Strategy, Legal & Operations
Bringing the best of public accounting to community health centers
In the unprecedentedly challenging climate every healthcare organization is navigating today, automated operational and financial workflows can provide some rare peace of mind. This is particularly true for community health centers, which deliver valuable services to 1 in 12 U.S. citizens, regardless of their ability to pay. One such center is Hunter Health, a full-service healthcare provider that’s been addressing the needs of underserved communities in Kansas for four decades.
Since adopting Sage Intacct four years ago, the federally qualified health center organization has increased finance team efficiency by 75%, shortened its month-end close by two-thirds, and enabled greater insight to support both operational decision-making and federal reporting requirements. To find out how they achieved these results, we recently chatted with Lora Winchell, who is not only Hunter Health’s CFO, but an active member of the National Association of Community Health Centers (NACHC) as well. As a regular NACHC speaker and contributor to the group’s CFO Institute and national conference, Winchell has a wealth of knowledge surrounding community health center finance, so it was no surprise to us that she recently received a Wichita Business Journal 2020 CFO Award.
When we spoke, she shared what it was like coming from a public accounting background at Grant Thornton into the paper-heavy world of community health, at a time when the government (which pays for around 50% of Hunter Health’s more than 50,000 annual patient visits via Medicare, Medicaid, and grant funding) was increasing its scrutiny into centers’ fiscal responsibility.
From Spreadsheets and Files to Paperless Automation and Self-Service Finance
Upon joining Hunter Health, Winchell leveraged her own experience with paperless systems, and turned to Sage Intacct as the cornerstone of a cloud-based approach that eliminated stacks and stacks of bills, invoices, and more. Previously, the finance team dumped data out of their Microsoft Dynamics GP system into Excel to track patient and grant income in whatever limited manner they could. Of course, this manual approach to segregating transactions slowed them down and left room for error when reporting back to federal regulators.
After implementing Sage Intacct’s dimensions capabilities, the organization started tagging each individual transaction to the relevant funding source, expense classification and type, department, program, and location. “To continue to receive funding from the Department of Health and Human Services, there are a lot of restrictions and statutes we have to comply with,” noted Winchell. “In order to do that, we need to think in a multi-dimensional, multi-project way. With Sage Intacct, we’ve organized our general ledger across five dimensions, so we can produce reports in many different ways without resorting to spreadsheets.”
Winchell and her team next decided to tackle their time-consuming purchasing tasks. They empowered departments by giving them more control over their spending decisions and vendor relationships, while implementing streamlined approval workflows and procurement requirements through Sage Intacct’s purchasing module. Winchell shared, “We’ve decentralized this process by making department directors the purchasing authorities, and educating them on how to maintain proper documentation in Sage Intacct. This saves accounting 40 hours of A/P work, and we’re never a bottleneck to needed renovations or equipment purchases.”
Hunter Health also reduced its month-end close from around 30 days to 10 or less, which was unheard of before Sage Intacct. The team accomplished this by digitizing journal entry approvals and automating high volume reconciliations for patients’ cash payments, bank statements, credit cards, and payroll transactions. This included replacing a manual bank rec process (that used to take up to five days at the end of each month) with a few simple uploads that take under an hour
“I’ve had the opportunity to meet a lot of CFOs in this community health center space, and everyone is always saying they have to work 60 hours a week just to keep up,” mentioned Winchell. “Because we’re so organized at Hunter Health, I don’t have that stress. I work 40 hours a week, and spend Saturdays with my two little kids. Thanks to Sage Intacct’s dynamic system, we can easily keep track of all our data, so my team is probably 75% more efficient overall.”
Leveraging Information for Mission-Driven Impact
The center has seen the benefits of Sage Intacct extend well beyond monthly and day-to-day accounting tasks. Now that grant reporting is less cumbersome and more accurate, its finance team spends more time on the budgeting process. They previously had difficulties maintaining department and grant budgets in Excel, which became a tangled mess that never quite reconciled, leaving managers flying blind. “If someone wanted to see how the dental, optometry, or lab departments were doing, well, that had nothing to do with who was funding it, so we didn’t have those reports,” said Winchell. “These days, we have 25 different budgets in place, and each of our department and grant managers has their own Sage Intacct login, so they can see their profit and loss statement anytime. Everybody is actively monitoring and managing their own results.”
This kind of visibility proved helpful last year, when Hunter Health wanted to add another full-time dentist. Winchell remembers, “We were able to pull our dental department P&L in Sage Intacct and analyze the numbers—How much would our expenses increase? What about revenue? What was the net number? How many more patients could we serve? This helped us decide that we had a good business case for adding a third dentist.”
Similarly, Sage Intacct helps the health center proactively manage across 15 different funding sources. Winchell pointed out, “We can monitor grant activity in real-time vs. just looking at it when the time comes to submit reports to the granting agency. If we were only checking these numbers once a year, we’d find ourselves having to ask our granting agencies to allow the carryover of unused funds, or needing to make other serious adjustments to ensure continued renewals at the same levels.”
Case in point, Hunter Health closely tracks its substance abuse programs, since it receives dedicated federal dollars to help battle the opioid crisis. The center can see exactly how much money is coming in from these particular grants, along with which supplies and who’s wages that’s going to pay. When a new grant comes out, it’s easy for the organization to determine whether they actually have the costs to justify going after the grant and what outcomes the additional funds would support.
To learn more about how Lora Winchell’s team has kept up with Hunter Health’s 57% revenue growth as the organization significantly expands its patient access through new locations and services, even while reducing accounting headcount by half and avoiding $100,000 in salary costs, read our customer success story here.
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