FIND YOUR CONSULTANT
JOIN OUR COMMUNITY
FIND YOUR CONSULTANT
JOIN OUR COMMUNITY

Industries > 

Healthcare > Health Systems & Hospitals Practice

Health Systems & Hospitals Practice

Umbrex connects hospitals and health centers to independent consultants with deep experience in the industry.

Over 90% of our Health Systems & Hospitals Practice consultants are alums of McKinsey, Bain, or BCG.

Finding the right consultant should be this easy.

1

Tell us about your project

2

Interview candidates

(We’ll provide bios within 48 hours on average)

3

Select your consultant and start work!

Find a consultant in our Health Systems & Hospitals Practice

Prefer email? Write to [email protected]

Client Segments Umbrex Serves

  • National Multistate IDNs (Non‑Academic): Large non-academic hospital systems operating across states, integrating acute and ambulatory care; optimizing enterprise strategy, capital allocation, payer negotiations, service-line growth, and quality.
  • Academic Medical Centers & Teaching Health Systems: Tertiary/quaternary hubs with research, residency programs, and faculty practices; advancing clinical excellence, translational research, funding diversification, and regional referral growth.
  • Regional Community Health Systems: Multi-hospital regional systems serving urban/suburban communities; strengthening service-line portfolio, cost and access, physician alignment, and ambulatory footprint while competing locally.
  • Independent Community & Rural Hospitals: Standalone community and critical access hospitals sustaining essential services; improving revenue cycle, staffing, partnerships, telehealth reach, and capital programs to remain viable.
  • Children’s Hospitals & Pediatric Health Systems: Independent or system-affiliated pediatric hospitals expanding subspecialties, network affiliations, payer strategy, and family experience while advancing quality and research.”

Selected Capabilities of our Health Systems & Hospitals Practice

Strategy & Corporate Development

  • Enterprise Growth Strategy And Market Prioritization: Quantify demand, share, and leakage by geography and segment; define growth vectors across inpatient, ambulatory, and virtual care to accelerate volume, revenue, and margin.
  • Service Line Strategy And Centers Of Excellence: Design cardiac, oncology, orthopedics, neurosciences strategies; define access, referral pathways, and Centers of Excellence models to grow market share, case mix, outcomes, and margin.
  • Ambulatory Network And Site-Of-Care Shift Strategy: Plan Ambulatory Surgery Centers (ASCs), imaging, and hospital-at-home footprint; optimize locations, cannibalization, partnerships, and Certificate of Need strategy to capture outpatient shift and margin.
  • Physician Alignment And Partnership Models: Define physician enterprise strategy—employment, professional services agreements, co-management, joint ventures, Management Services Organization models—align incentives and governance to improve access growth, referral retention, and quality.
  • Mergers And Acquisitions, Affiliations, And Joint Venture Structuring: Originate and evaluate targets; perform strategic diligence, synergy cases, valuations, and partnership structures to realize growth, scale advantages, and balance sheet flexibility.

Operations

  • Patient Flow, Bed Management, And LOS Optimization: Redesign bed management and discharge; deploy predictive admissions, discharges, transfers analytics and estimated discharge dates to cut ED boarding, days, diversions, and length of stay.
  • Perioperative Throughput And Block Optimization: Rebalance blocks, optimize scheduling, turnover, and room staffing; improve prime-time utilization, on-time starts, case throughput, and add capacity without capital.
  • Emergency Department Flow And Boarding Reduction: Design split-flow, intake, and consult pathways; deploy fast track and inpatient pull; reduce door-to-doc, left without being seen, boarding hours, and ambulance diversions.
  • Ambulatory Access And Scheduling Optimization: Redesign templates, centralize scheduling, and implement waitlist, recalls, and digital self-scheduling to increase visit fill rate, reduce no-shows, and shorten new patient wait times.
  • Workforce Productivity And Labor Cost Management: Optimize staffing models, float pools, and daily flexing; deploy productivity benchmarks and incentives to reduce premium labor, overtime, agency spend, and improve nurse retention.

