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Results That Move Healthcare Forward

Explore how enterprise transformation drives lasting business impact.

Every engagement below represents a healthcare 
organization that faced a complex challenge and achieved measurable financial, operational, and strategic results through disciplined execution.

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Explore Our Case Studies by Category

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Hospital Acquisition Program Management

Situation

A large national healthcare system strategically acquired an underutilized facility in Dallas, one of the nation’s most competitive and financially significant cardiovascular markets, to accelerate regional growth and expand specialty differentiation through the creation of a state-of-the-art Heart & Spine hospital.

Division executive leadership engaged TRUST to deliver end-to-end program management, operational readiness, and coordinated project execution across construction, clinical, and administrative domains, ensuring an accelerated, disruption-free opening, strong stakeholder alignment, and rapid market entry capable of generating early financial performance and long-term strategic value.

  • Aligned leadership, physicians, and care teams around shared vision, governance structure, and change champion network.
  • Conducted current-state assessment, KPI benchmarking, gap identification, and future-state operating model design.
  • Developed implementation playbook, pilot sub-specialty workplan, reporting cadence, and accountability framework.
  • Enabled training, communication, leadership transition support, and multidisciplinary collaboration to sustain adoption.
  • Established enterprise oncology leadership and governance model, improving ownership and accountability, enabling system-wide strategic impact.
  • Implemented referral, scheduling, and workflow enhancements, increasing access efficiency and care coordination, improving patient experience and throughput.
  • Advanced navigation and earlier access to care, strengthening clinical quality and outcomes, elevating value-based performance.
  • Enabled scalable growth across oncology sub-specialties, aligning service expansion with system priorities, supporting long-term market competitiveness.

Hospital Acquisition Strategy & Project Initiation

Situation

A large national healthcare system strategically acquired an additional facility in San Antonio, Texas, to expand surgical capacity and strengthen competitive positioning within a rapidly growing regional market. The organization’s objective was to convert the site into a 54-bed acute surgical hospital, requiring significant facility renovation, Operating Room build-out, equipment planning, and full operational activation aligned to enterprise clinical, financial, and regulatory expectations.

Division executive leadership engaged TRUST to provide program strategy, business case development, and end-to-end program management to define the fastest and most financially viable path to opening. The engagement included strategic planning, critical path assessment, capital and operating budget development, and execution governance, ensuring organizational alignment, regulatory readiness, and an accelerated timeline to market entry.

  • Led multi-disciplinary workstreams spanning strategy, finance, administration, construction, physician relations, nursing, and operations to coordinate planning for the 54-bed surgical hospital opening.
  • Directed business case development with Division C-Suite executives, defining financial assumptions, opening strategy, and critical path to accelerate go-live.
  • Delivered core execution artifacts including program budget, workplan, governance model, equipment design/layout, physician engagement strategy, weekly reporting, and monthly executive presentations.
  • Designed and implemented organizational change management and communications strategy to support clinical staff retention and transition during facility consolidation.
  • Defined enterprise critical path to opening, accelerating organizational decision-making, enabling the fastest feasible go-live timeline.
  • Completed facility and equipment condition assessment, prioritizing capital deployment and readiness actions, reducing execution risk and cost uncertainty.
  • Achieved regulatory licensure readiness, enabling timely operational approval, protecting revenue capture at opening.
  • Delivered executable opening workplan for leadership, improving program visibility and accountability, ensuring disciplined execution to launch.
  • Drove facility-Division alignment through change management, increasing staff stability and engagement, supporting sustained surgical growth post-opening.

Heart Hospital Activation & Transition Planning

Situation

A large regional healthcare system initiated a $200M clinical tower expansion to significantly increase tertiary and quaternary care capacity across cardiovascular, abdominal transplant, and ECMO service lines. The expansion introduced complex, high-acuity clinical infrastructure, including 5 Operating Rooms, 3 Cardiac Catheterization Labs, 2 Electrophysiology Labs, 16 PACU bays, 32 ICU rooms, Cardiac Diagnostics, and Same-Day Admission units, requiring precise coordination of equipment, staffing, and operational readiness.

Beyond new facility activation, the project required a large-scale operational transition across the existing campus, including the reaggregation of more than 10 clinical units and over 300 patients to enable tower integration. Executive leadership engaged TRUST to lead end-to-end activation, equipment transition, clinical readiness, and enterprise change management, ensuring patient safety, operational continuity, and a seamless transition into the new high-acuity environment.

