What Elevate Does
Elevate holds the finance seat for healthcare organizations that have outgrown a controller but cannot justify a full-time CFO, as well as stepping into the seat outright when a CFO leaves mid-year. Alongside that, it runs the accounting layer underneath — bookkeeping, month-end close, reconciliations, and financial reporting. It also takes on the defined pieces of work that sit between the two: margin and cost improvement, budget and accounting system implementations, audit and HCAI preparation, and the board reporting.
The through line is that the same practice covers the strategy and the plumbing. A CFO is only as useful as the numbers underneath, and healthcare organizations at this size are rarely in a position to hire twice.
Where the Practice Comes From
Elevate was founded on twenty years of operating finance roles inside healthcare organizations rather than consulting to them — academic medical centers, health systems, physician networks, behavioral health platforms and private-equity-backed hospital groups. That has meant carrying P&Ls as large as $2B across 136 clinics, and directing financial operations within a private-equity-backed health system of seven Southern California hospitals totalling $700M in revenue.
Operating experience changes where an engagement starts. The questions that take an outside adviser a quarter to work out — how the month actually closes, which service lines carry the overhead, where the payor mix is quietly moving — are ones this practice has already answered from the other side of the table. Two things it is proudest of are not numbers at all: building a finance function and team from nothing, and holding financial discipline through acquisitions and facility expansions.
How the Work Runs
Every engagement opens the same way, with a diagnostic across the P&L, payor contracts, revenue cycle, and staffing model. This generates a written picture of where margin is leaking, and what it would take to stop it. Nothing is proposed before that exists.
From there, the shape depends on the client: a monthly retainer with a set number of days, a standing finance meeting, and a reporting package, or a defined project with an end date. Engagement length, cadence, and terms are set on a call rather than sold as a package.
What does not vary is the method. Finance, revenue cycle, payors, staffing, and operations are examined together, because performance rarely breaks in one place. Pulling a single lever in isolation usually moves the cost somewhere else instead of removing it.
Who Elevate Works With
The practice engages with healthcare clients across hospitals and health systems, district and public hospitals, academic medical centers, medical groups and physician practices, surgery centers, behavioral health organizations, skilled nursing and post-acute providers, FQHCs and community clinics, and digital health companies — from small and rural through to multi-hospital systems. The operating background behind that is concentrated in health systems, physician networks, academic medical centers, and behavioral health.
The call usually comes at a particular moment: a CFO has just left, budget season has arrived on top of everything else, margin or EBITDA is under real pressure, denials are climbing, a finance system implementation is going sideways, the board has lost confidence in the numbers, an acquisition or affiliation is in motion, or a new chief executive wants a fresh set of eyes on the finances. Often, it is the chief executive or the board who brings the practice in.
The Questions Leadership Keeps Asking
Across twenty years, chief executives and boards return to the same short list. Why are we not as profitable as we should be, and where is the money going? Are we staffed appropriately for our revenue and census? Why are collections down when volume is up? What should our margins look like? Can we afford to grow, hire, or open another location? Which service lines, locations, and payors are actually profitable? What should we be watching? Before we commit: what is the financial impact of this decision?
Most of the work is answering those precisely enough to spur action.
What Elevate Does Not Do
Elevate does not perform audits and does not provide tax preparation. On audit engagements it sits on the organization’s side of the table, owning the process and the auditor relationship, which is a different job from signing the opinion.
It also does not take on many clients at once. The practice is deliberately small, which is what makes a genuine principal-level seat possible rather than a name on a proposal and a junior on the work.
Results across prior operating roles include a $7M receivables discrepancy traced and resolved after a failed system migration, a 20% improvement in collections at a community hospital, and a budget built for FY2020 that held through the first year of the pandemic.