Strengthening margins to thrive among emerging threats

Five years ago, Amy Floria, CFO at Goshen Health, was worried. ICD-10 was coming, and the reimbursement landscape was shifting. The hospital was thriving, but not enough to weather the storm ahead. That's when she turned to Advisory Board.

The result: best practices tailored to her needs supported far-reaching revenue cycle transformation, a 12% margin, and a strong foundation to continue to serve the community. Here's how we did it.


Goshen Health

  • 123-bed community hospital
  • Located in Goshen, Indiana
  • "Small, but mighty"


Cultural shift lifts money taboo

It’s never easy asking patients to pay. In a town of 30,000 like Goshen, when that patient may be in line with you at the supermarket tomorrow, it’s particularly difficult.

But when you bring together best-practice training for front-end staff, accurate patient obligation estimates from Payment Navigation Compass, and a very committed director of patient financial services, anything is possible—including a 50-times increase in monthly point-of-service collections in two years.

Goshen Health Monthly Point-of-Service Collections

IU Health Goshen Monthly Point-of-Service Collections

A makeover for clinical documentation

It wasn't that administrators at Goshen Health had a bad relationship with physicians. It was more that the relationship was non-existent. Advisory Board consultants showed staff how other hospitals successfully forged a path toward better collaboration. Today, CDI specialists use Advisory Board-generated data analysis to improve documentation—to the tune of $300,000 in added revenue annually.

Replacing madness with method in self-pay collections

Before working with Advisory Board, collectors at Goshen Health were spinning their wheels. To increase collections, and make collectors’ lives easier and their jobs more rewarding, Goshen Health installed Self-Pay Compass to easily stratify self-pay accounts to follow up with the patients likely to pay and write off those that wouldn’t. It paid off: one year later, the hospital had reduced self-pay days in accounts receivable by 40% and reduced A/R greater than 120 days by $1.9 million.



improved documentation and accurate reimbursement led to $300k in additional revenue

Because of our work with Advisory Board and other internal initiatives, we’re in a position now to really make some strategic moves, like looking at population health management and the key structures we need to put in place locally to serve the patients of Goshen.

Amy Floria
Chief Financial Officer
Goshen Health

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