  • Established executive governance, steering committees, and decision facilitation for 250+ leadership actions to maintain alignment and pace of execution.
  • Directed equipment, people, and patient transition planning across new activation and campus-wide operational reconfiguration.
  • Built and executed unit readiness plans, move sequencing, risk assessments, simulations, and executive reporting to ensure safe, coordinated transition
  • Implemented comprehensive change management, training, and physician/leader communications to drive readiness across impacted service lines.
  • Enabled safe transition of 300+ patients and 10 clinical units, achieving zero patient safety events, ensuring continuous high-acuity care delivery.
  • Facilitated 250+ executive and clinical decisions on schedule, maintaining critical path adherence, protecting $200M capital activation timeline.
  • Completed full clinical and operational readiness prior to opening, reducing go-live disruption risk, enabling immediate utilization of new capacity.
  • Aligned physicians, leaders, and staff through structured change management, accelerating operational adoption, supporting rapid service line growth post-opening.

Trauma New Service Line Activation

Situation

A large regional healthcare system initiated a $15M capital investment to establish a dedicated Trauma and Neurosurgical service line, requiring coordinated business case development, capital approval, equipment procurement, and full operational activation. The initiative also required facility aggregation of three inpatient units and the transition of 100+ patients to consolidate operations and enable the launch of 78 newly configured patient care rooms across emergency, medical-surgical, and intensive care environments.

Executive leadership engaged TRUST to lead the end-to-end strategic, financial, and operational execution necessary to secure Board approval, optimize capital deployment, and safely transition clinical operations. The engagement ensured rapid time to value, minimal operational disruption, and alignment of infrastructure, staffing, and equipment to support sustainable growth in high-acuity trauma and neurosurgical care.

  • Partnered with executive leadership to develop business case, capital request, ROI model, and board approval strategy for the $15M investment.
  • Planned patient reaggregation, stacked operational design, facility readiness, and move sequencing to enable single-floor trauma activation.
  • Directed equipment planning/procurement, budgeting, readiness planning, risk mitigation, and executive reporting to maintain schedule and cost discipline.
  • Implemented training, communications, simulations, and stakeholder engagement to ensure safe transition and rapid clinical adoption.
  • Achieved capital payback in 6 months vs. 16-month plan, accelerating ROI by >60%, significantly improving financial performance of new service line.
  • Delivered project on time and under $15M budget, reducing capital variance, strengthening Board and executive confidence in execution.
  • Reaggregated 100+ patients and consolidated 3 units safely, enabling launch 
of 78 trauma/neuro beds, expanding high-acuity capacity and market capture.
  • Coordinated move timing with facility repairs and refreshes, 
capturing previously unrealized opportunity cost, improving long-term infrastructure value.

Oncology Operating Model Redesign

Situation

A large regional healthcare system initiated a comprehensive transformation of its oncology service line to establish a sub-specialty operating model capable of advancing clinical quality, improving operational performance, and elevating the patient experience across the care continuum. The initiative required deep engagement with executive leadership, physicians, advanced practice providers, and clinic teams to realign governance, workflows, and accountability structures in support of modern, multidisciplinary cancer care delivery.

TRUST was engaged to lead the enterprise operating model redesign, stakeholder alignment, and implementation enablement necessary to create a scalable foundation for long-term oncology growth. The work focused on defining future-state structures, performance metrics, and standardized processes, while embedding cultural and operational change that would sustain adoption, strengthen collaboration, and position the organization for continued advancement in specialty cancer services.

  • Aligned leadership, physicians, and care teams around shared vision, governance structure, and change champion network.
  • Conducted current-state assessment, KPI benchmarking, gap identification, and future-state operating model design.
  • Developed implementation playbook, pilot sub-specialty workplan, reporting cadence, and accountability framework.
  • Enabled training, communication, leadership transition support, and multidisciplinary collaboration to sustain adoption.
  • Established enterprise oncology leadership and governance model, improving ownership and accountability, enabling system-wide strategic impact.
  • Implemented referral, scheduling, and workflow enhancements, increasing access efficiency and care coordination, improving patient experience and throughout.
  • Advanced navigation and earlier access to care, strengthening clinical quality and outcomes, elevating value-based performance.
  • Enabled scalable growth across oncology sub-specialties, aligning service expansion with system priorities, supporting long-term market competitiveness.

Service Line Value Optimization and Growth Architecture

Situation

TRUST Business Consulting partnered with a large regional healthcare system to assess and optimize the operational and financial performance of its transplant service line during a period of margin pressure and organizational misalignment. The program faced workflow inefficiencies, fragmented governance, and limited performance transparency, requiring a structured evaluation of cost drivers, throughput constraints, and long-term sustainability risks.

