In hospitals today, administrators and board members face a unique challenge: balancing the noble mission of healthcare delivery with the pragmatic needs of financial sustainability. This intersection of purpose and practicality finds a compelling solution in an investment philosophy that dates back to the Great Depression – value investing.

Benjamin Graham, often called the father of value investing, developed his investment principles during one of America's most challenging economic periods. His approach, first detailed in "Security Analysis" (1934), emphasized finding the true worth of investments beyond their market prices. This focus on intrinsic value mirrors how hospitals must evaluate both their clinical and financial decisions – with careful analysis, patient consideration, and a long-term perspective.

Howard Marks, a modern torchbearer of value investing principles, wrote in "The Most Important Thing" (2011) that "successful investing requires thoughtful attention to many separate aspects, all at the same time." This multifaceted approach resonates deeply with hospital operations, where success depends on simultaneously managing patient care, financial stability, and community health.

Where lives hang in the balance and split-second decisions can make all the difference, creating a safe environment isn't just about rules and regulations—it's about culture. Specifically, it's about fostering what healthcare experts call a "Just Culture," a framework revolutionizing how healthcare organizations approach patient safety and staff accountability.

At its heart, Just Culture represents a fundamental shift in our thinking about mistakes and accountability in healthcare settings. Rather than defaulting to blame when things go wrong, this approach encourages organizations to take a deeper look at both individual and systemic factors that contribute to errors. It's about finding the delicate balance between personal responsibility and organizational support—understanding that while healthcare professionals must be accountable for their choices, they also deserve support when systems fail them.

Standing out and creating a competitive advantage in the marketplace while delivering exceptional patient care has become more challenging than ever. Healthcare organizations continually search for ways to differentiate themselves meaningfully in their markets. One powerful approach that is gaining traction is pursuing Center of Excellence certification through leading accrediting bodies such as DNV GL Healthcare and The Joint Commission (TJC). While each accrediting organization has its unique approach, the strategic value of these certifications extends far beyond the credential itself.

When viewed through the lens of Michael Porter's competitive strategy framework, an orthopedic center of excellence certification emerges as a powerful tool for creating sustainable competitive advantage. Whether through DNV GL Healthcare's innovative ISO 9001-based approach, The Joint Commission's disease-specific care certification, or other recognized programs, the certification process doesn't just validate clinical excellence – it serves as a catalyst for comprehensive organizational transformation that can reshape market positioning and operational effectiveness.

Even with a well-defined financial strategy, ongoing monitoring, and adaptability are essential to ensure long-term success. Market conditions fluctuate, and healthcare needs evolve, necessitating a proactive approach to managing financial assets.

Regular performance reviews are essential to aligning with the hospital’s mission and goals. Monitoring helps ensure that investments continue to meet targeted returns and that assets are being optimally utilized to support operational and capital needs.

Introduction As hospitals increasingly rely on financial assets to support their missions, strong governance and fiduciary oversight become crucial. Effective asset management requires more than sound investments; it also requires a commitment to transparency, accountability, and adherence to fiduciary best practices.

The Role of Fiduciary Responsibility For hospitals, fiduciary responsibility means managing assets with the highest ethical standards and ensuring that investments are made in the best interest of the organization and its community. Adhering to standards like the Uniform Prudent Management of Institutional Funds Act (UPMIFA) provides a legal and ethical framework for responsible financial management.

Introduction Balancing operational and capital needs is a critical challenge for hospitals. As costs rise and reimbursements fluctuate, hospitals are often forced to make difficult choices between day-to-day operating needs and long-term capital improvements. One solution to this dilemma is optimizing balance sheet assets to generate a reliable revenue source that supports both immediate and future needs.

Why Alignment Matters Hospitals must be able to cover both daily expenses and long-term investments, such as facility upgrades, technology, and staff development. By strategically investing the financial reserves, hospitals can create a dedicated source of revenue that helps balance these needs, reducing the dependency on inconsistent operating income alone.

Introduction For years, many hospitals have taken a conservative approach to financial management, prioritizing asset protection with low-yield investments. While safe, this approach no longer meets the demands of today’s healthcare environment. Hospitals need a strategy that balances stability with growth—a value-based, fundamental approach that aligns with their mission and financial needs.

What is Value-Based, Fundamental Investing? Value-based, fundamental investing is an approach focused on long-term growth by investing in quality assets that are undervalued in the market. Rather than seeking short-term gains, this strategy prioritizes stability and alignment with the hospital’s goals, such as supporting healthcare innovation, community health, and financial resilience.

The financial landscape grows more challenging each year for hospitals, particularly those serving rural communities. Hospitals are increasingly pressured to do more with less with less - with declining reimbursement rates, rising operational costs, and a complex regulatory environment. Over the last two decades, over 180 hospitals closed nationwide—often leaving communities without access to essential healthcare services.

In response to these challenges, some healthcare leaders often overlook a valuable resource: balance sheet financial assets. When managed strategically, these assets can become a sustainable source of non-operating revenue, creating financial resilience and supporting reinvestment in patient care, staff, and critical infrastructure.

At Frontier Strategy Partners, the term "Frontier" is more than just a name; it encapsulates the very essence of what we stand for. We are explorers, navigators, and strategic partners helping healthcare organizations chart new paths to success, sustainability, and financial stability. This article delves into what the concept of a "frontier" means for our work and how we bring that spirit to life in our engagements.

