1. IORA STRATEGY PROJECT
Conducted by Gates Associates, LLC, a business consulting firm composed of Jeremy Gates, Léa
Serrano, Tiffanie Stamper and Zack Williford
“Serving as strategic management for Iora Health’s expansion”

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TABLE OF CONTENTS
Executive Summary – Gates Associates, LLC.……………………….......….…… 3
Meetour Team…………………………………………………………………... 3-5
About IORA Health……………………………………………………………...… 5
Executive Summary of IORA Health Project………………………………....... 6-7
Statement of Problem ………………………………………………………..……7-8
ProposedSolution………………………………………………………..…….…9-15
Conclusion…………………………………………………………………….…15-20
References……………………………………………………………………..…… 21

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ABOUT GATES ASSOCIATES, LLC
Gates Associates, LLC, was established in 2016 in order to provide high quality professional
services to businesses seeking innovative solutions that analyze, identify and address potential company
issues or concerns. Our knowledgeable and passionate professionals collaborate in a synergistic
environment that enables us to provide the upmost service to our clients and has caused our business
model to thrive. We continue to deliver superior financial results to investors while contributing to the
communities in which we live and work. Our professionals specialize in using their expertise and
imagination as well as their creativity to seek ways to apply things that we, overtime, have explored in our
professional experience.
MEET OUR TEAM
Jeremy Gates
Senior executive with over 15 years of leadership and management
experience in private and public sectors including, manufacturing,
healthcare, government insurance and social service organizations.
Developed and implemented staffing strategies and programs that improved
operational outcomes and maximized the available staff resources.
Extensive experience in human resource planning and operations,
organizational change, team building, organizational effectiveness and
facilitative leadership. Performed operational and organizational audits that
aligned business requirements with staffing plans and processes to enhance

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teamwork, and team performance along with team creativity and
innovation.
Léa Serrano
Consultant expert with over 15 years of professional experience in several
countries around the globe. Fields of endeavor include but are not limited
to business growth and development, marketing, advertising and branding,
as well as employee management. Specialized in the restaurant and art
industries, Lea Serrano brings her creative and innovative approaches to
management styles to organizations all over the world. Traveling and
experiencing different cultures is her biggest passion - something she puts
to use during her consulting services in order to provide an international,
diverse and insightful environment for any organization that seeks to be
taken to the next level, all while remaining true to their brand.
Tiffanie Stamper
Accomplished and highly respected subject matter specialist in planning,
developing and implementing customer operational strategies, contact
center diagnostics, and business process reengineering efforts. Over 25
years of functional and consulting experience in the communications,
defense, distribution, entertainment, financial services, health services, state
government, transportation and utilities industries. Possesses excellent
working knowledge of overall customer management processes, operational
management processes, marketing, sales, order entry, distribution,

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collections, customer service, and face-to-face processes, as well as in
recruitment, human resource development and training.
Zack Williford
Distinguished consultant with over 12 years of management experience in
healthcare, private, not-for-profit, and international organizations.
Specializes in customer service and employee participation. Previously led
an organization into a profitable and stable international market business.
Excited to share knowledge and gain new insight.
ABOUT IORA HEALTH
Iora Health is an innovative health care company that emphasizes a new team approach to primary
care. Iora’s business model believes it can solve two major problems in America’s health care system: the
first is misalignment of financial incentives and social issues that hamper people’s health. In their model,
they provide care based on a flat fee per customer in contrast to the traditional piecework model that most
providers use. They are treating the patient using a care team to ensure no one falls through the cracks and
to provide not only medical care but also mental health and emotional support. They believe their rational
approach can thrive off the money currently wasted in the health care system if successful expansion
occurs using their current profit-making model (Sanger-Katz, 2015).
EXECUTIVE SUMMARY OF IORA HEALTH PROJECT
Referred by professor Mark Fitzgerald, Gates Associates, LLC and their most trusted business
consultants were ask to provide an analysis concerning a specific organizational behavior problem that
Iora Health is likely to face and our strategic management solution to that problem.

