Transforming revenue cycle operations
After an initial assessment, the revenue cycle transformation project kicked off in early 2023, led by Catholic Health’s high-performing teams and dedicated KPMG resources to guide multiple workstreams, including revenue operations, analytics, technology, and governance. Executive sponsors included Catholic Health’s chief financial officer, senior vice president of revenue cycle management, and their leadership teams.
The 16-month, multiphase program was designed to expand and enable internal capabilities, deliver near-term financial benefits, and set a long-term foundation for performance and resilience. The combined teams worked side-by-side to execute the program across seven areas of focus, following a three-pronged approach:
- Map existing workflows.
- Design targeted process improvements and enhanced data and analytics to support change.
- Deliver solutions with embedded sustainability plans, training, and Catholic Health ownership.
Each workstream had dedicated owners from both Catholic Health and KPMG, with improvements coming online in phases. Here’s more about each area:
- Financial clearance: Improved preservice workflows for insurance verification and authorizations, reducing downstream delays and missed billing opportunities.
- Health information management reporting: Strengthened collaboration between coding, providers, hospital leaders, and billing teams to reduce midcycle delays.
- Patient accounting: Refined how follow-up accounts were prioritized and assigned, helping teams work more efficiently and accelerate collections.
- Denial prevention: Introduced root-cause tracking and a cross-functional oversight model to reduce preventable denials and support cleaner claims.
- Analytics and governance: Developed a suite of nine custom dashboards in Tableau to give leadership visibility into performance across A/R, denials, payments, productivity, and more.
- Payer issue escalation: Streamlined how payer issues were tracked, escalated, and resolved—reducing friction and speeding up resolution.
- Physician revenue cycle: Implemented improvements in professional fee billing environments, front-end processes, and reporting.
The project included a 120-day transition period in early 2025 to support training, documentation, and a smooth operational handoff. To date, these changes have enabled Catholic Health to achieve more than $25 million in net revenue improvement and provide leadership with new tools and governance models to sustain these improvements over time.
The crisis: Response and recovery
As Catholic Health’s revenue cycle initiative was midway through completion, the Change Healthcare outage demanded a rapid response and reset of the project’s priorities and resources. It affected 190 million US consumers and brought claims and payment processing to a standstill for hundreds of thousands of providers.1 And while there’s no good time to be facing a sudden cash gap of $150 million, the fact that Catholic Health was already 10 months into the overall revenue cycle transformation initiative with KPMG gave the combined teams the opportunity to quickly pivot and respond with urgency and excellence.
Catholic Health leadership worked quickly with KPMG to turn from operational improvements to crisis management—without losing momentum on either front. Leaders and team members from across Catholic Health’s revenue cycle, information technology, and finance teams came together with KPMG to:
- Stand up and project manage an interdisciplinary crisis response team, quickly deploying contingency plans and coordinating response activities.
- Position teams for business continuity: manually verifying more than 180,000 accounts to keep payments flowing while systems were rebuilt.
- Support the technology response, ultimately implementing a new clearinghouse in less than four months and integrating it with the existing EHR to support eligibility verification and claims submission.
- Redesign workflows and retrain staff across front- and back-office functions to adapt to the new functionality in the clearinghouse tool.
- Recover $132 million in delayed cash, including 100 percent recovery in professional billing, nursing home, and hospice claims, and approximately 90 percent in hospital billing.
- Avoid the need for emergency credit lines or drawdowns to preserve financial stability during the crisis.
To support this parallel response, Catholic Health extended the engagement to help ensure their revenue operations were stabilized and solidly on course for the “good to great” improvements envisioned in the original project. The return to positive net revenue improvement in less than nine months exceeded Catholic Health’s expectations for timing and outcomes. The healthcare payment platform disruption also demonstrated the strength of the program’s enhanced revenue cycle foundation and multidisciplinary leadership team. Catholic Health emerged with stronger infrastructure, better data visibility, and a more resilient revenue cycle operation—with teams capable of both transformation and real-time problem solving under pressure.
1 Ron Southwick, “Change Healthcare cyberattack affected 190 million,” Chief Healthcare Executive, January 28, 2025.
Ready for anything
The real test of a transformation isn’t how well it sticks to the plan—it’s how well it sticks, even when the plan changes. Catholic Health’s two-year revenue cycle journey proved its strength and resilience on both fronts: a meticulously planned transformation executed with discipline, and a rapid-fire crisis response that preserved financial stability when it mattered most.
But the true legacy of the program may be the way it has equipped Catholic Health’s people—at every level of the organization—to move faster, increase productivity, and deliver continuous improvements going forward. From billing staff to executive leadership, teams now have the tools, dashboards, and visibility they need to spot issues sooner, deliver more value, and respond with confidence. Indeed, six months after the conclusion of the engagement, the organization continues to meet its increased cash targets through ongoing improvements in areas like payment timelines and claims mitigation—demonstrating that its revenue cycle transformation is built to last.
