Restructuring and interim management in healthcare

By Stefan Treiber, Michael Musick and Alexander Schmithausen

Expert support in special situations involving restructuring, reorganization, crisis or transformation in the healthcare sector

Related expertise

Staff shortages, restructuring/reorganization, sudden crises: There are many reasons why organizations in the healthcare sector, especially hospitals, might need the temporary support of experts from Roland Berger IMPEX. Our interim management services offer you bespoke solutions when you need management executives fast. We know the specific challenges encountered in the healthcare sector and we understand them, and our experts have the extensive management experience needed to play a crucial part in solving a vast array of problems.

Portrait of Stefan Treiber — Stefan Treiber

Partner

Munich Office, Central Europe

Whether you're facing a strategic realignment, transaction , restructuring , or profit and liquidity crisis, almost every company will at some point have to deal with special situations and challenges that go beyond their normal business operations – and healthcare companies are no different. Organizations often lack the necessary management skills and capacity and the experience to handle the situation internally. This is where Roland Berger IMPEX (Interim Management Performance Executives) comes in: Roland Berger has been a leader in management consulting for individual hospitals as well as hospital alliances and operators for many years. Our interim management offering builds on this position and significantly broadens the scope of our core competency: We support healthcare companies in complex special situations, helping you successfully navigate change.

Management capacity to deal with special situations

Our experienced interim managers and tailored Roland Berger consulting teams support healthcare companies, especially hospitals and their owners or operators, in successfully managing complex transformations and restructuring processes. They provide precisely the missing or complementary management skills your organization needs to overcome temporary challenges and they assume management responsibility for an interim period. Drawing on their strategic and operational experience from assignments with other establishments and their unbiased outside perspective, our experts are ideally placed to guide your hospital through the challenges of transformation, deliver measurable results and create long-term value.

We tailor our interim management services to your individual needs. There are three basic models:

Interim management at CxO level
Our experts can take over the complete operational management of healthcare facilities on an interim basis as CEO (Chief Executive Officer), CRO (Chief Restructuring Officer), CTO (Chief Transformation Officer) or CFO (Chief Financial Officer); they can do this either in place of your previous executives or in addition to them. Our interim managers can also assume the official role of CEO or other board members to make them better able to enforce the necessary actions in the course of transformation projects or strategic realignments. This means they will act as key decision makers with full responsibility and all required decision-making powers, driving the necessary measures forward across the entire organization.

Alternatively, our interim managers can apply their broad-ranging experience of operations and strategy and take on specific functions or projects. In the role of interim CTO, for example, with a needs-based planning approach they can get numerous facilities working together. This can lead to the creation of regional hospital alliances or a merger between different hospitals.

Roland Berger IMPEX also provides support in cases where hospitals are in need of complete or partial restructuring, for instance to improve liquidity or operating profits or to initiate their long-term strategic evolution. Interim managers will then assume the role of CRO, where they will analyze the situation on the ground, develop a comprehensive restructuring plan and take responsibility for operationalizing it. If necessary, they can call in experts from our Roland Berger consulting team, including restructuring and healthcare specialists .

For all of these and other possible mandates, we will select the interim managers specifically so that their respective skills profile best matches your individual needs. We also work with leaders in healthcare facilities to develop precise action plans and monitor their implementation with regular action tracking. This guarantees a high level of certainty and enables us to take early countermeasures in the event of any deviations.

Transformation management
Interim managers from Roland Berger IMPEX support healthcare facilities in all types of transformation processes. In carve-outs or post-merger integration projects, they coordinate all relevant activities, making sure that transfer processes run smoothly and minimizing risks. In the case of a merger, closure or sale of hospitals or individual clinics, our experts will handle the planning – taking stakeholders, interfaces and dependencies into account – and develop suitable communication concepts to ensure successful implementation. When it comes to merger projects spanning different operators, the objective view of a CTO offers real added value.

Senior experts
Our healthcare experts have many years of experience, which they can also offer in a coaching role as senior advisors if required. In this role, they will support and advise your existing management or new executives on the ground, put together individual development plans and thus improve their overall performance. Senior advisors are situated outside of the formal organizational structure and work closely with top management, board members or owners. Their role also involves jointly evaluating and tracking progress and the achievement of objectives.

Case studies

Interim CRO for a district hospital

Situation: Two-thirds of German hospitals find themselves in a critical financial situation. They need to focus and prioritize so that they can at least cover their costs and keep providing their regional healthcare services. In our case, the hospital management had failed to implement important adaptations. Since productivity was also too low because of internal problems, the hospital's financial situation was continuously deteriorating.
Solution: An interim CRO from Roland Berger stabilized the business by taking on the role of executive director for nine months. Under his rigorous leadership, previously defined strategic measures were quickly implemented and further measures added. Proactive communication with all stakeholders was a key factor. The hospital's business operations were also reinforced with additional leadership personnel. This meant that they were able to plan and implement all further necessary measures without external support and develop a comprehensive strategy for the future.
Effect: Following the IMPEX team's deployment, the district hospital was once again available for patients 24/7, giving it a stable basis for further financial recovery. The staffing situation was fixed and the implementation of the transformation the hospital needed went largely unnoticed by the public.

Transformation of a hospital with uncertain prospects

Situation: The district hospital was in a critical situation, with minor financial losses caused by a large number of internal projects. But a lack of commitment and insufficient competency meant that these projects could not be delivered. The management was characterized by a CEO who was unable to maintain the trust and motivation of the workforce. In this challenging situation, Roland Berger helped the state authorities develop a plan for the future, and M&A talks were already in the works when the CEO decided to step down.

Solution: Following the CEO's departure, an experienced Chief Restructuring Officer (CRO) from Roland Berger took over the management of the hospital within just two weeks. Under his leadership, the business was stabilized by renegotiating service agreements and establishing close customer relationships. An ongoing transformation was also initiated and had a significant long-term impact on maintaining the specializations offered by the hospital.

Effect: The measures taken significantly improved the quality of service at the hospital, enabling it to resume serving patients 24/7. Customer relationships were successfully reinforced and expanded, leading to strong customer loyalty. As a result, the hospital's business situation stabilized, providing the basis for a positive future.

Leading the restructuring of a large German healthcare group during self-administered insolvency

Situation: A German healthcare company consisting of several hospitals and emergency services had revenues of around EUR 400 million and a workforce of some 5,500 staff. As a public entity, the company was faced with a tight liquidity situation and significant cash flow problems. The complex shareholder structure was an additional hurdle in this crisis situation.

Solution: An experienced CEO and a team of senior consultants delivered a comprehensive restructuring plan as part of the company's self-administered insolvency. The plan included stabilizing the business by increasing patient satisfaction and ensuring the rigorous management of relationships with doctors during the self-administered insolvency proceedings. At the same time, the team initiated an ongoing reorganization, resulting in a substantial reduction in staff numbers through an insolvency-related social plan. They also began an M&A process for the group to attract potential investors.

Effect: The measures implemented enabled the company to stabilize its business situation during the self-administered insolvency. Relationships with patients and doctors were successfully upheld, with a resulting positive impact on liquidity. In addition, the M&A process was initiated to support the restructuring program and facilitate the sale of the company to external investors.