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The Impact of Improving Accounts Receivable Collections on Cash Forecasts

February 12, 2024    •    6 min read

Enhancing accounts receivable (AR) collections can significantly transform the financial health of rural hospitals. Accurate and efficient AR collections ensure a steady cash flow, which is vital for sustaining hospital operations. This article explores the impact of improved AR collections on cash forecasts, emphasizing how to differentiate and include these improvements as distinct cash inflow lines in your financial planning.

Understanding Accounts Receivable Collections

What Are Accounts Receivable Collections?

Accounts receivable collections refer to the process of collecting payments for services rendered by the hospital. This includes payments from patients, insurance companies, and government programs. Effective AR collections are crucial for maintaining healthy cash flow and financial stability.

Current Run Rate

The current run rate of AR collections represents the typical, ongoing rate at which a hospital collects its receivables. This rate is based on historical data and reflects the average efficiency of the hospital’s billing and collection processes.


Efficient AR collections are vital for rural hospitals as they directly impact cash flow. Delays or inefficiencies in collecting receivables can lead to cash shortages, affecting the hospital’s ability to pay staff, purchase supplies, and invest in improvements. Improved AR collections can provide a much-needed boost to the hospital’s financial health, allowing for better resource allocation and enhanced patient care.

Identifying Opportunities for AR Improvement

Current Performance Analysis

To improve AR collections, it’s essential first to assess the current state of your AR performance. This involves analyzing key metrics such as days in accounts receivable (DAR), the percentage of receivables collected within 30, 60, and 90 days, and the overall collection rate.


Comparing your hospital’s performance against industry standards can help identify areas for improvement. Industry benchmarks provide a reference point, helping you understand where your hospital stands in terms of AR efficiency and effectiveness.

Common Issues

Identifying common barriers to efficient AR collections is crucial. These may include billing errors, delayed follow-up on unpaid claims, insufficient patient communication regarding financial responsibilities, and outdated technology or processes.

Strategies for Improving AR Collections

Process Optimization

Streamlining billing and follow-up processes can significantly enhance AR collections. This includes ensuring accurate and timely billing, reducing claim denials through proper coding and documentation, and implementing systematic follow-up procedures for unpaid claims.

Technology Utilization

Leveraging technology can improve AR efficiency. Automation tools can streamline billing and follow-up processes, reducing the risk of errors and ensuring timely collections. Advanced AR management software can provide real-time insights into receivables, helping staff prioritize and manage collections more effectively.

Staff Training

Enhancing the skills and efficiency of the billing and collections team is essential. Regular training on best practices, coding standards, and effective communication strategies can equip staff to handle AR processes more efficiently and reduce the incidence of errors and delays.

Patient Communication

Improving clarity and frequency of communication with patients regarding their financial responsibilities can boost payment rates. Providing clear billing statements, offering multiple payment options, and proactively discussing financial obligations with patients can lead to more timely payments and reduced AR days.

Quantifying AR Improvements

Setting Targets

Establishing realistic improvement goals is the first step in quantifying AR improvements. These goals should be based on current performance metrics and industry benchmarks, aiming for incremental improvements over time.

Measuring Impact

Using key performance indicators (KPIs) to track improvements is crucial. KPIs such as reduced DAR, increased collection rates, and lower denial rates can provide measurable evidence of AR improvements.

Estimating Financial Impact

Calculating the potential financial benefits of improved AR collections involves estimating the additional cash inflows resulting from these improvements. This can be done by comparing historical collection rates with targeted improvements and projecting the impact on cash flow.

Incorporating AR Improvements into Cash Forecasts

Normal Account Collections

The current run rate of AR collections should be represented as the normal account collections line in the cash forecast. This line reflects the baseline cash inflows from AR, based on historical performance and current processes.

AR Improvement Line

Adding a separate line for “catch up” or “AR Improvement” highlights the enhanced performance from AR optimization efforts. This line represents the additional cash inflows resulting from improved collections, providing a clear picture of the financial impact of AR initiatives.

Scenario Analysis

Exploring different scenarios can help understand the potential impact of AR improvements on cash flow. By modeling various levels of AR performance improvement, hospitals can prepare for a range of outcomes and develop strategies to maximize the benefits of enhanced AR collections.

Building a Cash Forecast with AR Improvements

Data Collection

Gathering accurate and comprehensive data is crucial for building a reliable cash forecast. This includes historical billing and collection data, current AR performance metrics, and projections for future collections.

Forecast Model

Creating a forecast model that includes both normal collections and AR improvements involves defining the assumptions and parameters for each line. The normal collections line is based on the current run rate, while the AR improvement line reflects the anticipated additional collections from optimization efforts.

Example Forecast

An illustrative example can clarify how to incorporate AR improvements into a cash forecast. Suppose a hospital’s normal run rate of collections is \$500,000 per month. With targeted AR improvements, the hospital projects an additional \$50,000 per month. The cash forecast would include \$500,000 as normal collections and an additional \$50,000 as AR Improvement, resulting in a total of \$550,000 in projected collections for the month.

Monitoring and Adjusting the Forecast

Regular Updates

Updating the cash forecast regularly with actual collection data is essential to maintain its accuracy. Monthly or quarterly reviews can help ensure that the forecast remains relevant and reflective of current performance.

Performance Review

Assessing the accuracy of forecasts against actual collections is crucial for continuous improvement. Regular performance reviews can identify discrepancies and provide insights into areas where adjustments are needed.

Continuous Improvement

Iteratively refining AR strategies and forecast models based on performance data ensures that the hospital’s cash forecasting process remains effective. Continuous improvement efforts can lead to sustained enhancements in AR collections and overall financial health.


Improving accounts receivable collections can have a profound impact on the financial stability of rural hospitals. By accurately estimating AR improvements and incorporating them into cash forecasts, hospitals can better manage their cash flow and allocate resources more effectively. Regular monitoring and continuous refinement of AR strategies and forecast models are essential for sustained financial health.

Gregory Brickner

Results Fanatic®


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