Senior partners. Specific problems.Irrefutable outcomes.
“Most cardiac programs hemorrhage margin on the wrong side of the acuity curve — not because of clinical decisions, but because no one has mapped contribution by DRG against actual fixed-cost allocation.”
A 14-hospital system in the Southeast was operating its cardiac catheterization program at an apparent 6% margin. After remapping case-mix index against true variable cost, we identified $47M in misallocated overhead across three facilities. The program's real contribution margin was 22% — and the system was about to exit the service line entirely.
overhead correctly reallocated within one quarter
“Behavioral health is the most chronically undervalued asset on a regional health system's balance sheet. The reimbursement complexity drives avoidance, but the margin opportunity inside a properly structured continuum is substantial and largely untouched.”
A Midwest integrated delivery network had been operating behavioral health at a reported $12M annual loss for six years. We restructured the payer mix strategy, implemented a partial hospitalization program that qualified for a higher-acuity reimbursement tier, and renegotiated three commercial contracts. The unit reached breakeven in 11 months.
from $12M loss to breakeven on behavioral health unit
“The revenue cycle is not a billing problem. It is a clinical documentation problem that presents as a billing problem. Systems that treat it as the former spend millions on software. Systems that understand the latter restructure physician workflows and recover the money.”
A 340-bed community hospital in the Mountain West was running a 9.2% denial rate against a 6.1% industry benchmark. Root-cause analysis revealed that 71% of denials originated from three hospitalist groups with inconsistent documentation protocols. A 90-day embedded engagement reduced the denial rate to 5.4% and recovered $18.3M in previously written-off AR.
in AR recovered through documentation protocol redesign
“A compliance audit finding is not a liability — it is a diagnostic. The organizations that treat it as a legal problem to be minimized miss the operational intelligence embedded in the finding. We read audits the way a cardiologist reads an EKG.”
Following a CMS Targeted Probe and Educate review, a regional health system faced $22M in potential recoupment across its home health division. We conducted a full clinical documentation re-review, identified a systematic coding misclassification introduced during an EHR migration, and submitted a successful self-disclosure that reduced the recoupment to $4.1M — while implementing controls that closed the underlying exposure permanently.
in recoupment exposure eliminated through strategic self-disclosure
The methodology is the product.Reproducible. Irrefutable. Board-ready.
Actuarial Baseline
We begin where most consultants stop — inside the data. Our actuaries map payer mix, cost-per-encounter, and DRG contribution margin before the first stakeholder interview. This eliminates the opinions and leaves only the arithmetic.
Operational Mapping
Clinical workflows, supply chain contracts, and staffing ratios are audited against peer benchmarks drawn from our proprietary database of 138 health systems. Gaps are quantified in dollars, not percentages.
Blueprint Delivery
The engagement concludes with a prioritized operational blueprint — sequenced by ROI, implementation complexity, and regulatory risk. Every recommendation is pre-modeled for Board presentation.
Implementation Oversight
We remain embedded through the first 90 days of execution. Our partners attend the operational reviews, not the kickoff calls. Results are measured against the baseline we established, not the targets we proposed.
Actuarial-First
Every engagement begins with quantitative modeling, not stakeholder interviews.
No Sub-Advisory
Senior partners conduct the work. No staffing pyramids, no knowledge transfer overhead.
Outcome-Linked
Fee structures are partially contingent on documented savings. We share the risk.
Board-Ready
All deliverables are formatted for Board of Directors presentation without modification.
The numbers that matterto a CFO on a Tuesday morning.
Average annual savings per engagement
Across 12-month post-implementation measurement periods
Average time from engagement start to first actionable finding
Industry standard: 90–120 days
Average ROI on consulting fees
Measured against documented savings within 18 months of delivery
“They arrived with the data already organized. By the second meeting, we were discussing solutions — not still defining the problem.”
- Regional health systems: 200–2,000 beds
- Academic medical centers navigating margin compression
- PE-backed platform acquisitions (pre- and post-close diligence)
- Health systems under post-audit compliance remediation
- Integrated delivery networks restructuring service lines
States with active or recent engagements
Concentrated in Southeast, Midwest, and Mountain West markets
By the time you reach this line,you already know your problem.
The Impact Report documents 24 engagements across six service lines with full financial disclosure — costs, timelines, and outcomes. It is the most specific document in healthcare consulting. It is also free.