Building a Performance Improvement Plan
Performance Improvement Plan Case Study.pdf
Build a Performance Improvement Plan
Download a PDF Version of the Case Study


HSG partnered with the leadership of an independent Midwest hospital to build a performance improvement plan for their growing network of employed practices focusing on financial improvement and greater engagement of providers in network operations and management.


  • Based in Midwest
  • 85-bed acute care hospital
  • 35+ employed providers
  • $75m net revenue
  • Client since: 2018

HSG collaborated with the leadership team to comprehensively evaluate our employed provider network. HSG is a trusted partner who helped us to elevate the productivity of our providers, improve efficiencies within our practice revenue cycle, and to create policies to better practice operations. Working closely with HSG has helped position this organization for many years of continued success.



The employed physician network had grown rapidly over the past five years, resulting in the operational and managerial needs of the network far outstripping the resources devoted to it. This included the following challenges:

  • Revenue cycle and office operational issues, partially driven by recent EMR implementation issues resulted in management spending its time fighting fires and feeling stuck in the current situation.
  • Growing subsidies on the practices resulted in continued under resourcing of staff and management talent.
  • Providers were largely disengaged from the performance of the employed network and did not have a voice in leadership of the network.



  • Benchmarked all aspects of performance of the network, including productivity, compensation, staffing, throughput, revenue cycle performance, coding, space.
  • Performed on-site operational review of each practice and the billing office to evaluate workflows, staffing, management structure and communication.
  • Engaged all providers, management, and leadership in 1-on-1 interviews to gather individual perspectives.
  • Led leadership, board, and all-provider meetings to discuss findings and potential improvements.

Based on the results of the process, HSG and health system leadership collaborated to develop a comprehensive performance improvement plan, which was approved by the board and accepted by the providers and staff within the network. Key outcomes included:

HSG executed a comprehensive assessment of employed physician network, followed with intense stakeholder engagement to educate and ensure the buy-in of key stakeholders in the outcomes of the planning process. This assessment included the four core initiatives outlined on the left.

HSG was able to support the organization and build a performance improvement plan to financially improve their medical group over the next 18-24 months.

building a performance improvement plan

  • Reorganized management team infrastructure to promote communication and accountability.
  • Developed a physician-led committee structure to prioritize strategic initiatives and ensure provider feedback into management of the network.
  • Identified significant revenue growth opportunities due to inefficient revenue cycle execution and issues with coding.
  • Implemented consistent policies and procedures for front office and billing office staff.

…helped us to elevate the productivity of our providers, improve efficiencies within our practice revenue cycle, and to create policies to better practice operations.

Kari Craig

Senior Manager