Physician Practice Sustainability

Project in Progress


  • A non-profit organization providing primary care and hospice services to patients in their homes.
  • 16 primary care providers
  • Hospic daily average census: 75

The Challenge

This primary care and hospice practice provides a unique service in only seeing patients in their homes, serving a vulnerable population, unable to easily get to a medical office for care.  With this high cost model, the organization was faced with financial sustainability challenges.

The Eleva Approach

  • Completed assessment to understand business model, financial drivers and operational challenges.
  • Identified top areas for improvement including: patient intake processes, patient scheduling, care model redesign, triage functions and revenue cycle. Formed and led workgroups to design, pilot and implement new solutions.
  • Developed and led 18 month improvement project implementation plan.
  • Implemented Lean daily management system across the organization.
  • Implemented monthly performance reporting dashboards for revenue cycle, primary care provider performance, quality and executive performance summary.
  • Completed payor contract analysis, developed a standard payor contracting model and supported contract modeling and negotiations with payors for increased contract rates.
  • Developed and implemented a primary care coding training and improvement plan.
  • Developed and implemented service line revenue forecasting model.

The Results to Date

  • 10% increase in primary care census without adding FTE.
  • Reduced primary care patient waitlist by 62% and reduced days from referral to enrolling the patient for service by 65%.