How a Hospital Turned its Rev Cycle Around by Refocusing on its Community
From Revenue Struggles to Financial Stability in Rural Wyoming
Three Rivers Health, a critical access hospital in Basin, Wyoming, was at a financial crossroads. With outdated systems, limited RCM resources, and nearly 5,000 unresolved claims totaling $4.3 million, core operations were at risk.
Partnering with TruBridge changed the trajectory. Starting with Extended Business Office support and ultimately moving to a Complete Business Office model, the hospital strengthened its revenue cycle, recovered critical cash, and set the foundation for long-term stability. Today, data-driven operations and sustainable growth are enabling new investments in its future.
Faced with $6 million in old AR and staggering long-term debt, Three Rivers Health gained stable financial footing by outsourcing its revenue cycle and prioritizing community trust.
Key Takeaways
For Joel Jackson, CEO of Three Rivers Health, the decision to move to a fully outsourced, end-to-end revenue cycle model was a matter of organizational survival.
Operating in the poorest county in Wyoming, with nearly three-quarters of its patient volume served by Medicare and Medicaid, the small critical access hospital had reached a financial breaking point.
“We were in a really tenuous cash position and it’s fair to say we could have closed,” Jackson says.
Returning the Focus to Patients and Community
When Jackson arrived, Three Rivers Health was encountering significant challenges on multiple fronts. The hospital was transitioning to a new EHR, it lacked a CFO, around $6 million in old AR had been sitting for at least two years, and the existing revenue cycle vendor relationship was “suboptimal at best,” according to Jackson.
The decision to fully outsource many revenue cycle functions gave Three Rivers Health the capacity to return its focus to the local community while its revenue cycle partner, with the requisite expertise in technology and complex billing, worked to collect on old AR.
“Part of the beauty of working with TruBridge is that they were taking care of the day-to-day,” Jackson says. “So we could refocus on the relationship with our patients and our community.”
RCM Starts with the Patient Relationship
Jackson attributes the hospital’s financial turnaround to a provider-centric belief that the revenue cycle starts with the relationship with the community.
Challenges stemmed from a broken connection with patients, according to Jackson. Financial success was limited without a foundation built on trust with patients.
“If that is broken, you can do everything you want to on the revenue cycle side, but you will hit a ceiling,” Jackson says.
Financial and Cultural Turnaround
Outsourcing functions of the revenue cycle led to a rapid financial turnaround.
The turnaround at Three Rivers Health was not driven by vendor technology alone, but by restoring its core mission to serve the local community.
“We have to focus on knowing our patients better than anybody else and creating an environment where they feel cared for in the revenue cycle,” Jackson says.