The Power of the Business Case

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By Jay Mazurowski, CRA, FAHRA

It’s becoming increasingly difficult for hospital executives to navigate the uncertainties of today’s healthcare climate. The financial challenges facing healthcare organizations today are multifactorial. Many are seeing shifts to higher percentages of government payers with more reductions in payment. Once-profitable hospital services are moving to outpatient venues, including physician-owned surgical centers and walk-in clinics. In addition, wages for healthcare professionals are on the rise while drug companies continue raising prices – outpacing the rate of healthcare inflation.

In the world of radiology, technology continually advances and many departments have millions earmarked in capital requests each year. But for hospital executives, access to capital dollars is increasingly challenging. Though many radiology capital purchases are revenue producing, now more than ever, radiology managers need to be strategic in their approach and planning for their capital projects, framing these requests into the larger organizational plans and goals.

Using a formal business case format can bring together the benefits, disadvantages, costs, and risks of the current situation and provide a future vision that is in line with organizational goals so that hospital administrators can decide if the project should move forward.

A typical business case begins with an executive summary or proposal objective statement describing the problem and/or opportunity and how it aligns with the larger organizational strategy. While this is the first section of the document, it is usually written last to ensure the content aligns with the body of the document and includes any last minute updates or changes. This section is the reader’s “first impression,” so you want to make sure you get it right!

The body of the proposal can be formatted in many styles, but should include headings such as:

  • Project background (current reality)
  • Options or alternatives (ie, stay with current technology)
  • Benefits (safety, improved clinical care, incremental growth, etc.)
  • Risks (and mitigation)
  • Financial implications – return on investment
  • Project timeline
  • Impact on operations (improved throughput, standardization, efficiencies)
  • Recommendation

Your written plan should be concise, clear, factual, and to the point with evidence to support your project statement. Include graphs and diagrams but make sure they’re clear and easy to interpret. It may be powerful to include a physician champion to co-author and/or co-present your proposal.

In your conclusion or recommendation, include a reminder of why it is important to address the problem with the action(s) that you want administrators to take. Clearly recap the salient points to underscore your proposal objective statement.

When it’s time to formally present your proposal:

  • Have both a short version and a longer version of your presentation ready, just in case they cut your allotted time or conversely ask for a deeper dive
  • Do not overwhelm the listeners with needless detail – keep it high level
  • Connect with your audience (ie, do not read from your slides)

A well-crafted business case will explain the problem or opportunity, identify options for moving forward, align with the organization’s goals, and allow decision-makers to decide the best course of action. In the words of Benjamin Franklin: If you fail to plan, you plan to fail.

Good luck!

Jay Mazurowski is the deputy executive director at AHRA. He can be reached at



One comment

  1. Well written! Short and sweet and clear — just the way the business case should be presented!

    Thanks for sharing this outline and thoughts!

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