Introduction Bon Secours St. Mary’s Hospital is an acute-care facility with nearly 400 beds, located in Richmond, Virginia. According to Definitive Healthcare, the hospital’s patient mix is about one-third Medicare, one-tenth Medicaid, and the rest primarily privately insured. Richmond median incomes and home values are below Virginia state averages, 1 and the Richmond population is probably slightly more price sensitive for healthcare services than average for the state. Hospitals such as St. Mary’s must maximize efficiency and productivity to maintain margins in lieu of lifting prices. Situation The St. Mary’s Hospital leadership team was increasingly concerned about the hospital’s competitiveness compared with other local hospitals and newly built ambulatory surgical cen

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