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Iora Health has retained our services in order to identify any potential organizational behavior
problems within its company and to provide strategic management solutions to that problem. They have
requested that we include clear action steps that can be taken by management to resolve this problem. Iora
Health desires to expand all while keeping customer satisfaction in addition to profits at an all-time
high. Iora’s expansion plan’s mission is to develop a standard formula and to allow its professionals to
experiment and adapt to local conditions. They have requested that the company’s proprietary electronic
medical records, the design of the consultation rooms and the daily huddle itself are not subject to change.
Gates Associates created and managed a synergistic team in which all members played a
significant role and made worthy contributions. Our synergistic team, gained insight into motivation,
goals, values, personality, communication and work habits. We collectively identified useful tools such
as useful assessments for employee selection, training, motivation, productivity and/or job assignment,
and identified effective management tools to solve the specific business problem faced by the company in
the case study: Iora Primary Care.
Gates Associates,
LLC.
• Syngergistic team consisted
of experienced professionals
Corporate Analysis
and Insight
• Motiv ation
• Goals
• Values
• Personality
• Communication
• Work Habits
IORA Health
• Will be provided a Performance
Management System that will be useful
for the following
• Employee Selection
• Training
• Motivation
• Productivity
• Job Assignment/Transfer
• These usefool tools will solve corporate
problems and guarantee safe and
successful development and expansion

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STATEMENT OF PROBLEM
Iora has set organizational goals that it hopes to achieve in the medium-to-long-term future
(Raymond, 2013). A main goal is to disrupt the current model of primary care delivery and to reduce
health care spending by placing a greater emphasis on primary care which prevents costly emergency
room visits and hospital admission along with fixing the inefficiencies that occur in traditional health care
practices here in the United States. The founder Dr. Fernandopulle’s strategy is to take something small and
effective and reproduce it in office after office (Sanger-Katz,2015) but in order to accomplish this you must seek
to gain a competitive advantage through your employees and must be able to manage the behavior and
results of all employees (Raymond A. Noe, 2013). Doing so will ensure that Iora’s current expansion
strategy effectively and successfully transform the health care system throughout the United States in the
ideas of its founder.
After careful analysis and with extensive collaborations with human resources, our business
consultants, as requested, have determined that Iora’s great ideals are feasible. However, implementing
an unconventional practice throughout the United States will require strategic management. In today's
competitive markets, organizations must engage in strategic planning to survive and prosper (Raymond
A. Noe, 2013).
Desire to
expand
• Pressure from
corporate to comply to
fixed and replicated
rules
Problems
faced along
the way
• Disassociation betw een
corporate desires and
actuality of local
environment and
individuals at each IORA
medial office location
• Employees’ misalignment
w ith organizationalgoals
and objectives
Decreased
productivity

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We as your business consultants have thoroughly performed an SWOTanalysis and have foreseen
a problem that will need to be address in order for Iora to transform health care. We will clearly address
both the problem and the steps to liberate the foreseen problem. Here is what our research has shown.
There have been several innovative and successful new primary care models, but few have grown beyond
1-2 clinics (Sanger-Katz, 2015). However, we see a key distinction that separates Iora from the rest. You
have fundamentally changed your operating models. Your operating model is aligned with your business
model, and that is – the “triple aim” of improving patient experience, clinical outcomes, and affordability
of care – through its unique delivery model. Since you have provided such beautiful architectural work,
we feel only right to provide you with a solution to get the best out of your constructors.
IORA faces productivity issues that arise as expansion occurs in regards to the disassociation
between corporate desires and the actuality of local environment and individuals at each IORA medial
office location. More specifically, in order to solve the problem of the employees’ misalignment with
organizational goals and objectives, Gates Associates, will organize and implement a performance
management system favoring strategic congruency.
Strategic management is a process, an approach to addressing the competitive challenges an
organization faces. It can be thought of as managing the “pattern or plan that integrates an organization's
major goals, policies, and action sequences into a cohesive whole” (Raymond A. Noe, 2013).
In order to accomplish realignment, Gates Associates performance management system will
provide a clear understanding of job responsibilities and expectations, which will result in increased
productivity and better information available to corporate to use for training, job experiences, and
developmental activities, thus allowing desired effective corporate expansion. It can also be used as a
basis for compensation, pay increases, promotions, transfers, and assignments. It is imperative that
corporate executives understand and apply this performance management system thoroughly in order to
for it to be effective. This system will be overseen and managed by a corporate liaison who will be in
direct contact with both corporate executives and employees at all IORA medical offices locations.

