Startups & De Novo Development
Aava Healthcare Management Group takes a healthcare venture from concept to stabilized operations — one accountable team across feasibility, licensure, clinical design, systems, staffing, and opening.
What the solution exists to solve
A new healthcare organization must solve everything at once: a licensable clinical model, a fundable financial model, a buildable facility, an employable team, a billable payer footprint, and a referral network that does not yet know it exists. Founders who assemble these through separate consultants inherit the seams between them — and the seams are where openings slip, budgets break, and first surveys fail. Aava develops the venture as one integrated build under one accountable owner.
Direct operating responsibility
- The integrated development plan and its single master timeline
- Licensure and regulatory pathway from application to approval
- Clinical model, staffing plan, and policy infrastructure
- Financial model, opening budget, and cash plan through stabilization
- Systems, billing readiness, and payer enrollment before day one
- Opening operations and the ramp to sustainable census
What the engagement covers
Business Model and Feasibility
Before capital is committed, Aava pressure-tests the concept: market demand, competitive saturation, reimbursement by payer, workforce availability, regulatory pathway, and realistic ramp economics. The output is a decision — proceed, reshape, or stop — supported by numbers ownership can defend to investors and lenders.
Licensing Roadmap
Licensure drives the calendar of everything else. We map the jurisdiction's requirements, sequence applications against facility and staffing dependencies, prepare submissions to approval standard, and manage regulator correspondence — so the license arrives when the building, the team, and the payers are ready to use it.
Clinical Program Design
The clinical model is designed for the population to be served and the standards it must meet: levels of care, programming and schedules, clinical staffing and supervision structure, documentation standards, and the medical and clinical leadership roles the license and payers require. Design decisions are made with reimbursement and survey requirements in the room.
Financial Model and Pro Forma
We build the operating pro forma from evidenced assumptions — ramp curve, payer mix, rates, full staffing costs, and pre-opening spend — and stress-test it against slower and worse cases. The model becomes the venture's financial operating plan: the budget, the cash forecast, and the milestones lenders and investors track.
Staffing and Organizational Design
The opening organization is designed before it is hired: structure, roles, spans, credential requirements, and a recruiting timeline that lands licensed staff when licensure and training require them — not weeks after. Onboarding and competency programs are built so the first team opens trained to standard.
EHR and Systems
Systems are selected and configured around the designed workflows: EHR, billing, scheduling, HR, and the integrations between them. Because the build starts clean, the venture avoids the legacy compromises that burden established organizations — and opens with data governance and reporting in place from the first patient.
Policies and Procedures
The full policy and procedure library is developed against licensure and accreditation standards and against the actual designed workflows — not adapted from another organization's binder. Documents are version-controlled and tied to training records, so day-one compliance is demonstrable rather than asserted.
Accreditation Readiness
Where accreditation is required by payers or strategy, readiness is built into the launch rather than scheduled after it: standards mapped to processes and evidence, mock surveys before the real one, and the survey cycle managed to the earliest achievable date — because accreditation timing often gates the payer contracts the pro forma assumes.
Revenue-Cycle Setup
Billing readiness is a launch dependency, not a post-opening project: payer enrollment and credentialing started early enough to be effective at opening, charge structures and clean-claim workflows configured and tested, and collections discipline installed from the first statement. The first month's care should produce the first month's revenue.
Go-to-Market and Referral Development
Census does not attend the ribbon-cutting. Referral development begins months before opening: source mapping, relationship building, admission criteria communicated clearly, and marketing that generates appropriate, compliant demand. Intake is staffed and rehearsed so the first referrals convert — first impressions with referrers are not recoverable.
Opening and Stabilization
Aava operates the opening and the fragile months after it: daily management of census, staffing, documentation, and cash; rapid correction of what the design got wrong; and a deliberate hand-off to permanent leadership — or continuation under a managed or enterprise engagement — once performance stabilizes against the pro forma.
Representative mandates and measures
Representative mandates
- Develop a behavioral health facility from feasibility through licensure, opening, and stabilized census
- Build the operating infrastructure for a funded startup whose founders hold the clinical vision
- Rescue a stalled de novo project with a slipping timeline and unresolved licensure path
Measures of performance
- Licensure and accreditation milestones achieved on plan
- Opening date held against the master timeline
- Ramp census and payer mix against the pro forma
- Pre-opening and ramp spend against budget
- Days-to-billable for the opening clinical roster
How this solution engages
De novo development typically begins as a defined initiative (feasibility and planning), becomes a managed program through build and opening, and may transition to enterprise management through stabilization.
Owners, boards, and investors evaluating this kind of mandate who need an accountable operator to lead it, not an advisor to describe it.
Behavioral health · Substance-use treatment · Mental health services · Ambulatory and outpatient care · Specialty healthcare
Adjacent capabilities and solutions
Tell us what needs to change.
Whether it is a single department or an entire enterprise, we will tell you plainly what we would operate, how, and what it would take.