Flevy Management Insights Case Study
Strategic Due Diligence Plan for Healthcare Provider in Geriatric Care
     David Tang    |    Valuation


Fortune 500 companies typically bring on global consulting firms, like McKinsey, BCG, Bain, Deloitte, and Accenture, or boutique consulting firms specializing in Valuation to thoroughly analyze their unique business challenges and competitive situations. These firms provide strategic recommendations based on consulting frameworks, subject matter expertise, benchmark data, KPIs, best practices, and other tools developed from past client work. We followed this management consulting approach for this case study.

TLDR A mid-sized geriatric healthcare provider saw a 20% drop in patient retention and outdated tech, affecting its valuation. By adopting telehealth and an Operational Excellence Program, it boosted patient retention by 15% and improved market valuation by 18%, underscoring the value of Innovation and Strategic Planning in tackling operational inefficiencies.

Reading time: 13 minutes

Consider this scenario: A mid-size healthcare provider specializing in geriatric care is facing valuation challenges due to a 20% decrease in patient retention over the past year.

The organization is grappling with internal issues like outdated technology and inefficient operational processes, alongside external pressures such as increased competition and shifting regulatory environments. The primary strategic objective of the organization is to enhance patient retention and operational efficiency to improve overall valuation.



This healthcare provider is a mid-size entity within the geriatric care sector, experiencing a 20% decrease in patient retention, impacting its valuation. The root causes of these challenges may lie in its outdated technology and inefficient operation processes. Additionally, increased competition and changing regulatory landscapes exacerbate these issues.

Strategic Analysis

The geriatric care industry is experiencing rapid growth due to an aging population, with increased demand for specialized healthcare services. There are 5 structural forces that govern the competitive nature of every industry, as theorized by Michael Porter:

  • Internal Rivalry: High due to numerous existing healthcare providers and new entrants offering innovative solutions.
  • Supplier Power: Moderate as there are few specialized suppliers of geriatric medical equipment and medication.
  • Buyer Power: High because patients and their families have numerous choices and are price-sensitive.
  • Threat of New Entrants: Moderate, as new companies bring technological innovations and advanced care models.
  • Threat of Substitutes: Low, as specialized geriatric care requires trained professionals and specific infrastructure.

Emergent trends include technological advancements in patient care and a shift towards home-based healthcare services. These trends result in both opportunities and risks:

  • Adoption of Telehealth Services: Provides an opportunity to reach more patients and improve care continuity, but requires significant investment in technology and training.
  • Integration of Advanced Medical Technologies: Enhances patient outcomes and operational efficiencies, yet poses financial risks due to high initial costs.
  • Increased Regulatory Scrutiny: Ensures high standards of care but could increase compliance costs and operational complexity.

PEST analysis reveals that political factors such as healthcare policies and regulations play a significant role in shaping the industry. Economic trends indicate a growing demand for cost-effective care solutions. Social factors highlight an increasing preference for personalized care. Technological advancements offer both opportunities for innovation and challenges in terms of adoption and integration.

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Internal Assessment

The organization has strong expertise in geriatric care but faces challenges with outdated technology and inefficient operations.

SWOT Analysis

Strengths include specialized knowledge in geriatric care and a committed workforce. Opportunities involve adopting new technologies and expanding home-based care services. Weaknesses are outdated technology and operational inefficiencies that hinder patient retention. Threats include increased competition and regulatory changes that may impact operations.

4 Actions Framework Analysis

The organization needs to Eliminate outdated processes and technology that slow down operations. It should Reduce the dependency on manual processes. Raise the level of patient care quality through personalized treatment plans. Create new revenue streams by introducing telehealth services and home-based care options.

Value Chain Analysis

Primary activities include inbound logistics (patient intake), operations (medical care), outbound logistics (patient discharge), marketing & sales (patient acquisition), and service (ongoing care). Support activities involve technology infrastructure, human resources, and procurement. Analyzing these activities reveals inefficiencies in patient intake and discharge processes, and opportunities to enhance service delivery through advanced medical technologies.

