Every healthcare executive in America knows the numbers by heart. Costs are climbing faster than reimbursements. Labor shortages drag on. Inflation keeps pushing the price of everything from surgical gloves to software. Meanwhile, the expectation never changes: improve patient outcomes and make life better for the people delivering the care.
That is the paradox of the modern health system; doing more, with less, without breaking the people or the mission in the process. Strategy is rarely the problem. Execution is.
Across decades of work with health systems, we have seen one approach deliver measurable, repeatable results when traditional initiatives hit a wall. We call them “breakthrough projects.”
A breakthrough is not an improvement plan. It is a result that seems impossible to achieve within current models and mindsets. It is the difference between shaving a few minutes off average length of stay and fundamentally rethinking how patients move through the continuum of care. It is the leap that turns “what if” into “what now.”
Breakthrough projects are built for the realities of today’s health systems; mission-driven, compliance-heavy, and perpetually under pressure. Each project begins with a bold, quantifiable outcome and a clear champion at the top. A small, cross-functional team commits to that outcome together, not as representatives of departments but as stewards of a shared result. They work with speed, accountability, and a refusal to accept the usual excuses that stall change.
The structure may sound simple, but the discipline is relentless. Every assumption gets challenged. Every process is up for redesign. The goal is to deliver results that defy precedent while preserving the integrity of care.
That matters more than ever. In 2025, operating margins across U.S. health systems narrowed to historic lows. Several states have enacted reimbursement cuts ranging from three to ten percent, just as expenses continue to rise nearly eight percent a year. Bad debt and charity care are climbing, and the burden of prior authorizations grows heavier by the month. Clinician burnout still affects nearly half of physicians. In this climate, incremental change is not enough.
Breakthrough projects were designed for precisely this kind of turbulence. They replace slow, risk-averse improvement cycles with a model that rewards urgency and collective ownership. The results speak for themselves.
Case in point: A major U.S. regional health system partnered with Insigniam to confront a persistent gap in performance. Its quality scores were average. Readmission and mortality rates hovered below national benchmarks. Patient satisfaction lagged behind peers. The leadership team decided to go after a result that, at the time, seemed unrealistic—to rank among the top ten percent of systems nationwide in quality, service, and cost within a decade.
More than nine hundred physicians, nurses, and staff joined the effort. The project became a proving ground for a new culture: one built on trust, transparency, and a bias for action. Five years later, the system had climbed from below average to the top decile in both readmission and mortality metrics, according to federal data. Patient satisfaction rose from the twenty-second to the seventy-second percentile. Employee engagement surged. Even more striking, the organization maintained a healthy four-to-six percent operating margin through the entire transformation.
Those numbers tell a story bigger than performance. They show what happens when a system stops treating cost, quality, and experience as competing priorities and starts pursuing them as a single outcome. The real breakthrough wasn’t in a spreadsheet; it was in how people thought and worked together.
We have seen the same dynamic in other systems that adopted the model. Emergency departments have slashed throughput time without adding staff. Care-coordination teams have reduced cost per case while improving throughput and satisfaction. Leaders who once hesitated to experiment now build new operating models around AI-enhanced scheduling and predictive analytics. The technology is not the hero; it is an enabler for a workforce newly aligned around what matters most.
Breakthrough projects succeed because they marry two forces that rarely coexist in healthcare: disciplined structure and creative freedom. The framework keeps teams focused; the culture invites invention. It is this balance—between rigor and imagination—that allows organizations to execute at the speed today’s environment demands.
After thirty-five years of helping enterprises deliver results once thought impossible, we have learned that transformation is less about what a system knows and more about what it believes is possible. In healthcare, that belief can feel fragile. The weight of regulation, tradition, and fear of failure can silence even the boldest ideas. But once a team experiences a breakthrough—once they see that extraordinary results are achievable within the same constraints—they rarely go back.
Healthcare systems are, at their core, communities of purpose. Every clinician, administrator, and executive entered the field to make a difference. Breakthrough projects reconnect people to that purpose by proving that excellence and economy can coexist. They turn hesitation into momentum, and momentum into measurable change.
The future of healthcare will not be written by the systems that have the best strategy documents or the most advanced analytics. It will be written by the ones that can move—fast, focused, and aligned—when the stakes are highest.
In a sector where lives and livelihoods are on the line, transformation cannot wait for perfect conditions. Breakthrough projects give health systems the means to act decisively, deliver boldly, and achieve what once seemed out of reach—without ever compromising the care that defines them.
Shideh Sedgh Bina brings over 35 years of experience advising C-suite leaders and large health-systems on enterprise-wide transformation. She has been named one of PharmaVOICE’s 100 Most Inspiring People in Life Sciences and the Healthcare Businesswomen’s Association’s Woman of the Year. For more information, visit Insigniam.com.
