iora strategy project final version (3)
TRANSCRIPT
IORA STRATEGY PROJECTConducted by Gates Associates, LLC, a business consulting firm composed of Jeremy Gates, Léa
Serrano, Tiffanie Stamper and Zack Williford
“Serving as strategic management for Iora Health’s expansion”
TABLE OF CONTENTS
Executive Summary – Gates Associates, LLC.……………………….......….…… 3
Meet our Team …………………………………………………………………... 3-5
About IORA Health……………………………………………………………...… 5
Executive Summary of IORA Health Project………………………………....... 6-7
Statement of Problem ………………………………………………………..……7-8
Proposed Solution ………………………………………………………..…….…9-15
Conclusion …………………………………………………………………….…15-20
References ……………………………………………………………………..…… 21
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ABOUT GATES ASSOCIATES, LLCGates Associates, LLC, was established in 2016 in order to provide high quality professional
services to businesses seeking innovative solutions that analyze, identify and address potential company
issues or concerns. Our knowledgeable and passionate professionals collaborate in a synergistic
environment that enables us to provide the upmost service to our clients and has caused our business
model to thrive. We continue to deliver superior financial results to investors while contributing to the
communities in which we live and work. Our professionals specialize in using their expertise and
imagination as well as their creativity to seek ways to apply things that we, overtime, have explored in
our professional experience.
MEET OUR TEAM
Jeremy Gates
Senior executive with over 15 years of leadership and management
experience in private and public sectors including, manufacturing,
healthcare, government insurance and social service organizations.
Developed and implemented staffing strategies and programs that
improved operational outcomes and maximized the available staff
resources. Extensive experience in human resource planning and
operations, organizational change, team building, organizational
effectiveness and facilitative leadership. Performed operational and
organizational audits that aligned business requirements with staffing
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plans and processes to enhance teamwork, and team performance along
with team creativity and innovation.
Léa Serrano
Consultant expert with over 15 years of professional experience in several
countries around the globe. Fields of endeavor include but are not limited
to business growth and development, marketing, advertising and branding,
as well as employee management. Specialized in the restaurant and art
industries, Lea Serrano brings her creative and innovative approaches to
management styles to organizations all over the world. Traveling and
experiencing different cultures is her biggest passion - something she puts
to use during her consulting services in order to provide an international,
diverse and insightful environment for any organization that seeks to be
taken to the next level, all while remaining true to their brand.
Tiffanie Stamper
Accomplished and highly respected subject matter specialist in planning,
developing and implementing customer operational strategies, contact
center diagnostics, and business process reengineering efforts. Over 25
years of functional and consulting experience in the communications,
defense, distribution, entertainment, financial services, health services,
state government, transportation and utilities industries. Possesses
excellent working knowledge of overall customer management processes,
operational management processes, marketing, sales, order entry,
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distribution, collections, customer service, and face-to-face processes, as
well as in recruitment, human resource development and training.
Zack Williford
Distinguished consultant with over 12 years of management experience in
healthcare, private, not-for-profit, and international organizations.
Specializes in customer service and employee participation. Previously led
an organization into a profitable and stable international market business.
Excited to share knowledge and gain new insight.
ABOUT IORA HEALTHIora Health is an innovative health care company that emphasizes a new team approach to
primary care. Iora’s business model believes it can solve two major problems in America’s health care
system: the first is misalignment of financial incentives and social issues that hamper people’s health. In
their model, they provide care based on a flat fee per customer in contrast to the traditional piecework
model that most providers use. They are treating the patient using a care team to ensure no one falls
through the cracks and to provide not only medical care but also mental health and emotional support.
They believe their rational approach can thrive off the money currently wasted in the health care system
if successful expansion occurs using their current profit-making model (Sanger-Katz, 2015).
EXECUTIVE SUMMARY OF IORA HEALTH PROJECTReferred by professor Mark Fitzgerald, Gates Associates, LLC and their most trusted business
consultants were ask to provide an analysis concerning a specific organizational behavior problem that
Iora Health is likely to face and our strategic management solution to that problem. 5
Iora Health has retained our services in order to identify any potential organizational behavior
problems within its company and to provide strategic management solutions to that problem. They have
requested that we include clear action steps that can be taken by management to resolve this problem.
