Gene Small


After several years of underperforming against budget, this nonprofit health care organization engaged Warren Whitney’s Gene Gregory to conduct an operational analysis to identify opportunities for improvement in operations and their potential impact on the financial position of the organization.


Gene began his process by interviewing the employees about their job duties, perceptions, and ideas about the organization. Next, he analyzed the number of people served, the cost of serving each category based on the type of services received, and the allowed reimbursement by payer for each type of service. The analysis highlighted areas where the cost of services exceeded reimbursement. Additional analysis determined the reason for the gap and whether it would be possible to adjust operations to close the gap.

In addition to identifying a number of expenses that were not being managed to meet the needs of the organization, Gene determined that changes in the industry were making this type of model increasingly difficult to sustain, even when resources were managed tightly.

Working together, Gene and the president developed a new model for providing care that substantially changed the organization’s business model, reducing overhead expenses and collaborating with other organizations to ensure that patients received excellent care within reimbursable limits.


The organization has made the operating changes required for the new business model. It is currently implementing the new model of service and testing its acceptance within the funding community.