Case Study – Primary Care Service Line Strategic Planning in Healthcare
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Case Study – Primary Care Service Line Strategic Planning in Healthcare


A community Health System in the Midwest committed to an aggressive primary care growth strategy, driven by their goal of stemming outmigration from the market. Strategic planning in healthcare is not straightforward, HSG helped the System define the parameters of that strategy and build the related tactics. 


The key outcomes were financial.  The organization experienced a 75% growth in net revenue from 2013 to 2018, a growth of $161 million.  In the same time period, operating margins improved dramatically.  In 2012 the organization was a breakeven operation.  In later years, operating margins were routinely in the 3-6% range. 

The number of employed primary care providers grew by more than 200% over the time period.  We must note that the quality of specialists in the community was upgraded significantly over this time period, allowing the organization to “earn” more specialty referrals.  

Keys to Success

HSG’s consulting approach for strategic planning in healthcare was combined with an insightful steering committee, and an executive team that was willing to invest in primary care despite the subsidies required to acquire top talent.  Six elements of the analysis standout as influential.

  1. Provider Manpower Analysis – The traditional manpower plan, defining need based on models that project need per 100,000 population, plus survey and interview opinions from doctors and executives, pointed to a massive primary care need. 
  2. Geographic Assessment – A key element to success was defining new practice locations. HSG analyzed:
    • supply deficits by zip code and aggregations of zip codes;
    • demographic attractiveness of zip codes/aggregations; and
    • drive times to primary care practices, with the goal of increasing the patient population within 10-minute access.
  3. Referral Leakage – Using HSG Physician Network Integrity Analytics suite of services, cases leaving the health system were analyzed with two purposes. First, to understand primary care provider (PCP) loyalty. Second, to better understand gaps in the System’s service capabilities. This analysis focused on private PCPs as well as those employed.
  4. Employed PCP Throughput  An assessment of volume growth opportunities in existing practices was key, along with scheduling, template, and other recommended adjustments to improve access. 
  5. Resident Retention   A key tactic was to focus on family medicine residents the health system wished to retain, and get early commitments to stay in the community long term. 
  6. Usage of Advanced Practice Providers (APPs) –  Improving access, and therefore patient capture, by expanding the usage of advanced practice providers was the final key element.  While this varied by practice based on the acceptance of the physician, it has facilitated the building of a culture where APPs are accepted and appropriately utilized. 

Contact DJ Sullivan to learn more about HSG’s Approach to building a winning primary care service line development strategy. 

Related Content

You can learn more on how HSG supported this organization in developing a comprehensive primary care growth strategy by reading related content on service line strategy development in 2020 or HSG’s comprehensive approach to physician manpower planning and 12 core questions that need to be considered in that process as originally posted in Becker’s Hospital Review.

D.J. Sullivan

Chief Strategy Officer and Managing Director of Claims Data Analytics