How to Unlock Revenue Potential in Healthcare

After a few candid conversations with health-system CFOs who collectively oversee billions in physician revenue, one theme rang loud and clear: revenue integrity only scales when clinicians can forget about billing. Here are the takeaways reshaping my roadmap: - Stop mopping—fix the pipe. Physician billing is high-volume, low-dollar. Every avoidable touch destroys margin. Accurate clinical context at the point of care is slashing denials before they happen. - Beware the DRG mirage. A $10 M coding lift can quietly blow up population-health costs if diagnosis creep inflates risk scores. Accuracy beats after-the-fact optimization every time. - 72-hour adjudication is coming. Medicare already pays 80 % of claims within seven days when the data are clean. Shared rails plus real-time records unlock a win–win for providers and payers. - Data as triage coach. Moving an ortho service from a 12:1 to 7:1 consult-to-surgery ratio freed OR time and lifted patient satisfaction, powered by feedback loops to PCPs. - Small practices = single-point-of-failure risk. One vacationing biller shouldn’t freeze cash flow. Submission logic must live in the platform, not in someone’s head. The future RCM stack won’t be a black box bolted onto the EMR. It will be a real-time, rules-aware copilot that flags payer changes before claims queue, adjudicates in hours, and lets clinicians focus on care, not CPT codes. Building toward that future now. If you’re experimenting in the same space, let’s chat. #HealthcareFinance #RevenueCycle #Automation #ValueBasedCare

𝗙𝗼𝗿 𝗛𝗲𝗮𝗹𝘁𝗵𝗰𝗮𝗿𝗲 𝗖𝗜𝗢𝘀 𝗪𝗿𝗲𝘀𝘁𝗹𝗶𝗻𝗴 𝘄𝗶𝘁𝗵 𝗥𝗢𝗜: 𝗪𝗵𝗮𝘁 𝗛𝗲𝗹𝗽𝗲𝗱 𝗠𝗲 𝗧𝗲𝗹𝗹 𝘁𝗵𝗲 𝗦𝘁𝗼𝗿𝘆 Let’s be honest, justifying tech investments in healthcare is hard. We see the burnout. We hear the provider feedback. We know the gaps. But when it’s time to sit across the table from finance and explain the return on something like ambient listening, we often fall back on soft wins: • It saves note time • Pajama time is down • Providers like it All true. All important. But not always enough. Over the past few months, I’ve talked with several CIOs some just beginning their ambient journey, others mid-rollout. And most asked the same thing: How do I actually quantify the ROI? At Reid, we’ve started to build a different kind of ROI story. One that ties soft wins to harder outcomes, like revenue cycle lift, physician retention, and net financial value. Ambient documentation is just one use case, but a powerful one. We built a framework that moves the conversation from “this feels helpful” to: • Here’s the payback period • Here’s the dollar impact • Here’s what happens if we scale it And we kept it conservative because it needs to hold up. A few lessons from the process: ✅ Time savings are just the start Cutting 10 to 12 minutes per note adds up fast. At 13,000+ notes a month, that alone could represent over $𝟰𝗠 𝗽𝗲𝗿 𝘆𝗲𝗮𝗿. ✅ Revenue cycle lift is the real multiplier Even a 1% improvement in Level 4 to Level 5 coding, or better HCC documentation accuracy, can 𝘆𝗶𝗲𝗹𝗱 𝘀𝗲𝘃𝗲𝗻-𝗳𝗶𝗴𝘂𝗿𝗲 𝗿𝗲𝘁𝘂𝗿𝗻𝘀. ✅ High performers amplify results Power users don’t just save time, they move faster. Some of our specialty lines saw double- and triple-digit growth. ✅ Retention is underrated Avoiding just two 𝗽𝗵𝘆𝘀𝗶𝗰𝗶𝗮𝗻 𝗱𝗲𝗽𝗮𝗿𝘁𝘂𝗿𝗲𝘀 𝗰𝗼𝘂𝗹𝗱 𝘀𝗮𝘃𝗲 $𝟭𝗠. That’s a real cost avoidance we often overlook. ✅ Pajama time is great. But CFOs want numbers And we have them. We just need to tell the story in their language. If you’re a healthcare CIO trying to measure the impact of any AI initiative or building the case to scale one I’d love to hear what’s working for you. What’s your strategy for telling the ROI story? What’s missing from ours? Let’s compare notes and sharpen the playbook together. #HealthcareCIO #AmbientAI #DigitalHealth #HealthIT #EHR #RevenueCycle #ClinicalEfficiency #AIinHealthcare #CFOReady #TechROI #BurnoutReduction #HealthcareLeadership #PajamaTime #WorkforceWellbeing #PhysicianRetention #Abridge

