Services

Four ways I work on physician group operations, with physician groups, hospitalist groups, and MSOs. They overlap more than they look like they do, because each one comes back to the same thing: a number moved, and the reason for it lives somewhere in the operation.

How I Help

Value-Based Care

Value-Based Care Operations

The contract is signed and the incentive dollars are real. The question is whether the operation underneath can actually reach them.

What this looks like

I start with what you already have. That means reviewing your current reporting platform and what it is genuinely producing, then rebuilding the reporting so it reflects the contract you actually signed. In most cases that means going back into the data sources, because the numbers that matter are sitting in systems that are not surfacing them.

From there the work moves to the floor. Workflows get redesigned around the measures that carry weight, and a monitoring cadence gets built so performance is reviewed by people who can move it, not just reported to people who cannot.

What you get

An assessment of your current reporting platform and where it falls short of your contract terms
Direct line of sight from quality performance to revenue, including the opportunities currently being left on the table
Rebuilt reporting, with data sources connected so numbers come from the system rather than a spreadsheet one person maintains
Redesigned clinical and administrative workflows tied to the measures that carry financial weight
A monitoring cadence with named owners and a defined review rhythm
KPI education for your team, and a briefing on the Medicare changes ahead that will affect how the model pays

When this fits

You have taken on risk and the first settlement came back worse than the model said it would, and nobody can explain which part of the operation caused it.
The quality reporting exists, but the numbers do not match what the clinical team believes is happening, so decisions are still being made on instinct.
You are heading into a contract renewal or a new risk arrangement and you need to know whether the operation can carry it before you sign.

Multi-Site Practice Ops

Multi-Site Practice Operations

Growth adds locations faster than it adds structure. At some point nobody can tell whether a site is underperforming or just different.

What this looks like

When an organization spans multiple facilities, service areas, and sub-specialties, each one develops its own way of working. Most of it was reasonable at the time. The work is standardizing the workflows and the reporting definitions across them without flattening the variation that is legitimate. A surgical sub-specialty and a primary care site should not be measured identically, but they should be measured consistently enough that leadership can compare them honestly.

The output works at two levels. Executive leadership gets a global view of how the organization is performing. Each site gets a view its own leadership can act on, in numbers they recognize as theirs.

What you get

A workflow review across facilities, service areas, and sub-specialties, separating variation that is justified from variation that is just drift
Standardized workflows and shared reporting definitions, so a metric means the same thing in every location
A global reporting view for executive leadership to evaluate performance across the organization
Site-level views that give each location’s leadership numbers they can act on
A rollout approach that gets the standards adopted rather than filed

When this fits

You have grown by acquisition and each site still runs the way it did before you bought it.
Two sites report the same metric and leadership cannot tell whether the gap is real performance or two different definitions.
One location is clearly underperforming and nobody can say whether it is the market, the staffing model, or the workflow.

Financial Analysis

P&L and Financial-Operational Analysis

A drop in distributions tells you something is wrong. It does not tell you what.

What this looks like

Most physician leaders were trained to practice medicine, not to read a P&L against a staffing model and a schedule. So the first signal that something has moved is often the personal one: the draw is smaller this month. That is real information, but it does not point anywhere on its own.

I go into the numbers and find what actually moved. Every line on a P&L is the end of a chain that starts somewhere operational, whether that is the schedule, the staffing mix, the case mix, or how charges get captured and how quickly. Finding the cause means reading the financial statement and the operation against each other rather than separately.

Then I build you something you keep. Not a one-time analysis that gets filed, but a tool that tracks each line item alongside the operational drivers behind it, so the next time a number moves you can see why without calling anyone.

What you get

Root-cause analysis of what is driving financial performance, line item by line item
The operational driver behind each line identified, so a number connects to a decision someone actually made
A monitoring tool built for your practice, tracking the financial lines and the operational inputs that move them
Opportunities surfaced line by line, including revenue that is not being captured
Working knowledge for your physician leaders on how the P&L and the operation connect, so the tool gets used rather than admired

When this fits

Distributions dropped and the explanation was that volume was down, which does not match what the schedule actually looked like.
You review financials every month and the review never changes a decision.
A physician leader has just stepped into owning a P&L for the first time.

Fractional & Interim

Fractional and Interim Operations Leadership

A seat is empty, or something has landed that the team does not have room for. Neither is a good reason to rush a permanent hire.

What this looks like

I join as a temporary member of your executive team. Sometimes that means covering an open operations seat while you run a proper search, so the function keeps moving and the hiring decision does not get made under pressure. Sometimes it means added capacity for a defined stretch, when something has arrived that the current team cannot get their arms around while still doing their own jobs.

There is a second question that often matters more than the first: whether the role you are about to fill is the role you actually need. Covering it for a period is the most reliable way to find out. Sometimes the answer is yes, hire exactly this. Sometimes the scope should change, or the work belongs distributed differently than it was.

What you get

An experienced operations executive in the seat, working as part of your leadership team rather than advising it from outside
Continuity through the vacancy, so the function does not stall and the search does not get rushed
Capacity for a defined stretch of work the current team cannot absorb
A clear read on whether the permanent role is needed as written, needs its scope changed, or is not needed at all
A handoff that sets your permanent hire up, rather than leaving them to reconstruct what happened while the seat was empty

When this fits

Your operations leader gave notice and the search will take months the organization does not have.
An acquisition, a new contract, or a system implementation landed and the team is already at capacity.
You are about to post a role and you are not certain it is the right role.

Not sure which of these fits? That’s a good first conversation. Most engagements start with a diagnostic look at what you have and what is actually happening, and the shape of the work follows from there.

Let’s talk