double payments.

As a means of reducing the cost of duplicate health care coverage, the health insurance industry utilizes a mechanism called coordination of benefits (COB). The main purposes of COB are to limit recovery to 100 percent of actual charges and to assign insurers primary and secondary responsibilities to pay these charges. Nearly all health plans, including HMOs, Blue Cross/Blue Shield plans, and commercial insurers, coordinate benefits, mostly for group coverage, often on the basis of procedures found in state insurance codes. While COB provides an effective cost reduction mechanism to health insurers, several issues remain in its administration, including difficulties that arise when carriers refuse to pay, when HMO members self-refer, and when coordination is attempted with an uninsured plan.     

The case for a physician director of the surgical suite

A typical hospital operating room can generate revenue of $1 to 3 million per year. About 30 to 40 percent of the total income of a hospital is produced in the surgical suite. This is a high-cost area in terms of personnel, equipment, and supplies, so strong management is increasingly important in the area. In the past few years, a number of hospitals have found a solution in a physician director for the surgical suite. Although the physician for this position may be of any specialty, the chief of anesthesiology or an anesthesiologist with strong management and communication skills is the best choice. Usually, an anesthesiologist spends the most time in surgery and does not have special allegiance to any surgical specialty. He or she has a vested interest in smooth functioning and success of the surgical suite.     

Strategic planning for commodities and specialties: A strategic industry study based on the example of the chemical industry

The objective of this paper is to identify general factors which are important to successful corporate strategic planning and to provide guidelines to requirements for successful entry into the specialty materials/products business. The study is based on the author's experience in the highly specialized Swiss chemical industry. While the concept of commodities/ specialties has been developed most intensively in the chemical industry, it has overall validity for all industries and services and the author gives many practical hints on strategic management.     

Can Sisyphus Succeed? Getting U.S. High‐Level Nuclear Waste into a Geological Repository

The U.S. government has the obligation of managing the high‐level radioactive waste from its defense activities and also, under existing law, from civilian nuclear power generation. This obligation is not being met. The January 2012 Final Report from the Blue Ribbon Commission on America's Nuclear Future provides commendable guidance but little that is new. The author, who served on the federal Nuclear Waste Technical Review Board from 1989 to 1994 and subsequently on the Board on Radioactive Waste Management of the National Research Council from 1994 to 1999, provides a perspective both on the Commission's recommendations and a potential path toward progress in meeting the federal obligation. By analogy to Sisyphus of Greek mythology, our nation needs to find a way to roll the rock to the top of the hill and have it stay there, rather than continuing to roll back down again.     

Specialist versus primary care: not an easy question

The central focus in the debate to reform our nation's health care system is on cost, quality, and access. There is general agreement that there are too many specialists in the wrong places, which is said to contribute to the rising cost of health care. Physician profiling has supported the concept that some specialists are more costly than primary care physicians, although the severity of illness in patients treated by specialists may often be greater. Increasing the number of primary care providers may be a solution to reduce costs and will clearly improve access. The study reported in this article was carried out to examine the efficiency of primary care physicians and endocrinologists, a specialty that has been cited as one in which resource utilization is high, in caring for hospital inpatients with diabetic ketoacidosis.     

Provider profiling: advancing to episodes of care

Judging by the interest expressed by managed care organizations, provider profiling has arrived. Surveys indicate that most organizations have adopted, or plan to adopt in the near future, a means to describe provider practice patterns. A further vote of confidence came from providers: In 1994, the American College of Physicians, the largest national specialty organization, issued a position paper supporting provider profiling and questioning the value of other approaches to utilization management, such as preauthorization of individual services. Also, an article and an editorial in the New England Journal of Medicine cautiously supported the concept of profiling. Provider profiling has great promise as a means to promote cost-effective care without the limitations of case-by-case preauthorization. The combination of a sophisticated episode of care methodology and a set of validated practice benchmarks offers the opportunity to perform true clinical profiling and to supply providers with data to review and alter practice patterns.     

Physician manpower needs under managed care. How to determine the need for MDs by specialty

The concern in the last quarter century in the United States over the shortage of physicians has now been supplanted by the fear of an excess number of doctors, particularly among the subspecialists. This article outlines four methodologies to be used in parallel to determine by clinical specialty whether a predetermined population base has an inadequate, sufficient, or excess number of physicians. Based on various assumptions, physician-population ratios per 100,000 persons for 28 clinical disciplines are supplied. Possibly the most intriguing questions as a result of this study are whether a broad spectrum of HMOs will use general internists or family practitioners as their prime "gatekeepers;" and, whether, in the long-run, the fiscal incentives inherent in the managed care concept will result in a more frugal utilization of physician services.     

Administrative fellowships in emergency medicine

Physicians today need to be effective managers, as well as clinicians. In previous years, physicians gained managerial experience either through on-the-job training, degree programs, or continuing medical education courses. The specialty of emergency medicine began its first administrative fellowship in 1990 in California. Currently, three administrative fellowships exist nationally in emergency medicine. This article will describe the purpose of the fellowships and their curricula. Each fellowship has a different emphasis, with the goal to educate physicians who are interested in developing administrative skills to manage emergency departments or management groups or accept roles in hospital leadership. The existence of these fellowships will ideally influence the establishment of administrative fellowships in other specialties.     

The challenge for women physician executives

After half a century of constituting 5 percent of the physician population, women will soon make up more than one-third of U.S. physicians. Women now practice in virtually every specialty. This enormous change has created both opportunities and tensions. Within the broader context of the changing role of women in U.S. society, women physicians are exploring new career paths--paths that are both similar to and different from those of their male colleagues. A future challenge for women physicians will be achieving significant representation in the medical management ranks.     

