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Case Study

Organizational Transformation
for a Faculty Practice Plan

Health Enterprise Strategy & Organization

Concrete Wall
  • Academic health enterprise consisted of 3 independent, poorly aligned entities – medical school, hospital (majority owned by for-profit operator) and faculty practice (independent 501(c)(3)) – with no shared vision, governance or management processes

  • Hospital’s record profits flowed mostly to shareholders,and only modestly to school, insufficient to fully fund academic enterprise

  • Medical school, unranked and adrift, operated at a loss and required ongoing university subsidy

  • Faculty practice lacked accountability and was led by a non-MD CEO and MD President/Board Chair and governed by a disengaged board which did not report to the Dean

  • University trustees engaged BDC to fix the structure, develop a clinical strategy, and place the academic health enterprise on financially stable footing

  • BDC quickly determined that faculty practice was close to insolvency, required a new debt facility and faced a risk of faculty exodus, threatening overall enterprise

  • Facilitated resignation of CEO and President/Board Chair, naming of new Board Chair, recruitment of an interim CEO

  • Led creation of a new credit line linked to the resignation of key faculty practice Board members

  • Supported new management team in designing the first-ever open, transparent budget process with all clinical and overhead departments

  • Created a Council of Clinical Chairs to stabilize/engage faculty practice leadership; facilitated retreat of Council resulting in 5 top priority goals for initial fiscal year, aligning leadership and enabling a cash-flow breakeven budget

  • Facilitated a $7.5M increase in funds flow from hospital to faculty practice to retain faculty and  helped recruit new permanent MD-CEO

  • Created enterprise-wide strategy process (faculty practice, hospital, and school) to grow clinical enterprise through investment and partnerships


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