Supply Chain

  • Supply Chain Operating Model And Governance: Define end-to-end operating model, KPIs, service levels, and clinician value analysis governance to improve fill rate, standardization, and total delivered cost.
  • Inventory Optimization And Demand Planning: Implement forecasting, safety stock, periodic automatic replenishment (PAR), Kanban, and cycle counting to cut days on hand, stockouts, and waste across sites.
  • Point Of Use And Perpetual Inventory Enablement: Deploy point-of-use cabinets, barcode/RFID, unique device identifier (UDI) capture, and MMIS and ERP integration to improve inventory accuracy, charge capture, and recall traceability.
  • Perioperative Supply Chain And Implant Management: Cleanse preference cards, optimize case picking and tray kitting, and manage implants and consignment to reduce waste, delays, and case cost variability.
  • Distribution Network And Logistics Optimization: Design consolidated service centers, low-unit-of-measure distribution, and courier routes; optimize staffing, picking, and replenishment to lift fill rate and lower supply chain cost per case.

Procurement & Strategic Sourcing

  • Enterprise Category Strategy And Sourcing Wave Planning: Build multi-year category strategies and sourcing waves across med surg, implants, pharmacy, capital, IT, purchased services to deliver sustainable savings and total cost reduction.
  • GPO Optimization And Direct Contracting Strategy: Optimize GPO selection, tier compliance, commitments, and local aggregation; pursue direct contracts and committed volume to achieve best-in-class pricing, rebates, and compliance.
  • Purchased Services Strategic Sourcing: Baseline spend and service levels; run RFPs and renegotiations for EVS, dietary, IT, clinical engineering; secure service level agreements (SLAs), KPIs, and rate reductions.
  • Physician Preference Item And Implant Contracting: Align surgeons through value analysis; reduce SKU variation; negotiate pricing bands, consignment, and rebates to lower case cost and improve supply standardization.
  • Pharmacy Sourcing And 340B Channel Optimization: Optimize wholesaler contracts, specialty distribution, biosimilar adoption, and rebate capture; align GPO, WAC, and 340B purchasing to reduce drug spend and compliance risk.

Organization

  • Enterprise Operating Model And Governance: Define system operating model across hospitals, ambulatory, and physician enterprise; clarify decision rights, committees, and accountability to accelerate decisions, reduce duplication, and improve performance.
  • Organizational Structure And Spans And Layers: Redesign corporate, regional, service line, and physician enterprise structures; optimize spans and layers to simplify management, reduce cost, and speed execution.
  • Service Line Governance And Dyad Leadership Model: Establish service line councils, dyad leadership, and accountability dashboards; align clinical and financial goals to improve access, quality, and margin.
  • Shared Services And Center Of Excellence Design: Design shared services for finance, HR, IT, supply chain, analytics; define service catalogs, service levels, and chargebacks to raise service quality and lower administrative cost.
  • Physician Compensation And Alignment Model: Align physician compensation plans, incentives, and governance with system goals; standardize contracts, panel expectations, and quality measures to drive growth, access, and stewardship.

Pricing

  • Enterprise Pricing Strategy And Governance: Define pricing philosophy, corridors, and governance; align to market position, cost, and payer mix to balance affordability, access, and margin.
  • Chargemaster Rationalization And Market Benchmarking: Cleanse and rationalize the chargemaster (CDM); build market-based price index against peers and Medicare; set department guardrails to reduce outliers and strengthen defensible pricing.
  • Shoppable Services Bundle Design And Transparency Pricing: Design shoppable service bundles with clear inclusions and pricing; calibrate cash prices to competitors; publish CMS machine-readable files and consumer displays to drive conversion.
  • Self-Pay And Financial Assistance Pricing Policy: Redesign self-pay rates, prompt-pay discounts, catastrophic caps, and financial assistance tables; improve affordability, net collections, and Community Health Needs Assessment (CHNA) alignment.
  • Direct To Employer And Cash Package Pricing: Price bundled procedures for employers and consumers; set inclusions, warranties, and steerage incentives; model cost and utilization to protect margin and grow volume.