🔍 A lightbulb moment that's transforming C-suites across America: Employers discovering that optimizing their health benefits strategy delivered the same bottom-line impact as a 30% increase in top-line revenue. In a slow-growth industry, that's game-changing. In inflationary times, it can save jobs and the bottom-line. Here's the wake-up call from CFO Magazine: Most companies spend more on healthcare than their core materials (think Starbucks → healthcare > coffee beans). Yet they manage other major expenses down to 0.01% while accepting 5-20% annual healthcare cost increases. The shift that's creating competitive advantage? - Treating healthcare as a strategic business unit, not an HR expense - Hiring healthcare administrators with financial + supply chain expertise - Demanding transparency in pricing and outcomes - Investing in prevention and primary care The results? Companies have achieved: • 40-55% lower per-capita health costs across a wide array of industries & size of orgs • Improved workforce performance • Enhanced recruitment/retention • Stronger bottom line The best part? These advantages compound over time, widening the gap between forward-thinking companies and those stuck in the status quo. What's your experience? Has your organization treated healthcare spending as a strategic opportunity or a necessary evil? #HealthcareSolutions #CFOStrategy #BusinessTransformation Jeffrey Hogan Chris Deacon Patrick Moore

7 ways the executive accounting class I dreaded made me a “numbers person” Sounds like a bad joke, right? A social worker walks into a healthcare finance lecture... After 10 years of advocacy, I thought I was starting over But something just clicked The numbers told the same stories I've been living. I quickly learned every spreadsheet shows: → Why prevention feels expensive (24-month ROI cycles) → Why social support looks like a cost center (but drives revenue) → Why short-term savings create long-term losses → Why system design determines patient outcomes → Why your budget tells your real story Here’s what I learned as I connected the dots: 1. Risk structures everything → Payment models shape organizational behavior → Risk-sharing changes operational priorities → Understanding risk flow = understanding power flow ↪ Your financial model is your business model 2. Infrastructure is revenue → Social supports are secret revenue drivers → Community networks determine financial success → Access barriers are hidden cost multipliers ↪ Your infrastructure limits determine your revenue ceiling>>> Support systems can help you reach your potential by making care delivery possible 3. Value Cycles are longer than you think → Prevention ROI takes 18-24 months to materialize → Population health investments pay back in 3-5 year cycles → Short-term metrics can hide long-term value ↪ The fastest path to profit isn't always the shortest 4. System design determines financial outcomes → Bottlenecks cost more than their immediate impact → Fragmentation creates hidden cost multipliers → Integration reduces total cost of care ↪ Your system's design is your financial destiny 5. Resource allocation is strategic storytelling → Budgets reveal real priorities, not stated ones → Investment patterns predict future problems → Resource flow maps real decision authority ↪ Follow the resources to find the strategy 6. Data tells multiple stories → Same numbers, different narratives → Context changes conclusions → Metrics shape behavior ↪ The metrics you choose determine the outcomes you get 7. Scale changes everything → Volume assumptions drive model viability → Fixed costs create strategic inflection points → Scale affects more than just unit economics ↪ Your scale determines your strategic options Starting over doesn't mean starting from zero A decade of social work taught me to read people's stories Healthcare finance taught me to read their numbers Turns out they're telling the same truth 💡

