Case Study

Improving Revenue Cycle and Cash Performance

A national DME and home-based care provider engaged CWH Advisors to assess revenue cycle operations and identify the drivers of underperformance. CWH combined workflow, data, and technology analysis to identify revenue improvement opportunities and develop a prioritized roadmap to strengthen revenue capture and cash performance.

Client Pain Points

  • Below-benchmark performance across key revenue cycle metrics, including net collection rate, order denials, and held accounts receivable, created opportunities to strengthen financial performance.
  • Workflow breakdowns across intake, eligibility, prior authorization, billing, and collections contributed to denials, delayed reimbursement, and revenue holds.
  • System configuration and data integrity issues limited effective workflow controls and contributed to preventable revenue cycle inefficiencies.
  • Fragmented payer knowledge and automation processes made it difficult to consistently address root causes and sustain performance improvements.

CWH Solutions

  • Analyzed revenue cycle data and benchmarked priority workstreams to quantify revenue leakage and identify the primary drivers of underperformance.
  • Mapped end-to-end workflows to pinpoint process breakdowns, cross-functional handoff issues, and opportunities to strengthen operational controls.
  • Evaluated system configuration, data integrity, payer rules, reporting capabilities, and automation readiness to identify technology optimization opportunities.
  • Developed a prioritized 1–2-year remediation roadmap spanning process, technology, data governance, payer management, and automation initiatives.

CWH Delivering Value

  • Identified approximately $7.7 million in potential annual revenue leakage opportunity across priority revenue cycle workstreams.
  • Provided leadership with greater visibility into the workflow, payer, data, and system drivers affecting revenue cycle performance.
  • Established prioritized near- and longer-term actions to reduce preventable revenue leakage, strengthen system controls, and improve revenue capture.
  • Equipped leadership with an actionable roadmap to strengthen revenue cycle operations, optimize technology capabilities, and build a more scalable operating model.