Unified reporting across acquired GI practices for a PE-backed MSO
A GI practice had acquired multiple gastroenterology practices, each on a different system with different patient IDs and different payer contracts. Prexisio built the integration layer, delivered three recurring monthly reports, and managed annual MIPS — running through the organization's acquisition by SCA Health (Optum).
Outcomes
- Patient data unified across all acquired GI practices — different systems, different patient IDs, one view
- Three recurring monthly reports delivered on schedule every cycle without manual assembly
- Annual MIPS submission managed across the full organization
- Revenue cycle definitions standardized across acquired practices
- Engagement sustained through acquisition
Client Context
This was a management services organization backed by private equity that had acquired multiple gastroenterology practices across different markets. Each acquired practice came in with its own systems, its own patient records, its own payer contracts, and its own operational processes.
The PE ownership needed three things: unified operational reporting across all practices, reliable revenue cycle visibility, and regulatory reporting (MIPS) managed at the organizational level. None of it existed in a single place.
The Problem
Multiple systems, no unified view
Each acquired practice ran on a different EMR and billing platform. The same patient who had visited two different acquired practices had a different record in each system — because each system assigned its own patient ID.
Before any cross-practice analysis was possible, those systems had to be connected. That connection had never been built.
Revenue cycle reporting built on manual assembly
The recurring reports that PE ownership depended on — AR aging, monthly billing performance, payer mix — were assembled manually each cycle. Different staff at different practices pulled different exports and reconciled them into combined reports. The process was slow, error-prone, and entirely dependent on the individuals performing it.
When someone left, the report stopped.
MIPS with no infrastructure
Annual MIPS submission required pulling quality measure data across all practice locations. There was no system that connected all of the required data in a form that could support the submission. Each practice's data lived in its own system, in its own format.
What Prexisio Built
Data integration layer across all acquired practices
The first deliverable was the integration layer — connecting the data from each acquired practice into a unified reporting foundation. Patient identity was resolved across systems using name, date of birth, and location matching where system-native identifiers did not cross-reference.
This layer was the prerequisite for every subsequent deliverable. Without it, cross-practice reporting was impossible.
Three recurring monthly reports
With the integration layer in place, Prexisio built and delivered three recurring monthly reports — delivered by the 10th of each month for the prior month's data:
AR Aging Report — accounts receivable aging across all practices, stratified by payer, practice location, and aging bucket. Used by the revenue cycle team to prioritize collections activity.
Monthly Billing Report — charges, payments, adjustments, and collection rates by practice, procedure category, and payer. Used by PE ownership and practice administrators to monitor revenue cycle performance.
Payer Mix Report — revenue breakdown by payer and CPT category across all practices. Used for contract renewal strategy and BD allocation decisions.
These reports ran on schedule every cycle. No manual assembly. No dependence on individual staff members to pull and reconcile exports.
Annual MIPS submission
Prexisio managed the annual MIPS submission across the organization — pulling the required quality measure data from each practice's systems, validating it against CMS requirements, and producing the submission documentation.
MIPS was built into the recurring delivery cadence rather than treated as a separate annual project.
Impact
Cross-practice visibility
PE ownership had, for the first time, a unified view of operational and financial performance across all acquired practices. The monthly reports made cross-practice comparison possible — identifying which practices were outperforming on collections, which had AR aging problems, and where payer mix was diverging from the organizational target.
Reporting reliability
The three monthly reports delivered by Prexisio ran on schedule for the duration of the engagement. A departure at any acquired practice was an HR event — not a reporting crisis.
Regulatory continuity
MIPS was submitted on time every year. The submission process was documented, repeatable, and not dependent on any individual at any acquired practice.
Summary
This was a PE-backed MSO doing exactly what PE in healthcare does — acquiring practices and trying to create value through scale. The reporting and data infrastructure required to manage that scale did not come with the acquisitions. Prexisio built it: the integration layer, the unified patient view, the three recurring monthly reports, and the MIPS submission workflow.
The engagement lasted through the organization's acquisition. The reporting infrastructure Prexisio built was not a project that ended. It was an operational function that ran until the organization was absorbed into a larger one.