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Upstream Strategies

Vision Tempered by Experience
Implemented with Principled Discipline
and Teamwork


Our Core Philosophy


With our world-class team, Upstream partners with Hospitals and Physicians to improve the Business of Healthcare. Our knowledge of healthcare finance, regulations, insurance, hospital operations, physician practices and clinical care represents a unique and powerful formula for providing our partners with a long-term solution for successful service line operations and management.

Business of Healthcare

Healthcare is constantly evolving and its borders are always shifting. To succeed at the most basic level, Hospitals and Physicians alike must be willing to explore innovative clinical service line business models that challenge the status quo. At Upstream we understand the business of healthcare and we are able to introduce new models for healthcare delivery beyond the walls of traditional hospital / physician relationships.


Healthcare is still an astonishingly fragmented industry. More than half of U.S. physician’s work in practices of three or fewer doctors and Hospitals have historically found it difficult to build sustainable relationships with physicians.  Innovative business models, particularly those that strategically integrate the clinical service line activities of large numbers of physicians, can increase efficiency, improve care, and increase profitability.


The healthcare system and the Federal and State laws governing the collaboration between Hospitals and Physicians erect an array of barriers to valuable models of innovation. More often than not, though, Upstream has demonstrated that these obstacles can be overcome by strategically assessing and organizing the business, financial and legal environments to ensure that collaboration between historically disparate providers becomes a hallmark of a program’s success.


As the complexity of health care increases, Hospitals, Physicians and other key stakeholders will only succeed when their professional interaction is driven by shared goals and objectives tied to clinical and financial outcomes – which otherwise are known as results.


Optimal patient care and economic outcomes are inextricably linked.  You cannot have one without the other… and together; they represent a powerful force for sustainable long-term partnerships.  Strategic innovation where meaningful collaboration and success is measured by achieving sustainable clinical and financial results is the key to improving the Business of Healthcare.

What We Do

Physician Hospital Joint Ventures

The healthcare system and the Federal and State laws governing the collaboration between Hospitals and Physicians erect an array of barriers to valuable models of innovation. Upstream has demonstrated that these obstacles can be overcome by strategically assessing and organizing the business into legally compliant joint ventures to ensure that collaboration between historically disparate providers becomes a hallmark of a program’s success.

Management Services and Operations

Upstream helps its hospital and physician partners solve their most challenging issues in operating their business in today’s healthcare environment. Our systematic approach to service combines our know-how and business resources to help healthcare organizations reposition their business to achieve top line revenue growth, improve quality and reduce costs. Specific emphasis is placed on helping our partners become effective, complex population health and value-based care organizations. We address business model transformation, rising cost-to-serve, growing chronic disease prevalence and growing system inefficiencies.

Medical Equipment / Supplies Procurement

Upstream is a full-service procurement company for hospitals, physician offices, nursing homes and other healthcare care facilities. We strive to obtain maximum profitability for our clients while offering innovative business solutions. Twenty-five years of healthcare management & purchasing experience enables us to provide our clients with knowledge of every major brand within our industry. We have access to over 125,000 products from hundreds of National manufacturers and local distributors. We are constantly working with Owners and Purchasing Directors to evaluating their needs, offering money-saving solutions in a variety of ways. Our complex budgetary compliance program has proven to cut facility costs and can be adapted to any industry/market.

Ancillary Healthcare Facility Development, Management and Operations

Certain trends affecting the health care industry have created a demand for specialized real estate services and new facilities. Starting in 2007, Upstream began providing comprehensive real estate services to hospitals, physician group practices, independent physicians, health maintenance organizations, and other specialized health care providers. We provide real estate development, construction management, property management, finance structuring and consulting services for the development of medical office buildings, surgery centers, diagnostic centers and physician offices.

Executive Leadership

Christopher Howard


As Vice President of Development for physician practice acquisitions, heart hospital syndications and acute care hospital collaboration for MedCath, Incorporated, was responsible for building relationships with physician and hospital providers and developing potential markets for the company across the United States. More

When Chris arrived at MedCath in 1998, MedCath Corporation was operating two hospitals and a handful of physician joint ventures. Over the ensuing 10 years, MedCath Corporation grew to 14 hospitals and dozens of physician joint ventures driving MedCath Corporation’s annual revenues from $200 million to more than $800 million. Prior to joining MedCath Corporation, Chris spent ten years with Cardiovascular Ventures Incorporated and Nuclear Imaging Systems, Incorporated as Executive Vice President opening new markets for the provision of freestanding and hospital based cardiac imaging services. Chris received his bachelor’s degree in Communications from Towson University and attended the University of Baltimore’s graduate school for business administration.

Paul Ingledue


Paul brings over twenty-six years experience in the healthcare industry to Upstream. Innovative and creative, Paul is skilled in developing and managing operating budgets, same store growth and in the complete development and implementation of cardiac programs, nuclear, cardiac sleep and EECP centers. More

Possessing a thorough understanding of the healthcare industry, Paul is skilled in building relationships and communicating clearly with individuals at all organizational levels. Prior to joining Upstream Strategies, LLC Paul spent the past eighteen months as a Chief Operations Officer for a prostate cancer company and as a Senior Vice President Business Development for a bariatric hospital company. For twelve years, Paul served Medcath Inc. in the position of Vice President of Operations, Director Corporate Services, Director Operational Implementation, Director Cardiac Services and Director Outpatient Cardiac Services for Partners Division. During that time, Paul’s achievements include the development and improvement of the financial profitability of multiple cardiac/sleep/nuclear centers, as well as the successful development and implementation of the Quality/Risk team. As VP of Operations, Paul was responsible for developing and maintaining relationships with hospital administrators and physicians, for operations of the mobile catheterization lab division, and for the operations of fifteen facilities producing over 5,000 procedures monthly.

Beginning his medical career in the USAF in 1982, Paul completed his BSN degree at the University of Florida in 1991. Paul served hospitals as a critical care RN before managing his first catheterization lab for Medcath Inc. in 1996. Recognizing his propensity for healthcare operations and implementation, Paul pursued his MBA, graduating from Wingate University in 2006.

We Look Forward to Hearing From You

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