Iora Health desires to expand all while keeping customer satisfaction in addition to profits at an all-time
high. Iora’s expansion plan’s mission is to develop a standard formula and to allow its professionals to
experiment and adapt to local conditions. They have requested that the company’s proprietary
electronic medical records, the design of the consultation rooms and the daily huddle itself are not
subject to change.
Gates Associates created and managed a synergistic team in which all members played a
significant role and made worthy contributions. Our synergistic team, gained insight into motivation,
goals, values, personality, communication and work habits. We collectively identified useful tools such
as useful assessments for employee selection, training, motivation, productivity and/or job assignment,
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Gates Associates, LLC.
Syngergistic team consisted of experienced professionals
Corporate Analysis and Insight
MotivationGoalsValuesPersonalityCommunicationWork Habits
IORA HealthWill be provided a Performance Management System that will be useful for the followingEmployee SelectionTrainingMotivationProductivityJob Assignment/TransferThese usefool tools will solve corporate problems and guarantee safe and successful development and expansion
and identified effective management tools to solve the specific business problem faced by the company
in the case study: Iora Primary Care.
STATEMENT OF PROBLEM
Iora has set organizational goals that it hopes to achieve in the medium-to-long-term future
(Raymond, 2013). A main goal is to disrupt the current model of primary care delivery and to reduce
health care spending by placing a greater emphasis on primary care which prevents costly emergency
room visits and hospital admission along with fixing the inefficiencies that occur in traditional health
care practices here in the United States. The founder Dr. Fernandopulle’s strategy is to take something small
and effective and reproduce it in office after office (Sanger-Katz, 2015) but in order to accomplish this you must
seek to gain a competitive advantage through your employees and must be able to manage the behavior
and results of all employees (Raymond A. Noe, 2013). Doing so will ensure that Iora’s current
expansion strategy effectively and successfully transform the health care system throughout the United
States in the ideas of its founder.
After careful analysis and with extensive collaborations with human resources, our business
consultants, as requested, have determined that Iora’s great ideals are feasible. However, implementing
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Desire to expand
Pressure from corporate to comply to fixed and replicated rules
Problems faced along
the way
Disassociation between corporate desires and actuality of local environment and individuals at each IORA medial office locationEmployees’ misalignment with organizational goals and objectives
Decreased productivity
an unconventional practice throughout the United States will require strategic management. In today's
competitive markets, organizations must engage in strategic planning to survive and prosper (Raymond
A. Noe, 2013).
We as your business consultants have thoroughly performed an SWOT analysis and have
foreseen a problem that will need to be address in order for Iora to transform health care. We will clearly
address both the problem and the steps to liberate the foreseen problem. Here is what our research has
shown. There have been several innovative and successful new primary care models, but few have
grown beyond 1-2 clinics (Sanger-Katz, 2015). However, we see a key distinction that separates Iora
from the rest. You have fundamentally changed your operating models. Your operating model is aligned
with your business model, and that is – the “triple aim” of improving patient experience, clinical
outcomes, and affordability of care – through its unique delivery model. Since you have provided such
beautiful architectural work, we feel only right to provide you with a solution to get the best out of your
constructors.
IORA faces productivity issues that arise as expansion occurs in regards to the disassociation
between corporate desires and the actuality of local environment and individuals at each IORA medial
office location. More specifically, in order to solve the problem of the employees’ misalignment with
organizational goals and objectives, Gates Associates, will organize and implement a performance
management system favoring strategic congruency.
Strategic management is a process, an approach to addressing the competitive challenges an
organization faces. It can be thought of as managing the “pattern or plan that integrates an organization's
major goals, policies, and action sequences into a cohesive whole” (Raymond A. Noe, 2013).
In order to accomplish realignment, Gates Associates performance management system will
provide a clear understanding of job responsibilities and expectations, which will result in increased
productivity and better information available to corporate to use for training, job experiences, and
developmental activities, thus allowing desired effective corporate expansion. It can also be used as a
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basis for compensation, pay increases, promotions, transfers, and assignments. It is imperative that
corporate executives understand and apply this performance management system thoroughly in order to
for it to be effective. This system will be overseen and managed by a corporate liaison who will be in
direct contact with both corporate executives and employees at all IORA medical offices locations.
