Improve Rural Hospital Financial Performance: Assess, Align and Accelerate

Rural healthcare has always demanded resilience—but in today’s climate of reimbursement shifts, staffing shortages, and rising costs, strategic performance improvement is no longer optional. Yet many rural hospitals operate with limited capacity, making it difficult to step back and objectively assess opportunities for growth and efficiency.

This session explores the value of independent financial and operational assessments in helping rural hospitals surface hidden inefficiencies, uncover actionable insights, and strengthen financial performance. Attendees will review real-world case studies that highlight how targeted recommendations—from workflow adjustments to cost report optimizations—can translate into measurable impact.

At the end of this session, participants will be able to:

  • Identify Areas for Improvement – Discover common gaps and inefficiencies in rural hospital operations that often go unnoticed.
  • Leverage Assessments for Financial Gains – Explore how assessment findings can lead to improvements in cost reporting, reimbursement, and overall bottom-line performance.
  • Apply Lessons from Case Studies – Gain practical takeaways from real-world examples of rural hospitals that implemented
    assessment-driven changes.
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Q&A

How do people stay on top of all the payer newsletters to sort through everything to pull out applicable information for the facility/provider? Who typically is going through the newsletter to gather the information to share with other staff?

Our billing specialists are organized by payer, allowing them to develop deep expertise in their respective areas. Each specialist subscribes to their payer’s newsletters to stay informed about updates and changes. Additionally, our team leads, Supervisor, and Director of Patient Accounts—along with the Prior Authorization Team—collaborate to share key insights and ensure the entire team stays up to date. This collective approach enhances our ability to navigate payer policies efficiently and provide the best possible service. 

What leadership structure do you have in place for your revenue cycle and who or what do you use for training when billers or coders need it? Especially for new service lines or common denials?

Our billing specialists are supported by a structured leadership team, including two team leads, one Supervisor, and one Director. Training for billing specialists is conducted by our Supervisor and team leads to ensure consistency and expertise. Additionally, billing specialists meet weekly with leadership to review denials and identify payer-specific trends. For new coders, who are required to be certified, training is led by our Coding Lead to maintain high standards of accuracy and compliance.

Are the billers assigned based on an alphabetical split or by insurance type, such as Medicare and Medicaid specialists?

Billers are first assigned by insurance type and then further divided by alphabetical split. Since each insurance type has multiple billers, the alpha split helps distribute the workload efficiently.

Since we have union employees, how could we implement a similar incentive to Kindal’s while ensuring compliance with union regulations?

This would depend on the specifics of your union contract. Stroudwater can work with you to review the contract and develop a compliant incentive model.

Does your Coding/HIM department manage CPT coding, modifiers, and ICD-10, or do they focus solely on ICD-10?

Our Coding team handles all aspects of coding, including CPT, modifiers, and ICD-10. They thoroughly review all provider documentation to ensure accuracy and compliance.