Kentucky Rural Hospital: $20M in Debt to Positive Margins in 12 Months

~$20M in liabilities (including agricultural loans). Chronic operating losses. Lab and imaging volume leaking to competitors. Misaligned ED/urgent care creating delays and inappropriate site-of-case. Months from closing.

What We Did:
  • 1

    Right-sized the facility and built an integrated ED/urgent care pathway. Patients present once, triage routes them to the right setting.

  • 2

    Repositioned the hospital as the community diagnostics hub to repatriate lost lab and imaging volume.

  • 3

    Deployed ClaimExcel to lift clean-claim rate, automate eligibility checks, detect underpayments, and accelerate A/R through weekly cash reviews.

  • 4

    Cleared authorization friction with payers and piloted direct-to-employer agreements.

  • 5

    Embedded interim leadership, reset staffing schedules, and instituted daily huddles with weekly KPI reviews.

Year One Results:

  • Positive monthly operating margin

  • Lab revenue stabilized payroll and cash flow

  • Radiology growth funded CT and MRI acquisition after Year 1

  • Reduced avoidable ED utilization and improved time-to-care

Kentucky Rural Hospital: $20M in Debt to Positive Margins in 12 Months

~$20M in liabilities (including agricultural loans). Chronic operating losses. Lab and imaging volume leaking to competitors. Misaligned ED/urgent care creating delays and inappropriate site-of-case. Months from closing.

What We Did:
  • 1

    Right-sized the facility and built an integrated ED/urgent care pathway. Patients present once, triage routes them to the right setting.

  • 2

    Repositioned the hospital as the community diagnostics hub to repatriate lost lab and imaging volume.

  • 3

    Deployed ClaimExcel to lift clean-claim rate, automate eligibility checks, detect underpayments, and accelerate A/R through weekly cash reviews.

  • 4

    Cleared authorization friction with payers and piloted direct-to-employer agreements.

  • 5

    Embedded interim leadership, reset staffing schedules, and instituted daily huddles with weekly KPI reviews.

Year One Results:

  • Positive monthly operating margin

  • Lab revenue stabilized payroll and cash flow

  • Radiology growth funded CT and MRI acquisition after Year 1

  • Reduced avoidable ED utilization and improved time-to-care

Success Metrics We Target

Financial Access Workforce Community
Days Cash on Hand ↑ ED LOS ↓ Agency Spend ↓ Essential Services Maintained ↑
Net Cash from Ops ↑ Avoidable Days ↓ Overtime ↓ Jobs Preserved ↑
Denial Rate ↓ Utilization ↑ HCAHPS ↑ Transfers for Basics ↓
A/R > 90 days ↓ Referral Leakage ↓ Staff Satisfaction ↑ Patient Satisfaction ↑

Success Metrics We Target

Financial Access Workforce Community
Days Cash on Hand ↑ ED LOS ↓ Agency Spend ↓ Essential Services Maintained ↑
Net Cash from Ops ↑ Avoidable Days ↓ Overtime ↓ Jobs Preserved ↑
Denial Rate ↓ Utilization ↑ HCAHPS ↑ Transfers for Basics ↓
A/R > 90 days ↓ Referral Leakage ↓ Staff Satisfaction ↑ Patient Satisfaction ↑
Build the Foundation & Position for Growth.

180 Day Sprint

Months 1-3
Cash Acceleration
  • 1

    Deploy ClaimExcel to audit 12 months of claims data and recover underpayments.

  • 2

    Implement proactive denial prevention workflows.

  • 3

    Unlock trapped cash in DNFB and A/R > 90 days.

  • 4

    Automate accounts payable to reduce supply chain costs.

Embedded Technology

ClaimExcel Platform
837/835 Reconciliation
AP Automation
Daily Cash Dashboards

Goal:
Positive monthly cash flow within 90 days

Months 4-6
Service Line & Operations
  • 1

    Repatriate lost lab and imaging volume by repositioning hospital as community diagnostics hub.

  • 2

    Right-size ED/urgent care pathways so patients present once and get triaged appropriately.

  • 3

    Cut agency spend and overtime premiums through smarter scheduling and productivity resets.

Embedded Technology

AI Call Center
Digital Scheduling Hub
Staff Utilization Analytics
Service-line P&L Dashboards

Goal:
Self-sustaining operations with predictable margins

Months 6+
Long-Term Independence
  • 1

    Build rural collaboratives and shared service agreements with neighboring facilities.

  • 2

    Negotiate better payor contracts and develop direct-to-employer health plans.

  • 3

    Create outreach clinic strategies to expand reach without overextending resources.

  • 4

    Identify and apply for federal and state grants.

Embedded Technology

Payor Contract Analytics
Regional Partnership Modeling
Executive Scorecards
Grant Application Support

Goal:
Hospital positioned for long-term independence and growth

Build the Foundation & Position for Growth.