PROPOSED SOLUTION
With no other elaboration, Gates Associates is concerned about some productivity issues that
may occur with regards to you expanding. We see this all the time. A company has great ideas. It works
within their current chain of stores, so they seek to expand. Attempting to manage the additional store or
facility they lose sight of their original ideas because it’s a lot tougher communicating and tracking
nonnegotiable job requirements in facilities in an expansion mode than in your current state. Thus, as
Professor Milstein points out, running one unconventional practice and keeping it great is very different
from running 100 (Sanger-Katz, 2015). In continuation, by this being an unconventional practice, our
business consultants are concerned that a dissociation between corporate desires and actuality of local
environments and individuals will eventually occur as Iora expands into new territories and opens new
medical offices.
We are proposing a solution in the form of a strategic congruence plan that will increase
productivity and prevent this dissociation from occurring. A strategic congruence is the extent to which
a performance management system elicits jobs performance that is congruent with the organizations
strategy, goals and culture (Raymond A. Noe, 2013). Since Iora’s emphasis is on its unique delivery
model that is centered on monthly fees as opposed to the conventional way of billing patients, we have
put together a plan that focuses on those important elements. Our plan encourages workers to positively
view those elements by implementing a reward plan that encourages those behaviors. Our plan increases
productivity, prevents employee misalignment, and could save you money because our performance
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management system provides for clear understanding of job responsibilities and expectation that can be
implemented on a large scale. Our plan facilitates Iora’s ability to transfer something small and effective
and reproduce it in office after office. In addition our plan can also be a basis for pay increases,
promotions, transfers, and individual assignment rewards. We have laid out the particulars, and it is
imperative that corporate executives understand and apply this performance management system
thoroughly. In order for this performance management system to be effective, this system will be
overseen and managed by a corporate liaison who will be in direct contract with both corporate
executives and employees at all lora medical offices locations.
Our plan is centered on Iora’s care teams’ expectations. A team of a doctor or nurse
practitioner, nurse, behavioral health specialist and a health coach works with each person. They set
goals with the patients, enabling them to become active participants in their own well-being. They
should know people by name, but more importantly by their dreams, fears and challenges (Iora Health,
2016). “We believe it’s easier for patients to manage their lives when mental health is also prioritized
and seen as integral to one’s overall health. At Iora, our patients can access their own behavioral health
specialist in the comfort and privacy of their doctors’ office (Iora Health, 2016). Individual team
members also have goals:
Doctor/ Nurse practitioner: Individual clinical assessments of each patient through
examination and communication to provide medical health goals.
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Care Team
Doctor/Nurse Practitioner Nurse
Behavioral Health
SpecialistHealth Coach
Nurse: Cares for patients, administers medicine and supports communication between doctors
and patients.
Behavioral health specialist: Provide short-term counseling, assessments and referrals, as well
as consultation to other team members.
Health coach: Build relationships between the patients and their care teams by connecting
deeply with patients by becoming their confidants, cheerleaders, and friends (Iora Health, 2016).
CARE TEAM PLAN
Patient satisfaction is determined based on three factors: How the patient rated their provider,
how much time they felt the provider spent on them, and how well their health care goals were
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Elements of Strategic Congruency Plan to be oustandingly met by Care Team
Patient experience
and satisfaction
Reward>80%=Team Dinner
Iora Avg > Performance =
Corrective actions
Industry Standard > Performance=
Termination, Job Transfer,
Assighnments, reduced
Engagement
Reward>25%=Non-Financial
Iora Avg > Performance =
Corrective actions
Industry Standard > Performance=
Termination, Job Transfer,
Assighnments, reduced
Access
Reward> Iora's standards
Non-Financial
Iora Avg > Performance =
Corrective actions
Industry Standard > Performance=
Termination, Job Transfer,
Assighnments, reduced
Clinical outcomes
Reward> Iora's Standards
Non-Financial
Iora Avg > Performance =
Corrective actions
Industry Standard > Performance=
Termination, Job Transfer,
Assighnments, reduced
Coordination of care
Reward> Iora's Standards
Non-Financial
Iora Avg > Performance =
Corrective actions
Industry Standard > Performance=
Termination, Job Transfer,
Assighnments, reduced
discussed.
