Enterprise Finance Center of Excellence

Context

A 10-hospital system was struggling with:

• Inconsistent financial reporting across hospitals
• High cost of finance operations (8% of revenue)
• Slow close process (15 days)
• Limited analytical capability for operational decisions

Pattern Applied

Shared Services Model - Consolidated all finance transactional and analytical work into three regional centers of excellence.

Implementation

• Transactional Hub: All accounts payable, general accounting, and payroll processed centrally
• Analytical Center: 8 FTEs dedicated to operational analysis and insights for each service line
• Compliance Center: Revenue cycle and compliance specialists ensuring accuracy
• Technology: Implemented cloud-based ERP with standardized chart of accounts

Results

• Finance costs reduced from 8% to 6.2% of revenue
• Financial close time reduced to 5 days
• Service line finance leaders shifted from transaction oversight to strategic planning
• Enabled new analytics capabilities (real-time dashboards)

Lessons Learned

• Clear SLAs and governance prevent COE from becoming bottleneck
• Requires significant change management and training
• Need for clinical finance liaisons to translate between operational and finance teams

Related Patterns

• Service Line Autonomy - Service lines maintain operational budgets