Platform Profile

Ownership

Private equity–backed healthcare platform

Geographic Footprint

Multi-state platform

Estimated Scale

450+ providers across 150+ locations

Subsector

Women's health 

Context

A multi-state women’s healthcare platform expanded rapidly through physician practice acquisitions.

As growth accelerated, revenue cycle performance began to decline, with increasing accounts receivable, fragmented workflows, and limited enterprise visibility into performance.

Performance indicators included declining net collection rates, rising accounts receivable balances, and inconsistent reporting across acquired practices. These dynamics limited leadership’s ability to accurately assess revenue performance at the enterprise level.

The CFO, in partnership with the Vice President of Revenue Cycle, initiated intervention to address these issues.

At the same time, the organization was preparing to transition to an outsourced RCM model. However, underlying operational fragmentation made it clear that outsourcing alone would not resolve performance challenges.

JHD Healthcare Partners was engaged to stabilize operations, guide the outsourcing transition, and build scalable revenue infrastructure.

 

The Challenge

Operational performance degradation was driven by a combination of workflow fragmentation, inconsistent processes, and limited enterprise-level visibility.

 

Declining net collection rates
Net collections declined as workflows and payer management varied across practices.

Increasing accounts receivable
Accounts receivable balances grew due to inconsistent follow-up processes and lack of centralized oversight.

Inconsistent workflows across practices
Revenue cycle processes varied significantly across locations, limiting operational consistency.

Fragmented billing processes
Billing and collections activities were not standardized, creating inefficiencies across the platform.

Limited reporting visibility
Leadership lacked consistent, enterprise-level reporting to monitor revenue cycle performance.

Integration complexity from acquisitions
Newly acquired practices were not consistently integrated into the revenue cycle infrastructure.

Outsourcing alone would not resolve these issues without first addressing underlying infrastructure gaps.

 

JHD Intervention

JHD Healthcare Partners was initially engaged as a strategic advisor to the CFO to assess revenue cycle performance and outsourcing readiness.

Following alignment, JHD transitioned into an execution role with authority to design workflows, embed them within the outsourcing model, and lead implementation across the platform.

The engagement focused on four coordinated workstreams.

Workstream 1: Outsourcing Governance

Redesigned the outsourcing contract structure, embedding performance-based service level agreements and KPI-driven accountability to align vendor performance with enterprise financial objectives.

Workstream 2: Operational Standardization

Established coding governance, implemented structured denial management workflows, and introduced payer variance tracking to improve consistency across practices.

Workstream 3: Financial Infrastructure

Modernized payment processing workflows, expanded ERA utilization, and strengthened reconciliation processes to improve financial accuracy and control.

Workstream 4: Integration Infrastructure

Implemented centralized billing processes, supported call center collections, and developed an integration playbook to guide onboarding of newly acquired practices.

Execution Context

The transformation was executed through a structured, multi-phase approach:

  • contract restructuring and outsourcing design
  • transition planning and knowledge transfer
  • phased go-live of outsourced operations
  • stabilization of the new operating model

JHD continued in an oversight role following go-live to support performance stabilization and ongoing operational alignment.

Total engagement duration was approximately 20 months.

This approach ensured alignment between vendor operations, internal workflows, and financial reporting throughout the transition and stabilization phases.

 

Results

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Net Collection Rate

Improved from approximately 85% to greater than 95%

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Coding & Denials

Improved coding accuracy and denial resolution

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Financial Visibility

Strengthened reconciliation processes and enterprise reporting visibility

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Scalability

Established infrastructure capable of supporting continued platform growth

Strategic Implication

In acquisition-driven healthcare platforms, performance degradation is often driven by infrastructure misalignment rather than isolated operational issues.

As organizations scale, operational complexity can outpace the maturity of revenue cycle infrastructure, resulting in variability in performance, reporting gaps, and reduced visibility.

Outsourcing without operational standardization can perpetuate or worsen these challenges.

Structured infrastructure — including standardized workflows, governance, and reporting alignment — enables platforms to stabilize performance and support continued growth.

Infrastructure discipline is required to sustain performance as platforms scale.

 

 

Evaluating Revenue Infrastructure Across a Platform?

JHD Healthcare Partners works alongside sponsor operating teams to evaluate and stabilize revenue infrastructure across multi-site healthcare platforms.