Developing a Complex Care Destination Strategy

A leading integrated delivery system with over 20 hospitals, a robust ambulatory network, and a medical group across its home state, anchored by a 500 bed tertiary and quaternary medical center, engaged ECG to develop a complex care destination strategy for its flagship campus and to define the implications and strategy for the surrounding facilities.

Amid strong regional competition for higher-end tertiary and quaternary care, ECG’s client wanted to grow its complexity profile in select services, including transplant, CV/CT, neuroscience, oncology, and specialized surgery. The system did not have a clear sense of the market opportunity across a multi-state referral network, which services should be prioritized, or the facility implications for its flagship campus if it were to successfully design and execute upon its complex care strategy. Compounding the matter, available data to inform the strategy was fragmented at best.

ECG defined the services that were truly quaternary to establish the basis for planning, then conducted robust analyses of each quaternary service category. We completed gap assessments to determine in which areas our client might best serve the super-regional demand, and then developed service-specific strategic plans with supporting initiatives and tactics related to growth of these programs and establishment of the referral network. 

ECG then used scenario planning and financial modeling to determine the various outcomes for the system to achieve its desired vision. We prioritized the five service categories to determine the investment intensity over a 10-year period and created an implementation roadmap. A master facility plan was then developed for the campus. Through this planning process, it was determined that the flagship campus would max out unless select services could be decanted to another system hospital, and ECG devised plans in consultation with system leadership accordingly.

ECG’s service-level assessment and demand, scenario planning, and financial modeling allowed the system to translate an overarching vision for its flagship into an actionable, service-level plan with a 10-year roadmap. ECG was able to provide detailed service and sub-service-level recommendations to drive quaternary growth while ensuring that the second order effects on lower-acuity volume were accounted for. The prioritization ECG provided ensured accretive financial performance and strategic phasing to mitigate against competitor reaction.