Developing growth strategies for a surgery clinic chain

Pinnacle operates a network of surgery centers across New York. The clinics accept payments from commercial insurers, workers’ compensation programs, government payers, and a growing roster of self‑pay clients. Each source follows its own settlement calendar, so a claim to a private insurer might clear in six weeks, while a workers’ compensation payment can stretch past half a year. Making matters worse, surgical teams documented procedures in two unrelated electronic medical record platforms, and many older cases survived only in sprawling spreadsheets. By the time Pinnacle’s leadership contacted Alehar, even simple questions about cash position triggered long email threads.

The board’s directive was blunt. They needed a single, reliable view that mapped every surgery to its likely cash‑arrival date and then rolled those streams into an integrated forecast. Without that clarity, the group could not decide whether to add operating rooms or branch into additional service lines such as pain management.

1. Building a unified data foundation

Our first step was to pull cash‑basis income statements from Pinnacle’s outsourced bookkeeping firm so we could establish a verified starting point. We then audited every data source the clinical and administrative teams touched. One center used a cloud-based EMR, another relied on an older on‑premise system, and a surprising number of billing codes lived only in color‑coded Excel files that changed hands through email.

2. Storytelling that converts interest into capital

We designed a lightweight data reconciliation process to integrate data from the multiple EMRs and spreadsheets into a single EMR. Early workshops focused on a single procedure naming convention and a unified chart of accounts so that a surgery filed in one system would match the same surgery coded in another. Within six weeks, Pinnacle’s finance and operations heads could see in one place the cash already collected, the claims in process, and the expected arrival windows for every outstanding receivable.

3. Discovering hidden liquidity

The consolidated dashboard revealed a stronger cash outlook than anyone predicted. Although payers with longer settlement cycles still dominated the ledger, a new flow of self‑pay cases meant a steady tide of near‑term collections was on its way. The twelve‑month forecast showed enough surplus to cover operating expenses, fund upgrades, and leave reserves for growth.

Pinnacle now conducts monthly management reviews using the single dashboard instead of manual spreadsheets. Staffing levels, equipment leases, and marketing budgets align with one consolidated financial truth. By transforming scattered records into a coherent narrative, Pinnacle has shifted from defensive cash management to proactive growth planning, turning data chaos into a strategic asset that underwrites its next stage of expansion.