Mission Drives Margin: A Former CEO’s Playbook to Fix Broken Healthcare

Healthcare Reframed

Rick Rawson on Healthcare Reframed

Production: Healthcare Reframed — Micah Buller | Todd Carpenter | Lindsay Swain Hunt

Rick Rawson explains why cutting costs and chasing transactions made hospitals weaker—and how a community-first, mission-driven strategy tripled revenue, rebuilt trust, and grew access across rural towns.

What You’ll Learn

• Escape the cut-to-survive trap with “make the hose bigger” growth

• Why consolidation erodes trust—and how to return power to communities

• Turning mission into margin (not the other way around)

• Practical examples: community clinics, CHWs with lived experience, cross-sector coalitions

• Governance that sustains strategy (purpose → metrics → accountability)

Episode Chapters

• 00:00 – Trailer and Introduction

• 02:08 – Early Leadership Challenges and Financial Realities

• 06:49 – Reframing Healthcare Challenges and Business Models

• 11:22 – Growing Revenue and Community-Centered Care

• 13:50 – Metrics, Productivity, and Strategic Growth

• 17:07 – Consolidation, Community Disconnection, and Systemic Challenges

• 23:25 – Capital Markets Influence and Nonprofit vs For-Profit Dynamics

• 28:33 – Leading Large Health Systems with a Community Focus

• 30:51 – Hospitals as Community Partners Beyond Clinical Care

• 34:00 – Pressure, Fear, and Leadership Accountability

• 35:54 – Systemic Power Dynamics and Community Empowerment

• 41:15 – Community Ownership and Trust in Healthcare Systems

• 43:30 – Fragility and Optimism in Healthcare Systems

• 47:08 – California’s CalAIM Program and Community-Based Care

• 51:13 – Leadership Gaps and Strategic Community Partnerships

• 54:30 – Balancing Government, Community, and Private Sector Roles

• 57:51 – Innovation at the State and Community Level

• 61:58 – Profitability Through Value and Integrated Care Models

• 63:10 – Personal Motivation and Commitment to Healthcare Reform

• 64:46 – Persistence and Collaboration for System Change

• 67:36 – Trust, Transparency, and Accountability in Healthcare

• 69:50 – Innovation, Movements, and Community-Led Change

• 70:53 – Future Outlook: Innovation and Scaling Change

• 73:19 – Coaching Leaders to Overcome Burnout Through Purpose

• 75:39 – Aligning Organizational and Individual Purpose

• 78:43 – Mission, Margin, and Authentic Leadership

• 80:36 – Nonprofit Governance and System Mentality Challenges

• 83:57 – Board Accountability and Courage in Healthcare Governance

• 86:06 – Case Study: Steward Healthcare Collapse and Lessons Learned

• 90:31 – Closing Reflections and Future Questions