Health System Integration
Employed Network Transformation.pdf
Employed Network Transformation
Download a PDF Version of the Case Study


With a client goal of full health system integration, inclusive of medical group providers, HSG partnered with the leadership of the health system over a four-month period to create a performance improvement plan. The plan was specific to the employed practice network with 175 providers with a focus on evolving the organizational and management structures, as well as strengthening physician leadership within the network.


  • Based in Western U.S.
  • 220-bed acute care hospital
  • 175 employed providers
  • $420M net revenue
  • Client since: 2020

HSG’s work has provided our health system with the basis for evolving to an integrated multispecialty group that can reduce variation in operations and clinical care delivery as well as support the organization’s overall success – now and in the future.



The health system’s employed physician network was built over time in response to economic pressures and growing specialty access. Practices were largely left intact after transitioning to employment from a managerial and governance perspective. As the number of practices (and subsidies) grew, the health system struggled with the disconnectedness of the network and began turning over leadership on a frequent basis. This ultimately left the network in a state of operational chaos, which included the following challenges.

  1. Lack of centralized management infrastructure.
  2. Inadequate reporting on network performance due to EMR issues and lack of management depth.
  3. Provider leadership bypassed the network reporting structure.
  4. No centralized polices and procedures.
  5. Historic weakness in the training and mentoring of network and practice management.


HSG performed an Employed Provider Network Transformation Assessment, deeply diving into the network’s data and operations, while engaging Executive Leadership and providers to seek opinions as well as educate stakeholders on the current state of the network. Final recommendations to achieve positive health system integration, accepted by the leadership team, included the five core initiatives outlined.

  1. Aligning organizational structure and management structure with health system strategic goals.
  2. Addressing the historic management span-of-control issues that impacted accountability and authority.
  3. Addressing identified opportunities for reduction in subsidy through revenue enhancement and expense reduction.
  4. Evolving the physician governance structure to promote appropriate scope of decision-making.
  5. Adopting operations best-practices.


HSG and health system leadership have built an effective partnership that has been extremely beneficial to the operations of the network and its impact on ahcieving health system integration of the medical group.

  • The leaderhsip of the system is more confident in directional performance.
  • Management infrastructure has been rightsized to promote effective accountability and authority.
  • Policies and Procedures, as well as a standardized dashboard, have been adopted across the network.
  • The Physician Leadership structure has become an even more effective part of the organizational chart, providing significant input and leadership into management of the network

…an integrated multispecialty group that can reduce variation in operations and clinical care delivery as well as support the organization’s overall success – now and in the future.

Travis Ansel

Chief Executive Officer and Managing Director, Strategy

Terrence R. McWilliams, MD, FAAFP

Chief Clinical Officer and Managing Director, Employed Provider Networks