Dartmouth-Hitchcock Health Realizes 12.6% Increase in Cash Collected Over Baseline Through Improved Revenue Cycle Operations


Dartmouth-Hitchcock Health (D-HH) is a nonprofit academic health system serving communities in New England. D-HH provides access to more than 1,000 primary care doctors and specialists in almost every area of medicine at Dartmouth-Hitchcock Medical Center; the Norris Cotton Cancer Center, one of only 45 Comprehensive Cancer Centers in the nation; the Children’s Hospital at Dartmouth-Hitchcock; four affiliate hospitals; 24 ambulatory clinics across New Hampshire and Vermont; and through the Visiting Nurse and Hospice for Vermont and New Hampshire.


D-HH had two primary areas of focus to drive business outcomes for their health system. First, they wanted to maintain and enhance their day-to-day revenue cycle performance. This meant better managing the Single Business Office (SBO), improving cash collections and successfully securing funding for uninsured patients, as well as improving patient satisfaction. Additionally, D-HH had several high-priority strategic initiatives that required strong integration expertise and significant Epic knowledge and experience.


D-HH partnered with Conifer Health Solutions to assume operational management of the revenue cycle for the entire health system, including physicians, outpatient surgery centers and imaging centers. As D-HH’s service provider, we supported key strategic initiatives including a “OneTouch” Customer Service approach, Epic ADT Implementation, as well as ICD-10 conversion support.

D-H is achieving sustainable long-term financial performance, while focusing in on key health system strategic initiatives.

Dartmouth-Hitchcock Health localized their customer service model, improved performance in their SBO and successfully operationalized strategic business projects across the health system.

Implemented ‘One Touch’ Customer Service Approach

Resolved patient billing issues during the initial call, improving overall patient satisfaction with the billing process. By improving operational efficiency, the D-HH customer service team became more effective and produced significant results.

Improved Performance in the Single Business Office

Focused on implementing Conifer’s revenue cycle operational best practices, including automation and workflow, as well as a team of Revenue Cycle expertise to help improve D-HH’s performance from a previous vendor.

Completed High-Priority Strategic Initiatives

Focused on improving revenue capture opportunities and facilitating transparent access to data for the Epic ADT implementation. Worked closely using a cross-walk approach and ensured all issues were addressed during the ICD-10 conversion.


Conifer Health’s revenue cycle operational approach and flexible ‘one-touch’ customer service methodology helped D-HH improve financial outcomes and improve satisfaction with patients in the tight-knit community.

Chief Financial Officer Dan Jantzen says “Conifer Health has helped D-HH achieve significant improvement in patient satisfaction with billing-related issues and key revenue cycle financial metrics.” Some of these improvements include:

  • Reduced inbound customer service calls by 13.7%
  • Reduced abandonment rate by 50%
  • Decreased the number of executive/administrative escalations
  • Improved every customer service survey response category
  • Almost doubled the amount of cash collected through financial assistance and eligibility counseling
  • Improved Point-Of-Service (POS) collections by 40%
  • Reduced Initial Denial Rates by 23%
  • Decreased ‘Aged A/R > 90 days’ by 20%

Now, the SBO Net Days in A/R are at a historic low for the system and D-HH has exceeded their cash collection goal by 101%* in 2017. In addition, D-HH was recognized as an Epic Top Performer – Ranking in the Top Quartile in DNFB, Candidate for Bill (CFB), Coding Days, and Billed Lag Days.

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Revenue Cycle Performance

50% Reduction

in patient call abandonment rate

20% Decrease

in ‘Aged A/R > 90 days’

“Conifer Health outperformed in FY2017, reducing A/R days from 60 to 47 days and achieving 104% of the cash collections goal. Thanks for your responsiveness and thanks for producing these results. It is greatly appreciated!”

— Dan Jantzen, CFO,
Dartmouth-Hitchcock Health

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