How AccessHealth Modernized Their Finance Operations

Federally Qualified Health Centers (FQHCs) can benefit from robust solutions like Sage Intacct. Read how AccessHealth, an FQHC in West Virginia, managed the transition to it.

"It's hard to think of anything where we're not better off right now by switching to Sage Intacct. ... Our old accounting software was just very antiquated. It was cumbersome. It was not useful for what we needed. Almost every piece of what we do is better in some way, shape, or form because of the new software."

Organizational Overview

AccessHealth's mission is to fully "ensure the health and well-being of the entire family as well as the community at large" by attending to patients regardless of their ability to pay. Maintaining this mission since they started as a primary care organization in 1967, they now treat more than 58,000 patients annually and maintain a workforce of about 450 employees in over 30 locations. And they provide every kind of health specialty from primary care, pediatrics, women's health, and behavioral health to podiatry, and more. They even have surgeons on staff as well as on-site pharmacies.

"We have services going from OBGYN to the end of life," reports Grant Davis, Senior Financial Accountant, AccessHealth, "so we can care for a patient from the moment they come into this world, all the way through their entire life."

Plus, their medical technology is just as far reaching and advanced, offering on-site diagnostics like CT and MRI scans.

But one area of technology where they lagged was their legacy accounting system. It just didn't keep up. Using MIP, they'd experienced operational bottlenecks and their reporting capabilities were limited, among other issues.

"We are very data-driven in healthcare, because the profit margins are not huge," reports Davis, "and we just couldn't get data out of MIP in a useful way. It was there; everything was accurate. The books were right. But there was just no useful way to extract it."

Another key issue according to Davis: "We were closing pretty much two months behind. ... Our CFO would be presenting the financials from February or even from January at our April board meeting, because it was taking so long to close the books." In other words, the board members were presented with outdated data.

Finally, the MIP system was not user friendly. "We had a rule that no one could post anything on MIP except for one person, because if you posted something that was wrong, it was a disaster," says Davis.

From Workarounds to Full Platform Replacement

Initially, AccessHealth attempted to work around those limitations by hiring a third-party vendor to extract all the data and build dashboards on a separate web page. But that approach failed. The problem says Davis: "You couldn't just look at it and trust the number. You had to go verify it each time."

Eventually, they concluded that they needed a full reset with a new platform rather than keeping the legacy system with the incremental improvements they were developing.

Considerations for a new system included being able to track multiple revenue streams ranging from the federal grants and commercial insurance, Medicare, and Medicaid reimbursements to sliding-scale cash payments. And they needed to, as a federally qualified health center (FQHC), fulfill the strict regulatory and reporting requirements. Otherwise, it would impact the funds they receive from the U.S. Department of Health and Human Services' (HHS) Health Resources & Services Administration (HRSA).

"Everything we do goes through the lens of making sure that this is acceptable to the auditors," says Davis. "We need to track who approved something, who submitted something, and show that the CEO's the one that approved the checks."

One more designation and associated grant they had to maintain was that enabling them to be a certified teaching health center for their medical residency program. As a different, separate award from the HRSA to pay for the training of community-based providers, this one comes with a different set of just as strict regulatory requirements.

While Davis knew the name Sage, he rediscovered them again through their advertising during major league baseball games.

"I kept seeing Sage commercials," says Davis, "It turned out to be one of the greatest ads that I ever actually fell for. I was like, I am going to see the types of software they have and if they are even applicable. I went on their website and scheduled a demo. They put us in contact with JMT Consulting. And from there on out, we were, full force."

Paul Pedrosi was sales contact at JMT. "He was super easy to work with and showed us what Sage had," reports Davis. "We ended up having several different demos with more and more people, because it started more as a secret mission."

A Different Kind of Implementation Approach

Prior to implementing Sage Intacct, everyone on the team of five in the finance and accounting department had specific duties because of the lack of, as mentioned earlier, "user friendliness" with their system. But AccessHealth's CFO, Billy Belcher, wanted everyone to be cross trained with the new system.

"That way, we could all step up, help each other, and close the month end a lot quicker," says Davis.

So, rather than just installing the new platform and then simply holding a training for the users, the implementation specialist from JMT, Adam Beyer, suggested a collaborative and iterative process.

That meant, the internal team helped figure out the configurations, tested them, and refined and validated them in real time.

"I appreciated that approach," says Davis. "I understand how the system works, because I was involved in helping create it. The training was simultaneous. We didn't need separate trainings because, we were learning as we did it."

"I can't say enough good things about the implementation. Our implementation specialist (from JMT) Adam Beyer was a phenomenal asset to us. He really helped us every step of the way. ... He answered everything, and we got comfortable in the new software super quickly."

As a result of this process, the team now fully understands the platform configurations, enabling greater collaboration between them.

Driven by this success, the team then modernized their other financial processes and platforms, moving their credit card payment system to Ramp and the payroll to ADP. The Ramp integration was easy. ADP, on the other hand, proved to be more complex because of its platform. But the transition to it and integration with Sage Intacct paid off almost immediately.

For one, the CEO could now approve checks on the system and print them with his signature already on them.

"We couldn't do that in the old MIP system," says Davis. "We'd print off well over 100 checks a week, and he'd have to sign each one by hand. I can't tell you how many times a check would get stuck to the back of another, and he'd miss it. We'd then have to run a separate check to him to sign. Just little things like that have greatly improved our processes from start to finish."

And since bills, journal entries, and approval records are now all digitized and searchable, tasks that once required digging through file cabinets could now be completed in just seconds.

"Before, everything was kept on paper, so if someone wanted a copy of a bill, you had to go find the check number, then you had to go dig through a file cabinet to find that check and make a copy of it," says Davis. "Now it's just a couple clicks away."

Finally, Hank Wright, a JMT analyst, formatted AccessHealth's fixed assets data from another antiquated system so it could be easily transferred to Sage Intacct.

Documented Outcomes: Faster. Easier. Smarter.

Overall, Sage Intacct's built-in tools helped them quickly identify any variances and anomalies. And instead of the static reports they used to rely on, dynamic dashboards tailored to different roles now enable executives and clinical leaders to monitor performance in real time.

More importantly, their month-end close cycles dropped from roughly two months to about three weeks today. And they expect to close even sooner now that they've linked their bank account to Sage Intacct, making their monthly reconciliations more efficient.

But greater speed and visibility are only part of the story. Moving to Sage Intacct boosted morale. "Everyone in our department loves working in Sage Intacct," says Davis. "Everyone likes the user-friendliness of it. Everyone better understands the accounting processes. And it helped us operate more as a team."

Ready to Get Started?

Whether your organization is outgrowing its legacy accounting system or preparing for its next stage of growth, JMT Consulting can help. Our nonprofit and healthcare finance specialists guide organizations through system selection, implementation, and optimization every step of the way.

Contact JMT Consulting to learn how your organization can modernize its finance operations with Sage Intacct.