If a team exceeds the patient
satisfaction (average of three percentages
on website) IORA’s average of 80%, then
the patient care team will receive a team
dinner within one week of the quarterly
report, which increases corporate morale
and increases employee satisfaction and
motivation. If performance falls below
IORA averages/standards corrective actions in the form of developmental activities and training will
take place. The consequences if performance falls below industry averages/standards could be
termination, job transfer, additional assignments, or reduced compensation.
If a team’s patient engagement exceeds
Iora’s average of 25%, a non-financial
compensation such as recognition that leads to
increased motivation and employee satisfaction
will be rewarded. If their performance falls
below Iora’s averages/standards, then
corrective actions will be implemented in the
form of developmental activities and training.
The consequences if performance falls below industry averages/standards could be termination, job
transfer, additional assignments, or reduced compensation.
If as a team they provided their patients access to useful resources, produced clinical outcomes or
had coordination of care that exceeds Iora’s averages or standards then a non-financial compensation
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Pr o v id e r R a t in g o f 9 o r 1 0
Sa id P r o v id e r A lw a y s Sp e n t En o u g h T im e
D is s c u s e d H e a l t h C a r e G o a ls
18%
35%
21%
75%
89%
77%
Patient SatisfactionIndustry Standards Iora Averages
Industry Average
Iora
0% 5% 10% 15% 20% 25% 30%
2%
25%
Patient Engagement
Series 1
such as recognition that leads to increased motivation and employee satisfaction will be rewarded. If
their performance falls below Iora’s averages/standards, then corrective actions will be implemented in
the form of developmental activities and training. The consequences if performance falls below industry
averages/standards could be termination, job transfer, additional assignments, or reduced compensation.
If a team manages to achieve the quarterly bonus reward for all 5 elements of our strategic
congruency plan, across three consecutive quarters an additional bonus may be rewarded in the form of
3 extra paid days off that can be taken at the individual team member’s discretion.
INDIVIDUAL TEAM MEMBER PLAN
An individual team member’s performance assessment is based on provider ratings, time spent
with patient, and discussed health care goals. This information is received by the corporate liaison and is
provided through customer surveys.
If a team member’s patients rate them a 9 or 10 for the quarter then that member will receive
recognition in their practice and receive a small financial incentive such as a gift card or voucher. If the
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Individual Team Member
Performance Assessment
Provider rating Time spent with patient
Discussed health care goals
member is rated a 9 or a 10 throughout all four quarters the team member will receive an end of the year
bonus according to team member’s merit. If a team member is a 6 or 7, they will receive training in
order to prevent member from falling below average. If member is rated lower than a 5, member will
receive warnings that can result into termination if performance does not improve over time.
Individual team members will receive recognition in team huddles and entered into special
drawings for financial incentives if their time spent with patient exceeds Iora’s standards. If member is
at or falls below Iora’s average then they will receive training in direct relation to level of customer
satisfaction concerning time spent with their patients. Meaning the higher the score the less training, the
lower the score the more training the team member will be required to attend. Consequences if member
falls below healthcare industry average is verbal warning with additional training and if continues across
multiple quarters may result in termination.
The reward for team members who discussed health care goals with their patients and exceeded
Iora’s standards will be recognized in team huddles and entered into to win special financial incentives
in the form of a drawing. If a member is at or falls below Iora’s average they will receive training in
direct relation to level of customer satisfaction concerning health care goals. Meaning the higher the
score the less training, the lower the score the more training the team member will be required to attend.
Consequences if member falls below healthcare industry average is verbal warning with additional
training and if continues across multiple quarters may result in termination.