The engagement extended beyond assessment to include strategic repositioning of the service line’s operating model. TRUST conducted an end-to-end review of financial performance, organizational design, physician alignment, and growth scalability. The objective was to strengthen margin performance while building a durable growth architecture capable of supporting future volume expansion and competitive differentiation.

  • Conducted stakeholder interviews, process mapping, and benchmarking to define performance gaps and establish standardized service line KPIs.
  • Identified cost-containment levers and throughput improvements to address structural inefficiencies impacting margin.
  • Developed a clear business case with financial projections and roadmap to drive executive alignment and informed decision-making.
  • Supported updated organizational structures and governance frameworks to embed sustainable ways of working.
  • Implemented standardized KPIs that improved visibility into margin and throughput drivers, enabling data-driven leadership decision-making.
  • Identified operational and financial improvement levers that reduced structural inefficiencies and strengthened long-term margin sustainability.
  • Developed and secured approval for a business case and execution roadmap that increased executive alignment and organizational buy-in, advancing transformation execution.
  • Implemented governance redesign and structural updates that improved 
cross-functional collaboration and positioned the transplant program for sustainable growth.

Establish Specialty Pharmacy Program

Situation

A top-20 Academic Medical Center sought to mature its specialty pharmacy program to unlock enterprise growth, improve patient outcomes, and achieve national specialty pharmacy accreditation. Leadership required a comprehensive assessment of current capabilities, validation of operational and financial opportunity, and development of a strategic pathway to expand payer access, strengthen clinic integration, and scale sustainable program performance.

TRUST was engaged to deliver end-to-end specialty pharmacy strategy, operational transformation, and implementation partnership, spanning opportunity identification, current- and future-state validation, embedded clinic model design, payer and limited distribution drug (LDD) access strategy, and multi-year growth enablement. The engagement focused on accelerating margin capture, accreditation readiness, and value-based patient outcomes while positioning the program for long-term enterprise reinvestment and expansion.

  • Structured engagement through four strategic sprints—Learn, Synthesize, Build, Refine— to align leadership on insights, priorities, and execution roadmap.
  • Conducted qualitative stakeholder interviews and quantitative performance analytics to define capability maturity, operational gaps, and growth opportunities.
  • Built validated opportunity model, strategic capability roadmap, and future-state operating design to guide margin capture and accreditation readiness.
  • Partnered in multi-year co-implementation, embedding clinic integration, payer access strategy, and operational transformation to sustain program growth.
  • Identified total annual margin opportunity, quantifying $171M potential value, enabling data-driven executive investment and prioritization.
  • Scaled specialty pharmacy performance post-implementation, surpassing $300M annual gross margin, driving sustained enterprise revenue growth.
  • Delivered 24-month strategic roadmap to URAC readiness, defining milestones, capabilities, and investments, enabling a clear path to accreditation and scale.
  • Improved payer access, adherence, and experience metrics above industry benchmarks, enhancing value-based outcomes, strengthening competitive differentiation.

Pharmacy Financial Growth and Performance Enablement

Situation

A large academic medical center sought to expand and operationalize advanced specialty pharmacy capabilities as part of its broader strategy to achieve URAC accreditation, strengthen longitudinal patient management, and improve access to high-cost specialty medications. Leadership identified several priority initiatives required to mature program performance, including the launch of at-home specialty medication delivery, implementation of a comprehensive patient financial assistance program, and deployment of claims adjustment technology to enhance administrative efficiency and reimbursement accuracy.

TRUST was engaged during an early phase of the organization’s specialty pharmacy evolution to provide strategic guidance, operational design, and implementation enablement aligned to accreditation readiness and sustainable program growth. The work focused on establishing foundational capabilities, scalable workflows, and patient-centered service delivery models that would position the specialty pharmacy for future expansion, improved financial performance, and enhanced clinical outcomes.

  • Partnered with pharmacy and health system leadership to prioritize specialty pharmacy growth initiatives aligned to URAC readiness and enterprise strategy.
  • Designed operational models for at-home delivery, financial assistance, and claims adjustment integration to expand access and administrative capability.
  • Established foundational workflows, technology enablement, and execution planning to support scalable specialty pharmacy operations.
  • Guided stakeholder engagement, training, and operational transition to embed new services into routine pharmacy practice
  • Launched foundational specialty pharmacy capabilities, enabling expanded patient access to therapy, supporting progress toward URAC accreditation readiness.
  • Implemented patient financial assistance and claims optimization processes, improving medication affordability and reimbursement accuracy, strengthening program financial sustainability.
  • Enabled at-home specialty medication delivery model, enhancing care continuity and patient experience, advancing value-based care performance.
  • Established scalable operational infrastructure for future growth, positioning specialty pharmacy expansion, supporting long-term enterprise margin opportunity.
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