Published clinical finding
38.5%Lower-acuity choice after intended ED care
Published external evidence — not an outcome of the advisory engagement.
01 · Business Challenge
The original model estimated about $300K in annual value from low-acuity ED avoidance. That number was real, but it answered only one question. Health system CFOs evaluating a $1M+ multi-year license typically required a 3.0x to 5.0x hurdle rate, meaning $3M to $5M+ in created value. A $300K annual return fell well short of that gate.
View the business challenge details
02 · Executive Mandate
Vendor leadership needed a model that kept ED (Emergency Department) avoidance but added acquisition, access, care-setting and reimbursement pathways, each localized to the buyer's population, payer mix, utilization, cost and access conditions.
View the mandate requirements
03 · Work Addressed
Decision shift: one headline ROI number became four separable pathways buyers could localize, challenge and sensitivity-test. The model made the economics reviewable across finance, clinical, digital and operating leadership for a $1M+ enterprise license decision.
04 · Accountable Review
Historical data showed only 6% of patients who completed an online assessment immediately scheduled an appointment. InteliGems modeled a 15–25% conversion scenario, informed by competitor benchmarks. Capturing those additional appointments depended on health system owned capabilities: open provider schedules, real-time patient–provider matching, and timely follow-up. Framing the business case around those shared operational levers shifted vendor–executive discussions from a single-driver software sale to a collaborative business case focused on patient acquisition and joint revenue realization.
View modeled scenario finds revenue opportunities
05 · Operating Insight
The model became useful when each executive could interrogate the assumptions that affected their part of the decision. Finance, clinical, digital and operating leaders did not need the same proof, but they needed to test the same value case.
Finance
Clinical
Digital & Access
Operations
06 · Clinical Validation
Later peer-reviewed evidence supported the care-navigation behavior treated as economically important in the value architecture.
Published external evidence — not an outcome of the advisory engagement.
View the detailed evidence
07 · Advisory Relevance
A single ROI claim rarely carries an enterprise decision on its own. The review showed that one headline number becomes more credible when it is broken into clear value drivers, each tied to an operating lever, an economic outcome, and an accountable owner. That structure helps buyers see what matters, question assumptions, and decide what must be true before making a broader commitment.
WHAT CHANGED
The redesign kept the original ED-avoidance logic visible, but placed it inside a broader value structure that also included acquisition, access, care-setting, and reimbursement. Instead of asking buyers to accept one headline ROI number, the model showed where value could come from, what assumptions shaped it, and who would need to own each part.
A single ROI number can hide what actually drives the decision. Break the value case into separate drivers first.
Each driver should map to an executive or operating owner who can validate the assumptions behind it.
Modeled value is more useful when leaders can see what has to be true operationally before relying on it.
View the Health System Value Driver Tree
FOUR TRANSFERABLE CONSTRUCTION STEPS
Start with the enterprise commitment being evaluated, not a single product feature or isolated operating metric.
Break the case into clear economic drivers so each pathway can be reviewed on its own terms.
Show which variables change the answer—population, payer mix, utilization, cost, access, workflow, or market conditions.
Historical inputs, modeled scenarios, trials, and published findings can all inform one decision without representing the same level of proof.
When important decisions need operating experience, get principal-led support.
Principal-led advisory and operating leadership for executive teams facing consequential AI, governance, transformation, commercialization, and recovery mandates.
advisory@inteligems.io
