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Case Studies

An illustrative selection of SCALE Consulting case studies.
Case study:

Fully Managed Diligence

Client Profile

23 Locations

OR, VA and DC


Services Deployed

Quality of Earnings

Coding & Clinical Compliance


Payer Black Box Analysis

Revenue Cycle Management

Centralized Project Management


Our Client is a highly acquisitive MSO with operations across seven states and seeking to continue
its rapid add-on M&A activity across transactions of varying sizes from small solo practice tuck-ins
to larger multi-site add-on acquisitions.

Our Client was aiming to improve its add-on diligence program to meet key objectives:

  • Highly flexible diligence scope positioned to scale up and down to address varying add-on acquisition sizes
  • User-friendly diligence experience for Client and Target teams
  • Efficient third-party diligence pricing
  • Value-add diligence findings that go beyond traditional “check-the-box” risk analysis


SCALE was engaged to provide an integrated diligence services across three simultaneous add-on

Unique aspects of SCALE execution approach:

  • SCALE deployed six diligence teams across three add-on transactions to provide a one-stop, integrated diligence solution.
  • All diligence workstreams were centrally coordinated through SCALE’s project management team to streamline communications with Client and Target throughout the process.
  • In addition to traditional diligence risk analysis, SCALE’s diligence teams incorporated post-close execution & integration preparedness analysis into the diligence reports.
  • Coordinated with Client department leadership to sufficiently understand Client’s base operational program and post-close integration needs to support development of post-close integration plans customized to Client’s operational program.


SCALE achieved meaningfully discounted third-party diligence cost relative to the traditional
approach of working with disparate third-party vendors across individual diligence workstreams by
providing bundled, repeat diligence services in addition to:

  • Highly reliable, flexible and integrated one-stop diligence solution that could be scaled up and down to address a broad range of diligence needs across multiple simultaneous add-on transactions of varying sizes
  • Rapid diligence execution with reliable, on-time delivery of diligence reports
  • SCALE’s diligence team was able to develop a uniquely holistic view of Target for a third-party vendor by leading a broad range of diligence workstreams
  • Delivered thoughtful diligence reports across six functional areas (i.e., coding, compliance, cybersecurity, revenue cycle management, payer black box analytics, and quality of earnings) that:
  • Confirmed key transaction components, such as Target’s adjusted financial performance, to facilitate transaction execution
  • Identified, quantified and stratified key risks
  • Defined practical, value-add post-close operational performance improvement opportunities by functional area
  • Developed initial framework for post-close integration + Improved Client and Target diligence process experience through:
  • Developed initial framework for post-close integration + Improved Client and Target diligence process experience through:
  • Centralized
  • Process coordination across diligence workstreams
  • Information requests to avoid duplicate requests across diligence workstreams
  • Reduced burden on Client to manage the diligence workstreams by leveraging SCALE’s project management leadership
  • Transparent and user-friendly status updates throughout diligence process
Solve for the Missing MSO Pieces

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SCALE Healthcare is based on the foundation of a singular focus – elevating management performance across healthcare services. We are focused on the entire suite of operational advisory and diligence services exclusively to healthcare service organizations, with local team presence across 10 states.

Unlike the many consulting firms that offer more narrow and often more impractical solutions borne of limited or very general expertise, we rely on our team of 75+ carefully selected senior operational healthcare experts to ensure we provide the most relevant and value added experience across the full range of management disciplines and clinical specialties that fall within healthcare services.

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