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Case Studies

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

Post-Close Integration

Client Profile

52 locations



Services Deployed

Revenue Cycle Management

IT Systems Strategy & Implementation

MSO Operation

Human Resources


Our Client completed a sizable acquisition expanding their footprint in additional states.
The Company had not completed a transaction of this size previously and was seeking support
to develop a holistic integration strategy across core functional areas. Further, the Company
was experiencing specific pain points in its current IT and RCM departments and was seeking
guidance on how to address these pain points and how to develop the right integration strategy
in the context of these pain points.

Specifically, the acquiring Company’s EMR architecture was structured as individual on-premise
instances for each clinic location. Integrating the target into this environment would present
performance challenges and yet changing the acquiring company’s EMR infrastructure was both
complex and delicate.


7 SCALE team members were deployed throughout the engagement including team members across:

  • DSO domain team
  • HR
  • RCM
  • IT
  • Data analytics
  • Project management
  • SCALE defined and developed strategies for a holistic range of integration workstreams
  • We evaluated opportunities for DSO service centralization, workflow standardization, systems consolidation and cost savings

SCALE provided centralized integration execution project management for process status tracking
and status transparency in addition to specialized domain expert integration execution oversight
across key functional areas including:

  • RCM
  • IT
  • HR
  • Operations
  • Call center
  • Data analytics

We support the evaluation of various alternatives for addressing key operational & platform scaling
needs and challenges to support the Company’s larger pro forma footprint such as:

  • RCM performance workflow automation
  • IT / EMR architecture

SCALE used a holistic, multidisciplinary approach leveraging our deep functional domain expertise
specific to comparable healthcare platforms across all core functional areas to collaborate with,
advise and support Client’s leadership who had not previously been through a sizable integration
process before.

General Results

  • SCALE achieved substantial completion of key phase 1 integration objectives within 5 months of kick-off including the assessment phase
  • We empowered and reduced confusion across management team who had not previously been through a sizable integration process before
  • Improved post-close communication across management teams from the acquiring and target companies, as well as heightened integration execution accountability
  • Improved post-close communication across management teams from the acquiring and target companies, as well as heightened integration execution accountability
  • Thoughtful, informed, systematic, analytical and transparent decision-making around key decisions
  • Highlighted key performance improvement needs and opportunities within RCM that brought heightened transparency, accountability and structure to addressing these opportunities

Department Results

Human Resources

  • Developed and rolled out revised mission, vision values across the pro forma organization
  • Developed a pro forma talent recruitment program structure across expanded geographic footprint with a hybrid model of centralized oversight and local market representation
  • Standardized / integrated core HR operations and team structure

Call Center

  • Supported feature / cost evaluation of call center software solutions, as well as business plan for centralizing call center operations across the various geographic markets

Information Technology

  • Developed pro forma enterprise EMR architecture strategy to remediate legacy performance issues and integration objectives
  • Completed a comparative financial model, features evaluation, and operational and executive stakeholder needs analysis of current state architecture relative to various potential alternative scenarios
  • Developed a recommended plan for remediating base business IT performance issues
  • Defined a regional EMR architecture / consolidation strategy
  • Developed a strategy for migrating the acquiring company to a pod-level cloud-based environment to mitigate the challenges with the Company’s legacy individual EMR instance per clinic site
  • Supported restructuring and centralization of IT team
  • Structured and oversaw base IT program integration

Revenue Cycle Management

  • Developed pro forma org chart
  • Brought clarity, specificity and transparency to key hiring needs to overcome current state performance improvement needs & system challenges until these challenges were remediated
  • Identified payment posting automation performance improvement opportunity within acquiring company and accelerated pathway for achieving
  • Developed a plan for migrating the target company away from an outsourced payment posting solution to achieve cost savings
Solve for the Missing MSO Pieces

Let's SCALE together

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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