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PROPOSED SOLUTION
With no other elaboration, Gates Associates is concerned about some productivity issues that may
occur with regards to you expanding. We see this all the time. A company has great ideas. It works within
their current chain of stores, so they seek to expand. Attempting to manage the additional store or facility
they lose sight of their original ideas because it’s a lot tougher communicating and tracking nonnegotiable
job requirements in facilities in an expansion mode than in your current state. Thus, as Professor Milstein
points out, running one unconventional practice and keeping it great is very different from running 100
(Sanger-Katz, 2015). In continuation, by this being an unconventional practice, our business consultants
are concerned that a dissociation between corporate desires and actuality of local environments and
individuals will eventually occur as Iora expands into new territories and opens new medical offices.
We are proposing a solution in the form of a strategic congruence plan that will increase
productivity and prevent this dissociation from occurring. A strategic congruence is the extent to which a
performance management system elicits jobs performance that is congruent with the organizations
strategy, goals and culture (Raymond A. Noe, 2013). Since Iora’s emphasis is on its unique delivery model
that is centered on monthly fees as opposed to the conventional way of billing patients, we have put
together a plan that focuses on those important elements. Our plan encourages workers to positively view
those elements by implementing a reward plan that encourages those behaviors. Our plan increases
productivity, prevents employee misalignment, and could save you money because our performance
management system provides for clear understanding of job responsibilities and expectation that can be
implemented on a large scale. Our plan facilitates Iora’s ability to transfer something small and effective
and reproduce it in office after office. In addition our plan can also be a basis for pay increases, promotions,
transfers, and individual assignment rewards. We have laid out the particulars, and it is imperative that
corporate executives understand and apply this performance management system thoroughly. In order for

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this performance management system to be effective, this system will be overseen and managed by a
corporate liaison who will be in direct contract with both corporate executives and employees at all lora
medical offices locations.
Our plan is centered on Iora’s care teams’ expectations. A team of a doctor or nurse practitioner,
nurse, behavioral health specialist and a health coach works with each person. They set goals with the
patients, enabling them to become active participants in their own well-being. They should know people
by name, but more importantly by their dreams, fears and challenges (Iora Health, 2016). “We believe it’s
easier for patients to manage their lives when mental health is also prioritized and seen as integral to one’s
overall health. At Iora, our patients can access their own behavioral health specialist in the comfort and
privacy of their doctors’ office (Iora Health, 2016). Individual team members also have goals:
 Doctor/ Nurse practitioner: Individual clinical assessments of each patient through examination
and communication to provide medical health goals.
 Nurse: Cares for patients, administers medicine and supports communication between doctors and
patients.
 Behavioral health specialist: Provide short-term counseling, assessments and referrals, as well
as consultation to other team members.
 Health coach: Build relationships between the patients and their care teams by connecting deeply
with patients by becoming their confidants, cheerleaders, and friends (Iora Health, 2016).
Care Team
Doctor/Nurse
Practitioner
Nurse
Behavioral
Health
Specialist
Health Coach

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CARE TEAM PLAN
Patient satisfaction is determined based on three factors: How the patient rated their provider, how
much time they felt the provider spent on
them, and how well their health care
goals were discussed.
If a team exceeds the patient
satisfaction (average of three percentages
on website) IORA’s average of 80%, then
the patient care team will receive a team
dinner within one week of the quarterly
Elements of Strategic Congruency Plan to be
oustandingly met by Care Team
Patient
experience
and
satisfaction
Reward>80%=
Team Dinner
Iora Avg >
Performance =
Corrective actions
Industry Standard >
Performance=
Termination, Job
Transfer,
Assighnments,
reduced
Engagement
Reward>25%=
Non-Financial
Iora Avg >
Performance =
Corrective
actions
Industry Standard >
Performance=
Termination, Job
Transfer,
Assighnments,
reduced
Access
Reward> Iora's
standards
Non-Financial
Iora Avg >
Performance =
Corrective
actions
Industry Standard >
Performance=
Termination, Job
Transfer,
Assighnments,
reduced
Clinical
outcomes
Reward> Iora's
Standards
Non-Financial
Iora Avg >
Performance =
Corrective
actions
Industry Standard >
Performance=
Termination, Job
Transfer,
Assighnments,
reduced
Coordination
of care
Reward> Iora's
Standards
Non-Financial
Iora Avg >
Performance =
Corrective
actions
Industry Standard >
Performance=
Termination, Job
Transfer,
Assighnments,
reduced
PROV IDER RA TING OF 9 OR
1 0
SA ID PROV IDER A L WAYS
S PENT ENOUGH TIME
DISSCUSED HEA L TH CA RE
GOA L S
18%
35%
21%
75%
89%
77%
PATIENT SATISFACTION
Industry Standards Iora Averages

