Case Study
Value-based Care Medical Group
From Fragmented Call Centers to Centralized Operations — Reducing Costs by 35% and Boosting Patient Visits by 11%
 
          Company background
The Medical Group has been a growing healthcare provider for the last 5 years. They aim to redefine the way healthcare is administered through community-driven preventative care and proactive treatment.
With locations in multiple cities across Nevada, the Medical Group offers a wide range of services while maintaining a dedication towards value-based care. The practice also accepts a large variety of insurance plans, including Anthem, Medicare Advantage, and United Healthcare.
 
            Challenges
Disconnected Call Center Model
The Medical Group had a hybrid front office operations setup with an in-house call center and external offshore vendor. The in-house call center and offshore vendor were plagued with high turnover. Patient calls were often missed leading to poor patient experience and unfilled appointment scheduling.
The external vendor’s turnover impacted service quality. Persistent insurance eligibility denials increased administrative workload for internal teams, delayed care, and resulted in significant revenue losses.
Lack of Technology
As a VBC organization, closing care gaps is a top priority. A lack of centralized resourcing and analytics led to an inability to engage patients to schedule annual wellness visits (AWVs). Additionally, a lack of patient engagement tools – such as online scheduling, appointment reminders, and satisfaction surveys – meant high no-shows, missed appointments and no structured patient feedback to drive improvement.
