Warren Beck
Warren Beck Photo credit: Crowe Horwath LLP

Effective post-merger integration is a critical component of virtually every successful mergers and acquisitions transaction. In the healthcare sector, these integration efforts typically focus on care delivery issues such as streamlining patient access, standardizing care, eliminating duplication in clinical services, normalizing physician contracts and support services, and managing patient engagement and population health, to name a few.

Often, however, less energy and attention are given to the integration of administrative functions – particularly finance – which can be critical to the overall success of the transaction. Rather than viewing finance and accounting solely through the prism of follow-up and reporting activities, successful M&A teams will recognize that finance actually can play a leadership role in guiding the post-merger integration.

In addition to managing the traditional finance functions, the CFO in a post-merger healthcare organization must juggle multiple integration priorities such as improving analytic capabilities, creating a highly reliable finance function, developing scalable finance and reporting infrastructure, improving cost efficiency, mitigating regulatory and credit risks, managing at-risk payments, and replacing legacy systems.

Here are 10 useful strategies that can help organize and guide this complex effort:

1. Provide a full suite of comprehensive financial services
Day-to-day functions such as billing and collections, accounting, payroll, and accounts payable and receivable are important and necessary activities, but a post-merger finance group should look beyond the basics to develop a vision for fully meeting the financial needs of a growing organization. This broader vision encompasses issues such as strategic planning, debt management and oversight, regulatory compliance, charge integrity, and reimbursement.

For example, when charge integrity is left to physician providers, stringent coding conventions and billing procedures sometimes are poorly understood. A strong finance function can help standardize billing across newly acquired providers. In addition to reducing rejected claims and rebilling costs, this practice also can help avert costly fines and penalties for compliance violations.

Finance’s objective is to provide a broad array of financial services that can help optimize revenue streams and minimize risk – in addition to performing accurate reporting and transaction processing functions.

2. Meet internal and external customer needs and requirements
For the finance department to be a customer service organization and not just a back-office function, it first must have a clear understanding of its internal and external customers’ needs, including when and how information and services must be delivered. This becomes particularly important when a new organization is brought on board.

Ascertaining these needs requires meeting with customers, surveying them, and collaborating with them to provide guidance. In this way, finance can help other departments improve their analytic capabilities by getting the right information to the right person at the right time.

3. Create centralized and standardized processes
This is undoubtedly the most widely recognized post-merger integration activity. Every acquired organization has its own accounting, payroll, collections, accounts payable, planning, and other processes. Allowing diversity in these processes after a merger will result in inconsistent customer service models and a dysfunctional management approach.

In addition to making the merged organization more efficient, centralizing and optimizing these routine functions will give the organization’s leadership better understanding and control over the performance of its various operating units. It also benefits the internal customers, providing greater clarity, consistency, and reliability in their day-to-day operations.

4. Develop a robust governance structure and framework for sustained integration performance
It is important to strike the right balance between centralization and consistency on one hand, and flexibility and innovation on the other. Effective leaders will seek to build an organization that does not create random risk or unnecessary duplication but at the same time is open to change when needed.

Senior management must drive this effort, but this can happen only within the framework of a strong governance structure that helps make sure that change is implemented properly. This structure often begins with a steering committee that has strong employee involvement, and it includes processes for performing systematic follow-through and periodic progress reporting based on tangible performance indicators.

5. Transition to a single IT platform
When merging the finance functions from two organizations, the IT systems from both organizations must be capable of communicating with each other using a single source of data. Data must be accessible on a single platform – but that’s not to say there must be a single vendor.

What’s critical is that all systems and functions rely on a “single source of truth.” In many instances, an enterprise data warehouse or other integration technology can make this possible across multiple IT vendors and applications.

6. Make financial reporting a priority – not an afterthought
With the initial post-merger focus on integrating patient populations and operating systems, establishing integrated and timely financial reporting often is postponed. But without timely financial reporting systems, operating units do not have the information they need to run their businesses. What’s more, isolated, disconnected systems will generate outdated or incomplete information that must be identified, cleaned, and corrected later – putting the finance department even further behind.

7. Create a culture congruent with the leadership vision
Just as cultural barriers can doom the overall integration effort, differing visions within the merged finance department can stall the functional integration. The CFO and integration team should develop a plan for breaking down cultural barriers and communicating the new vision while also working to understand the culture of the acquired organization and adapting those elements found to be useful. Communications should be planned, deliberate, and frequent to create a culture that supports the leadership vision.

8. Integrate talent as well as systems.Invariably, both organizations will have good talent
A wise manager will objectively evaluate talent in order to take advantage of new skills and diversity of thought. A focused talent retention strategy will maximize the skills and talents of employees by supporting them with tools and education while allowing them the freedom to do what they do best without micromanaging every aspect of their work.

9. Involve operational leadership in finance integration
In creating a customer service culture, it is important that finance not be seen as isolated, detached, or resistant to helping the operational leadership team. Operational leaders want to have input into management and reporting processes, so finance should make a visible effort to collaborate with them. The goal is to identify new opportunities to provide service to internal customers – actively looking for new ways to help in a proactive manner rather than merely responding to requests.

10. Demonstrate value by creating economic benefits
Among all the various groups involved in a healthcare merger, the finance department should be the first to set an example by creating economies of scale and generating cost savings. In addition, though, finance also should be able to demonstrate added financial value by contributing ideas toward revenue generation and risk management as well as offering supporting evidence of the direct economic benefits growing out of the merger.

With the American healthcare system undergoing a sustained period of disruption, integrated healthcare operations are likely to continue their focus on streamlining operations, improving patient experience and satisfaction, and reducing duplication in clinical and professional services. The 10 strategies listed here can help merged organizations accelerate these operational integrations while also identifying additional opportunities to generate value from their integrated finance functions.

Warren Beck is a healthcare advisory services provider with Crowe Horwath LLP. Tracey Coyne is a senior manager and Jay Sutton is a principal.