Finance

  • FP&A And Rolling Forecast Modernization: Build driver-based models linking volumes, payer mix, rates, labor, supplies; implement rolling forecasts and scenario planning to improve forecast accuracy, agility, and margin management.
  • Service Line And Patient-Level Profitability Analytics: Implement advanced cost accounting and decision support; move beyond ratio-of-cost-to-charges (RCC) to activity-based costing; quantify contribution margin by service line, site, physician.
  • Finance Process Transformation And Close Acceleration: Redesign general ledger, accounts payable, fixed assets, and close processes; deploy automation and shared services to shorten close, lower cost, and strengthen controls.
  • Capital Allocation And Portfolio Prioritization: Build capital planning framework using net present value (NPV), internal rate of return (IRR), and affordability; prioritize projects within debt capacity, covenant limits, and strategy.
  • Treasury, Liquidity, And Rating Agency Strategy: Optimize liquidity, investments, and debt structure; model covenants, debt service coverage ratio (DSCR), days cash on hand; craft rating narratives to protect credit and flexibility.

AI, Data & Analytics

  • Enterprise Data Platform And Governance: Build cloud lakehouse integrating EHR Epic/Cerner, ERP, revenue cycle, device data; establish FHIR APIs, master data, data quality to power KPIs, self-service analytics, and AI.
  • Clinical Variation And Outcomes Analytics: Benchmark LOS, readmissions, mortality, complications, and cost per case; identify unwarranted variation and care pathway opportunities to improve outcomes, throughput, and margin.
  • Predictive Patient Flow And Staffing Optimization: Forecast census, ED arrivals, and discharges; predict LOS and bottlenecks; optimize nurse staffing, float pools, and OR schedules to reduce boarding, overtime, and cancellations.
  • Denials And Revenue Integrity Analytics: Predict and prevent denials using machine learning; pinpoint coding and charge capture leakage; prioritize root causes to increase clean claim rate, revenue, and cash yield.
  • Population Health And Risk Stratification Analytics: Integrate claims, EHR, and social determinants data; build risk stratification, risk prediction, and care gap targeting to improve ACO performance, quality, and cost of care.

Transformation

  • Enterprise Transformation Office And Value Realization: Stand up enterprise transformation office with finance lock and roadblock clearing; track benefits to deliver margin improvement across labor, supply chain, and revenue cycle.
  • Margin Improvement Program And Rapid Cost Reduction: Run 12–18 month cost program across labor, length of stay (LOS), supply, and purchased services; lock initiatives, owners, and timelines to deliver sustainable EBITDA uplift.
  • Digital Core Modernization And Platform Replacement: Orchestrate business-led modernization of EHR, ERP, revenue cycle, and contact center; sequence cutovers and change management to unlock productivity, interoperability, and clinician experience.
  • Post-Merger Integration And Synergy Realization: Plan Day 1–100 integration across service lines, physician enterprise, supply chain, IT, and revenue cycle; capture cost and revenue synergies with disciplined benefits tracking.
  • Agile At Scale And Change Adoption: Implement agile-at-scale and change adoption for clinical, digital, and back-office programs; re-prioritize portfolios, accelerate value delivery, and hardwire frontline adoption.

Innovation

  • Innovation Thesis And Portfolio Governance: Set system innovation theses, horizons, funding model, and stage gates; prioritize growth, patient experience, and cost-of-care impact; establish pipeline and governance cadence.
  • Venture Studio And New Revenue Incubation: Incubate and launch payer and employer ventures via minimum viable products, rapid pilots, and commercialization to create new revenue, margin growth, and strategic differentiation.
  • Care Model Innovation And Hospital At Home: Design and pilot hospital at home, virtual nursing, team-based care; measure outcomes to reduce length of stay, readmissions, labor cost, and improve patient experience.
  • Digital Front Door And Consumer Experience Innovation: Prototype and scale digital front door journeys—search, scheduling, triage, check-in, payments—to increase access, conversion, retention, and service line growth.
  • Startup Scouting And Co-Development Partnerships: Scan digital health, device, and service startups; run evidence-based pilots, contracting, and risk-sharing to scale proven solutions that improve outcomes, throughput, and cost.