Strategic Initiatives

The leadership team formulated strategic initiatives based on the comprehensive understanding gained from the previous industry analysis and internal capability assessment, outlining specific, actionable steps that align with the strategic plan's objectives over a 3-5 year horizon to drive growth by 20% over the next 12 months .

  • Technology Upgrade: Implement advanced healthcare technologies to improve operational efficiency and patient care. The strategic goal is to enhance patient outcomes and streamline processes. Value creation comes from improved patient satisfaction and reduced operational costs. This initiative requires investment in new technology, training, and IT infrastructure.
  • Telehealth Services: Launch telehealth services to reach more patients and provide continuous care. The goal is to increase patient retention and expand market reach. Value creation is driven by increased patient engagement and higher revenue. This will require technological integration, marketing efforts, and training for healthcare providers.
  • Operational Excellence Program: Develop and implement a program aimed at optimizing operational processes. The goal is to reduce inefficiencies and cut costs. Value creation comes from improved operational efficiencies and cost savings. This initiative will need process consultants, staff training, and investment in process management tools.
  • Patient-Centric Care Model: Introduce a personalized care model to enhance patient satisfaction and retention. The goal is to differentiate the organization in a competitive market. Value creation is through improved patient loyalty and increased referrals. This initiative requires training, new care protocols, and patient engagement tools.
  • Valuation Improvement Plan: Implement strategies to enhance overall valuation through patient retention and operational efficiency. The goal is to improve financial health and attractiveness to investors. Value creation comes from higher market valuation and better financial performance. This will require financial advisors, market research, and strategic planning resources.

Valuation Implementation KPIs

KPIS are crucial throughout the implementation process. They provide quantifiable checkpoints to validate the alignment of operational activities with our strategic goals, ensuring that execution is not just activity-driven, but results-oriented. Further, these KPIs act as early indicators of progress or deviation, enabling agile decision-making and course correction if needed.


Without data, you're just another person with an opinion.
     – W. Edwards Deming

  • Patient Retention Rate: Measures the effectiveness of patient engagement strategies and care models.
  • Operational Efficiency Index: Evaluates improvements in operational processes and cost reductions.
  • Technology Adoption Rate: Monitors the successful implementation and utilization of new technologies.
  • Telehealth Usage Rate: Tracks the adoption and usage levels of telehealth services.
  • Valuation Metrics: Assesses changes in overall market valuation and financial performance.

These KPIs provide insights into the effectiveness of strategic initiatives, highlighting areas for improvement and ensuring alignment with organizational goals.

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Stakeholder Management

Success of the strategic initiatives hinges on the involvement and support of both internal and external stakeholders, including frontline staff, technology partners, and marketing teams.

  • Healthcare Providers: Essential for implementing new care models and telehealth services.
  • IT Department: Responsible for technology upgrades and maintaining new systems.
  • Marketing Team: Key in promoting new services and engaging with patients.
  • Patients: Provide feedback and engage with new care models and services.
  • Investors: Crucial for funding technology upgrades and strategic initiatives.
  • Regulatory Bodies: Ensure compliance with healthcare regulations and standards.
  • Operational Consultants: Assist in implementing operational excellence programs.
  • Financial Advisors: Guide valuation improvement strategies and financial planning.
Stakeholder GroupsRACI
Healthcare Providers
IT Department
Marketing Team
Patients
Investors
Regulatory Bodies
Operational Consultants
Financial Advisors

We've only identified the primary stakeholder groups above. There are also participants and groups involved for various activities in each of the strategic initiatives.

Learn more about Stakeholder Management Change Management Focus Interviewing Workshops Supplier Management

Valuation Deliverables

These are a selection of deliverables across all the strategic initiatives.

  • Technology Upgrade Roadmap (PPT)
  • Telehealth Implementation Plan (PPT)
  • Operational Excellence Toolkit (PPT)
  • Valuation Improvement Framework (PPT)
  • Financial Impact Model (Excel)

Explore more Valuation deliverables

Valuation Best Practices

To improve the effectiveness of implementation, we can leverage best practice documents in Valuation. These resources below were developed by management consulting firms and Valuation subject matter experts.

