Good daily management combines the prioritization tools of health care management with tested leadership visions that create a symbiosis for success. We introduce the concept of REER--revenues, expenses, efficiencies and risk--as daily benchmarks to guide managers and blend REER with other leadership premises. A complete REER model includes leadership elements that define the tools and when to use them. A vision for the business requires a broad spectrum of tools to succeed: integrity, persistence, energy, insight into people and the instinct to know when to focus on revenue and when to allocate for risk.