The Operating Baseline

See What You Would Have in Your Hands

A findings memo should make a decision easier. A scorecard should make the next conversation more useful. Here is how we organize both.

Start with the Operating Baseline

Illustrative template, not a client engagement or a reported outcome. There are no invented practice figures here. The memo below shows how a possible finding would be tested before it becomes a recommendation.

Edison Breakwater

Operating Baseline · Illustrative memo excerpt

Can late cancellations be offered to waiting patients?

What needs testing: A long wait for appointments can coexist with late openings. The question is whether those openings are usable for patients waiting for the same visit type, with the right room, preparation and authorization.

Evidence to review: Appointment audit log, cancellation timestamps, waitlist records, completed visits and staff coverage for the same period. Separate routine visits from procedures. Exclude blocked time and openings that could not safely be used.

Measure: Eligible late openings offered to waiting patients, offers accepted and visits completed. Keep a reason for each opening that could not be offered.

Financial estimate: Eligible openings × the practice’s observed completion rate × expected contribution per completed visit. Use contracted allowed amounts less variable delivery cost. State the period and assumptions before annualizing; do not treat the estimate as guaranteed revenue.

First action: The scheduling lead tests a same-day waitlist review for one provider and one visit type. Agree the start date, review date and eligibility rules with clinical leadership.

Measure of done: Every eligible opening in the pilot has a recorded offer or a documented reason it could not be offered. Compare completed visits and staff time before deciding whether to extend the change.

What we are not recommending: Overbooking, shorter clinical visits or new scheduling software before checking whether the existing process can use the available time.

The scorecard behind the discussion

In your scorecard, each row has a named report, reporting period, current value, trend, agreed target and accountable owner. Values remain blank here because they must come from your practice. These definitions are starting points to reconcile with your reporting.

Measure	Definition to agree before use
Net collection rate	Payments ÷ collectible allowed amount for the same service cohort, after contractual adjustments
First-pass denial rate	Initially denied claims ÷ claims with a first adjudication in the same period
Days in A/R	Receivables ÷ average daily net patient service revenue, using an agreed reporting period
A/R over 90 days	Receivables older than 90 days ÷ total receivables, with patient and payer balances separated
Third next available appointment	Calendar days to the third open routine appointment, by provider and visit type
Slot utilization	Completed appointments ÷ usable appointment slots, by provider and visit type
No-show rate	Missed appointments without cancellation ÷ scheduled appointments eligible to occur
Cost per encounter	Agreed operating expense ÷ completed encounters; define included costs before comparing
Support staff per provider FTE	Support staff FTE ÷ provider FTE, with consistent role and hours definitions
Operating margin per physician FTE	Operating income ÷ physician FTE; state physician compensation treatment explicitly

This is an excerpt, not the full deliverable. The paid four-week engagement includes a 10 to 15 page findings memo, a KPI scorecard and a 90-day plan. Each action has one owner, one due date and one measure of done. We sequence the work so no team absorbs two changes in the same two weeks.

Start with the Operating Baseline

Four weeks to understand what is getting in the practice’s way. A fixed fee, a written findings memo, a KPI scorecard and a 90-day plan your team can use.

Start with the Operating Baseline See a sample of the work

We reply within two business days. You speak directly with the operator who will do the work. Scope and fee are agreed in writing before you commit.