Healthcare organizations strive to provide top-tier patient care while grappling with complex accounts receivable and revenue cycle management challenges. Unpredictable payment schedules in healthcare create financial instability, making it difficult to accurately plan budgets and manage cash flow. This can lead to difficulties in paying bills, investing in growth and maintaining patient care.
As healthcare organizations navigate this intricate landscape, the need for innovative technological solutions becomes increasingly evident. Healthcare organizations can overcome these challenges by adopting advanced data solutions and also achieve sustainable growth.
Exploring this topic further, our team of digital advisors at Cherry Bekaert hosted a webinar, The Data Lakehouse Advantage: Seamless Integration and Analytics, on June 12, 2025. The webinar explained how integrating data lakes and warehouses into a unified platform transforms business operations, streamlines decision-making and unlocks valuable insights.
Decoding the Complex Billing Cycle
The healthcare billing cycle is inherently intricate. A typical patient's journey begins with a doctor's visit, followed by the submission of a claim. This claim can follow multiple pathways, including private insurance, Medicare, Medicaid, or even private pay, each with distinct processes and timelines. Each claim passes through a clearinghouse, where delays may occur before it is resolved. Payments could occur within the same month as the service date or be deferred into subsequent months due to varied influencing factors, such as:
- Unpredictable Reimbursement Patterns: Insurance companies and government payers are taking longer to reimburse claims. Prior authorization and claim denials are becoming more frequent and time-consuming to resolve.
- High Denial Rates: Errors in coding, missing documentation or eligibility issues increase denial rates. Denial management requires significant manual effort, which slows down cash flow.
- Volume Uncertainty: High-deductible health plans are transferring more costs onto patients. Collecting payments from patients is more difficult and slower than from insurers, leading to an increase in bad debt.
- Regulatory Changes: A lack of skilled billing and revenue cycle staff affects timely claim submission, follow-up and collections. Many providers still rely on outdated systems or manual processes, which worsens the issue.
- Insufficient Use of Analytics: Many accounts receivable are sitting in 90+ or 120+ day buckets, reducing liquidity. This increases the difficulty of identifying which claims are collectible versus those likely to be written off.
“This uncertainty complicates healthcare financial planning, demanding the use of precise technologies to streamline the revenue cycle process. Forward-looking, it’s imperative for healthcare providers to have insight from their data to model future revenue, thus the importance of leveraging a Data Lakehouse architecture.”
Data Lakes vs. Data Warehouses: Databricks' Revolutionary Fusion
Data lakes and data warehouses represent two distinct paradigms in data management, each with its own strengths. Data lakes, known for their scalability and flexibility, allow the storage of vast amounts of raw data in its native format. This enables organizations to perform ad-hoc analysis and handle diverse data types. In contrast, data warehouses offer structured storage with optimized query performance, ideal for consistent reporting and analytics on historical data.
Databricks integrates these concepts through its innovative Data Lakehouse architecture, which combines the best traits of both data lakes and data warehouses. This unified platform brings the scalability and cost-effectiveness of data lakes together with the reliability and performance of data warehouses.
Harnessing the Power of Data With Databricks
Databricks signifies a groundbreaking shift in how healthcare organizations can utilize data solutions to refine revenue cycle management. Its sophisticated data analytics capabilities enable healthcare providers to efficiently track claims, anticipate payment cycles and optimize revenue streams.
“By ensuring real-time data availability and consistent analytics across diverse datasets, the Databricks Lakehouse empowers healthcare organizations to extract holistic insights, making data-driven decisions that enhance both operational efficiency and patient care,” commented McDonald. "Databricks is our go-to platform, revolutionizing how we manage data."
Impressive Returns Through Data Innovation
It is vital to offer bespoke solutions that accommodate the distinct needs of various healthcare entities, ranging from expansive hospital systems to individual practices. Cherry Bekaert specializes in supplying clients with custom approaches to address specific challenges, whether involving complex regulations or cash flow optimization. “Recognizing the unique context of each provider ensures strategic insights that enhance financial resilience and operational growth,” commented McDonald.
