A system-wide approach that strengthens margins and elevates the patient financial experience.
A Tale of Two CEOs
In the final days of the fourth fiscal quarter, two health system CEOs face the same dilemma: how to improve patient outcomes while strengthening financial performance. Both have five years in the role, both lead three-hospital systems and both are exhausted from years of margin pressure.
Reactive strategies and incremental cuts haven’t delivered results. Continued margin compression – driven by workforce shortages, payer complexity and reimbursement challenges – threatens profitability, even for clinically strong optimizations.1,2 Fragmented systems, siloed data and physician misalignment undermine efficiency, while patients increasingly delay care due to cost concerns.3
Every element of the patient journey matters. Revenue cycle management, clinical workflows and labor decisions are deeply interconnected. Move one lever, and everything shifts. With limited time and mounting pressure, both CEOs ask the same questions: Where do I start?
One CEO chooses a quick fix, hoping for a short-term win. The other commits to a structural change, knowing lasting improvement requires an experience advisory partner. This is where their paths diverge.
“It’s not advisory from the sidelines. We’re in it with our partners – shoulder to shoulder – from advising to implementation to accountability.” – Amanda Vallozzi, Managing Director of Financial Transformation Advisory Services, Premier Inc.
The Essentials of Enterprise-Wide Financial Transformation
Improving financial performance in today’s complex care environment requires enterprise-wide, data-driven and sustainable transformation. Premier’s Financial Transformation Advisory approach begins with trusted relationships and close collaboration.
By combining unmatched data, technology and proven strategies, Premier helps health systems address margin management and the patient financial experience holistically. Analytics, automation and artificial intelligence (AI) surface opportunities and remove friction, while strategic collaboratives provide benchmarks no single organization can see alone.
The result is a durable foundation for clinical and financial excellence – improving margins, strengthening payer relationships and elevating the patient experience.2 Incremental change can’t deliver these outcomes; it leads to short-term partnerships, abstract advice and point solutions that fall short of healthcare’s complexity.4
To understand the impact of structural change, consider the three pillars of financial transformation.
1.Clinical Integrity
The “visionary CEO” begins where risk and revenue intersect: clinical documentation. Incomplete documentation leads to missed revenue, compliance risk and compromised outcomes. Her advisory team strengthens documentation standards, improves coding accuracy and aligns level-of-care decisions with medical necessity.
Targeted technologies — predictive analytics, ambient documentation and autonomous coding — reduce burden and improve consistency. Discharged-not-final-billed days decline, cash flow accelerates, reimbursement accuracy improves and compliance risk falls. Clinical integrity becomes a strategic lever.
By contrast, the “status quo CEO” hires consultants for advice only. Without implementation support, denials rise, revenue leaks and compliance gaps widen.
2.Revenue Cycle and the Patient Financial Experience
With clinical integrity in place, the visionary CEO focuses on the revenue cycle. The advisory team optimizes front-end workflows such as prior authorization, insurance verification and patient collections, while strengthening back-end denial and collections management. Vendor contracts are reviewed and renegotiated.
The results are record cash flow and margin gains — and better patient experiences driven by clearer, more streamlined billing. These improvements stick because the advisory team works side by side with staff every day.
The status quo CEO sees a brief boost by increasing appointments, but the added volume overwhelms the revenue cycle team, creating delays and patient frustration.
3.Managed Care and Payer Strategy
The visionary CEO treats managed care as a strategic growth lever. With advisory support, she assesses people, processes and technology, using national benchmarking data to evaluate payer performance and negotiate from a position of strength. Strategic collaboratives and regulatory expertise further elevate payer accountability.
With hands-on support and AI-enabled contract modeling, she secures stronger reimbursement agreements aligned with both near-term needs and long-term growth. Ongoing benchmarking ensures relationships remain fair.
Without data or guidance, the status quo CEO locks into a costly payer deal — the tipping point that pushes him to reconsider his approach.
What Lasting Change Looks Like
The visionary CEO’s journey is fiction, but it reflects real results.
Prisma Health partners with Premier on a systemwide transformation, achieving $450 million in margin improvement in just three years, half the planned timeline, and reinvesting those gains into care delivery.
A community health system facing financial crisis and an EHR migration partnered with Premier under a 100% performance-based agreement. In five months, the collaboration delivered $10 million in revenue improvement and positioned the system for sustained growth.
When Health Systems Thrive, Communities Flourish
Strong financial performance extends beyond hospital walls. Financially healthy systems expand access, create jobs, invest locally and improve population health.5 A resilient health system becomes an anchor for its community.6
That vision drives Premier’s financial transformation advisors every day, partnerships rooted in results, not promises. Because when health systems thrive, communities, and the nation, grow stronger.
Let’s write your next chapter together.
Sources:
- https://www.mckinsey.com/industries/healthcare/our-insights/how-the-healthcare-industry-can-weather-ongoing-challenges
- Premier’s internal data
- https://www.kff.org/health-costs/americans-challenges-with-health-care-costs/
- https://www.jpmorgan.com/insights/banking/commercial-banking/how-ai-m-and-a-and-policy-planning-are-shaping-health-care
- https://www.aha.org/costsofcaring
- https://www.aha.org/news/perspective/2024-09-27-hospitals-are-community-cornerstones-and-advance-health-many-ways