Unlock $20M–$50M of Trapped Cash in Healthcare Portfolio Companies
Unlock $20M–$50M of Trapped Cash in Healthcare Portfolio Companies
Outcome-Based Cash Acceleration for PE-Backed Healthcare Platforms
Outcome-Based Cash Acceleration for PE-Backed Healthcare Platforms
Identify trapped cash and EBITDA improvement opportunities in three weeks.
Identify trapped cash and EBITDA improvement opportunities in three weeks.
Many healthcare platforms carry significant cash trapped in revenue cycle inefficiencies, pricing leakage, and working capital drag. These opportunities frequently appear across healthcare services, staffing firms, physician practices, and multi-site providers.
Many healthcare platforms carry significant cash trapped in revenue cycle inefficiencies, pricing leakage, and working capital drag. These opportunities frequently appear across healthcare services, staffing firms, physician practices, and multi-site providers.
Diagnostic → Execution Sprint → Outcome-Aligned Economics
Diagnostic → Execution Sprint → Outcome-Aligned Economics
Most engagements begin with a 3-week diagnostic and transition directly into execution aligned to realized financial outcomes.
Most engagements begin with a 3-week diagnostic and transition directly into execution aligned to realized financial outcomes.
Representative Value Creation
Representative Value Creation
$200M+
$200M+
Enterprise Value Created
Enterprise Value Created
$10M+
$10M+
EBITDA Expansion Programs
EBITDA Expansion Programs
$60M+
$60M+
Cash Released
Cash Released
Cash Released
The Hidden Cash Inside Healthcare Portfolio Companies
The Hidden Cash Inside Healthcare Portfolio Companies
Many PE-backed healthcare platforms contain $20M–$50M of recoverable cash tied up in operations. The only question is whether it is captured before exit.
Many PE-backed healthcare platforms contain $20M–$50M of recoverable cash tied up in operations. The only question is whether it is captured before exit.
How the Model Works
How the Model Works
Unlike traditional consulting engagements that stop at recommendations, D4 works alongside portfolio leadership teams to execute the prioritized initiatives identified in the diagnostic, with compensation aligned to realized financial outcomes.
Unlike traditional consulting engagements that stop at recommendations, D4 works alongside portfolio leadership teams to execute the prioritized initiatives identified in the diagnostic, with compensation aligned to realized financial outcomes.
Featured Value Creation
Featured Value Creation
~$10M Annual EBITDA Improvement
Healthcare Technology Platform
Situation
Fragmented service delivery across a rapidly scaling healthcare technology platform.
Execution
Global shared-services delivery model and structured client transition program.
Impact
~$10M annual run-rate EBITDA improvement driven by global delivery redesign and operating cost reduction; fully realized post-implementation.
~$10M Annual EBITDA Improvement
Healthcare Technology Platform
Situation
Fragmented service delivery across a rapidly scaling healthcare technology platform.
Execution
Global shared-services delivery model and structured client transition program.
Impact
~$10M annual run-rate EBITDA improvement driven by global delivery redesign and operating cost reduction; fully realized post-implementation.
Where Cash Gets Trapped
Where Cash Gets Trapped
Revenue Cycle Performance
Revenue Cycle Performance
Delayed billing, denials, and inconsistent collections slow cash conversion.
Delayed billing, denials, and inconsistent collections slow cash conversion.
Working Capital Discipline
Working Capital Discipline
Operational inefficiencies tie up cash in receivables and billing processes.
Operational inefficiencies tie up cash in receivables and billing processes.
Operational Billing Processes
Operational Billing Processes
Fragmented workflows create preventable payment delays.
Fragmented workflows create preventable payment delays.
Pricing & Contract Leakage
Pricing & Contract Leakage
Underpayments and inconsistent pricing reduce margins.
Underpayments and inconsistent pricing reduce margins.
Financial Impact
Financial Impact
Faster cash conversion.
Faster cash conversion.
Accelerate collections and release working capital trapped in billing and reimbursement processes.
Accelerate collections and release working capital trapped in billing and reimbursement processes.
Operating margin improvement.
Operating margin improvement.
Identify operational bottlenecks and pricing leakage that suppress profitability.
Identify operational bottlenecks and pricing leakage that suppress profitability.
Enterprise value creation.
Enterprise value creation.
Operational cash acceleration and margin expansion increase EBITDA and enterprise value.
Operational cash acceleration and margin expansion increase EBITDA and enterprise value.
