Academic Health Systems (AHSs) face challenges balancing the missions of patient care, education, and research against the nuances of disparate funding streams, success measures, and internal competition for limited resources.

Intricate legal and operational structures and myriad external affiliations and financial arrangements add to the complexity of managing these important institutions.

PYA understands the headwinds AHSs face. Volatility in external funding, increased presence of narrow networks that exclude AHSs, the need to succeed in value-based payment models, and decentralized governance structures that complicate decision-making are challenges other providers rarely face.


PYA is privileged to have worked alongside more than 100 of the nation’s leading AHSs on strategy, transactions, compliance, operations, and much more.

PYA-Led Initiatives for AHSs:

Strategic planning, clinical operations improvement – Led strategic planning initiative to meet goals for clinical practice plan expansion and operational reorganization – ensuring success of innovative educational model for medical students, physicians assistants, and residents.

Hospital/medical school master affiliation and clinical integration – Provided integration analysis and strategy support for health system/hospitals and medical schools with a focus on creating sustainable partnerships meeting the goals and objectives of both partners. Considered innovative options for partnership to meet partnership plans.

Fair Market Value – Performed fair market value analyses related to: (a) physician compensation for employment, call coverage, medical directorship, and consulting services; (b) high-level administrative/management positions, management services agreements, and professional services agreements; and (c) acquisition of physician practices, surgery centers, radiation therapy centers, and other facilities.

Brand valuation – Provided brand value analysis to help a large AHS evaluate the financial terms of proposed affiliations with other health systems and ensure the incremental value provided by the AHS brand was appropriately compensated.

Data analytics and BPCI contract assistance – Assisted in securing the Centers for Medicare & Medicaid Services’ Bundled Payment for Care Improvement Initiative (BPCI) contract for various episode-based bundles. Provided a data analytic resource to measure the total cost of care and recommendations for strategic financial opportunities.

Organizational structure and governance – Designed organizational and governance structure to balance participants’ interests and build trust among previously unaffiliated hospitals and AHS; created strategic and operational plans to fit the new entity’s functions.

Compensation redesign – Completed a compensation redesign for all faculty and medical staff, incorporating significant metrics for physician and executive education into the compensation formula.

Audit and support services – Provided audit services and interim reimbursement support services for a teaching hospital, including periodic assistance related to the preparation of Medicare cost reports and required supporting documentation.

Internal education – Facilitated planning engagements and retreats to develop consensus around key strategic and operational issues.

Project feasibility studies – Developed financial analyses and feasibility studies for a variety of projects from new services and joint ventures to new hospital facilities.

If you would like guidance with any matter related to compliance, valuation, strategic planning, or transaction solutions, please email our executive contacts or call 800-270-9629.