Operational Baseline and 90-Day Plan
Three Weeks to Know Where You Stand and What to Do About It
Most practices that are struggling operationally do not have a clear picture of what is actually wrong. They have symptoms: cash flow pressure, staff burnout, access problems, aging A/R. This engagement maps the current state, identifies the root causes, and delivers a 90-day plan your team can execute without waiting for a longer engagement to begin.
Why Start With a Diagnostic
I have been inside enough physician practices to know that the presenting problem is rarely the real problem. Access issues are usually scheduling design problems. Cash flow problems are usually billing or denial management problems. Staff burnout is usually a systems problem. The diagnostic is how we find out which one it is before committing to a longer engagement.
This is also the right starting point for practices that are not sure what kind of help they need. The baseline assessment tells us where the leverage is. Sometimes the right next step is a Margin Recovery engagement. Sometimes it is a Fractional COO retainer. Sometimes the practice just needs the 90-day plan and the internal capacity to execute it. The diagnostic gives us the information to make that call correctly.
The work is fast by design. Three weeks. Real data. No surveys or intake questionnaires. We work from what the practice actually produces: scheduling reports, A/R aging, denial patterns, the P&L. If the data is available and the practice is willing to move, we can deliver the readout and the plan within 21 days of kickoff.
How the Three Weeks Work
Each week has a specific focus and a specific output. The pace is intentional: fast enough to maintain urgency, structured enough to produce something useful at each step.
Week 1
Intake and Baseline
We pull the data that matters: scheduling reports, A/R aging, denial patterns, authorization volumes, staffing roster, and the trailing P&L. We map the current-state workflows for access, intake, and revenue cycle. No surveys. No intake questionnaires. We work from what the practice actually produces.
- Data collection and review
- Baseline KPI establishment
- Current-state workflow mapping
Week 2
Constraints and Root Causes
We identify the top constraints and trace them to their root causes. Most practices have three to five issues that are driving the majority of their operational friction. We find them, quantify the impact, and identify the early quick wins that can move before the engagement ends.
- Constraint identification
- Root cause analysis
- Quick win prioritization
Week 3
Plan and Handoff
We finalize the 90-day plan with owners, dates, and weekly milestones. We deliver the executive readout designed for partner alignment. If the practice is moving into a Fractional COO or Margin Recovery engagement, this plan becomes the foundation for that work.
- 90-day plan with owners and dates
- Executive readout for partner alignment
- Handoff to execution cadence
What You Receive
Five deliverables that give you a complete picture of where the practice stands and a practical plan to move forward.
Current-state workflow maps
Documented workflows for access, intake, revenue cycle, and staffing. Most practices have never seen their own processes mapped end to end. This alone surfaces problems that have been invisible.
Baseline KPI scorecard
A starting point for 10 to 15 KPIs with trend data where available. This becomes the measurement foundation for any ongoing engagement.
Top constraints and root causes
A clear-eyed assessment of what is actually driving performance problems, not a list of symptoms. The root cause analysis is what makes the 90-day plan executable.
90-day plan with owners and milestones
A prioritized action plan with specific owners, weekly milestones, and measurable outcomes. Not a roadmap for someone else to implement. A working document your team can execute against.
Executive readout for partner alignment
A structured presentation designed to align physician partners and leadership on the findings and the plan. Built for the room where the decisions actually get made.
Where This Engagement Creates the Most Value
Five operational patterns where a structured diagnostic consistently surfaces the most actionable findings.
Access and Scheduling Problems
Unstable templates, long wait times, and scheduling friction that is straining the team and reducing capacity. These problems are almost always structural, not staffing.
Cash Flow Drift and Aging A/R
Revenue looks stable but cash is inconsistent and A/R is aging. The diagnostic identifies whether the issue is in billing, denial management, payer behavior, or collections follow-through.
Denial and Authorization Backlogs
Denial rates that are climbing, authorization queues that are growing, and nobody has time to figure out why. We trace the pattern to its source and build the fix into the 90-day plan.
Team Burnout and Execution Gaps
Staff are stretched, turnover is up, and the same problems keep recurring. Usually this is a systems problem, not a people problem. The diagnostic separates the two.
Leadership Misalignment on Priorities
Partners are not aligned on what matters most, which means nothing moves with real urgency. The executive readout is specifically designed to create that alignment.
What We Need From the Practice
The diagnostic is fast because we keep the data requirements minimal. Three things are required to move at the pace this engagement is designed for.
Standard operational reports
Scheduling utilization, A/R aging, denial summary, authorization volumes, and the trailing 12-month P&L. These are reports most practices already produce. We do not need anything custom.
One internal point of contact
Someone who can coordinate data requests, schedule brief interviews with key staff, and keep the engagement moving. This does not need to be a senior leader.
Willingness to pick a short KPI list
We will work with you to select 10 to 15 KPIs that reflect the health of the practice. This becomes the baseline scorecard and the measurement foundation for any ongoing work.