Case study · Healthcare
A 12-page board pack for a 14-clinic physical therapy group
A 14-clinic physical therapy group cut its board pack from 40 pages to 12, brought DSO down from 58 to 34 days and lifted EBITDA margin from 6% to 13%.
Board pack, down from 40
EBITDA margin, up from 6%
Days sales outstanding, by quarter
Client
Multi-site physical therapy group · 14 clinics
Revenue
$5–15M
Engagement
Ongoing since 2024
The group had grown to 14 outpatient physical therapy clinics through new openings and small acquisitions, with revenue in the $5–15M range. Each clinic ran its own front desk and reported through a shared billing team.
Board meetings were long and inconclusive. The pack ran to 40 pages assembled from site spreadsheets and billing exports, and directors spent most of each meeting asking which numbers were current. Collections were the biggest blind spot. Days sales outstanding stood at 58, denied claims sat in a queue nobody owned, and no one could say which payers or sites were slowest to pay.
Margins were thin as well. EBITDA margin was about 6%, and the owners could not tell whether that came from a few weak clinics, from payer rates or from staffing across the group. They wanted a clear view before deciding on further expansion.
We started in 2024 and still work with the group. Maren Stavely serves as fractional CFO, and Sam Iverson set up the close and reporting.
Site-level reporting. Visits, charges, collections, denials and contribution for each clinic, built from aggregated billing and scheduling reports. Patient records never left the group’s systems.
A collections cadence. A weekly report of days sales outstanding and denials by site and payer, with the billing team owning each aged item. Front desks began collecting copays at the visit.
A 12-page board pack. A one-page summary, KPIs by site against plan, financials, cash and one page per decision. It goes out three days before each meeting.
Margin work. We compared visits per therapist, staffing and rent across sites. Two clinics moved to shared front-desk staffing, and scheduling templates were reset to match demand.
Payer contract terms and billing compliance questions went to the group’s healthcare counsel and billing specialists. We supplied the numbers behind each decision.
Days sales outstanding fell from 58 to 34 over five quarters, releasing cash the group had been borrowing to cover payroll in slow months. The board pack went from 40 pages to 12 without losing a metric the directors used, and meetings now spend their time on decisions such as where to open next.
EBITDA margin rose from 6% to 13%, driven by fewer denials, better staffing ratios and the two clinics that changed front-desk models. The COO can now see every payer, every site and every week on one page.
The engagement continues on a monthly Fractional CFO scope.
Figures are from a demo engagement and are illustrative. Past results do not predict future outcomes.
Alana P.
COO, multi-site physical therapy group
Client, people and figures are fictional demo content. Past results do not predict future outcomes. Disclaimer
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