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How We Work

The Challenge: Balancing Cost, Compliance, and Alignment Without Robust Evaluation Tools

Trying to manage hospital-based service agreements effectively amid rising costs, evolving care models, and the lack of structured evaluation and negotiation frameworks can lead to a series of challenges, including:

  • Limited visibility into current performance and subsidy levels for hospital-based groups.
  • Difficulty negotiating fair and sustainable subsidy arrangements with existing providers.
  • Lack of strategic frameworks for determining whether to retain the current group or pursue alternative options.
  • Fragmented processes for issuing and managing Requests for Proposal (RFPs).
  • Compliance and fair market value (FMV) risks associated with compensation structures and subsidy agreements.

Strategic Benefits and Deliverables

  • Current-state evaluation. HSG conducts a comprehensive review of hospital-based group performance, subsidy levels, and contractual terms to identify improvement opportunities and compliance considerations.
  • Strategic decision-making. We help leadership determine whether to continue with the existing group or pursue an RFP based on performance, financial impact, and organizational priorities.
  • RFP development and execution. If an RFP is pursued, HSG manages the entire process—from drafting the RFP to coordinating responses, facilitating evaluations, and supporting final selection.
  • Negotiation and implementation support. Our team assists with negotiating subsidy arrangements, implementing compensation strategies, and addressing FMV and regulatory compliance requirements.
  • Ongoing performance monitoring, HSG provides annual reviews of group performance, subsidy levels, and FMV opinions to ensure sustainability and alignment with market conditions.
  • Deliverables. Executive summary reports, detailed performance and subsidy analyses, RFP documents, evaluation frameworks, and compliance guidance.

By combining strategic advisory expertise with structured execution, HSG enables hospitals and health systems to optimize hospital-based service agreements, reduce financial risk, and ensure compliance. Our approach delivers measurable improvements in performance, cost management, and organizational alignment—creating a foundation for sustainable success.

Travis Ansel

Chief Executive Officer and Managing Director, Strategy

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