Clients & Engagements

Project Highlights


  • Market-based review of the community service needs and the capabilities and deficits of the hospital and its physicians to meet the demand in an economically viable manner.
  • Engagement of consumers throughout the planning process.
  • Design and location of services to enhance health care services in line with value-based payments.

Case Study:† Health Care Delivery System Strategic Design

Purchased out of bankruptcy several years after a natural disaster destroyed a hospital and shuttered most medical practices on a barrier island, the acquiring hospital had to develop a new and sustainable delivery system to serve an island community of 40,000+ residents. Keys to the success of the hospitalís efforts to rebuild the islandís health care infrastructure were meeting the consumer needs/expectations while maintaining its historically strong market and financial position.

New Solutionsí consultants worked with the acquiring hospital to identify inpatient and outpatient utilization patterns, lifestyle preferences and purchasing patterns, physician resources, competitor profiles, and disease burden to arrive at an economically sustainable plan to maintain ambulatory health services on the island and expand clinical services at the hospitalís principal campus, five miles away. Community outreach was maintained with local and state elected officials, the community, and a local advisory group throughout the process. Plans have been completed or are underway to:

  • Enhance the Islandís Emergency Response Service.
  • Build a 25,000 sq ft Medical Arts Pavilion to include:
    • a freestanding emergency department,
    • imaging services,
    • behavioral health services,
    • primary care services, and
    • physician specialty services.
  • Expand operating rooms, critical care and ED services at the hospitalís principal campus.


  • Evaluate options to grow the business now and over the next two to three years.
  • Use a multidisciplinary approach to business development.
  • Evaluate the environment, including the competition and service line trends.
  • Pull together data from disparate sources and data systems to compare with financial and performance benchmarks.
  • Identify areas to increase uniformity, reduce costs, increase productivity, and enhance quality.

Case Study:  500-Bed Community Hospital
With a large primary stroke center, a neuroscience unit, a wide range of neuroscience specialists and excellent neuroscience technology, this hospital had all the necessary components of a neuroscience center of excellence.† To integrate the service line components and establish priorities, medical staff leadership and key administrators worked together to establish a detailed and actionable neuroscience strategic plan.† Specifics included:

  • Plans for the growth of eight neuroscience services including targets for implementation and achievement.
  • Financial performance targets.
  • Development of evidence-based medical protocols and nursing procedures.
  • Internal and external marketing plans.


  • Identify and prioritize your communityís key health needs.
  • Collaborate with community organizations to provide a continuum of services to address priority needs.
  • Align community benefit planning with strategic initiatives.

Case Study:† Multi-Site Integrated Health System

Identifying and addressing community health needs and priorities is a major focus for this urban/ suburban hospital system as it prepares its response to the new IRS rules. Working with a collaborative community advisory board, they conducted 3 evaluations of their community health needs assessment (CHNA) to determine the unmet needs of the communities and a complemental plan amid at improving the health of area residents while reducing inappropriate hospital utilization.

Understanding system-wide competencies, community health priorities and existing financial commitments helped refocus community benefit programs on identified clinical priorities that align with strategic initiatives.† Key aspects included:

  • A community health index focusing attention on at-risk populations within the service area.
  • Review of utilization data to assess major areas of need in the community.
  • Focus groups and surveys to identify key populationsí health needs, priorities, and preferences.
  • Evaluation of current programs, their cost and impact on addressing community need and reducing health care costs.

The CHNA strategies allowed them to cost effectively:

  • Develop high quality needed services with very little upfront financial investment.
  • Expand the medical staff through strategic alliances.
  • Enhance community collaborations to provide patient care services and treatment in the most appropriate and lowest acuity settings.
  • Improve the system hospitalsí images with consumers, community agencies and area physicians through more effective communication and outreach.
  • Serve as the impetus for bringing together a wide range of community, civic and religious organization to deal with a wide range of community health concerns on an ongoing basis.

An unanticipated benefit of the CHNA is the financial savings that has accrued to the hospital system and the community because of provider collaborations. Outcomes in the areas of improved health, enhanced quality and reduced cost resulted.



  • Conduct assessment of existing hospital/medical staff integration structures.
  • Involve key physicians in identifying potential alignment activities.
  • Assess community health system and physician needs to achieve access, quality and cost- effective care.

Case Study:† Physician / Hospital Alignment

Developed primarily as a defensive strategy, the hospitalís physician enterprise was largely ineffective in serving the needs of patients, physicians or the health system. Late and insufficient investments in the enterprise, ineffective physician leadership, lack of physician engagement, and the absence of a clearly identified strategy were all underlying causes. These issues were compounded by aging medical staff content to practice hospital-based medicine was resulting in high lengths of stays, unnecessary admissions resulting in cost inefficiency and revenue losses for the health system.

Following our assessment of existing medical staff structures and alignment activities from by-laws to on-boarding and physician liaison activities, the health system engaged NSI to develop a medical staff development plan and strategy to enhance physician hospital alignment. Resultant activities include:

  • Development of a faculty practice.
  • Enhanced development of medical homes.
  • Locating/Recruiting physicians in markets with strategic importance to the system.
  • Developing new physician leaders via leadership training.
  • Strengthening physician marketing and relationship building to stem leakage.
  • Expanding support services to better align the system and its independent physicians.