| System 1 | System 2 | System 3 |
---|---|---|---|
Background information | |||
Service | Mental healthcare | Hospital care (eye-care) | Care for the intellectually disabled |
Year of establishment | 2004 | Franchise since 2007, system started in 2003 | 2003 |
Motive for franchising | Gain stronger position in more competitive market through high-quality, efficient care | Gain stronger position through provision of high-quality, efficient care in increasingly competitive market | Founded by a father who was highly dissatisfied with the quality of regular care for his intellectually disabled son |
Type of franchise | Fractional: a portion of the care delivery of mental healthcare organizations is franchised. | Fractional: eye care departments of general hospitals are franchised. | Stand-alone: two care professionals operate a small-scale full-time living facility. |
Number of units | 26, owned by 4 franchisees. Units are daily operated by employed managers. | 14, of which 11 franchised and 3 owned by the franchisor | 107, of which 99 franchised and 8 owned by the franchisor |
Payment method of care provided in units | (Obligatory) health insurance reimbursement, complemented with personal contribution of clients. | (Obligatory) health insurance reimbursement, complemented with personal contribution of clients | Personal budget of clients provided by governmental regional care offices following the Exceptional Medical Expenses Act |
Contractual payments | All franchisees are shareholder of the franchise. All costs are proportionally divided and paid. | Fixed initial fee for quick scan/research before joining franchise. Ongoing annual fee comprising fixed base fee + variable fee per FTE ophthalmologist. | Fixed initial fee and fixed annual ongoing fee. |
Business format: positioning | |||
Positioning toward customers | Specialized evidence-based ambulatory care provision to adults with an optimistic approach visible through office-like interiors, a specialized focus and excellent accessibility | Providing the entire spectrum of ophthalmology care in an excellent manner through regional and national cooperation, competent people, hospitable attitude, modern and smooth operations, and fine communication. | Providing care and living in a small-scale beautiful house with family-like atmosphere where disabled individuals can live as normal a life as possible with ample opportunities to do pleasant activities and receive love and attention |
Business format: support services | |||
Support services provided to units | Branding, logo, website, folders, intranet, shared access system, operations manual (process improvement), routine outcome measurement (measure client progress), benchmarking, training, knowledge sharing/development structures | Branding, logo, intranet, website, publicity, frequent advisory support of franchisor representative to implement the operations manual with many ideas about process improvement, benchmarking, training, possibilities for shared purchasing, structures for knowledge sharing/development | Branding, logo, intranet, website, other publicity, facilitation of care building, facilitation of a loan, administration system, benchmarking, initial training, advisory support/coaching, lobby government, structures for knowledge sharing/development |
Business format: level of control | |||
Initial control | Low | Low to medium | Medium, initially low |
Level of standardized operating instructions in the franchise | • Care processes: medium to high | • Care processes: low, moving to medium | • Care processes: low to medium |
  o fixed treatment programs, standardized intake (became looser), standardized pathways in treatment programs |   o Protocols of professional bodies; currently works on certification of care pathways (e.g., which treatments, control moments) |   o standardization of some boundary conditions: no. of customers allowed; guidelines about day-time care, medication lists, fixation | |
• Non-care processes: medium to high (became looser) | • Non-care processes: low, tries to move to medium | • Non-care processes: medium | |
Level of centralized decision-making | • Care: now low on franchisee level (four franchisees are together franchisor), was more centralized at start), low-medium centralized from unit perspective | • Care: low | • Care: low |
• Non-care: now medium centralized from unit perspective; level differs per franchisee. | • Non-care: relatively low (almost all aspects that impact the franchisees are decided in consultation or by the hospital) | • Non-care: medium |