A large academic healthcare system had a service line that was seeing significant erosion of their service income, problems with service delivery and a failure of their clinical and hospital operations to work effectively together. a^squaredm senior management personally engaged with hospital and clinical management to review the issues, suggest a series of changes to the financial management and operations, including changes to physician compensation, re-structuring of hospital management and improvements to regulatory compliance that gave the client a pathway to turn around the service line and expand patient capacity.