How about a plan around indirect cost reduction, focusing on a Population age shift with growth of revenue generated from the indirect costs.
Clinic's when structured by the professionals have made money but are still indebted to the banker's. I know there are few leaders in this undertaking, with many years of background experience. And buying into this sector has not proved profitable, Kind of like the "Gossman's Matrix experiment" An octopus with no plan. My friend Doug said it best, kind of like herding Cats.