One Provider’s Plan to Stay Profitable When Reimbursements Slow

When economic conditions shift, healthcare providers face a dual pressure: financial tightening and growing patient demand. This case study shows how a multi-specialty provider took early action to protect margin, improve cash flow, and create a sustainable growth plan that wouldn’t compromise care, even in a downturn.​

The Company Profile

• Type: Multi-specialty outpatient provider (primary care, diagnostics, urgent care)
• Size: 3 locations, 65 staff including 14 providers
• Revenue Model: 65% insurance reimbursements, 20% cash-pay diagnostics, 15% employer contracts
  
  

Primary Vulnerabilities:

• Reimbursement lags from commercial and government payers
• High fixed staffing and lease obligations
• Limited visibility into profitability by service line

The Approach: Margin Protection and Liquidity Planning

1. Accelerated Accounts Receivable Management

Solution: Improved payer follow-up and shortened claim cycle

Key Actions:

• Segmented A/R by payer type and implemented aging report flags
• Reassigned billing staff to prioritize claims over 45 days
• Negotiated faster remittance schedules with key employer contracts

​Result: Reduced average days in A/R from 56 to 34 days


2. Service Line-Level Margin Analysis

Solution: Identified underperforming services based on payer mix and resource intensity

Key Actions:

• Modeled profitability by CPT group, adjusting for staff utilization and space costs
• Flagged underperforming urgent care service that had high weekend labor cost and low net revenue
• Shifted resources toward diagnostics and occupational health services with higher margin predictability

​Result: Improved blended service line margin by 9% in 90 days

3. Staff Cost Management Without Burnout

Solution: Introduced a cross-coverage model and productivity-based incentives

Key Actions:

• Designed flexible coverage model across front office and MAs using shared resource pool
• Shifted provider incentives to include margin-per-hour alongside patient volume
• Implemented burnout tracking indicators and quarterly staffing forecast reviews

​Result: Reduced overtime pay and improved provider engagement without cutting hours

4. Cash Flow Forecasting and CapEx Pause Strategy

Solution: Built a liquidity plan around a 6-month forecast model

Key Actions:

• Deferred a new imaging equipment purchase, opting to service existing assets
• Modeled minimum cash runway needed to absorb 10% revenue drop
• Created a restricted reserve account funded from excess Q1 cash

Result: Avoided $250K in near-term capital expense and built a 90-day cash buffer

Key Takeaways

• Recession-proofing in healthcare means getting proactive with A/R, margin visibility, and workforce flexibility.
• Not all growth is worth pursuing—knowing which service lines actually deliver value is critical.
• Delaying capital investments can be a strategic strength, not a sign of retreat.
• A well-run forecast is more than a spreadsheet—it’s a leadership tool.​​