Developing a High-Performing Physician Enterprise

Developing a sustainable strategy for an employed physician enterprise rooted in a data-driven culture of accountability.


A county health system (CHS) in the Southeast engaged Coker to assess and improve financial and operational performance. At the time, CHS employed 40 multi-specialty providers and had a primary hospital location with roughly 150 licensed beds. As is the case for many, financial performance of the physician enterprise was declining for a variety of reasons, and CHS had to make tough decisions about their long-term physician alignment strategy.


Initially, we conducted a revenue cycle assessment for the employed provider network and provided recommendations related to performance improvement, resource and staffing needs, and IT system utilization.

Our analysis and recommendations highlighted multiple areas of opportunity directly related to the revenue cycle and indicated broader opportunities across medical group operations.

After developing an implementation work plan with prioritized initiatives and action items, it was clear that CHS did not have the internal bandwidth or leadership experience to manage these efforts efficiently. To drive outcomes, we served as the interim Vice President of the physician enterprise for the next ten months, charged with improving all areas of medical group operations and financial performance and developing a sustainable infrastructure and leadership team for the future.


  • Step 1Organizational Development
    Establish an aligned physician governance and leadership structure and cultivate a high-performance culture through department planning.
  • Step 2Operational Efficiency
    Implement Lean resource management, define operational tactics to achieve goals, and develop a data-driven organization.
  • Step 3Vision & Leadership
    Clearly define organizational objectives and vision. Engage employees and providers in their unique contributions.
  • Step 4Monitoring & Accountability
    Establish an aligned incentive structure tied to compensation and reviews, implement continuous learning opportunities, and more.

CHS achieved impressive financial and operational improvement thanks to this process. The holistic impact of these improvements continues to compound the overall benefit to the organization, employees, providers, and patients.

Impressive Financial & Operational Improvement

Results At a Glance
  • 25%Increase in provider productivity
  • 21%Revenue increase
  • 10%Decrease in non-provider expenses
  • 39%Improvement in operating margin
  • 27%Increase in patient satisfaction scores

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