People choose healthcare as a career because it fulfills their individual sense of purpose. It is passion driven.  Consumers select their healthcare provider because they feel a real sense of concern and dedication from those professional providing the care. It is the combination of these feelings and desires that creates the basis of a great culture within an organization. In a practical sense, it is the coming together of two major strategic approaches into organizational goals: one great experience - one great team. 

Physician recruiting in the healthcare environment remains more competitive than ever. While compensation and benefits remain important, culture is emerging as a key differentiator for organizations seeking to attract and retain top physician talent. The physicians I’ve spoken with describe a common theme: beyond pay and career growth, they want to feel valued and have a voice in shaping their practice. Many have experienced what they describe as a “treadmill” environment, where they were seen merely as "producers," leading to burnout and disengagement.

In many healthcare organizations, the key to achieving success lies in effectively managing People, Process, and Plan. To truly harness this triad, it requires a disciplined, structured approach that keeps the entire team aligned with the organization’s mission, strategic goals, and improvement initiatives. One highly effective method for maintaining this alignment and keeping progress on track is what I call the "Around-the-Room Review."

This blog will explore how to set up a structured review process by utilizing the physical layout of a room to track progress and address key strategic priorities in a systematic way.

Delivering sustainable results requires more than just setting broad organizational targets. It’s about creating a system where every aspect of the organization, from leadership to individual departments, aligns its efforts with a unified purpose. To accomplish this, I propose using a “Pillar” framework by which we measure the success of our efforts across the critical areas of People, Process, and Plan (Employee Engagement/Culture, Lean Process Improvement, and Strategy).

These strategic pillars - Quality, Workforce, Patient Satisfaction, Finance, and Community - serve as foundational guides that shape our future. Each pillar will have overarching organizational goals that cascade down to specific departmental objectives, creating a cohesive framework where every hospital department plays an active role in achieving the organization’s mission.

Fostering a strong organizational culture is a competitive advantage and a key factor in driving employee engagement, patient satisfaction, and operational success. A thriving culture doesn’t happen by accident; it is cultivated through intentional leadership and active participation from all levels of staff. This blog explores two critical themes: (1) how consistent leadership expectations, guided by evidence-based practices, can create an environment where staff excel, and (2) the importance of gathering input from staff on the organization’s future, fostering a culture of inclusion and ownership.

Evan Williams and I grew up in Clarks, Nebraska, in the late 1980s and early ’90s, in a small, rural community where most families, including ours, were tied to farming and agriculture. Our classes were small—generally 10 to 15 students—and life was grounded in hard work and simple values. Yet from this modest background, Evan went on to co-create platforms that reshaped how the world communicates: Blogger, Twitter, and, most recently, Medium. Today, I find myself writing blog posts in healthcare, an industry in dire need of the same type of forward-thinking innovation that Evan pioneered in technology. There’s a certain irony in that, and it’s this contrast that I want to explore—how Evan’s remarkable ability to create what wasn’t even available can inspire the healthcare sector to reimagine its own possibilities.

"Patient Centered Strategy" by Jeff Hunter provides a comprehensive guide for healthcare leaders looking to transform their organizations by focusing on patient-centered care. The book argues that by putting patients at the center of strategic decision-making, healthcare organizations can achieve better clinical outcomes, higher levels of patient satisfaction, and greater operational efficiency. It’s a strategic approach that balances patient needs with the overarching goals of healthcare providers, aligning the two for mutual benefit.

Hunter offers a roadmap for implementing this strategy, focusing on key areas such as leadership, organizational culture, operational excellence, and the adoption of value-based care models. He emphasizes that the transition to a patient-centered strategy is not just a superficial change in policy but a fundamental shift in how healthcare organizations operate.

Emotional intelligence (EI) has emerged as a vital skill for both personal and professional success. Understanding your own emotions and those of your team members can create a more cohesive, productive, and empathetic workplace. At its core, emotional intelligence is about awareness, control, and expression of emotions and handling interpersonal relationships judiciously and empathetically. But how can you measure and improve your emotional intelligence? Thankfully, there are tools and assessments designed to help you better understand yourself and your team.

In this post, I will discuss some key assessments I have taken, which have provided invaluable insights into my emotional intelligence and the dynamics of team.

In healthcare, we often focus on clinical outcomes, patient satisfaction scores, and operational efficiency. But beneath these metrics lies something fundamental to every hospital’s success: its culture. A strong organizational culture isn’t just a buzzword—it’s the very foundation that supports positive staff relationships and enhances the quality of care patients receive.

When a hospital or healthcare organization fosters a healthy, supportive culture, the effects ripple through every aspect of the organization, from staff morale to patient outcomes. In contrast, when culture is neglected, even the best clinical practices can falter under the weight of disconnection and discontent.

Achieving organizational excellence isn’t just a goal—it’s a necessity. Hospitals and healthcare organizations face the complex task of balancing financial constraints, shifting patient demands, and workforce challenges while maintaining the highest standards of care. How can organizations not only survive but thrive? The answer lies in pursuing excellence, rooted in strategic vision, operational efficiency, and a culture of continuous improvement.

However, the path to excellence can be unclear. The healthcare sector’s complexities—tight regulations, dynamic market forces, and fluctuating patient needs—make it difficult to navigate. This is where a consultant can make all the difference. By offering objective insights, identifying opportunities for improvement, and helping craft strategies aligned with long-term success, the right consultant can turn organizational excellence from an aspiration into reality.