Sustainability

  • Greenhouse Gas Inventory And Net Zero Roadmap: Build GHG Protocol inventory for Scopes 1–3; establish ESG disclosure controls; prioritize electrification, HVAC optimization, anesthetic gas reduction to reach net zero with ROI.
  • Energy Efficiency And Retro-Commissioning Program Design: Design portfolio energy programs—audits, retro-commissioning, building analytics, controls—quantify savings, rebates, capital plans; reduce energy intensity, utility spend, and Scope 2 emissions.
  • Renewable Energy And Power Procurement Strategy: Evaluate onsite solar and storage, offsite power purchase agreements, renewable energy certificates; structure contracts to reduce emissions, hedge price risk, and strengthen resilience.
  • Waste And Circularity Strategy: Redesign waste streams—regulated medical, recycling, food, construction; implement reusables and single-use device reprocessing; cut landfill tonnage, red bag ratio, and disposal costs.
  • Climate Risk, Resilience, And Adaptation Planning: Assess climate hazards, facility criticality, and supply disruptions; plan flood protection, heat mitigation, backup power, and continuity to safeguard care delivery and operations.

Compliance

  • Enterprise Compliance Program And Risk Assessment: Design hospital compliance program with three lines of defense, risk assessment, policies, training, monitoring, auditing, reporting, and corrective action to prevent sanctions and penalties.
  • Accreditation And CMS Survey Readiness: Prepare for Joint Commission, DNV, and CMS Conditions of Participation; run mock surveys, tracers, data validation, and plans of correction to sustain continuous readiness.
  • HIPAA Privacy And Security Compliance: Operationalize HIPAA Privacy and Security Rules; strengthen OCR readiness, breach response, business associate oversight, minimum necessary controls, and PHI monitoring to reduce risk.
  • 340B Program Integrity And Optimization: Build 340B governance, policies, and audit controls; optimize split-billing, eligibility, contract pharmacy oversight, and diversion prevention to protect compliance and maximize eligible savings.
  • Physician Arrangements And Referral Laws Compliance: Inventory and standardize physician arrangements; implement fair market value and commercial reasonableness reviews, timekeeping, and monitoring to reduce Stark Law and Anti-Kickback Statute risk.

Program & Portfolio Management

  • Enterprise Portfolio Governance And Prioritization: Establish systemwide portfolio governance and stage gates; prioritize clinical, digital, capital initiatives by ROI and risk to align investments with strategy and capacity.
  • Capital Program Portfolio And Project Controls: Run capital PMO with stage gates, budgeting, scheduling, and earned value; manage risk, change orders, and commissioning to deliver on-time, on-budget facilities.
  • Regulatory Implementation Program Management: Coordinate enterprise implementation of CMS, Joint Commission, price transparency, and interoperability rules; manage timelines, owners, testing, and go-lives to sustain compliance.
  • Resource, Capacity, And Dependency Management: Stand up resource management office; model project demand and constraints; manage cross-program dependencies and change freezes to de-risk clinical operations and cutovers.
  • Portfolio Performance Reporting And Benefits Tracking: Build executive dashboards and finance-locked baselines; track milestones, spend, and benefits across labor, supply, throughput to ensure accountability and realized value.

Information Technology

  • EHR Platform Optimization And Integration Architecture: Optimize Epic or Cerner build, interfaces, device integration, and SMART on FHIR apps; improve clinician workflows, reliability, and data quality while reducing clicks and downtime.
  • Interoperability And API Enablement: Implement HL7 FHIR APIs, TEFCA connectivity, and master patient index; enable care coordination, price transparency, prior authorization, and patient access with secure, performant data exchange.
  • Cloud And Infrastructure Modernization: Design hybrid cloud, migrate workloads, modernize networks and storage, implement observability and automation; improve resilience, disaster recovery objectives, scalability, and cost for hospital operations.
  • Cybersecurity And Zero Trust Architecture: Deploy zero trust, identity and access management, microsegmentation, data loss prevention, and detection and response; harden EHR, ERP, and Internet of Medical Things against ransomware.
  • Imaging, PACS, And Data Center Modernization: Modernize imaging storage with vendor neutral archive, lifecycle policies, and edge compute; consolidate data centers and backup to improve performance, resilience, and cost of ownership.

