The problem

Strategy that never reaches the floor

0.4%

median hospital operating margin, year to date March 2026

Industry figure, not an Adelo Consulting result. Source: The Health Management Academy analysis of hospital margin performance, 2026.

Health systems rarely lack strategy. They lack a strategy anyone below the executive suite can act on. A service line growth plan that assumes staffing you do not have, referral patterns you have not tested, and capital you have not sequenced is not a plan — it is a forecast.

We work the other direction. We start from operating reality — capacity, workforce, payer mix, referral leakage, the actual condition of your ambulatory front door — and build the growth case from there.

Where to compete, what to build, and what to stop doing.

What we do

Capabilities in strategy & growth.

Service line strategy

Portfolio assessment across cardiovascular, oncology, orthopedics, neurosciences, women's and behavioral health. Where you have the right to win, where you are subsidizing, and what a credible three-year build looks like.

Market and demand analysis

Catchment modeling, migration patterns, referral leakage, competitor capacity and physician alignment — quantified rather than asserted.

Ambulatory and access strategy

Site-of-care shift, ASC and outpatient positioning, access economics, and the design of a front door patients can actually get through.

Growth capital and business case

Pro formas that carry staffing, ramp and payer assumptions explicitly, so finance and operations are arguing about the same numbers.

Partnership, affiliation and M&A support

Clinical and operational diligence, integration planning, and the honest assessment of whether a partnership solves the problem you actually have.

Strategic planning facilitation

Board and executive sessions that produce decisions and owners, not a document that gets circulated once.

What we target

Outcomes we scope engagements against.

These are the results we design toward and measure. We commit to targets in writing at the start of an engagement, and we report against them honestly — including when we miss.

We do not publish client results we cannot substantiate or attribute. Targets on this page describe engagement design, not guaranteed outcomes.

  • A ranked portfolio with explicit invest, hold and exit calls
  • Growth cases tied to real staffing and capacity constraints
  • Referral leakage quantified by service line and geography
  • A capital sequence the board can approve and finance can defend
  • Named owners and milestones, not a strategic plan on a shelf
Engagement models

Three ways to start.

1

Diagnostic2–4 weeks

A focused assessment with a written finding and a ranked set of actions. Fixed fee, defined scope. Most relationships start here because it is a low-risk way to find out whether we are useful.

2

Sprint8–16 weeks

A defined improvement engagement against a named target — throughput, denials, turnover, survey readiness. We work alongside your team rather than around them, and we transfer the method as we go.

3

Embedded6–18 months

Interim leadership or sustained transformation support. Our leader carries real accountability in your operating structure, with a written mandate and measurable commitments.

Frequently engaged by