A multiplayer hospital-system strategy simulation for graduate healthcare management courses. Student teams govern four competing health systems in one shared regional market — setting staffing, negotiating payer contracts, funding capital, and answering for every decision in a written memo. Advised by AI division directors. Resolved by a deterministic market engine. Debriefed by you.
The market doesn't grade on a curve — and neither does it hand out one right answer. The simulation is built around the real-world trade-offs healthcare executives weigh every day to drive a strategy of success. You see each team's performance in operational, clinical, and financial metrics — and you see the thinking behind it: the rationale and expectations written into every decision memo, and the questions teams asked their AI division directors along the way. The engine is deterministic, but the record is rich: use it to build your own rubric and grade not just results, but learning and competence.
Each round is one simulated quarter. The rhythm fits a weekly class: results early in the week, decisions due before you meet, debrief with fresh numbers.
Teams open their quarterly packet: financial statements, operations and quality panels, a market bulletin — and competitors' public disclosures, lagged the way real 990s and bondholder filings are.
Four AI division directors — finance, operations, quality, population health — answer from the team's own released facts, cite their evidence, and disagree with each other when the evidence supports it.
Twelve decision forms, autosaved and shared across the team. A visible implementation-hours budget forces prioritization: commit to too much and the excess visibly defers.
A pro forma planner runs the team's draft through the same engine against named scenarios — continuation, weaker demand, a rival's expansion — before anything is final.
Decisions ship as one versioned bundle with a rationale memo for every action. No memo, no submission. Missed deadlines apply a published default — marked, never papered over.
All four teams resolve together — no order advantage. Results release to everyone at once, and your faculty console arrives pre-briefed: exception flags, forecast-vs-result, teaching moments.
Every lever a health system executive actually holds — and every coupling between them. The nurses one team recruits come out of a shared regional pool. The campaign that wins demand can overwhelm the beds that weren't staffed for it. The prevention program that improves community health reduces fee-for-service revenue — until the payer contract changes.
Set staffed beds per hospital and an agency ceiling — against hiring lags, onboarding productivity, and 1.9× agency premiums.
Position wages against the regional market and fund retention programs — knowing every raise pulls nurses from the same shared pool.
Open clinic sessions in chosen neighborhoods — lease fast or build bigger — to shorten travel, win attribution, and feed referrals.
Fund safety bundles and discharge programs that cut length-of-stay and readmissions — with effects that mature over quarters, not overnight.
Launch transitions-of-care, pharmacist-led chronic care, or long-horizon prevention — and live the prevention paradox under fee-for-service.
Aim spend at service lines and neighborhoods. Demand responds — and a winning campaign can fill beds the team never staffed.
Take rate asks into renewal windows and elect pay-for-performance riders — where pushing rate concedes patient steering.
Step up collections initiatives that pull cash forward and trim denials — liquidity without a single new patient.
Fund an OR–imaging upgrade, an ambulatory clinic, or resilience hardening — choosing the cash-versus-debt mix and absorbing build timelines.
Borrow at terms set by the lender's read of your balance sheet; set the days-cash floor the team promises not to breach.
Implement revenue-cycle analytics or access-and-scheduling platforms — productivity dips first, benefits follow adoption.
Defer maintenance to free cash now, or catch up and harden the plant — the bill arrives when the shock does.
This is the simulation's defining feature. Each team runs its system the way real executives do: by talking to their division directors. The simulation leverages AI to generate the real-world conversations that happen in the C-suite — a CFO pressed on why cash fell while revenue rose, a COO warning that the campaign will hit a full house, a population health director defending a program that loses money and improves lives.
These aren't canned answers on a decision tree. Directors analyze their team's actual numbers, cite the record behind every claim, flag what they'd escalate, and disagree with each other when the evidence cuts both ways. Students convene multi-director meetings, push back, share analyses, and learn what it is to be briefed by smart people with different vantage points.
What directors never do is decide. The enterprise synthesis — the actual strategy — belongs to the students, and the memo makes them show it. Every conversation is archived verbatim, so you can read any team's advisory record exactly as the students saw it.
The directors advise within their remit; students own the whole.
Under the simulation is a deterministic engine with real financial machinery: double-entry ledgers, linked statements that must reconcile, payer-specific rates and settlement lags, debt covenants, depreciation, working capital. The classic traps emerge from the mechanics — a team can grow surplus while cash quietly drains away.
Every assumption — a wage elasticity, a program's effect size, a payer's negotiating posture — is recorded in an evidence register with its source, its class, and its uncertainty range. Effect ranges deliberately include weak and null outcomes: a sound investment can disappoint, and rankings must survive honest noise.
The same inputs always produce the same results. Any round can be replayed, byte for byte — there is no hidden hand on the scale.
The faculty console runs the course rhythm for you — deadlines, reminders, resolution, release — and concentrates your attention where it earns the most: the debrief and the grading.
Students join with a code; you assign teams. A guided setup pins the scenario and calendar to your syllabus — holiday weeks included. A practice round lets everyone fail safely first.
Live submission status per team, deadline countdown, one-click audited extensions. After resolution: exception flags with their evidence — the team under its cash floor, the campaign that hit full beds, the contract that rolled silently.
Memos land in a rubric workspace beside the decisions they justify. Export grades as CSV, and a per-team justification package — decisions, memos, results — survives as your record.
Join the instructor list for early access, pilot results, and adoption details ahead of general availability.
Request instructor access