Capital Projects

  • Master Facility Planning And Campus Programming: Align service line growth, care models, and throughput with block and stack, adjacencies, and phasing to prioritize capital and optimize patient and staff flow.
  • Delivery Model And Procurement Strategy: Select delivery models—design build, construction manager at risk (CMAR), integrated project delivery; structure incentives and risk to control cost, schedule, and change orders.
  • Design To Budget And Value Engineering: Apply target value design, constructability reviews, prefabrication, and modularization to reduce square footage, materials cost, and schedule without compromising clinical workflows.
  • Medical Equipment Planning And Technology Integration: Plan imaging, surgical, and patient care equipment; coordinate building systems, low-voltage, and information technology (IT) to eliminate scope gaps and reduce change orders.
  • Commissioning Activation And Move Planning: Orchestrate commissioning, life-safety testing, licensing inspections, staff training, activation sequencing, and move logistics to ensure day-one readiness, safety, and minimal clinical disruption.

Revenue Cycle Management

  • Patient Access And Financial Clearance Optimization: Redesign scheduling, eligibility, coverage discovery, price estimation, prior authorization, and front-end collections to lower avoidable denials, reduce bad debt, and improve patient financial experience.
  • Clinical Documentation Integrity And Coding Optimization: Build clinical documentation integrity and coder workflow redesign; improve physician queries, DRG capture, severity documentation, reduce DNFB days, raise case mix index and net revenue.
  • Charge Capture And Revenue Integrity: Build revenue integrity governance, charge capture audits, CDM-to-EHR mapping, and edit design to cut late charges, under-coding, and leakage while strengthening compliance.
  • Denials Prevention And Appeals Management: Establish denial governance, root-cause fixes, clinical validation strategy, and automated appeal workflows to reduce initial and final denial rates and accelerate overturns and recoveries.
  • Accounts Receivable And Cash Acceleration: Optimize edits, filing timeliness, payer follow-up, small-balance resolution, cash posting, and credits; reduce DNFB and days in AR, improve net collections and cost to collect.

Payer Contracting & Network Strategy

  • Payer Portfolio Strategy And Negotiation Readiness: Prioritize payers, set rate lift targets and walk‑aways; build data room and negotiation playbooks; manage notices, escalation, and communications to de-risk disputes and protect access.
  • Contract Modeling And Term Optimization: Model DRG, APC, per diem, and case-rate reimbursements; optimize escalators, carve-outs, outliers, stop-loss, prompt pay, and denial terms to maximize net revenue and predictability.
  • Value Based Contracting And Incentive Design: Design shared savings, bundles, and capitation models; set quality measures, attribution, and risk corridors; forecast margin impact and operating requirements to secure sustainable, performance-based agreements.
  • Network Positioning And Product Participation Strategy: Evaluate narrow networks, centers of excellence, and steerage; decide Exchange and Medicare Advantage participation; model volume, payer mix, and rate trade-offs to protect margin.
  • Out Of Network And No Surprises Act Strategy: Set out-of-network pricing, negotiation workflows, and data packages; define Independent Dispute Resolution (IDR) posture and continuity plans to manage reimbursement risk and patient experience.

Clinical Quality & Patient Safety

  • High Reliability Organization And Safety Culture: Drive high reliability organization principles, just culture, leadership rounding, safety huddles, and event reporting to reduce serious safety events and sentinel events.
  • Hospital-Acquired Infection And Harm Reduction: Implement bundles and surveillance for central line-associated bloodstream infection (CLABSI), surgical site infection (SSI), pressure injuries, and falls; reduce harm rates and noncompliance penalties.
  • Sepsis Recognition And Bundle Compliance: Standardize screening, rapid response, and order sets; raise Centers for Medicare & Medicaid Services (CMS) sepsis bundle (SEP‑1) compliance; cut mortality and length of stay.
  • Clinical Pathway Standardization And Outcomes Improvement: Build evidence-based order sets and care pathways; monitor compliance; reduce unwarranted variation, complications, readmissions, and cost per case.
  • Medication Safety And Antimicrobial Stewardship: Strengthen medication reconciliation, barcoding, adverse drug event review; implement antimicrobial stewardship to reduce days of therapy, resistance, and Clostridioides difficile infections.

Connect with the right consultant

Umbrex rapidly connects you with independent professionals who combine top‑tier consulting experience at firms such as McKinsey, Bain, Boston Consulting Group with hands‑on roles.

Find a consultant in our Health Systems & Hospitals Practice

Prefer email? Write to [email protected]

Thought Leadership

Industry Insights from Umbrex:
How to analyze a Healthcare Provider

How to Analyze a Healthcare Provider