Case Study: California-based community acute care hospital achieves improved cash flow and reduces A/R >60 days from 13% to 2% with Conifer Health Solutions

Hospital Takes Proactive Approach to Manage Risk, Improves Quality and Financial Performance

California Based Community Acute Care Hospital, a 350‑bed, independent not‑for‑profit in California that treats more than 100,000 patients annually, faced challenges serving its population cost‑effectively and administering risk‑based agreements. Chronic county delays in adjudicating managed Medicaid claims created a large backlog and the hospital needed a partner to help transition from fee‑for‑service to capitated, risk‑bearing arrangements. The hospital contracted Conifer Health Solutions to manage the risk pool and operate utilization management and claims adjudication.

Conifer Health Solutions implemented ongoing risk‑pool management and claims processing, improved physician engagement and care coordination, and accelerated payments and cash flow. As a result, outstanding A/R over 60 days fell from 13% to 2% in FY17 (an 11% reduction as reported), physician groups received distributions under the shared‑risk arrangement, and the hospital is positioned to expand risk‑based contracts with other payers. Conifer’s efforts also helped the risk pools meet targets and improve clinical alignment since the program’s inception.