Blog: The RCM Question That Should Make Every CEO Uncomfortable
Editor-in-Chief
Behavioral health visits passed primary care visits for the first time this year: 66.4 million versus 62.8 Can you say, right now, what it actually costs you to admit a client? Not your contracted rate or what the payer promised in the fee schedule, but the real number, after the deductible negotiations, the level-of-care mix, and the time it actually takes to get paid.
If you hesitated, you’re not alone. Drew Laboon, COO of Pathway Recovery Centers, and Tracy Rogers, CEO of Stanford Behavioral Health, recently made the case that revenue cycle stopped being a CFO problem years ago. It’s a leadership discipline now, and a CEO who can’t produce that number on the spot is making decisions on numbers that don’t reflect the business they’re actually running.
As they shared in their panel at Kipu’s Elevate 2026 conference, now available on demand, there’s a few practices worth stealing:
1. Fix your front door before you fix your billing. Tracy puts 60 to 85% of RCM errors at intake, the moment demographic and eligibility data gets captured wrong. One census audit she ran found $1.4 million leaking out through authorized treatment days nobody used.
2. Track reimbursement, not contracted rate. Drew’s rule of thumb: the gap between what a payer promises and what actually lands in the bank can run 20% or more once deductibles, coinsurance, and payment plans work through the math. Planning around the contracted number instead of the real one is how a good quarter quietly turns into a bad one.
3. Get the financial conversation off your admissions team. Pathway and Stanford route it to a dedicated financial engagement function instead. The instinct that makes someone great at admissions, building trust fast with someone in crisis, is the same instinct that makes it hard for them to also ask for a deductible.
4. Put your KPIs in front of leadership daily, not quarterly. Stanford’s dashboard, clean claims rate, AR aging, denial rate, hits leadership inboxes by 9 a.m. every morning. Waiting for the monthly close to catch a payer problem means finding out about it 45 days too late.
The real work is putting revenue cycle on the executive team’s weekly agenda, right alongside clinical outcomes and growth strategy, and holding it to the same level of scrutiny. Drew and Tracy go deeper on all of this in Operational Excellence Equals Profit: The CEO Guide to High-Performance RCM, now available on demand.
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