Healthcare leaders are under constant pressure to improve financial performance, streamline operations and create a better patient experience, while working with limited resources and increasing complexity. A recent KLAS ROI Validation report examining the partnership between Carilion Clinic and Ensemble offers a real-world look at the measurable impact an end-to-end revenue cycle outsourcing model can achieve.
Carilion Clinic, a seven-hospital academic health system in Virginia with more than 1,000 licensed beds and annual patient revenue exceeding $2 billion, partnered with Ensemble to improve revenue cycle performance, operational consistency and the patient financial experience. The organization sought to address the challenges of a highly customized EHR environment while leveraging Ensemble’s expertise, technology investments and best-practice processes.
The results show what can happen when revenue cycle transformation is managed as one connected system, not a series of disconnected workstreams. Improvements extend across the longitudinal scope of the revenue cycle, including financial performance, operational efficiency, claims accuracy, digital engagement and the patient financial experience.
Financial performance improved across key metrics
One of the most significant outcomes was growth in cash collections. Carilion increased total cash collections by more than $217 million while also improving cash yield relative to net revenue. Average daily cash collections increased from $8.2 million to $9.1 million.
The organization also achieved meaningful improvements in accounts receivable performance, reducing total AR days from 50.6 to 36.7 days. Denial adjustments decreased from approximately $84.7 million to $67.6 million, representing a 20% reduction. At the same time, overall financial stability remained strong, with improved liquidation rates and sustained cash reserves.
These outcomes show the value of managing the revenue cycle as one connected system, improving financial performance for the hospital while making processes more accurate, efficient and easier for patients to navigate.
Want the full results and methodology? Download the KLAS ROI Validation report
Operational efficiency creates a foundation for sustainable improvement
Beyond financial metrics, the report highlights substantial operational improvements.
Carilion reduced outstanding outpatient scheduling cases by 83%, from approximately 6,000 to 1,000. Patient contact times also improved dramatically, dropping from five to seven days to just one day. Together, these improvements helped patients connect with care more quickly while giving the organization a more efficient, accurate scheduling process.
The health system also expanded reporting capabilities to strengthen enterprise visibility and help leaders make faster, more informed decisions. Carilion moved from having no KPI dashboards to 10 core KPI dashboards supported by Epic and Microsoft Power BI reporting. Vendor consolidation further streamlined operations, reducing the vendor portfolio from 37 vendors to 18.
Additional improvements included increased claims accuracy, with the percentage of claims submitted without error rising from 94.9% to 97.6%, as well as lower vendor, labor and technology costs through outsourcing and consolidation.
RCM improvement brings additional benefits for the patient experience
The KLAS validation found measurable improvements in patient engagement and satisfaction.
MyChart adoption increased from 52.0% to 60.1%, reflecting stronger digital engagement among patients. Patient satisfaction scores also improved across outpatient and ambulatory surgery settings, including gains in top-box performance and likelihood-to-recommend measures.
For those requiring financial assistance, applications were streamlined, resulting in processing times of just 7 days, down from 70, accelerating support for patients who needed help navigating the cost of care.
Executive highlights: action areas for revenue cycle leaders
The report identifies several best practices that other health systems can apply when pursuing revenue cycle transformation:
- Prioritize organizational alignment and change management.
- Standardize processes before attempting optimization.
- Invest in technology optimization, automation and data-driven decision-making.
- Measure success across financial, operational and patient-focused outcomes.
These findings reinforce an important reality for healthcare organizations: sustainable revenue cycle improvement requires more than solving isolated operational challenges. Success comes from aligning people, processes and technology around a shared set of goals.
Explore the complete KLAS ROI Validation report to see the full results, methodology and lessons learned from Carilion Clinic’s partnership with Ensemble