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report, which increases corporate morale and increases employee satisfaction and motivation. If
performance falls below IORA averages/standards corrective actions in the form of developmental
activities and training will take place. The consequences if performance falls below industry
averages/standards could be termination, job transfer, additional assignments, or reduced compensation.
If a team’s patient engagement exceeds
Iora’s average of 25%, a non-financial
compensation such as recognition that leads to
increased motivation and employee
satisfaction will be rewarded. If their
performance falls below Iora’s
averages/standards, then corrective actions
will be implemented in the form of
developmental activities and training. The consequences if performance falls below industry
averages/standards could be termination, job transfer, additional assignments, or reduced compensation.
If as a team they provided their patients access to useful resources, produced clinical outcomes or
had coordination of care that exceeds Iora’s averages or standards then a non-financial compensation such
as recognition that leads to increased motivation and employee satisfaction will be rewarded. If their
performance falls below Iora’s averages/standards, then corrective actions will be implemented in the
form of developmental activities and training. The consequences if performance falls below industry
averages/standards could be termination, job transfer, additional assignments, or reduced compensation.
If a team manages to achieve the quarterly bonus reward for all 5 elements of our strategic
congruency plan, across three consecutive quarters an additional bonus may be rewarded in the form of 3
extra paid days off that can be taken at the individual team member’s discretion.
2%
25%
0% 5% 10% 15% 20% 25% 30%
INDUSTRY AVERAGE
IORA
Patient Engagement
Industry Average Iora

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INDIVIDUAL TEAM MEMBER PLAN
An individual team member’s performance assessment is based on provider ratings, time spent
with patient, and discussed health care goals. This information is received by the corporate liaison and is
provided through customer surveys.
If a team member’s patients rate them a 9 or 10 for the quarter then that member will receive
recognition in their practice and receive a small financial incentive such as a gift card or voucher. If the
member is rated a 9 or a 10 throughout all four quarters the team member will receive an end of the year
bonus according to team member’s merit. If a team member is a 6 or 7, they will receive training in order
to prevent member from falling below average. If member is rated lower than a 5, member will receive
warnings that can result into termination if performance does not improve over time.
Individual team members will receive recognition in team huddles and entered into special
drawings for financial incentives if their time spent with patient exceeds Iora’s standards. If member is at
or falls below Iora’s average then they will receive training in direct relation to level of customer
satisfaction concerning time spent with their patients. Meaning the higher the score the less training, the
Individual Team
Member
Performance
Assessment
Provider rating
Time spent with
patient
Discussedhealth
care goals

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lower the score the more training the team member will be required to attend. Consequences if member
falls below healthcare industry average is verbal warning with additional training and if continues across
multiple quarters may result in termination.
The reward for team members who discussed health care goals with their patients and exceeded
Iora’s standards will be recognized in team huddles and entered into to win special financial incentives in
the form of a drawing. If a member is at or falls below Iora’s average they will receive training in direct
relation to level of customer satisfaction concerning health care goals. Meaning the higher the score the
less training, the lower the score the more training the team member will be required to attend.
Consequences if member falls below healthcare industry average is verbal warning with additional
training and if continues across multiple quarters may result in termination.
CORPORATE LIAISON
We also more clearly defined the corporate liaison’s responsibility within and outside the
organization. The corporate liaison will work from Iora’s existing headquarters where they will provide
technical, staffing, and operations support to practices across the country. The liaison will go into branches
when there are specific problems to be dealt with that have been consistently reported to corporate and
resolve them, as well as evaluate corporate performance standards. Based on these standards, they will be
able to enforce the rules of the congruency plan.
CONCLUSION
Interpretation of Findings
In supposition, Iora an innovative health care company that emphasizes a new team approach to
primary care seeks our expert advice as they expand. Moreover, Iora’s goal is to disrupt the current models
of primary care delivery and reduce health care spending by placing a greater emphasis on primary care
to prevent costly emergency room visits and hospital admission. Iora seeks to accomplish this by aligning

