Multi-site physician services platform
Post-Close Operating System Build
Founder-led reactive management to institutional operating discipline in 12 months
The situation
Sixty days post-close. The board asks for the first KPI report. There isn’t one. The CFO is pulling numbers out of three spreadsheets the founders maintain by hand, and nobody can answer how the business actually performed last month.
That was the picture when the PE sponsor stepped in. Strong clinical reputation. Loyal patients. Committed providers. And a business that ran on the founders’ presence: decisions in hallways, performance in the CEO’s head, board updates filtered through whatever the founders chose to share. The platform needed an operating system that could survive the founders stepping back without destroying what made the business work.
What I built
Organizational assessment presented to board to inform restructuring
KPI dashboards across clinical, operational, and financial dimensions
Monthly operating reviews, quarterly board reviews, annual planning cycles
Clear ownership: every initiative had an owner, a timeline, and a metric
These three dimensions are interdependent. Assessment without performance infrastructure produces a one-time snapshot. Performance infrastructure without a planning cadence produces dashboards nobody acts on. A planning cadence without organizational clarity produces plans that stall on execution. The operating system needs all three running together.
The result
Administrative cost per visit fell from $65 to $44 as visits grew 40%
Employee engagement rose 20%
The planning cadence held through the handover
The board and leadership had one reconciled view of performance for the first time
The trajectory
Over the four-year hold that followed, the leadership team scaled the platform from roughly 16 to 36 sites, ~100 to 400+ providers, and ~$50M to $100M+ in revenue, completed around 20 add-on transactions, and stood up a clinically integrated network covering tens of thousands of lives. Every subsequent build ran on this base.
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