By leveraging Databricks Lakehouse, Cherry Bekaert helps healthcare organizations revolutionize their data operations into a cohesive and data-driven ecosystem, providing:
- A reporting framework that enables analysis through a variety of dimensions
- A real-time 360-lens into enterprise-wide data
- A centralized repository for all data and reporting
- An established and trusted data governance infrastructure
The combined solution enhances claim tracking, predicts payment timelines, and optimizes the revenue cycle while reducing payment delays, improving cash flow, and providing predictive insights to address claim denial trends. By leveraging this solution, healthcare organizations can experience notable returns, including:
- Reduction in Denial
- Artificial Intelligence/Machine Learning (AI/ML) predicts denial likelihood before submission
- Automated compliance checks and coding assistance
- Natural Language Processing (NLP) to extract justifications from clinical notes
- Improvement in Days Sales Outstanding (DSO)
- Integrates data from electronic health records (EHRs), billing and claims
- Power BI dashboards for DSO, accounts receivable (AR) aging and denial trends
- Real-time insights for better decision-making
- Faster AR Cycle Times
- Clean, centralized financial data
- Actionable insights on denials and AR
- Faster claim follow-up and resolution
- Better billing transparency
- Improved Cash Flow
- Power Automate for routing notifications and decisions at critical decision points
- Power Apps to manage appeals, write-offs and task routing
“Our unique implementation approach includes developing tailored data models to support healthcare-specific needs, like patient profit and loss (P&L) reporting and key performance indicator (KPI) tracking, incorporating subject area security and governance. We then migrate legacy reports and develop new data pipelines in the Lakehouse, enhancing existing data models with additional healthcare data sources. Finally, we enable advanced analytics and machine learning capabilities, such as integrating large language models and MLFlow, to transform raw data into actionable insights for improved patient outcomes.”
Use Case at Work
A manufacturing and consumer goods PE portfolio company was in need of defining key metrics and modernizing its capabilities around reporting and analytics. The organization elicited help from the team at Cherry Bekaert to develop a reporting strategy across multiple sites. Cherry Bekaert developed a data architecture and repository for the company’s data lakehouse.
Next, the team onboarded multiple Epicor enterprise resource planning (ERP) instances from disparate data sources such as ADP, Target, budget data and Advanced Manufacturing Execution System. Cherry Bekaert then developed key Power BI dashboards for order tracking, profitability (margin analysis, unit metrics, pricing variability, margin initiatives) sales analysis and open order details.
Enhanced strategic analytics capabilities and usage of reports and dashboards for customer operations were deployed, driving greater visibility to KPIs. Additionally, the executive team now leverages daily and monthly reporting to drive proactive outcomes.
For a healthcare company, this approach can be adapted to unify data from disparate clinical, operational and financial systems, enabling real-time insights across the organization. By leveraging a similar architecture to Power BI dashboards, organizations can better monitor patient outcomes or resource allocation.
Benefits of a Holistic Data Ecosystem
“As healthcare organizations seek to modernize their operations, two critical areas have emerged: effective healthcare financial planning and the integration of AI in healthcare billing. These focus areas not only improve fiscal resilience but also streamline billing processes through intelligent automation and predictive analytics.”
The combined strengths of Databricks and Azure Data Platform allow healthcare companies to uncover valuable insights masked by the sheer volume and velocity of institutional data, visualize data effectively, predict cash flow with greater accuracy, and identify areas for operational improvement. This holistic data ecosystem leads to enhanced decision-making capabilities while ensuring compliance, accelerating the transformation of financial processes and fostering a more proactive approach to managing accounts receivable.
“Ultimately, it enhances both efficiency and patient satisfaction by ensuring timely, accurate and compliant billing practices, giving healthcare providers the competitive edge needed to navigate the complexities of today's financial landscapes in the healthcare sector,” advised McDonald.
The Critical Role of Data Lakehouse Architecture in Healthcare AI Tools
Data Lakehouse architecture plays an instrumental role in organizing and preparing data for AI tools, which are becoming increasingly vital in healthcare applications. By bridging the gap between data lakes and data warehouses, the data lakehouse provides a unified framework that facilitates efficient data processing and analysis.
For healthcare organizations, this architecture ensures that vast quantities of diverse data types — ranging from patient records to billing information — are readily accessible and optimally structured for AI algorithms. This ensures that AI tools can deliver timely insights into patient outcomes, optimize resource allocation and enhance diagnostic accuracy.
International Data Corporation (IDC) research reveals that preparing data to yield optimal AI results has a strong bottom-line effect on the business, delivering a fivefold improvement in customer retention as well as strong gains in profit, efficiency and revenue.” In essence, the Data Lakehouse architecture empowers healthcare systems to leverage AI's full potential, ensuring mature data while driving advancements in patient care and operational efficiency,” emphasized McDonald.
For example, AI/ML could predict the likelihood of a claim submission being denied, enabling smarter workflows and reducing manual effort. These innovations represent the growing role of AI in healthcare billing, among other operations.
About Cherry Bekaert
Cherry Bekaert navigates the complexities of healthcare financial management by aligning cutting-edge technology with tailored approaches to deliver solutions where exceptional patient care aligns with robust financial health and operational resilience. By integrating Databricks with the Azure Data Platform, healthcare providers are empowered to develop a scalable Lakehouse model that transforms their data into a strategic asset. Experience the transformative power of the Databricks Lakehouse for healthcare.
Contact us today to learn how our tailored solutions can elevate your data strategy, improve patient outcomes, and enhance operational efficiency.