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their business model with their operational model, which is – the “triple aim” of improving patient
experience, clinical outcomes, and affordability of care – through its unique delivery model approach.
With that approach, Iora seeks to fix the inefficiencies that occur in traditional health care practices
here in the united states by taking something small and effectively reproduce it in office after office, which
in theory would solve two major problems in America’s health care system: the first is misalignment of
financial incentives and social issues that hamper people’s health.
In their unique business model, Iora provides care based on a flat fee per customer in contrast to
the traditional piecework model that most providers use. Iora’s aligned business model allows its care
team members to fully focus on its patient, and provide a service that is incomparable to the less stellar
practices provided through traditional practices.
Implementation of Findings
To better understand the Iora’s expansion leading mangers and Iora’s operational managers’ ability
and limitation we had all managers answer a few self-assessments which can be found in Stephen P.
Robbins Self-Assessment Library “Insights into your skills, interest and abilities”. These assessments give
insight on Iora’s abilities to expand while keeping their “triple aim” approach. We chose the assessments
which would be the most helpful and aid our business consultants in customizing our solutions plan to the
strength of Iora’s employees. Here are those assessments:
 How good am I at disciplining others? (Page 62)
 This test is used to provide insight into how effective a person might be in practicing
discipline in the work place (Stephen P. Robbins, 2012). It contains eight disciplining
practices, managers needed to read the statements and select the answer that best
described them. They were asked to respond as they have or would behave and not as
they think they should behave. (Stephen P. Robbins, 2012). The following scale was
used to express their response: 1= Usually, 2= Sometimes, 3=Seldom.

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 The ideal manager that provides effective discipline would provide ample warning,
act in a timely fashion, use a calm and serious tone, be specific about the problem,
keep the process impersonal, and use disciplinary action that is progressive and
consider the circumstances (Stephen P. Robbins, 2012). An ideal manager would
score 22 or higher, with anything below 19 possibly needed additional training.
 Results: Iora managers scored an average of 18 and this means that on average
managers in an Iora health care facilities do not have the best practices for
disciplining its employees on a local level.
 Based on these results our business consultants felt strongly that Iora needed an
outside contact to provide training and support on a regular basis to branch
managers. These support task would include technical, staffing, and operations
support. This translated into the corporate liaison position we recommended to Iora.
 How good am I at building and leading a team? (Page 64)
 In this test managers used a rating scale to answer 18 questions on building and
leading an effective team. The following scale was used: 1= Strongly disagree, 2=
Disagree, 3=Slightly disagree, 5=Agree, 6=Strongly agree (Stephen P. Robbins,
2012).
 This assessment assumes that teams develop in 5 areas: diagnosing team
development, managing the forming stage, managing the conforming stage,
managing the storming stage, and managing the performing stage. The results can
estimate where a manager is compared to others with the top quartile being 95 or
above and the bottom quartile being below 60 (Stephen P. Robbins, 2012).
 Iora’s managers scored an average of 84 and this means they know how to build
effective teams, which will be extremely important as Iora expand. According to
Robbins & Judge, 2012 a team generates positive synergy through coordinated

