Revenue Cycle – It’s More Than Numbers
A Provider RCM Turnaround
The Challenge: A 400+ clinician regional health system had a problem with its revenue cycle (RC). Its $200M fee for service (FFS) revenues were a problem. Owing to the fact that charges had steadily increased or remained consistent, yet days in accounts receivable (AR) were static and collected revenues weren’t rising in line with charges, something was amiss. The market COO called to inquire about an assessment of the FFS RC.
The Charge: Perform an operational assessment of the entire FFS RC and provide a quantitative/qualitative perspective on the operations and functionality of the RC. Summarize findings in a concise data-driven report delineating creative and sustainable solutions designed to deliver financial and structural relief.
The Process: More than reviewing billing and collections, interviews with key constituents and collection of a variety of data points was essential in determining the process, structural, and human capital issues currently embedded in the system.
The Findings: A report was crafted that delineated, quantitatively, RC issues within the health system. This report offered a prioritized examination of key issues and financial vulnerabilities. These issues negatively impacted efficient operation of the RC and created cashflow issues.
The Results: After the assessment the health system sought a partner to identify and work on the issues to expedite the turnaround timeline. In concert with the system, a team was constructed, workplans and KPIs were developed, and the combined team took steps to remedy the fractured system.
With attention to data, detail, and timelines, the six (6) month project was effective at reconstituting the RC. (Within 6 months the heavy lift was completed; further pinpoint cleanup was still needed).
When the dust had settled, deploying simple structural opportunities and remedies coupled with an implementation timeline that assisted the client in building a cohesive data driven RC, EBITDA improved considerably.
If you’re “worried well” and curious about how Cubed can help you, please email us for a gratis chat about your situation - questions@cub3d.org
The Private Practice Challenge – Improving Profitability
The Challenge: A private practice with two clinic locations and two endoscopy suites was struggling with cashflow. The physicians and APPs were working above expected volumes. Yet compensation was below expectation. Additionally, two doctors had retired and two had departed for the competition. The structure was built with a full physician coterie in mind. The two locations, 30 miles apart, operated, in many respects, autonomously.
The Charge: Provide shareholders with a synthesized and objective examination of the clinic locations from check in to check out and everything in between.
The Process: We examined data, met staff, examined policies and procedures, and reviewed the physical plants to understand the dynamism of each location including endo suites and clinic footprints. We paid careful attention to the RC process, fee schedules, etc.
The Findings: A report was built delineating the genesis of the cashflow issues. Space was not utilized efficiently, processes were fragmented, the management structure was incongruent, RC was not optimized, and departing physician separation agreements all contributed to the cashflow pinch.
The Results: We worked with the shareholders to prioritize low hanging fruit that delivered high dollar value impact. We handed off detailed list to the new CEO to deploy throughout both locations.
If you’re “worried well” and curious about how Cubed can help you, please email us for a gratis chat about your situation - questions@cub3d.org
Acquisition Analysis – Buy Side Due Diligence
The Challenge: A private equity (PE) fund required a review and external due diligence to determine the value and feasibility of acquiring a healthcare business.
The Charge: Perform due diligence of the business operation to assist the PE firm in understanding the value and logic of acquiring the target firm.
The Process: We examined data, reviewed operational history, examined proposed 3 year plan/strategy and associated revenue flows, and delivered a pithy data-driven report to the PE firm.
The Findings: The report delineated our findings based benchmarking and on the history in the space, the prospect of the “future state,” and a careful analysis of the healthcare climate. This helped the PE firm make their “go/no-go” decision.
The Results: The PE firm opted to pass on this funding deal, at least in the near-term.
If you’re “worried well” and curious about how Cubed can help you, please email us for a no-cost chat about your situation - questions@cub3d.org
Patient Access Success
The Challenge: A 4,000 clinician $10B academic medical center (AMC) had a problem getting patients in the door and seen in its faculty practice. While there were plenty of clinicians, there was capacity imbalance.
The Charge: Get an understanding of the impediments to patient access. Perform an evaluation of the multi-specialty clinic locations to understand bottlenecks and issues.
The Process: We examined several outpatient clinic sites and interviewed staff and clinicians. We were told, explicitly, that our output could not simply say “see more patients.”
The Findings: A report was built delineating impediments to patient access which included inconsistent scheduling processes, communication issues between the hospital and the faculty practice, and an infrastructure incapable of meeting demand.
The Results: After deploying the reported findings, the system attained significantly improved patient access in its faculty practice without added expense translating directly into extra revenue. In one clinic alone capacity expanded 90%.
If you’re “worried well” and curious about how Cubed can help you, please reach out to us for a gratis chat about your situation - questions@cub3d.org
Losing Money – Hospital in Distress
The Challenge: A small hospital in the southwest was losing >$300K per provider in their employed model outpatient clinics.
The Charge: Examine the outpatient clinics to understand what contributed to the ongoing negative cashflow in the clinics.
The Process: We examined data, met staff, reviewed policies and procedures, and inspected the physical plants to understand the dynamism of each location. We performed a detailed quantitative analysis to inform a data driven report.
The Findings: A report was built delineating the drivers for the financial distress. We determined that as the hospital acquired clinics, it had simply bolted on the businesses without integrating the systems. Over time the disparity in clinic operations compounded and created unsustainable financial issues. A vacuum of policies, differing schedules and office hours, disparate IT systems and EMRs, added burden to the organization.
The Results: We worked with the Board and a physician advisory committee to deploy fixes to the infrastructure and streamline operations. Within 18 months the clinics were at breakeven.
If you’re “worried well” and curious about how Cubed can help you, please email us for a gratis chat about your situation - questions@cub3d.org