Today: Therapy is a "cost center" in hospitals. Tomorrow: Therapy will be a strategic asset driving financial performance. The TEAM Model is about to flip the script on hospital economics. Here's why 👇 Currently, when a therapist provides services in the hospital: Their salary comes out of the fixed DRG payments More therapy and more therapists on staff 🟰 lower revenue for the hospital -Early mobility programs are an expense, not an investment -Length of stay is the hospital's primary financial driver Under TEAM, when therapists help patients avoid unnecessary post-acute care: -Every day not spent in a SNF saves ~$500-800, reducing the likelihood the hospital will owe CMS for utilization above the anticipated episodic target price -Early and appropriate mobility becomes a revenue-generating strategy -Hospital leadership will track the ROI on early and frequent therapy interventions for patients who need therapy, and not just mobility -Downstream utilization and outcomes matter as much as length of stay This isn't just a minor adjustment - it's a fundamental realignment of incentives. 🌅 The best hospitals will recognize this shift and invest accordingly in: -Ensuring therapists' roles leverage the skills only they can provide -Advanced mobility programs staffed by ancillary staff such CNAs and PT aides, but developed by a strategic team led by the therapy department -Better discharge planning resources deployed more strategically -"Why not home?" as the starting point for creating discharge plans -Post-discharge follow-up systems that prioritize accurate and specific communication between sites of care, with the "warm hand-off" as the gold standard We're witnessing the beginning of a paradigm shift in how hospitals view therapy services. These five TEAM episode types may be the beginning of a "DRG plus 30" structure for acute care episodic accountability and payment. Have you thought about how to leverage the rehab department for TEAM success? #HealthcareEconomics #ValueBasedCare #TEAM #PhysicalTherapy #FutureOfHealthcare

Having spent a lot of time digging into the RCM space recently, it's been fascinating to see how little visibility many health systems and providers have into the underlying drivers of their revenue cycle performance. A clear and accurate picture of the revenue cycle can literally mean the difference between profitability and losing millions of dollars. However, once you start to realize how many different systems are involved in the end-to-end RCM process, its understandable why getting a comprehensive picture is so hard. It's no wonder then that revenue intelligence is becoming a key priority for more and more provider orgs. 📊 ONE DASHBOARD TO RULE THEM ALL The greatest hurdle to having a well-modeled version of the full revenue cycle is data integration: pulling in claims data, clinical data and codes, and data from other billing systems. Once accomplished, it’s much easier to not only get a comprehensive view of the state of revenue and accounts receivable, but to run modeling and see where improvements can be made. For example, visibility into the revenue cycle can enable workflows like: • Understanding common sources of revenue leakage across the system—denials, audits, takebacks, concurrent denials, patient payments, etc.     • Monitoring and identifying changes in performance across service codes, practice sites, providers, and denial reasons.    • Evaluating collection strategies and patient segmentation.    • Reviewing contract performance to identify trends in underpayment or inform re-negotiations.    • Forecasting and understanding the financial health of the system. 💸 CATCHING REVENUE LEAKAGE WITH AI Going a step further, we’re seeing some vendors focus on specific tools to improve denial management and other sources of revenue leakage. This is where machine learning (ML) often comes into play. When payers change their adjudication engines, impacting claims denials, ML is effective at spotting patterns and identifying potential process changes. We’re also seeing some vendors start to use LLMs to produce action reports for specific stakeholders based on intelligence derived from the data. 💡 ➡️ 🏃♀️ STREAMLINING INSIGHT TO ACTION While we see substantial value in having the high-level view and feedback mechanism to improve aspects of the revenue cycle, we're most excited about the potential for solutions that are “self-tuning”—uncovering and acting on the insights in a single self-contained workflow. We think the future of revenue cycle management is intelligent, integrated, end-to-end systems that can reason along the longitudinal journey of a claim, ultimately enabling more efficient issue identification and resolution. --- Current vendors in our revenue intelligence category include: • MedeAnalytics • VisiQuate • adonis • Anomaly • Deloitte Revenue Intellect • Rivet Revenue Diagnostics • Etyon • RevOps Health • Sift Healthcare Rev/Track   

