SUCCESS STORY

Accelerating Cash and Optimizing the Revenue Cycle Post-Epic

A multi-regional health system faced a $100M cash deficit shortly after implementing Epic, prompting a partnership with Impact Advisors to stabilize and optimize revenue cycle management. Through collaboration, targeted initiatives, and enhanced use of technology, the health system achieved significant
financial recovery and operational improvements.
Time-lapse shot of a green-lit tunnel

A large, multi-regional health system with a growing footprint sought to strengthen its financial position following an enterprise Epic implementation. Within months of its
first go-live, the organization experienced a $100M cash deficit that could not be easily explained. Facing mounting pressure to stabilize cash flow before fiscal year-end, health
system leadership turned to Impact Advisors for guidance.

From the beginning, this engagement was defined by collaboration. Working side by side with health system leaders across finance, operations, and IT, Impact Advisors and the client formed a united front to address challenges quickly and effectively. That shared trust and partnership became the foundation for every success that followed.

Establishing the Foundation

Impact Advisors began with a rapid but comprehensive assessment of the organization’s Accounts Receivable (AR) and overall Patient Financial Services (PFS) operations. Interviews with key stakeholders revealed that nine months after go-live, many staff and leaders were still adapting to Epic workflows and reporting tools—hindering their
ability to effectively manage AR. The Impact Advisors team established a Cash Acceleration Program focused on transparency, accountability, and speed to value—anchored
by strong relationships and daily collaboration with PFS leadership.

Key components included:

  • Leadership system training to help managers use Epic dashboards and reports more effectively to pinpoint bottlenecks, monitor team performance, and drive accountability.
  • Targeted AR recovery across both Epic and Meditech systems, allowing staff to work open accounts efficiently and reestablish cash flow.
  • Cash posting optimization to eliminate erroneous records, streamline workflows, and create new productivity standards across locations.
  • Agile scrum tracking, where PFS leaders and Impact Advisors met three times weekly to review progress, align priorities, and celebrate wins. 
 
Within three months, the results were striking: the health system achieved the three highest cash collection months in the organization’s history and accelerated $236M in cash above expectations between April and June. This early success—and the trust it built—laid the groundwork for an expanded collaboration focused on long-term revenue cycle optimization.

"I have enjoyed working with Impact Advisors, their partnership has helped us improve our processes and deliver improved outcomes. We are witnessing organizational transformation right before our eyes and I would not hesitate to recommend them to another organization or work with them again in the future.”

- Senior Vice President of Revenue Cycle

Expanding the Partnership

In Professional Billing (PB), the Impact team supported a new operational director in standing up a consistent governance and performance structure across a vast clinic
network. The work included:

  • Identifying and recovering collectible, timely filing AR through targeted analytics and staffing plans.
  • Establishing a PB-specific scrum to review KPIs and monitor the denial reduction program and overall progress twice weekly.
  • Partnering with Revenue Integrity to create standardized charge reconciliation policies.
  • Developing a “bot” to automate medical records requests, freeing staff time for higher-value work.
 

These initiatives helped reduce the denial rate by 8 percentage points and increase yearly PB cash collections by $10M. 

In Hospital Billing (HB), Impact Advisors worked shoulder to shoulder with PFS managers to optimize Epic work queue (WQ) routing, establish ownership, and use real-time analytics to identify root causes of delays. The team also led high-dollar and clinical denial reviews, improving recovery rates and deepening staff understanding of Epic’s revenue tools. 

Meanwhile, a comprehensive Cash Management cleanup effort brought Epic’s reconciliation functions fully online for the first time. Impact Advisors partnered with operations

and IT to delete erroneous records, automate Provider-Level Balance (PLB) transactions, and provide on-site staff training—restoring trust in daily cash visibility.
 
To ensure sustainable performance, Impact Advisors also helped redesign the health system’s Epic training and QA programs, shifting the curriculum toward workflow-driven, role-based education and establishing a shadowing model for new hires. This approach helped leaders and staff alike feel more confident managing their responsibilities and be equipped to sustain change.

Positive Impact

Over nearly two years, Impact Advisors and the client developed a partnership rooted in trust, transparency, and shared purpose. Working together across every corner of the
revenue cycle, they achieved both measurable financial gains and meaningful cultural transformation.

Today, the organization is collecting 15% more cash than in 2024 and has established the operational discipline, data literacy, and leadership alignment needed to sustain growth. Several principles defined the engagement’s success:

  • Relationships first: Strong connections across all areas of the organization built trust—and that trust allowed the Impact Advisors team to move quickly, solve problems collaboratively with the client, and implement initiatives that directly improved the health system’s bottom line.
  • Technical and operational fluency: By combining deep Epic and Meditech expertise with practical operational insight, Impact Advisors helped health system leaders understand not just what to change, but why it mattered.
  • Data-driven accountability: Training health system leaders to use Epic tools and dashboards empowered them to track performance, identify trends, and hold their teams accountable to established goals.
  • Focused execution: Together, Impact Advisors and the health system avoided trying to “boil the ocean.” Instead, they prioritized high-value initiatives that created visible wins and built momentum for lasting transformation.

Through strong partnership, clear communication, and shared commitment, Impact Advisors helped the health system turn a $100M deficit into sustained financial health—positioning the organization for continued success and growth in the years ahead. 
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