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Growth Pains at Mountain States Healthcare


Mountain States Healthcare (MSH) is a regional system of hospitals located

in several large metropolitan areas of New Mexico, Arizona, Utah, Colorado,

and in Acapulco, Mexico. MHS started as a single hospital in Salt Lake City,

Utah, and, due to the business acumen and experience of its officers and

Board of Directors, was quite successful and profitable.

Over the years, Salt Lake Hospital began purchasing other hospitals and

clinics in the state that were not as profitably operated, and eventually

changed its name to Utah Health Group (UHG). Each facility continued to

operate as an independent entity, except that its name was changed to

include “Utah Health Group” and UHG instilled its own successful

management style in the newly purchased facilities. When a hospital was

bought in Denver, Colorado, the firm created a medical facility holding

company in Salt Lake City, named Mountain States Healthcare. MHS treated

each facility as a separate subsidiary, except for the clinics, which were

associated with a larger hospital in the area. MSH continued to grow, adding

facilities from the states it declared as its strategic area.

Later, they added a new division of several clinics, an assisted living facility,

and a hospital in the resort city of Acapulco, Mexico, to take advantage of

medical needs of the large tourist and American retirement population there.

The Mexico venture was the most profitable and fastest growing of the MHS


MSH was a profitable venture, but began to realize that some of its

administrative costs were, collectively, much higher than other medical

holding companies, and reducing the profits that could be used for the

benefit of shareholders. Additionally, the higher overhead costs were

affecting the advantage of some hospitals to compete within their districts.

The divisions had historically set themselves apart from other medical

facilities by offering a full line of specialties within their service packages.

The corporate holding company supported this by sharing resources,

technology, and even personnel between the divisions when needed. This

allowed each of the hospitals to position themselves as medical technology

competent full service providers.

A consulting firm pointed out several areas of administration which could be

consolidated, using the latest technology, to realize a tremendous reduction

in costs. The new VP of Finance, Aaron Nelson, newly promoted from the

state billing office manager’s position, suggested that medical billing should

be the first to consolidate. He reasoned that as each of the facilities had

consolidated the billing operations for all facilities within their five geographic

areas a few years ago, they should be able to completely consolidate all

billing with the latest database technology in a fairly short time, and

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