11 million American are set to lose their health insurance - and healthtech entrepreneurs need to find solutions FAST. The One Big Beautiful Bill Act, signed July 4th, cut $1 trillion from Medicaid over the next decade. This leaves the equivalent of Ohio’s entire population without coverage. This is heartbreaking for working families and the hospitals that serve them. As healthtech entrepreneurs, it’s on us to find solutions to help these people. Because this shift also creates the biggest opportunity in healthcare I've seen in 25 years - a potential $50 billion market shift. Here are the solutions we need to build now: ▶ Medical payment plans Build financing platforms that let families pay for healthcare over time, like Klarna does for shopping. ▶ Comparative healthcare marketplaces Create transparent platforms where uninsured patients can compare affordable quality care with upfront, transparent pricing. ▶ Hospital efficiency tools Develop solutions that help hospitals reduce costs while serving more uninsured patients - think preventing readmissions and streamlining care. Hospitals are about to see massive spikes in ER visits from people who can't afford preventive care. The good news? States recognize this crisis and are preparing $5-10 billion annually in innovation funding to find solutions. We're moving from a world where insurance companies decide who gets care, to one where patients have direct control. We need to build build solutions for the newly uninsured - not just to capture market share - but to save millions of lives. Have any ideas for healthtech solutions? Send me a DM - I’ll help you build it. #entrepreneurship #healthtech #funding

💰 𝐋𝐨𝐬𝐭 𝐑𝐞𝐯𝐞𝐧𝐮𝐞. 𝐅𝐨𝐮𝐧𝐝 𝐅𝐚𝐬𝐭𝐞𝐫. 🎙 Featuring Frank Forte, #CEO of EnableComp | #HITshow “The things they can't find… that last mile — that's what #EnableComp does.” Hospitals are sitting on millions in unrecovered #revenue — often locked behind the most complex claims in the system. In this HITshow conversation, Frank Forte breaks down how EnableComp uses #AI, #automation, and deep #expertise to recover what others can’t — especially when it comes to: * VA claims * Motor vehicle accidents * Out-of-state Medicaid * Denials 🏥 “EnableComp finds over $2 billion of annual recoveries for healthcare systems.” “We’re working with over 800 health systems and focused on very specialized, complex revenue services.” 🧩 VA claims are a prime example: Multiple payer types (ChampVA, Tricare), distributed processing centers, and non-VA care delivery create layers of complexity. “Knowing which payer to submit to… which center to send it to… coordination of benefits — it adds a fourth dimension.” 💡 That’s why EnableComp built #Enforcer — a proprietary platform that processes over 3 terabytes of data annually to streamline complex claims using AI and advanced rules engines. ⏱️ “What takes 90 minutes manually can now be done in minutes… sometimes seconds. That is absolutely impossible to do without AI.” And the results? 📈 “We recovered $35 million in complex claims over 3 years for one Southeast health system.” 💰 “In New York, we solved a 180-day-old claim in 72 hours and returned $540,000 within 60 days.” More cash. Less friction. EnableComp is reshaping how hospitals think about revenue recovery. 💬 What part of your revenue cycle feels the most broken right now? 👇 Drop a comment or tag someone on your revenue team. #RCM #HealthcareRevenue #AIinHealthcare #RevenueCycleManagement #VAClaims #HealthcareFinance #HospitalOperations #DigitalHealth

Healthcare growth doesn't have to be hard. Sometimes it's about seeing what you already own differently. A multi-specialty group was stuck at $45M revenue (that's top 10%). Every growth strategy involved the usual expansion plays: build/buy a new location, hire more providers (with the usual quibbling over physicians or APPs), and add some new technology that allowed them to deliver additional reimbursable services. Also, cut opex and hammer the BUCAs. Add some AI! Then they mapped their existing assets differently: Their sleep center served multiple counties = regional monopoly Their endo team had excellent outcomes relative to their market = payor goldmine Their urgent care location sat next to the area's largest employer = direct contract opportunity, not just with benefits teams (hello, workplace safety) Within 6 weeks we'd mapped $18M in new revenue streams without hiring a single additional provider, buying or leasing new office space, or purchasing expensive equipment. In #healthcare, you don't have to grow by adding more. The most successful groups grow by leveraging better. #healthcaregrowth #strategy #assets