Tri-State Community Healthcare

Tri-State Community Healthcare is a Federally Qualified Health Center serving patients across California, including rural locations such as Needles, where recruiting and retaining dental providers has always been the hardest part of the job.

The challenge

Several pressures were working against the organization at once. Communication across teams was uneven, too much day-to-day operational load sat with a small group of leaders, and scheduling was not being used as a strategic lever.

The organization also went six months without a Chief Operating Officer, which left gaps in both daily decision-making and longer-range planning. The team was committed, but without a strategic plan and a defined structure behind it, their resources were never doing full work.

The approach

Tri-State engaged Optimize Practice Alliance to run the Practice Optimization Process™, built around performance, alignment, and patient outcomes:

• Vision Days to align leadership and set direction
• Quarterly focus sessions, which became fixed points for strategic review
• Direct recruiting support, including interviewing and onboarding, taking that load off internal leadership
• Personnel work to place the right providers in the right roles
• Dr. Diba placed as fractional Dental Director for clinical oversight and compliance
• Accountability built on stated KPIs and goals the whole organization could see

What that produced was a roadmap specific to Tri-State: defined KPIs, clear and measurable goals, accountability that crossed departments, and recruiting support matched to real placement needs. The structure held while leaving enough room for the rural service areas, where retention and consistency matter most, to operate with more clarity and autonomy.

The results

Between February 2024 and February 2025, total dental encounters rose from 866 to 1,470. The operational changes account for part of that. The rest is the Tri-State team’s own adoption of the process.