The problem

The last dollar is rarely in the labor line

$18B

spent by US hospitals in a single year overturning claim denials

Industry figure, not an Adelo Consulting result. Source: American Hospital Association estimate of denial-related administrative spend, 2025.

Median hospital operating margins have run near or below one percent for several years while workforce, supply and drug costs have grown faster than reimbursement. The pressure is real and it is structural.

But the first response — reduce positions — is often the most damaging and the least effective. Denial write-offs, undercoded acuity, unfavorable contract terms and an unmanaged mid-cycle routinely represent more recoverable margin than a workforce reduction, and they do not degrade the product.

Margin recovered from the middle, not the bedside.

What we do

Capabilities in revenue cycle & finance.

Denials management and prevention

Root cause by payer, denial type and originating department; prevention built upstream rather than appeal capacity built downstream.

Clinical documentation integrity

CDI program design, query quality, physician engagement and the accuracy of case mix index and severity capture.

Mid-revenue-cycle operations

Utilization review, status determination, medical necessity, care management and the observation population.

Payer contracting and yield

Contract modeling, underpayment identification, and the analytics to negotiate from evidence.

Cost structure and non-labor spend

Supply, purchased services, pharmacy and clinical variation — the categories where reduction does not cost you a nurse.

Financial planning and decision support

Service-line profitability, contribution margin by physician and procedure, and budgets built on operating assumptions.

What we target

Outcomes we scope engagements against.

These are the results we design toward and measure. We commit to targets in writing at the start of an engagement, and we report against them honestly — including when we miss.

We do not publish client results we cannot substantiate or attribute. Targets on this page describe engagement design, not guaranteed outcomes.

  • Initial denial rate and write-off dollars reduced
  • Case mix index and severity capture aligned to acuity treated
  • Underpayments identified and recovered from payers
  • Non-labor cost reduction delivered without clinical degradation
  • Service-line economics leadership can actually act on
Engagement models

Three ways to start.

1

Diagnostic2–4 weeks

A focused assessment with a written finding and a ranked set of actions. Fixed fee, defined scope. Most relationships start here because it is a low-risk way to find out whether we are useful.

2

Sprint8–16 weeks

A defined improvement engagement against a named target — throughput, denials, turnover, survey readiness. We work alongside your team rather than around them, and we transfer the method as we go.

3

Embedded6–18 months

Interim leadership or sustained transformation support. Our leader carries real accountability in your operating structure, with a written mandate and measurable commitments.

Frequently engaged by