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John R Reeves III, MHA

Field Notes

Plain language. Hard problems.

Physician compensation. Clinic development. The operating work behind a plan. These are decisions I have worked through with healthcare teams and Tribal leadership.

Explore the workMore essays

Consulting & operations, in practice

What needed to change, what we built, and what the work produced. Each example connects the practical decision to the people carrying it out.

Physician compensation

Make the compensation model explainable.

I translated compensation design into guides and worked examples that clinicians and finance teams could follow, from the inputs to the final check.

Read the physician compensation example
Three components. One explainable model.
  • Base payThe starting commitment
  • ProductivityA defined threshold and calculation
  • PerformanceFinancial, quality, and service expectations

Check the components against the stated target.

Workforce compensation

Model the work before setting the number.

An IHA workforce model connected role grades, workload, market comparisons, and starting placement, including positions that combine two roles.

The inputs behind a pay recommendation
  • RolePosition, grade, and workload
  • MarketTribal ranges and regional comparisons
  • PlacementEducation, experience, and documented judgment

A model for review. Decisions stay with the Tribe.

Read the workforce compensation example

Clinic development

Open in stages. Track each dependency.

A Tribal clinic launch kept patient care, workflow testing, and payer setup visible as separate responsibilities.

Readiness has separate workstreams
  • CareClinical workflows and testing
  • AccessTribal members, then broader access
  • PaymentContracts, enrollment, claim connections

Opening day does not close the readiness review.

Read the clinic development example

Consulting implementation

Put the operating work in place.

A clinic consulting engagement connected reporting lines, job descriptions, accessible procedures, and an implemented payroll and timekeeping process.

Connect responsibility to the daily process
  1. ResponsibilityReporting lines and job descriptions
  2. ProcessWritten procedures staff can access
  3. UsePayroll and timekeeping in operation

The process, its owner, and the work still ahead.

Read the consulting implementation example

Policy systems

Give every policy a place in the work.

An IHA project turned a requirements review into a completed policy library, with a crosswalk, practical forms, and defined ownership.

A policy handoff with the tools to maintain it
  • RequirementMapped to the relevant policy
  • PracticeSupported by logs and forms
  • OwnershipNamed roles and review cycles

Document completion and implementation are separate milestones.

Read the policy systems example

Clinic access

Build the schedule with the clinical team.

A rural clinic operating plan paired shared scheduling rules with specialty-level decisions about how care is delivered.

From clinical judgment to a working schedule
  1. DefineVisit types and appointment lengths
  2. BuildTemplates and same-day access
  3. MeasurePatients seen, not just scheduled

A clear measure before a performance target.

Read the clinic access example

Leadership decisions

Keep care working when the plan changes.

A pandemic-era telehealth decision put reliable visits ahead of a planned technology integration.

The telehealth tradeoff
  • Expected benefitIntegration with the clinical record
  • Observed problemAudio, joining visits, workflow
  • DecisionRetain the established platform

Make the tradeoff visible to leadership.

Read the leadership decisions example

More Field Notes

Practical essays on Tribal healthcare, leadership, and the systems that support care.

Have an operating problem to work through?

Tell me where the work stands and what needs to change.

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