CORPORATE LIAISON
We also more clearly defined the corporate liaison’s responsibility within and outside the
organization. The corporate liaison will work from Iora’s existing headquarters where they will provide
technical, staffing, and operations support to practices across the country. The liaison will go into
branches when there are specific problems to be dealt with that have been consistently reported to
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corporate and resolve them, as well as evaluate corporate performance standards. Based on these
standards, they will be able to enforce the rules of the congruency plan.
CONCLUSION Interpretation of Findings
In supposition, Iora an innovative health care company that emphasizes a new team approach to
primary care seeks our expert advice as they expand. Moreover, Iora’s goal is to disrupt the current
models of primary care delivery and reduce health care spending by placing a greater emphasis on
primary care to prevent costly emergency room visits and hospital admission. Iora seeks to accomplish
this by aligning their business model with their operational model, which is – the “triple aim” of
improving patient experience, clinical outcomes, and affordability of care – through its unique delivery
model approach.
With that approach, Iora seeks to fix the inefficiencies that occur in traditional health care
practices here in the united states by taking something small and effectively reproduce it in office after
office, which in theory would solve two major problems in America’s health care system: the first is
misalignment of financial incentives and social issues that hamper people’s health.
In their unique business model, Iora provides care based on a flat fee per customer in contrast to
the traditional piecework model that most providers use. Iora’s aligned business model allows its care
team members to fully focus on its patient, and provide a service that is incomparable to the less stellar
practices provided through traditional practices.
Implementation of Findings
To better understand the Iora’s expansion leading mangers and Iora’s operational managers’
ability and limitation we had all managers answer a few self-assessments which can be found in Stephen
P. Robbins Self-Assessment Library “Insights into your skills, interest and abilities”. These assessments
give insight on Iora’s abilities to expand while keeping their “triple aim” approach. We chose the
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assessments which would be the most helpful and aid our business consultants in customizing our
solutions plan to the strength of Iora’s employees. Here are those assessments:
How good am I at disciplining others? (Page 62)
This test is used to provide insight into how effective a person might be in practicing
discipline in the work place (Stephen P. Robbins, 2012). It contains eight disciplining
practices, managers needed to read the statements and select the answer that best
described them. They were asked to respond as they have or would behave and not as
they think they should behave. (Stephen P. Robbins, 2012). The following scale was
used to express their response: 1= Usually, 2= Sometimes, 3=Seldom.
The ideal manager that provides effective discipline would provide ample
warning, act in a timely fashion, use a calm and serious tone, be specific about the
problem, keep the process impersonal, and use disciplinary action that is
progressive and consider the circumstances (Stephen P. Robbins, 2012). An ideal
manager would score 22 or higher, with anything below 19 possibly needed
additional training.
Results: Iora managers scored an average of 18 and this means that on average
managers in an Iora health care facilities do not have the best practices for
disciplining its employees on a local level.
Based on these results our business consultants felt strongly that Iora needed an
outside contact to provide training and support on a regular basis to branch
managers. These support task would include technical, staffing, and operations
support. This translated into the corporate liaison position we recommended to
Iora.
How good am I at building and leading a team? (Page 64)
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In this test managers used a rating scale to answer 18 questions on building and
leading an effective team. The following scale was used: 1= Strongly disagree, 2=
Disagree, 3=Slightly disagree, 5=Agree, 6=Strongly agree (Stephen P. Robbins,
2012).
This assessment assumes that teams develop in 5 areas: diagnosing team
development, managing the forming stage, managing the conforming stage,
managing the storming stage, and managing the performing stage. The results can
estimate where a manager is compared to others with the top quartile being 95 or
above and the bottom quartile being below 60 (Stephen P. Robbins, 2012).
Iora’s managers scored an average of 84 and this means they know how to build
effective teams, which will be extremely important as Iora expand. According to
Robbins & Judge, 2012 a team generates positive synergy through coordinated
efforts. The individual efforts result in a level of performance greater than the sum
of those individuals inputs making it extreme important that Iora continues to
increase its abilities to build such great teams as they lead and build new
established care teams throughout the expansion process.
Based on these results Gates associates wanted to encourage the teams to continue
to work with excellence and strive to be better as a whole. We built into our
congruency plan specific rewards and consequences to the patient care team based
on their team performances.
