Flint, Mich.-based Insight Health System launched as a small physician office in 2006 and has evolved into a multistate hospital system with more than 5,000 employees and $450 million in revenue.
Now, Insight operates eight hospitals — five of which are nonprofit — across Michigan, Ohio, New Jersey, Iowa and Illinois, and is expected to grow at a rapid rate with more hospital takeovers in the works.
Insight recently took over operations of two Ohio hospitals and plans to acquire Coldwater (Mich.) Regional Hospital from Toledo, Ohio-based ProMedica.
"I started as a practice builder, which is uncommon for hospital operators, but this background has helped us develop a system that can address all elements of healthcare," Insight Founder and CEO Jawad Shah, MD, told Becker's. "This comprehensive understanding helps us quickly deploy service lines and make hospitals run efficiently."
Dr. Shah, a neurosurgeon, said Insight's definition of healthcare goes beyond hospitals and clinics: it extends into the community to address issues like social determinants of health.
"Our mission is to tackle these barriers by engaging with communities, especially focusing on youth," he said. "For example, through our work in Flint with Sylvester Broome Empowerment Village, we provide educational programs, transportation, computers and tutoring, aiming to change the trajectory for thousands of young people."
Insight's model has proven successful in areas such as metropolitan Detroit and Chicago, where it acquired the former 414-bed Mercy Hospital in 2021. Insight kept the hospital out of foreclosure, reestablished its emergency department and expanded service lines in areas including behavioral health, maternal health, neurosurgery and cardiology.
"What stood out to me in Chicago was how politically engaged the community was, from local politicians to people on the ground. We knew it was essential to involve the community, so we created a fiduciary board with community members to ensure transparency and include them in decision-making," Dr. Shah said. "This engagement helped us attract resources, both philanthropic and relational, which are often underestimated. Relationships are a powerful asset, and when people trust that you're ethical and keep your word, they become invested."
Dr. Shah said the key is to build a coalition of staff and community members who are equally invested in the success of the hospital.
"By leveraging local resources — human, financial and otherwise — we've been able to grow," he said.
Insight's first priority for its Chicago hospital was clinical safety, followed by regulatory and legal compliance, and then financial solvency.
"One of our strongest tools is our patient experience system, which allows us to address problems quickly. For example, when a patient had a disappointing experience early in the Chicago takeover, we spent hours resolving the issue, apologizing, and ensuring a better experience," Dr. Shah said. "This approach changed the culture, and our growth reflects that — while the industry averages 1.9% growth, we're at 37%, with more commercial patients coming to us due to our commitment to underserved populations."
"This isn't retail; it's healthcare. These institutions are vital parts of the community infrastructure, and mismanagement can jeopardize entire communities. Our approach is built on high ethical standards, community collaboration and transparency, unlocking tremendous resources."
Dr. Shah said this same strategy was present when Insight went to Trumbull, Ohio, where leaders and community members were eager to help because they trusted the organization.
"Reputation, collaboration and transparency are key assets for any institution, far beyond any financial strategy. It's a team effort," he said.
Earlier this month, Insight took over interim management of two Ohio hospitals — Warren-based Trumbull Regional Medical Center and Hillside Rehabilitation Hospital — from Dallas-based Steward Health Care. Steward's financial problems have been widely reported this year, and the system initially shared plans to close both hospitals in September.
"We've always operated with financial discipline. Our growth wasn't based on a grand financial plan — it evolved naturally," Dr. Shah said. "Now, we remain cautious about over-leveraging, understanding that separating property from the operating entity can cripple a facility. This approach has been crucial to our continued success."
Asked about where other health systems have gone wrong with hospital takeovers, Dr. Shah said it is often "often death by a thousand cuts" — many small issues adding up, not one big problem.
"The other key factor is the team, and our team has been exceptional," he said. "Many joined before completing their bachelor's, went on to get MBAs, and have developed internally. They work tirelessly, often 15-20 hours a day, and that dedication is a huge asset. We continue to attract talented people for those reasons, which is a critical part of our success model."
Insight's model includes both for-profit and nonprofit entities, but hospitals, as 501(c)(3)s, are meant to be public trusts that serve the community, according to Dr. Shah.
"This should be the core focus, even for for-profit hospitals," he said. "While there is exceptional leadership across the country — people from top universities with strong financial expertise — their priorities will differ if the goal is maximizing shareholder profit versus providing the best healthcare for the community while remaining solvent."
Of course, being financially savvy is also essential — without solvency, a hospital can't survive.
"But why not apply those financial skills to the 501(c)(3) model, where all profits are reinvested into the hospital? This approach drives growth and inspires others to contribute," he said. "The real question leaders in healthcare need to consider is: Are we aiming for great health outcomes, or are we simply another business focused on revenue? That difference in focus will shape decisions and, ultimately, the future of healthcare."
Like many healthcare leaders, Dr. Shah sees a massive change coming, driven by artificial intelligence and data analytics.
"It is becoming crucial in healthcare operations, similar to the internet's transformative impact. Many systems we interact with — government, billing and insurance — already use algorithms to process data, but we still rely on human intervention," he said. "That will change as AI takes over these tasks, working faster and more accurately than humans. It won't replace human touch, but it will redefine how we operate."
Another concern is the rise of tech oligopolies, with large companies consolidating power and creating less competition.
"A few years ago, I thought the biggest issue was facility management costs, but IT infrastructure — software, subscriptions and staff — has now far surpassed that. Many hospitals don't fully grasp the extent of this shift, and without control, IT costs could consume a large portion of resources," he said. "The final shift I see is in ethics. While financial incentives are a part of human nature, we must also prioritize ethical decisions in areas like access to care. These are not just ideals to hang on a wall, but issues we need to reflect on deeply to guide us forward."