Case Studies

Operational Redesign and Successful Transition to New Technology Platform
Situation:

The practice, a seven-physician primary care group, previously experienced an unsuccessful PMS/EMR conversion and reverted back to paper claims. The practice was in need of a structured PMS/EMR conversion for efficiency as well as CMS requirements.  The practice also desired to move to a new vendor for overall information technology (IT) support.

Action:

StratiFi Health facilitated the selection, design and implementation of a new EMR/PMS system—training staff and physician partners on new technology for efficiency and compliance.  In addition, StratiFi Health became the new IT support vendor.  StratiFi Health placed the new EMR/PMS system in StratiFi Health’s hosted environment and implemented the StratiFi Health IT support services model.

Result:

The practice successfully transitioned to the new technology with minimal short-term impact to revenue. All systems were placed in the StratiFi Health hosted environment for a more stable, secure and sustainable experience.  In addition, StratiFi Health engineered over $500K in annual savings from reduced staffing expenses via new efficiencies gained in through the operational redesign performed along with the system implementation.

Improving Reimbursement Ratios and Overall Cash Flow
Situation:

The practice, a fertility and IVF clinic, was experiencing significant fluctuations in collections from month to month. In addition, the practice saw a consistent decline in reimbursement over time. This ultimately effected profitability and caused frustration among the partners.

Action:

StratiFi Health initially brought visibility to the degradation of the billing and collection process. StratiFi Health helped the practice monitor billing performance, and implemented processes and controls for cash management and payment postings. In addition, StratiFi Health reviewed the clinic’s contractual rates to ensure the complete adjudication of claims.

Result:

Through the engagement, the client changed billing management and adopted recommended processes. The practice improved financial controls—safeguarding employees and cash. In addition, the practice experienced a 1% increase in reimbursement ratio and 30% decrease in Days in A/R year over year. The improvement in cash flow assisted the practice in its expansion into a new location.

Redesigning and Improving Financial Reporting and Physician Compensation
Situation:

The practice, a spine surgery group, transitioned their accounting to StratiFi Health in 2009, including their compensation model calculation and revenue cycle analysis.  The physician compensation model calculation process was very complicated and detailed, but the physicians did not easily understand it and the accuracy was routinely questioned by physician ownership.

Action:

StratiFi Health brought consistency in accounting, which meant better accuracy in the physician compensation model.  The model was adjusted to have a more simple and understandable interface while still maintaining the complexity of the desired compensation calculations. In addition, escrow balances, asset payment splits and line of credit utilization were accurately accounted for in the calculation and tracked over time.

Result:

After completing the physician compensation model re-design and improving the accuracy of the accounting, the physicians now trust the calculation and have suggested our services to their colleagues. The practice has endured physician transitions and began a fellowship program, all while the integrity and accuracy of the accounting and compensation model scaled with the growth of the practice and has earned the continued confidence of the physician owners. 

Creating Financial Visibility and Simplifying Cash Flow Management
Situation:

The client, a large primary care group (35+ providers), was experiencing dramatic growth and was in need of financial visibility as well as efficient processes. The practice’s accounts payable process was manual and did not provide leadership clear visibility to cash flow management. In addition, the practice’s reconciliation process from the practice management system to financial systems had limited oversight, as the two systems provided inconsistent information.

Action:

StratiFi Health created a robust management-reporting platform that measures physician productivity, compensation and operating results by location and function.  StratiFi Health also transitioned the practice to an electronic account payable and cash flow management platform. The new technology allowed more appropriate segregation of duties and approvals, daily ACH payments to vendors as well as up to date cash balance information. In addition, StratiFi Health’s accounting team created a day end close process to ensure that the clinic’s bank accounts reconciled with its practice management system on a daily basis. 

Result:

With the new systems in place, the client now has clear visibility to all financial results with a keen understanding of the related operational aspects of the business.  The practice also has improved internal controls and transparency in its accounts payable process, which has become more crucial as the practice has grown. The processes established now allow management to quickly review and approve expenses through a defined and secure structure.  The technology has allowed management to improve decision making related to cash flow management, as well as ensure consistency among its various systems. 

Conducting Insurance Contract Analysis to Identify Most Profitable Rates
Situation:

The practice, a vascular surgery group, historically acquired contracts from several local IPAs with little visibility to the contractual terms provided by each IPA. The Office Manager had historically managed the practice’s insurance contracts.

Action:

StratiFi Health identified the practice’s opportunity for better oversight in managing payor contracts. StratiFi Health performed a comprehensive review of the practice’s procedural mix as well as a review of local IPA contract terms to determine the most favorable terms from the major payors. 

Result:

The practice has since begun the transition to a new IPA based on StratiFi Health’s findings. The practice will now receive an estimated 2% increase in annual collections through transitioning insurance contracts to a new IPA.

Seamlessly Launching New Practices and Adding Physicians Without Financial Burdens
Situation:

The practice, a large colon/rectal surgery group, realized the need for growth into new geographic regions, but had concerns with the financial implications as well as the different structures necessary for establishing new physicians. 

Action:

StratiFi Health handled negotiations with a local hospital system to create a physician loan arrangement to support the startup costs of the new physicians. StratiFi Health built proformas for the new locations, provided financial consulting and coordinated the monthly reconciliation process with the hospital system.

Result:

The practice, through the physician loan agreement, was provided substantial operating funds to support the growth of its new physicians. This successful startup had built confidence within physician leadership regarding their ability to efficiently and effectively plant and grow new physicians.  More growth is now planned in the short-term future of the group.

Evaluation of Strategic Options
Situation:

The practice, a large oncology group, was evaluating their strategic options in their local market.

Action:

StratiFi Health provided strategic analysis and insights regarding potential relationships the group should consider.  The analysis included relationship structures, financial modeling and due diligence along with overall strategic considerations.

Result:

The practice thoroughly assessed the market and evaluated several potential strategic partnerships.  StratiFi Health’s services empowered the client to make a deeply researched, well-informed decision that aligned philosophically and strategically with the practice’s long-term goals.

Operational Support Through Management Transition
Situation:

The practice, a cardiology group, who was an existing client receiving financial and analytical services from StratiFi Health, experienced a transition in the office manager role.  The practice needed interim assistance with operational support and hiring a new officer manager/practice administrator.

Action:

StratiFi Health provided interim practice administrator support and assisted in the process of hiring a new, permanent practice administrator.  During the interim support, StratiFi Health personnel identified a number of opportunities for operational process improvement.

Result:

Through the provision of interim operational support, StratiFi Health maintains efficient practice operations, optimized several operational processes (staffing and revenue cycle related) and successfully recruited a permanent office manager.