180 Day Sprint

Months 1-3
Cash Acceleration
  • 1

    Deploy ClaimExcel to audit 12 months of claims data and recover underpayments.

  • 2

    Implement proactive denial prevention workflows.

  • 3

    Unlock trapped cash in DNFB and A/R > 90 days.

  • 4

    Automate accounts payable to reduce supply chain costs.

Embedded Technology

ClaimExcel Platform
837/835 Reconciliation
AP Automation
Daily Cash Dashboards

Goal: Positive monthly cash flow within 90 days

Months 4-6
Service Line & Operations
  • 1

    Repatriate lost lab and imaging volume by repositioning hospital as community diagnostics hub.

  • 2

    Right-size ED/urgent care pathways so patients present once and get triaged appropriately.

  • 3

    Cut agency spend and overtime premiums through smarter scheduling and productivity resets.

Embedded Technology

AI Call Center
Digital Scheduling Hub
Staff Utilization Analytics
Service-line P&L Dashboards

Goal: Self-sustaining operations with predictable margins

Months 6+

Long-Term Independence

  • 1

    Build rural collaboratives and shared service agreements with neighboring facilities.

  • 2

    Negotiate better payor contracts and develop direct-to-employer health plans.

  • 3

    Create outreach clinic strategies to expand reach without overextending resources.

  • 4

    Identify and apply for federal and state grants.

Embedded Technology

Payor Contract Analytics
Regional Partnership Modeling
Executive Scorecards
Grant Application Support

Goal: Hospital positioned for long-term independence and growth

Full Tech Stack Without The Enterprise Price Tag

What You Get

ClaimExcel Revenue Platform

  • Predictive A/R Modeling

  • Denial Prevention Workflows

  • Underpayment Detection via 835/837 Reconciliation

  • Payer-Specific Automation

  • Payer Contract Negotiation Analytics

MKC ERP for Hospitals

  • Procure-to-Pay Automation

  • Inventory Management

  • Vendor Rationalization

  • Real-time Contract Performance Tracking Tied to Clinical and RCM Data

AI Patient Access Hub

  • Natural Language AI Call Center

  • Triages to Medical Necessity

  • Books Appointments

  • Escalates Appropriately

  • Tracks Abandonment and Hold Times

Operations & Analytics Suite

  • ED-to-Inpatient Flow Dashboards

  • Bed Management

  • OR/Clinic Utilization Tracking

  • Daily Huddle Frameworks

  • Executive KPI Scorecards

Partnership & Growth Tools

  • Service-Line Business Case Modeling

  • Rural Collaborative Design

  • Grant Application Packages

  • Direct-to-Employer Health Plan Frameworks

Full Tech Stack Without The
Enterprise Price Tag

What You Get

ClaimExcel Revenue Platform

  • Predictive A/R Modeling

  • Denial Prevention Workflows

  • Underpayment Detection via 835/837 Reconciliation

  • Payer-Specific Automation

  • Payer Contract Negotiation Analytics

MKC ERP for Hospitals

  • Procure-to-Pay Automation

  • Inventory Management

  • Vendor Rationalization

  • Real-time Contract Performance Tracking Tied to Clinical and RCM Data

AI Patient Access Hub

  • Natural Language AI Call Center

  • Triages to Medical Necessity

  • Books Appointments

  • Escalates Appropriately

  • Tracks Abandonment and Hold Times

Operations & Analytics Suite

  • ED-to-Inpatient Flow Dashboards

  • Bed Management

  • OR/Clinic Utilization Tracking

  • Daily Huddle Frameworks

  • Executive KPI Scorecards

Partnership & Growth Tools

  • Service-Line Business Case Modeling

  • Rural Collaborative Design

  • Grant Application Packages

  • Direct-to-Employer Health Plan Frameworks

The Model That Works for Rural Budgets

We built our pricing specifically for critical access, rural, and independent hospitals. Our monthly subscription is a fraction of what traditional firms charge and 25% of our total fees are tied to your performance.

We only get paid when you achieve the metrics we define together.

The Model That Works for Rural Budgets

We built our pricing specifically for critical access, rural, and independent hospitals. Our monthly subscription is a fraction of what traditional firms charge and 25% of our total fees are tied to your performance.

We only get paid when you achieve the metrics we define together.

Let’s Talk

Direct conversation with our leadership. We’ll discuss your most pressing concerns, identify high-impact opportunities, and outline a 180-day stabilization path.

If we can’t deliver measurable results, we’ll tell you.

Let’s Talk

Direct conversation with our leadership. We’ll discuss your most pressing concerns, identify high-impact opportunities, and outline a 180-day stabilization path.

If we can’t deliver measurable results, we’ll tell you.