Full Case Study

Context

A private equity-backed, multi-state Applied Behavior Analysis (ABA) platform was pursuing an active acquisition strategy while preparing for continued growth under sponsor ownership.

Leadership initiated a review of the organization’s revenue cycle infrastructure after identifying signs of revenue underperformance and limited transparency into revenue operations.

The existing revenue cycle function was largely managed through an outsourced RCM vendor, with portions of the operational workflow supported offshore.

However, leadership lacked reliable visibility into performance across the revenue cycle and began to observe increasing gaps between operational RCM reporting and financial reporting.

The sponsor and executive team sought to determine whether:

the existing RCM vendor was delivering appropriate performance
alternative vendors could provide improved service at lower cost
revenue cycle reporting and operational visibility could be strengthened

The organization engaged JHD Healthcare Partners to evaluate the RCM function and lead the transition to a more disciplined and scalable revenue infrastructure.

RCM Performance Underperformance
The existing vendor model was not consistently delivering expected revenue cycle results, contributing to revenue leakage and performance variability.

Limited Reporting Visibility
Revenue cycle reporting lacked standardized dashboards and performance metrics, limiting leadership’s ability to evaluate revenue performance across locations.

Data Misalignment
Revenue cycle reporting did not consistently reconcile with financial reporting, creating uncertainty regarding actual revenue performance and margin realization.

Front-End Revenue Cycle Issues
Charge capture, authorization management, and verification of benefits (VOB) issues created upstream problems that impacted downstream collections performance.

Lack of Standardized Infrastructure
Policies, procedures, and reporting structures were incomplete or inconsistently applied across the organization, making it difficult to scale revenue operations as the platform expanded.

Leadership recognized that resolving these issues required both vendor transition and operational infrastructure redesign.

JHD Intervention

JHD Healthcare Partners was engaged to lead both vendor evaluation and implementation of a new revenue infrastructure model.

The engagement lasted 14 months and reported directly to the CEO and Vice President of Revenue Cycle.

JHD was given full authority to manage the vendor evaluation and oversee implementation of the selected solution.

The engagement included five coordinated workstreams.

Workstream 1: Revenue Cycle Vendor Evaluation

JHD led a structured RFP process to evaluate offshore RCM vendors capable of supporting the platform’s growth and performance objectives.

The process included:

vendor market evaluation
RFP design and administration
operational capability assessment
financial comparison of vendor options
leadership decision support

Workstream 2: Revenue Cycle Performance Assessment

JHD conducted a detailed evaluation of the existing revenue cycle function to identify operational gaps and improvement opportunities.

The assessment included:

collections performance analysis
denial pattern review
front-end revenue cycle evaluation
vendor service performance review
reporting capability assessment

Workstream 3: Revenue Infrastructure Development

In preparation for transitioning to a new offshore RCM partner, JHD led the development of standardized revenue cycle infrastructure.

This included:

development of revenue cycle policies and procedures
documentation of workflows across the revenue lifecycle
definition of operational roles and performance metrics

Workstream 4: Reporting and Dashboard Development

JHD worked with leadership to design and implement improved revenue performance reporting.

This included:

development of standardized performance dashboards
improved transparency into collections and denial trends
alignment between operational RCM reporting and financial reporting

Workstream 5: Implementation Governance

JHD established and led a structured Project Management Office (PMO) responsible for coordinating the transition to the new RCM partner and implementing the new revenue infrastructure.

The PMO managed:

vendor transition planning
cross-functional implementation coordination
milestone tracking and execution governance
executive reporting to leadership

Add a closing sentence:

The objective was not simply vendor replacement, but the creation of a disciplined revenue infrastructure capable of supporting platform growth.

Execution Context

This engagement required coordinated execution across revenue cycle operations, finance, vendor management, and executive leadership.

JHD Healthcare Partners operated as an extension of the leadership team, providing both execution capacity and structured governance to ensure alignment across the vendor transition and infrastructure buildout.

The work involved:

managing a complex offshore vendor transition
aligning operational and financial reporting structures
standardizing workflows across a multi-state platform
supporting leadership decision-making throughout implementation

Results

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4% Cost Reduction

Transitioning to the new RCM partner reduced revenue cycle operating costs.

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$6M Annual Impact

Combined operational improvements and vendor transition initiatives generated approximately $6 million in projected annual improvement.

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Improved Reporting Visibility

Leadership dashboards provided improved transparency into revenue cycle performance across the organization.

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Infrastructure Standardization

New policies, procedures, and reporting frameworks created a more consistent revenue operating model across locations.

Strategic Implication

In sponsor-backed healthcare platforms, revenue cycle infrastructure often evolves reactively as organizations scale.

As acquisition velocity increases, operational complexity frequently outpaces the maturity of revenue infrastructure. Without disciplined operational governance, platforms can experience revenue leakage, reporting fragmentation, and margin variability.

Structured execution governance during vendor transitions allows sponsors and operating partners to strengthen infrastructure while maintaining strategic focus.

Deploying this type of governance can:

stabilize revenue performance
strengthen financial reporting visibility
reduce margin volatility
accelerate integration of acquired practices
reinforce exit readiness

Infrastructure discipline is not simply an operational improvement.

It is a foundational capability for scaling healthcare platforms.

Revenue Infrastructure Realignment in a Sponsor-Backed ABA Platform

Platform Profile

Ownership

Geographic Footprint

Estimated Scale

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