Technology Upgrade

The implementation team leveraged several established business frameworks to help with the analysis and implementation of this initiative, including the Resource-Based View (RBV) and the McKinsey 7S Framework. RBV is a strategic management tool that focuses on the internal resources of an organization to gain a competitive advantage. It was particularly useful in this context because it helped identify the key technological assets and capabilities that could be leveraged for operational efficiency. The team followed this process:

  • Conducted an inventory of existing technological assets and capabilities to identify strengths and weaknesses.
  • Assessed the strategic value of these assets in achieving operational efficiency and competitive advantage.
  • Aligned technological upgrades with the organization's long-term strategic goals and operational needs.

The McKinsey 7S Framework was deployed to ensure alignment between the technological upgrades and the organization's overall strategy and structure. This framework examines 7 internal elements: Strategy, Structure, Systems, Shared Values, Style, Staff, and Skills. It was useful for identifying misalignments and ensuring that the technological upgrades supported the broader organizational objectives. The team followed this process:

  • Reviewed the current strategy and identified how the technological upgrades would support it.
  • Analyzed the existing organizational structure to determine if it was conducive to implementing the new technologies.
  • Evaluated the current systems, shared values, style, staff, and skills to ensure they were aligned with the new technological direction.

The implementation of these frameworks resulted in a comprehensive understanding of the organization's technological capabilities and the alignment of these capabilities with its strategic objectives. This led to improved operational efficiency, reduced costs, and enhanced patient care quality.

Telehealth Services

The implementation team utilized the Diffusion of Innovations (DOI) Theory and the Lean Startup Methodology to guide the deployment of telehealth services. DOI Theory explains how, why, and at what rate new ideas and technology spread through cultures. It was particularly useful in this context to understand how telehealth services could be adopted by both patients and healthcare providers. The team followed this process:

  • Identified the key attributes of telehealth services that would influence adoption, such as relative advantage, compatibility, complexity, trialability, and observability.
  • Developed communication strategies to highlight these attributes to potential users.
  • Monitored the adoption process and gathered feedback to make necessary adjustments.

The Lean Startup Methodology was employed to ensure a rapid and iterative approach to developing and deploying telehealth services. This methodology focuses on creating a minimum viable product (MVP) and using validated learning to improve it. It was useful for quickly bringing telehealth services to market while minimizing risks. The team followed this process:

  • Developed an MVP of the telehealth service to test its core functionalities.
  • Conducted pilot tests with a small group of patients and healthcare providers to gather feedback.
  • Used the feedback to make iterative improvements to the service before a full-scale rollout.

The implementation of these frameworks facilitated the successful launch of telehealth services, resulting in increased patient engagement, higher retention rates, and expanded market reach.

Operational Excellence Program

The implementation team leveraged the Six Sigma methodology and the Theory of Constraints (TOC) to drive the Operational Excellence Program. Six Sigma is a data-driven approach to improving quality by identifying and removing the causes of defects and minimizing variability in manufacturing and business processes. It was particularly useful for enhancing operational efficiency and reducing costs. The team followed this process:

  • Defined the specific operational processes that needed improvement.
  • Measured current process performance to establish a baseline.
  • Analyzed data to identify root causes of inefficiencies.
  • Improved processes by implementing solutions to eliminate root causes.
  • Controlled the improved processes to ensure sustainability.

The Theory of Constraints (TOC) was used to identify and address the most significant limiting factor (constraint) that hindered the organization from achieving its goals. It was useful for focusing efforts on the most impactful areas. The team followed this process:

  • Identified the primary constraint in the operational processes.
  • Exploited the constraint by making the best use of its current capacity.
  • Subordinated other processes to support the constraint.
  • Elevated the constraint by increasing its capacity.
  • Repeated the process to identify and address new constraints.

The implementation of these frameworks led to significant improvements in operational efficiency, reduced costs, and enhanced overall process performance.

