You could say Accretive Health makes sure hospitals don't leave money on the operations table. The company provides its own employees and management systems to improve back-office operations for health care providers and specializes in maximizing profits while reducing costs. Services include benefit coordination, coding, billing, and collection management. Typical customers are not-for-profit and for-profit hospital systems, as well as independent medical centers, such as Ascension Health, Dartmouth-Hitchcock Medical Center, and Henry Ford Health System. It also serves physician practice groups and home health agencies.
Accretive, founded in 2003 by chairman J. Michael Cline and CEO Mary Tolan, completed an initial public offering in 2010. The company's IPO was completed in May 2010. Proceeds from the offering are being used to finance further growth and expansion by offering new services and, to a lesser extent, acquire related businesses. Accretive decided to go public after a phenomenal rate of increase in revenue in the first few years of operation.
Accretive earns most of its revenue through managed service contract fees; the contracts typically also include additional incentive payments for increasing revenue for its clients. As the central part of a managed service agreement, a deployed team of Accretive employees (also called "infused management") take over the management of the client's entire revenue cycle, from preregistration and admissions to patient and insurance billing. It also connects clients' systems to its proprietary data management and analytics and interface systems, including its AHtoAccess software suite. Once the contract expires, the hospital can either renew or transition to rely on its own employees, who have been trained by the infused management team (and are temporarily on Accretive's payroll).
In addition to its total revenue cycle management services, the company has launched several new services, including its physician advisory solution that helps streamline ER patient admission processes. In 2010 Accretive started offering a quality and total cost-of-care package, which assists health care providers in managing defined patient groups. The solution helps hospitals identify high-risk individuals and try to keep those patients healthy and well monitored. In 2011 it launched another quality program that aims to reduce the average hospital-stay lengths at its clients' facilities.
The company's revenue from contracts alone experienced a compound annual growth of about 40% from 2006 through 2010. In 2011 Accretive's revenues climbed 36% to some $826 million due to new customer contracts, incentive payments from existing contracts, and from expanded specialty services such as physician consulting. Accretive has also increased its profitability, including a 131% jump in net income to some $29 million in 2011. The firm's rate of growth comes in part from the broad market opportunity to provide cost-control services to an industry under increasing financial pressure; an environment that has been enhanced by overall economic conditions and an increase in government health care reform proposals.
Accretive aims to expand its customer base to include customers across the US, with a focus on large hospital systems. It also works to provide larger service packages to existing customers, partly by adding new offerings such as its physician advisory and quality programs, as well as by developing new technology and software programs. As its customer base grows, the firm must also be able to attract and retain qualified personnel to serve on its management teams. Meanwhile, Accretive continually strives to tweak its revenue cycle management techniques, including improving bill collection, process correction, and shared service arrangements, to help clients improve their operating margins.
CEO Mary Tolan owns a 13% stake in the company, down from 18% prior to Accretive's 2010 IPO. Chairman J. Michael Cline owns an 8% interest; he previously had a 22% stake. – less