Service Line Development Best Practices: Grounding Growth in Financial and Operational Realities

Adding a new service line can strengthen access, grow contribution margin, and enhance community value — but only when grounded in disciplined analysis.

This session will explore best practices in service line development, with a focus on strategic and financial considerations. Participants will learn how to evaluate market need, reimbursement nuances, staffing needs, and operational impacts in a structured and defensible way.

The discussion will also highlight how to effectively communicate service line growth opportunities to boards, physicians, and operational leaders — ensuring shared understanding of risk, return, and performance expectations. Common pitfalls will be addressed, including overly optimistic assumptions, lack of grounding in operational realities, incomplete financial modeling, and misalignment between actual and perceived need.

Attendees left with a practical framework for evaluating potential service lines, and improve the success rate of new service line investments.

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

Develop a practical framework to evaluate new service line opportunities, incorporating volumes, reimbursement, cost, and other assumptions.
Identify common pitfalls that can undermine service line performance, including unrealistic projections and incomplete financial considerations.
Communicate service line opportunities clearly to boards and leadership teams, supporting informed, data-driven decision-making.

Q&A

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.