Structural Deficit
Structural Deficit
Structural Deficit Market Archetype Mechanical Natural
Tier
Priority Review
Trajectory Thumbprint

Structural Deficit

What does this mean?

Persistently low financial health over 5 years despite strong programmatic output. They are borrowing from their future (or bleeding an endowment) to pay for today's programs.

The Path Forward

The Truth-Teller

Forces necessary, painful cuts to preserve the core. It demands that the organization stop borrowing from its future and align its current programmatic output with actual sustainable revenue.

The Truth-Teller
The Truth-Teller
Institutional Health Scores
5-yr trend: Structural Deficit
Overall
39
Score
Governance
58
Score
Financial
10
Score
Program
60
Score

Institutional Epochs

2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
Financial Era
Governance Era
Trajectory Era
Structural Deficit

Historical Performance

Year Revenue Top Comp Comp % Rev Score Phase Label Outlook Details
2024 Hidden Hidden Unknown
2023 0.1% 39 Financially Distressed Recovery
2022 0.3% 37 Financially Distressed Recovery
2021 34 Critical Intervention Needed Decline Risk
2020 0.2% 39 Financially Distressed Recovery
2019 34 Critical Intervention Needed Recovery
2018 32 Critical Intervention Needed Stable Watch
2017 32 Critical Intervention Needed Decline Risk
2016 0.1% 37 Financially Distressed Stable Watch
2015 0.1% 37 Financially Distressed Recovery
2014 0.1% 35 Financially Distressed Stable Watch
2013 0.1% 35 Financially Distressed Recovery
2012 32 Critical Intervention Needed Stable Watch
2011 32 Critical Intervention Needed Stable Watch
2010 32 Critical Intervention Needed Stable Watch

Officer compensation history

Tax year 2025

Name Title Phone Email Compensation
MARGARET TROYTHROUGH AUG 2024 Executive Director 0.5% of Rev
MARC CADIEUX Treasurer 0.2% of Rev
GIL PERIBEGINNING AUG 2024 Executive Director 0.2% of Rev
MARK RAKOWSKI Board President 0.2% of Rev
LESLIE TECTOR Secretary 0.1% of Rev
JAMES SLAWSON MD CHIEF MEDICAL OFFICER 0.1% of Rev
MICHAEL BOEDER Board President 0.1% of Rev
KELLY HODGES MD ASSOCIATE CHIEF MEDICAL OFFICER 0.1% of Rev
JACQUELINE WHELAN Vice President 0.0% of Rev
MICHAEL PELYHES Board Member 0.0% of Rev
JULIE ANTHOLINE DIR HEALTH PLAN OPERATIONS 0.0% of Rev
MICHELLE METTNER FORMER OFFICER 0.0% of Rev
JAMES PURKO Board President
MARY HANNES Board Member
MARK HOGAN Board Member
DANI MACHATA Board Member
BEN MELSON Board Member
THOMAS PRECIA Board Member
MICHAEL SILVER Board Member
CLARK SLIPHER Board Member
RALPH WEBER Board Member

Tax year 2023

Name Title Phone Email Compensation
MARGARET TROY Executive Director 0.4% of Rev
MARC CADIEUX Treasurer 0.2% of Rev
MICHELLE METTNER END 123122 Vice President 0.1% of Rev
MARK RAKOWSKI Board President 0.1% of Rev
JAMES SLAWSON CHIEF MEDICAL OFFICER CCHP 0.1% of Rev
KELLY HODGES ASSOCIATE CMO CCHO 0.1% of Rev
ROBERT DUNCAN END 12822 Board President 0.1% of Rev
MICHAEL BOEDER COO CCHP 0.0% of Rev
LYNN MASKEL END 9222 MEDICAL DIR 0.0% of Rev
LYNN KRYFKE END 102922 Executive Director 0.0% of Rev
DANIELLE COTEREL DIR COMMERCIAL PROD DEV SALES 0.0% of Rev
JAMES PURKO Board President
DAVID DRURY Board Member
MARK HOGAN Board Member
BEN MELSON Board Member
THOMAS PRECIA Board Member
MICHAEL SILVER Board Member
CLARK SLIPHER Board Member

Tax year 2021

Name Title Phone Email Compensation
MARGARET TROY Board President 0.4% of Rev
ROBERT DUNCAN Board President 0.2% of Rev
MARC CADIEUX Treasurer 0.2% of Rev
MICHELLE METTNER Secretary 0.1% of Rev
MARK RAKOWSKI Vice President 0.1% of Rev
JAMES SLAWSON CHIEF MEDICAL OFFICER CCHP 0.1% of Rev
MICHAEL BOEDER Executive Director 0.0% of Rev
LYNN MASKEL MEDICAL DIR CLINICAL SERVICES 0.0% of Rev
LYNN KRYFKE Executive Director 0.0% of Rev
JULIE ANTHOLINE DIR HEALTH PLAN OPERATIONS 0.0% of Rev
JAMES PURKO Board President
DAVID J DRURY Board Member
MARK HOGAN Board Member
BEN MELSON Board Member
THOMAS PRECIA Board Member
CLARK SLIPHER Board Member
MICHAEL SILVER Board Member
Officer contact details, exact compensation figures, and active litigation are available to verified members.
Request access
Score breakdown

Score breakdown

Financial resilience
10 / 100
weight 40%
Governance risk
58 / 100
weight 40%
Program scale
60 / 100
weight 20%
Overall
39 / 100
Priority Review

The three components combine into a single 0–100 score weighted as shown. Full methodology →

Peer comparison

Fewer than 3 peers found in WI for this NTEE subcategory; peer comparison would not be statistically meaningful.

5-year trend: Structural Deficit

Persistently low financial health over 5 years despite strong programmatic output. They are borrowing from their future (or bleeding an endowment) to pay for today's programs.

What's driving this score

What would change this score

The two changes that would most improve this score:

  1. Build cash reserves to at least 3 months of operating expenses — moves financial resilience score meaningfully (~10 points).
  2. Stabilize program expenses or grow earned-income revenue to break the consecutive-deficit pattern (~8 points to financial score).

Improving governance is a board decision. These are the levers.