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efforts. The individual efforts result in a level of performance greater than the sum
of those individuals inputs making it extreme important that Iora continues to
increase its abilities to build such great teams as they lead and build new established
care teams throughout the expansion process.
 Based on these results Gates associates wanted to encourage the teams to continue
to work with excellence and strive to be better as a whole. We built into our
congruency plan specific rewards and consequences to the patient care team based
on their team performances.
 How confident am I in my abilities to succeed? (Page 102)
 Managers were to indicate the extent in which they agreed or disagreed to 8 different
statements. The following scale was used: 1=strongly disagree, 2=disagree, 3= neutral,
4=agree, 5=strongly agree (Stephen P. Robbins, 2012).
 People who are confident have high-self efficacy that generalizes across a variety of
situations (Stephen P. Robbins, 2012). Confidence or lack of it can have influence on
many things we do (Stephen P. Robbins, 2012). The scores on this assessment can
range from 8 to 40, higher the score, high the confidence you have in yourself to be
successful.
 Iora’s managers scored an average of 34. Meaning although you have some outliers the
group as a whole are confident individuals.
 The goal of Iora to expand means it needs confident individuals to make up their patient
care teams. A confident individual will set goals for themselves and push harder in the
face of failure. One other key feature of a confident person is even when they receive
negative feedback they respond by increasing their effort and self-motivate to do better
(Stephen P. Robbins, 2012). If an individual is not confident it doesn’t mean they

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cannot become more confident. Managers can use trainings and tasks to increase
confidence in a team member.
 Using information gathered through this assessment about Iora’s existing managers and
about the role confidence plays in an individual’s ability to succeed we came up with
our congruency plan concerning the individual members of each patient care team.
Recommendation from Findings
Strategic
Congruency
Plan
• Rewards and punishes care team based on their perf ormance in core areas of IORA's expectations and high
standards:
• Patient experience and satisf action
• Engagement
• Access
• Clinical outcomes
• Coordination of care
Implementation
• Encourages workers to positiv ely v iew the abov e-mentioned key elements by implementing a rewards plan that
encourage those behav iors
• Indiv idual perf ormance rating will be based on:
• Prov ider rating
• Time spent with patients
• Discussed healthcare goals
Increased
Productivity
• Prev ents employ ee misalignment
• Increase corporate morale
• Sav es money

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 Strategic congruency plan- the extent to which a performance management system
elicits jobs performance that is congruent with the organizations strategy, goals and
culture (Raymond A. Noe, 2013).
 It rewards and punishes a care team based on their performance in core areas
of Iora’s expectations and high standards:
o Patient experience and satisfaction
o Engagement
o Access
o Clinical outcomes
o Coordination of care
 Individual performance rating will be based on:
o Provider rating
o Time spent with patients
o Discussed healthcare goals the appropriate actions
Rewards/consequences.
 Implementation of the corporate liaison - Because Iora’s managers on average scored
less than what we would have liked to have seen, we have determined that one of the
requirements for the corporate liaison position is to have scored a 22 or more on “-How
good am I at disciplining others”? Assessment because he or she is to oversee and manage
our entire congruency plan. The corporate liaisons will be in direct contact with both
corporate executives and employees at all Iora health locations.
 Reward system-is a strategic tool that will motivate Iora’s employees to willingly meet
Iora standards. According to Robbins & Judge, 2012, motivation is the process that
accounts for an individual’s intensity, direction, and persistence of effort towards attaining

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a goal. Our rewards plan was implemented to incentivize employees that met or exceeded
company standards, which eludes any misalignment between corporate desire and
individuals as you seek to expand.
 It highly favors representative participation. According to Robbins & Judge,
2012 representative participative is goal that redistributes power within an
organization, putting labor on a more equal footing. Thus, ensuring that your
doctors continue their rolls as intended by you and ensuring they don’t become
too dominate.
We recommend that every detail in the above-mentioned plan be followed as laid out. Following
our strategic congruence plan will lead Iora to competitive advantages such as:
 Prevention of employee misalignment (Resulting in increased productivity)
 Increase corporate morale
 Saving of money
REFERENCES
Iora Health. (2016, March 10). Retrieved from Restoring Humanity to Health Care- Iora Health:
http://www.iorahealth.com/
Raymond A. Noe, J. R. (2013). Human Resource Management: Gaining a competitive advantage. New
York: The McGraw-Hill Companies.
Sanger-Katz, M. (2015). Company Thinks It Has Answer for Lower Health. The New York Times, 9.
Stephen P. Robbins, T. A. (2012). Essentials of Organizational Behavior. New Jersey: Pearson.

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