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West Kendall Baptist Hospital: meeting the demand of community-based healthcare in the new (and stormy) regulatory environment

Miriam Weismann (School of Accounting, Florida International University, Miami, Florida, USA)
Javier Hernandez Lichtl (West Kendall Baptist Hospital, Miami, Florida, USA)
Heather Pierce (West Kendall Baptist Hospital, Miami, Florida, USA)
Denise Harris (West Kendall Baptist Hospital, Miami, Florida, USA)
Lourdes Boue (West Kendall Baptist Hospital, Miami, Florida, USA)
Cathy Campbell (West Kendall Baptist Hospital, Miami, Florida, USA)

Publication date: 11 September 2017



The first three years of operation of the West Kendall Baptist Hospital (WKBH) in Miami, Florida provided a “poster child” for efficient and cost effective healthcare delivery to the West Kendall community that it served. The hospital leadership and management team exemplified a quality-oriented staff that moved as a cohesive and dedicated organization. WKBH exceeded every budget prediction and showed a profit in year 3, well before expected. Then came the winds of regulatory change. With the passage of the Affordable Care Act (ACA) and the attendant imposition of new reimbursement metrics, the picture at WKBH changed almost overnight. By the first quarter of 2016, WKBH started to lose money in excess of budget predictions despite its increased patient admissions, careful financial planning, expense reductions, quality service, and excellence in patient care delivery. A serious financial crisis was looming with little relief in sight. The hospital management team began to search for solutions.

Research methodology

The research methodology includes collecting quantitative data: original financial statements and financial data from WKBH, as well as qualitative data: interviews of hospital administrators and historical information.

Relevant courses and levels

Graduate capstone course in a finance course; masters in health administration; and/or the MBA program.

Theoretical bases

While it is clear that the ACA was designed with all good intentions, it has created substantial and perhaps, unanticipated financial burdens for caregivers. These issues are not only faced by WKBH. Most hospitals could relate to one or more of the four questions examined as part of this learning process. Graduate MBA students worked with the hospital to identify, define, focus, and resolve difficult quantitative and qualitative issues faced by the hospital as a result of major changes in the regulatory environment with the passage of the ACA. This case focuses upon the current reimbursement environment that has only recently emerged as a result of the implementation of the ACA.



Disclaimer. This case is written solely for educational purposes and is not intended to represent successful or unsuccessful managerial decision making. The authors may have disguised names; financial, and other recognizable information to protect confidentiality.


Weismann, M., Hernandez Lichtl, J., Pierce, H., Harris, D., Boue, L. and Campbell, C. (2017), "West Kendall Baptist Hospital: meeting the demand of community-based healthcare in the new (and stormy) regulatory environment", , Vol. 13 No. 5, pp. 592-632.



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Copyright © 2017, Emerald Publishing Limited

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