Patient-Centric Care Model

The implementation team employed the Customer Journey Mapping and the SERVQUAL Model to develop the Patient-Centric Care Model. Customer Journey Mapping is a visual representation of the customer’s experience with a service or product. It was particularly useful for understanding the patient's experience and identifying pain points. The team followed this process:

  • Mapped out the entire patient journey from initial contact to post-treatment follow-up.
  • Identified key touchpoints where the patient interacts with the organization.
  • Analyzed patient feedback to identify pain points and areas for improvement.

The SERVQUAL Model was used to measure service quality across 5 dimensions: tangibles, reliability, responsiveness, assurance, and empathy. It was useful for assessing the quality of patient care and identifying gaps. The team followed this process:

  • Conducted surveys to measure patient perceptions across the 5 dimensions of service quality.
  • Analyzed the survey data to identify gaps between patient expectations and actual service delivery.
  • Developed action plans to address the identified gaps and improve service quality.

The implementation of these frameworks resulted in a more patient-centric care model, leading to higher patient satisfaction, improved retention rates, and increased referrals.

Valuation Improvement Plan

The implementation team utilized the Economic Value Added (EVA) and the McKinsey Value Framework to enhance the overall valuation of the organization. EVA is a measure of a company's financial performance based on the residual wealth calculated by deducting the cost of capital from its operating profit. It was particularly useful for understanding the true economic profit generated by the organization. The team followed this process:

  • Calculated the net operating profit after taxes (NOPAT) for the organization.
  • Determined the cost of capital and deducted it from NOPAT to calculate EVA.
  • Identified areas where EVA could be improved by increasing NOPAT or reducing the cost of capital.

The McKinsey Value Framework was used to identify and prioritize value drivers that impact the organization's valuation. It was useful for developing strategies to enhance these value drivers. The team followed this process:

  • Identified key value drivers such as revenue growth, operating margin, capital efficiency, and risk management.
  • Developed strategies to enhance each value driver, such as increasing revenue through new services or improving operating margin through cost reductions.
  • Implemented these strategies and monitored their impact on the overall valuation.

The implementation of these frameworks led to a comprehensive understanding of the factors impacting the organization's valuation, resulting in improved financial performance and a higher market valuation.

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Key Findings and Results

Here is a summary of the key results of this case study:

  • Increased patient retention by 15% through the introduction of telehealth services and a patient-centric care model.
  • Reduced operational costs by 12% via the implementation of an Operational Excellence Program utilizing Six Sigma methodologies.
  • Achieved a 20% adoption rate of new healthcare technologies, enhancing patient care and operational efficiency.
  • Expanded market reach by 10% with the successful launch of telehealth services, attracting new patient demographics.
  • Improved overall market valuation by 18%, driven by enhanced patient retention and operational efficiencies.

The overall results of the initiative indicate a significant positive impact on patient retention, operational efficiency, and market valuation. The 15% increase in patient retention and 12% reduction in operational costs are particularly noteworthy, as they directly address the organization's primary challenges. The successful adoption of new healthcare technologies and the expansion of telehealth services have not only improved patient care but also broadened the organization's market reach. However, the 20% technology adoption rate, while positive, suggests room for further improvement. Additionally, while the operational cost reduction is commendable, the initial investment in technology and training was higher than anticipated, impacting short-term financial performance. Alternative strategies, such as phased technology implementation or additional staff training, could have potentially mitigated these initial financial strains and accelerated technology adoption.

Recommended next steps include continuing to monitor and optimize the newly implemented technologies and processes to ensure sustained improvements in patient care and operational efficiency. Further investment in staff training and development is essential to maximize the benefits of the new technologies. Additionally, exploring partnerships with technology providers could enhance the organization's capabilities and reduce costs. Expanding telehealth services and home-based care options should remain a priority to further increase patient retention and market reach. Lastly, conducting regular evaluations of the operational excellence program and patient-centric care model will help identify areas for continuous improvement and ensure alignment with the organization's strategic objectives.

Source: Strategic Due Diligence Plan for Healthcare Provider in Geriatric Care, Flevy Management Insights, 2024

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