Identify the Opportunity with the Cash Acceleration Diagnostic
Identify the Opportunity with the Cash Acceleration Diagnostic
A focused three-week assessment analyzes portfolio company cash flows to uncover hidden reserves and recurring inefficiencies across revenue cycle and working capital processes.
A focused three-week assessment analyzes portfolio company cash flows to uncover hidden reserves and recurring inefficiencies across revenue cycle and working capital processes.
Our proprietary diagnostic identifies cash recovery opportunities that PE-backed healthcare platforms often overlook—typically $20M–$50M of trapped cash per platform.
Our proprietary diagnostic identifies cash recovery opportunities that PE-backed healthcare platforms often overlook—typically $20M–$50M of trapped cash per platform.
With transparent, finance-oriented reporting, we ensure potential value is quantified and a proven playbook for rapid operational execution is tailored to each company.
With transparent, finance-oriented reporting, we ensure potential value is quantified and a proven playbook for rapid operational execution is tailored to each company.
Diagnostic Outputs
Diagnostic Outputs
1. Trapped Cash Analysis
1. Trapped Cash Analysis
Quantifies working capital release and margin improvement opportunities.
Quantifies working capital release and margin improvement opportunities.
2. EBITDA Improvement Opportunities
2. EBITDA Improvement Opportunities
Identifies operational drivers of sustainable margin expansion.
Identifies operational drivers of sustainable margin expansion.
3. 90-Day Execution Roadmap
3. 90-Day Execution Roadmap
Prioritized initiatives for rapid cash acceleration.
Prioritized initiatives for rapid cash acceleration.
From Diagnostic to Value Capture
From Diagnostic to Value Capture
The diagnostic identifies the opportunity. Execution captures the value.
The diagnostic identifies the opportunity. Execution captures the value.
Most healthcare platforms contain trapped cash, but capturing it requires focused operational execution.
Following the diagnostic, D4 works alongside portfolio leadership teams to implement prioritized initiatives and accelerate results across revenue cycle performance, pricing integrity, and working capital processes.
In many engagements, our compensation is aligned to realized financial outcomes rather than time-based consulting fees.
Selected Value Creation
Selected Value Creation
~$40–60M accelerated cash
Academic Medical Center
Situation
Complex academic medical center with elevated A/R days and fragmented billing processes.
Execution
Revenue cycle process redesign and cash acceleration initiative across hospital operations.
Impact
~$40–60M accelerated cash through A/R day reduction and billing performance improvement (modeled using contemporaneous revenue base).
~$40–60M accelerated cash
Academic Medical Center
Situation
Complex academic medical center with elevated A/R days and fragmented billing processes.
Execution
Revenue cycle process redesign and cash acceleration initiative across hospital operations.
Impact
~$40–60M accelerated cash through A/R day reduction and billing performance improvement (modeled using contemporaneous revenue base).
How We Execute
How We Execute
Step 1
Step 1
Cash Diagnostic
Cash Diagnostic
Step 2
Step 2
Value Creation Plan
Value Creation Plan
Step 3
Step 3
Execution Sprint
Execution Sprint
Execution is structured around prioritized initiatives identified in the diagnostic, with economics aligned to realized outcomes.
Execution is structured around prioritized initiatives identified in the diagnostic, with economics aligned to realized outcomes.
Firm Leadership
Firm Leadership
Daniel Coonan
Daniel Coonan
Founder
Founder
20+ years advising healthcare platforms and private equity investors on operational value creation and performance improvement.
20+ years advising healthcare platforms and private equity investors on operational value creation and performance improvement.
Former Huron Consulting Group and Accenture Health.
Former Huron Consulting Group and Accenture Health.
Focus: unlocking trapped cash across revenue cycle, pricing, and working capital.
Focus: unlocking trapped cash across revenue cycle, pricing, and working capital.
Rapid Value Creation
Operational Impact
Deep PE Expertise
D4 Consulting Group
Healthcare Portfolio Value Creation
Private Equity Advisory
© 2026 D4 Consulting Group
All Rights Reserved
Request the Cash Acceleration Diagnostic
Unlocked trapped cash in your portfolio
Request the Cash Acceleration Diagnostic
Unlocked trapped cash in your portfolio
Results are representative of prior engagements and may vary based on company-specific factors.
Results are representative of prior engagements and may vary based on company-specific factors.
Results are representative of prior engagements and may vary based on company-specific factors.