Palliative medicine in Britain

In Britain, Palliative Medicine was recognized as a subspecialty of Internal Medicine exactly 20 years after Cicely Saunders founded St Christopher's, at exactly the same time that government was at last recognizing the worth and the needs of general practice. Both had far-reaching effects and implications for patients, doctors, and the future of medicine. For Palliative Medicine it meant units wishing to train specialists going through a rigorous selection process; the development of an equally rigorous training program for the doctors who had already gained a higher qualification before starting Palliative Medicine, demonstrating the need for and benefits of palliative medicine to the sceptics in the profession and, now, continuing to recruit the staff for the steadily increasing number of new services. Today there are more Palliative Medicine consultants/specialists than there are oncologists and neurologists combined, with Hospital Palliative Care Teams in every major hospital and cancer center. With nine Chairs in Palliative Medicine, there is now a drive for research and professional education. The specialty faces major challenges, however, ranging from training to care for patients with non-malignant disease to enabling patients to die in the place of their choice-something that rarely happens today; from defining what is distinctive or unique about palliative medicine to clarifying the respective place of general practice and the specialty. Most would agree that the biggest challenge for the young, thriving specialty is how to share its principles with other doctors wherever they work.     

From knowledge to decision – a case study of sales and operations planning in health care

One of the most important challenges in health care management is balancing resources with fluctuating and uncertain demand. This study examines whether introducing a standardised process for sales and operations planning at a large university hospital improved specialty department managers’ knowledge of planning conditions and if so, whether decisions were made based on this knowledge. Using responses from a survey of 30 specialty department managers at Sahlgrenska University Hospital in Sweden, the analyses indicate that operational knowledge strengthens insights about the needs for strategic decisions, and vice versa. Moreover, knowledge is a necessary, but not sufficient, condition for making decisions at the department level. An overall planning and decision structure is required and should be implemented first at the hospital level to effectively allocate resources.     

Practice standards use with internal partners

U.S. Department of Defense experience with internal partnership programs has indicated that a lack of close supervision by medical treatment facilities can result in cost increases. The use of medical practice guidelines or standards is the subject of active investigation. The global guidelines tend to be too rigid or too vague to affect the provision of care. Their general acceptance can often be low. The use of clinical guidelines, with supervision by a clinic peer, has been determined to be a provider-friendly method of delivering cost-effective, high-quality care. Comparisons were made between the supervised partners against the total expenditures for ENT outpatient CHAMPUS care. The results indicated not only a savings but a reduction in the rate of cost increases by more than 250 percent. It is our feeling that specialty provider, peer-directed medical standards can be applied in a cost-effective manner. Their adoption as an organization-wide standard for referral can be an important tool in maintaining quality while containing costs.     

Der Einfluss von Mehrfachmandatstr?gern auf die Unternehmensperformance

Although interlocking directorates are regularly associated with a negative connotation, empirical evidence is as yet insufficient to offer convincing answers about their impact on performance. Contradicting results can mostly be explained both by the use of different theoretical frameworks and value creation measures. In order to shed more light as to what effect busy directors have on shareholder??s wealth, we have developed a two-pillar model explaining the potential contributions of directorship interlocks to value creation within an enlarged corporate governance perspective. The validity of the model has been tested through a panel data analysis of director networks within German Blue Chip corporations over a 5 year period from 2001 to 2005. Empirical tests indicate that the performance effects of interlocks depend on the nature of the board positions occupied. Moreover, statistical modelling confirms the existence of cognitive contributions of interlocked directors and partially shows positive effects on value creation. Finally the study argues in favour of board composition without external executive directors and suggests that a simple reduction of the number of external board positions legally authorized, does not within itself enhance corporate performance.     

New ways to support specialty inpatient services

Examine how hospitals and specialty groups can design financially efficient alternatives to traditional practice models while maintaining high-quality tertiary services.     

Nurturing clients’ trust to encourage engagement success during the customization of ERP systems

Customization is a crucial, lengthy, and costly aspect in the successful implementation of ERP systems, and has, accordingly, become a major specialty of many vendors and consulting companies. This study examines how such companies can increase their clients’ perception of engagement success through increased client trust that is brought about through responsive and dependable customization.Survey data from ERP customization clients show that, as hypothesized, clients’ trust influenced their perception of engagement success with the company. The data also show that clients’ trust in the customization company was increased when the company behaved in accordance with client expectations by being responsive, and decreased when the company behaved in a manner that contradicted these expectations by not being dependable. Responses to an open-ended question addendum attached to the survey corroborated the importance of responsiveness and dependability. Implications for customization companies and research on trust are discussed.     

Scared silent: the clash between malpractice lawsuits & expert testimony

As the Bush administration pushes Congress to place a $250,000 cap on pain and suffering awards in medical malpractice lawsuits, other moves quietly afoot by state medical boards, state medical associations, and specialty societies may reduce liability insurance premiums by limiting the number of suits.     

California's Wickline decision revisited

In a recent California appellate decision, Wilson v. Blue Cross of Southern California, 222 Cal. App 3d 660, 271 Cal Rptr 876 (2d Dist., 1990), the court cut back on its earlier decision in Wickline v. State of California, 192 Cal. App. 3d 1630, 239 Cal Rptr 810 (2d Dist. 1986), which had provided substantial protection for third-party payers against liability for utilization review decisions. The Wilson decision not only limits Wickline to its particular facts, but also criticizes some of its rationale.