There are only three “real” limitations to a community hospital’s (CH’s) success:

  1. Service area population,
  2. Proximity to your nearest competing hospital, and
  3. Desire to succeed.

HospitalMD (HMD) invites you to learn about a solution that predictability and consistently achieves success and long-term viability.


A review of the financial and clinical metrics of many CHs confirms financial distress. 64% (or 765) of all 1,195 acute care community hospitals (CHs) with 150 beds, and less, across 16 states had operating losses that each averaged $5.8 million annually. A state-by-state recap of these results is available for your review. 120 CHs have closed since 2010. Over 400 CHs are defined as vulnerable and at risk of closing because their financial metrics are the same as those that closed. Both the rates and vulnerability of closing are continuing to increase yearly.

The tipping point occurred 20 years ago with the Balance Budget Act (BBA) of 1997 spawning fundamental changes in payers’ payment formulae for services. Financial difficulty did not come about overnight. Led by CMS, all payers have systematically followed this path to their common goal of reducing rates. We will never go back. 20 years has allowed many CHs to sink deep into financial distress.

Over these 20 years, many people have come to believe that declining reimbursement rates are the primary cause of financial difficulty. Rate decline is a contributing factor, not a cause. HMD analyses and experience indicate that operating income does not directly correlate with:

  • Reimbursement rates.
  • Bed size.
  • CAH or PPS payment methods.
  • State or geographic region.
  • Form of ownership.
  • Population and demographics.

Solutions to financial difficulties of the past are not working today.


Treatment of financial difficulties is analogous to the treatment of a critically ill patient. Financial difficulty results from interdependencies of operational comorbidities. The disease is complex. The treatment is complex. And the worst outcome can be the same for either a patient or CH. Time may be a more critical risk than the treatment. A successful outcome is often the choice of doctor and treatment.

Financial viability is not “financial” only. There are three dimensions of patient care performance listed below, and each is intrinsic to every patient care encounter.

  • Financial.
  • Service/satisfaction.
  • Medical/clinical.

Every medical outcome and every customer perception starts at the patient encounter. The medical outcome and customer perception along with the work processes and workflows at the level of every patient encounter are the source of every dollar of revenue and cost. Solving financial difficulty must reach down and start at this level. Financial difficulty is a “bottom-up” problem. The solution must not be a superficial “top-down” solution. And physicians have primary responsibility for all 3 decisions.

HMD invites you to learn about a solution that consistently and predictably achieves short and long-term success in all three dimensions.

Service Line Excellence (SLX).

HMD can assure you of predictable success, a minimum of 200% ROI, and no risk because:

  • HospitalMD is your partner, not a vendor.
  • We are responsible for 90% of your revenue.
  • We are taking the financial risk for our solution.
  • Our solution is comprehensive – from the start to success. It consists of two components:
    • Comprehensive management system – we know what to do.
    • Medical decisions and interpersonal behavior – we do what we know to do.

View our solutions as designing and building a multi-story building for immediate needs and for growth outward and upward. The foundation is an integrated emergency medicine (EM) and hospital medicine (HM) practice.

The number of physicians and how each is deployed to provide both EM and HM services varies with volume, diagnoses, and acuity. However, all physicians possess equivalent skills, experience, and privileges and can interchangeably treat both EM and HM patients. This integration eliminates the traditional “silo” barriers of different departments. We call this “think as two, act as one”.

This structure ensures that there is no disagreement about patients that can be admitted and treated locally that were previously transferred, medical necessity, nor how they will be treated. Both services work under the leadership of a single Medical Director.

This 24/7/365 “base camp” for all hospital-based patient care can support growth and addition of all other short- and long-term needs. This foundation enables you to efficiently and incrementally support:

  • Growth of both current and future services by other specialties (e.g., surgery, cardiology).
  • Build more robust service lines.
  • Optimize your Medical Staff.

What is Optimizing Your Medical Staff?

Optimize means maximum patient volume and revenue from the right number and specialty mix of physicians wherein each member of the Medical Staff is individually more successful because of relationships with the group than alone and without threat to or from the others.

The core patient care provided by our integrated EM/HM practice model complies with our proprietary Standards of Excellence (SOX) adopted by HMD physicians at each site. SOX prescribes the standard diagnostic and treatment decisions for high value and high volume diagnoses. SOX also prescribes the expected interpersonal behaviors with patients, colleagues, and hospital staff. And finally, each SOX is designed to ensure that every medical decision optimizes the profit contribution of each encounter.

SOX ensure maximum market share, continuity, and consistency of care. Your CH becomes the public’s first and preferred choice for patient care.

SOX is a system. And the system is the solution.


We are not a staffing company or a consulting firm. We are a partnership of physicians and business leaders that develop and implement solutions. Our physicians do not make decisions in a “silo” or a vacuum. We practice “TEAM MEDICINE” (TMD). TMD includes the integration of nurses and all ancillary clinical staff with our physicians.

Physicians generally do not understand the science of business. Physicians do not exercise the same judgment. Nor do they naturally excel at financial and behavioral decisions.  Therefore, we have learned to integrate the disciplines of the business of medicine with the practice of medicine which comprises the DNA for the HOSPITAL of the FUTURE.


We Work for Your Performance.

We assure a minimum of 200% ROI, and you have no financial risk.