Fractional CFO · Operating Advisory
Siddiqi Advisory works with health systems, physician organizations, and healthcare services companies on the finance and operating problems that need senior attention without a full-time hire. Engagements are scoped, fixed-fee where possible, and discreet.
01 · How I help
Engagements are scoped to the problem and the moment. Diagnostic work is fixed-fee with clear deliverables; longer work runs on retainer. All work is delivered by the principal — no leveraged teams, no offshored analysis.
Redesign of physician compensation plans to align with strategy, market, and productivity. Restructuring of Professional Services Agreements across multiple sites. Work has been deployed at academic medical centers, large physician organizations, and multi-specialty groups.
8–12 week fixed-fee engagementDesign and implementation of funds flow models, academic medical center–university integration, hospital-PO consolidation, and post-merger financial structures. For health systems and academic institutions navigating governance and economic alignment across multiple entities.
12–16 week fixed-fee engagementBuild of performance management systems, productivity benchmarking, executive dashboarding, and disciplined cost takeout. For organizations where the finance function reports but doesn't yet partner with operations to drive margin — work that has produced more than $80 million in cost reduction.
8–12 week fixed-fee engagementEmbedded senior finance leadership for PE-backed healthcare platforms, physician organizations between full-time CFO hires, or health system divisions that need senior attention without a full-time role. Operating presence at the leadership table.
3–6 month retainer minimum02 · How I work
Diagnostic work is fixed-fee with clear scope and deliverables. Open-ended billing creates the wrong incentives for both parties.
Most finance and operating issues are structural before they are personal. The work focuses on what to change in the system, not who to blame.
Recommendations are presented as a menu with trade-offs in financial impact, cultural impact, and effort. Leadership decides what to implement.
Senior advisory work requires confidentiality. Engagements operate under mutual NDA with discreet stakeholder access.
All work is delivered by the principal. No leveraged teams, no offshored analysis, no white-labeled deliverables.
03 · Fit
04 · Background
Assad Siddiqi
Healthcare CFO. Fifteen years of finance leadership across academic medical centers, large physician organizations, and global healthcare services.
Most recently SVP of Finance at Fresenius Medical Care, leading finance for Fresenius Kidney Care, its $10 billion U.S. business. Before that, System SVP of Finance at Tufts Medicine, with CFO accountability for both Tufts Medical Center and the Professional Group. Earlier, a decade in progressive finance leadership at Massachusetts General Hospital.
Across those roles, the work has centered on physician compensation redesign, funds flow and multi-entity integration, performance management, and margin improvement at scale.
Siddiqi Advisory was founded to bring this work to organizations on a focused, scoped basis. MBA, Boston University Questrom School of Business.
Focus areas · Academic medical centers · Physician organizations · Ambulatory care · PE-backed healthcare services · Health system finance integration
05 · Work
Representative work, anonymized. Specifics are shared under NDA.
Confidential · Academic Medical Center
Problem. A large academic physician organization's compensation plan had drifted from strategy — misaligned across physician types, with productivity lagging national benchmarks.
Approach. Led a full redesign aligning pay to productivity, market, and divisional priorities, and shepherded it through a 20-member physician compensation committee to full-faculty approval.
Outcome. Physician productivity raised to the 50th percentile, with payments rationalized and realigned to strategy.
Confidential · Academic Health System
Problem. A multi-entity health system needed to align economics across its hospital and physician enterprise while improving margin under pressure.
Approach. Redesigned the system funds-flow model, realigned cost centers, and deployed performance management and productivity analytics across the system.
Outcome. More than $80 million in cost reduction and margin improvement, alongside a board-ratified five-year financial plan.
Confidential · Multi-Site Healthcare Services
Problem. A large multi-site healthcare services organization lacked consistent visibility into cost, labor, and unit-level profitability across its network.
Approach. Implemented governance and performance frameworks integrating company-owned and joint-venture sites, and modernized enterprise reporting and forecasting.
Outcome. Standardized performance management across thousands of sites, with unit-level profitability visibility established at scale.
06 · Contact
I take on a small number of engagements at a time. Most start with a 30-minute conversation — no agenda, no pitch — to understand the situation and whether I'm the right person to help.
Thank you. I'll be in touch within a day or two.