How confident am I in my abilities to succeed? (Page 102)
Managers were to indicate the extent in which they agreed or disagreed to 8 different
statements. The following scale was used: 1=strongly disagree, 2=disagree, 3=
neutral, 4=agree, 5=strongly agree (Stephen P. Robbins, 2012).
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People who are confident have high-self efficacy that generalizes across a variety of
situations (Stephen P. Robbins, 2012). Confidence or lack of it can have influence on
many things we do (Stephen P. Robbins, 2012). The scores on this assessment can
range from 8 to 40, higher the score, high the confidence you have in yourself to be
successful.
Iora’s managers scored an average of 34. Meaning although you have some outliers
the group as a whole are confident individuals.
The goal of Iora to expand means it needs confident individuals to make up their
patient care teams. A confident individual will set goals for themselves and push
harder in the face of failure. One other key feature of a confident person is even when
they receive negative feedback they respond by increasing their effort and self-
motivate to do better (Stephen P. Robbins, 2012). If an individual is not confident it
doesn’t mean they cannot become more confident. Managers can use trainings and
tasks to increase confidence in a team member.
Using information gathered through this assessment about Iora’s existing managers
and about the role confidence plays in an individual’s ability to succeed we came up
with our congruency plan concerning the individual members of each patient care
team.
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Recommendation from Findings
Strategic congruency plan- the extent to which a performance management system
elicits jobs performance that is congruent with the organizations strategy, goals and
culture (Raymond A. Noe, 2013).
It rewards and punishes a care team based on their performance in core
areas of Iora’s expectations and high standards:
o Patient experience and satisfaction
o Engagement
o Access
o Clinical outcomes
o Coordination of care
Individual performance rating will be based on:
o Provider rating
o Time spent with patients
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Strategic Congruency
Plan
Rewards and punishes care team based on their performance in core areas of IORA's expectations and high standards:Patient experience and satisfactionEngagementAccessClinical outcomesCoordination of care
Implementation
Encourages workers to positively view the above-mentioned key elements by implementing a rewards plan that encourage those behaviorsIndividual performance rating will be based on:Provider ratingTime spent with patientsDiscussed healthcare goals
Increased Productivity
Prevents employee misalignmentIncrease corporate moraleSaves money
o Discussed healthcare goals the appropriate actions
Rewards/consequences.
Implementation of the corporate liaison - Because Iora’s managers on average scored
less than what we would have liked to have seen, we have determined that one of the
requirements for the corporate liaison position is to have scored a 22 or more on “-How
good am I at disciplining others”? Assessment because he or she is to oversee and
manage our entire congruency plan. The corporate liaisons will be in direct contact with
both corporate executives and employees at all Iora health locations.
Reward system-is a strategic tool that will motivate Iora’s employees to willingly meet
Iora standards. According to Robbins & Judge, 2012, motivation is the process that
accounts for an individual’s intensity, direction, and persistence of effort towards
attaining a goal. Our rewards plan was implemented to incentivize employees that met
or exceeded company standards, which eludes any misalignment between corporate
desire and individuals as you seek to expand.
It highly favors representative participation. According to Robbins & Judge,
2012 representative participative is goal that redistributes power within an
organization, putting labor on a more equal footing. Thus, ensuring that your
doctors continue their rolls as intended by you and ensuring they don’t
become too dominate.
We recommend that every detail in the above-mentioned plan be followed as laid out. Following
our strategic congruence plan will lead Iora to competitive advantages such as:
Prevention of employee misalignment (Resulting in increased productivity)
Increase corporate morale
Saving of money
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REFERENCES
Iora Health. (2016, March 10). Retrieved from Restoring Humanity to Health Care- Iora Health: http://www.iorahealth.com/
Raymond A. Noe, J. R. (2013). Human Resource Management: Gaining a competitive advantage. New York: The McGraw-Hill Companies.
Sanger-Katz, M. (2015). Company Thinks It Has Answer for Lower Health. The New York Times, 9.
Stephen P. Robbins, T. A. (2012). Essentials of Organizational Behavior. New Jersey: Pearson.
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