Challenge
In 2018, Mahaska Health, a Critical Access Hospital (CAH) in Oskaloosa, Iowa, faced significant financial and operational headwinds. With only 40 days of cash on hand, the organization was navigating resource inefficiencies, revenue cycle, recruitment, and operational challenges. Mahaska’s newly-appointed CEO, Kevin DeRonde, sought an objective, expert assessment of the hospital’s financial and operational health.
Recognizing the value of an external perspective, DeRonde partnered with Stroudwater Associates through a USDA grant provided by the National Rural Health Association (NRHA). Stroudwater has extensive expertise in rural healthcare, financial turnarounds, and strategic planning. DeRonde hoped this collaboration would address immediate fires and provide a clear, actionable roadmap for growth and long-term sustainability.
Process
Stroudwater Associates implemented a comprehensive approach tailored to Mahaska Health’s unique needs. Key steps included:
- Rapid Financial Assessment: Within an hour of their initial review, Stroudwater identified $1 million in potential improvements from cost report optimization.
- In-Depth Operational Review: Over the next three days, Stroudwater analyzed Mahaska Health’s financial and operational reports, revenue cycle, and operational workflows, uncovering opportunities for immediate improvement.
- Strategic Planning: Stroudwater facilitated a full-day strategic planning session with the leadership team and board members. This collaboration produced a 12-point strategic plan that became a foundational document for Mahaska Health’s future growth.
- Engaging the Board: Stroudwater presented its findings and recommendations directly to the board of trustees. This independent, third-party perspective provided external validation and helped align leadership around the strategic vision. DeRonde noted, “There’s a point where you’re finding opportunities as the CEO and communicating them to the board, but when a third party does the same thing, it carries significant weight.”
- Seeing the Bigger Picture: While DeRonde was focused on immediate challenges—such as hiring certified coders and addressing operational gaps—Stroudwater helped him “see the forest through the trees” by identifying opportunities for long-term growth and practical steps to achieve them.
Results
The partnership between Mahaska Health and Stroudwater Associates was transformative, and included the following outcomes:
- Financial Improvements: Immediate identification of over $1 million in cost report reimbursement improvements and significantly more in other revenue growth opportunities.
- Operational Efficiencies: Enhanced clinic workflows and revenue cycle processes.
- A Strategic Vision: A clear, actionable plan to drive growth, improve financial performance, and expand care for the community.
- Empowered Leadership: DeRonde and the leadership team gained clarity, direction, and confidence to execute their strategic goals by adding specific action items to their strategic plan.
- An Expanded Footprint: Under DeRonde’s leadership, together with the executive team and physician leaders, Mahaska Health has become a regional center for care in Southeast Iowa, broadening its impact and ensuring greater access to quality healthcare for 16 surrounding counties.
Impact
Stroudwater Associates’ deep expertise in rural healthcare and dedication to client success have left a lasting impact on Mahaska Health. The initial collaboration not only addressed immediate financial and operational challenges but also established a clear roadmap for sustained growth and community impact. Through a consultative approach and access to a robust network of healthcare experts, Stroudwater helped Mahaska Health build a culture of measurement, streamline operations, and enhance care delivery.
Recognizing the value of this partnership, Mahaska Health recently invited Stroudwater back to reassess its financial and operational performance. This renewed collaboration uncovered several new areas of improvement with a potential for significant financial benefits —demonstrating the ongoing value of a strategic and forward-thinking approach to rural healthcare.
Testimonial
“Stroudwater’s depth of wisdom and genuine passion for rural healthcare made all the difference. Their humility and expertise ensured immediate results but also laid the groundwork for sustained success.” – Kevin DeRonde, Mahaska Health CEO
