Becker Private Equity & Business Podcast Episode Summary: Driving Efficiency and Growth in Ambulatory Care with Sri Velamoor of NextGen Healthcare Release Date: June 18, 2025
Introduction
In this insightful episode of the Becker Private Equity & Business Podcast, host Scott Becker engages in a deep conversation with Sri Vellimore, President and Chief Operating Officer (soon to be CEO) of NextGen Healthcare. The discussion centers on how healthcare organizations, particularly those in ambulatory settings, are navigating contemporary challenges to achieve sustainable growth and profitability.
Guest Introduction: Sri Vellimore
Scott Becker begins by introducing Sri Vellimore, highlighting his impressive academic background from Duke and Wharton, and his professional experience with prestigious firms like McKinsey and PricewaterhouseCoopers. Sri shares his journey at NextGen Healthcare, noting his progression from Chief Growth Officer to President and COO, and his upcoming role as CEO.
Notable Quote:
“I started my career at NextGen here as the Chief Growth Officer... I’m excited to have this conversation with you.”
[01:52]
NextGen Healthcare Overview
Sri Vellimore provides a comprehensive overview of NextGen Healthcare, emphasizing its 50+ years of experience as a leading provider of cloud-based healthcare IT solutions. He explains that NextGen specializes in electronic health records (EHR) and practice management systems catering to medical groups across 40 clinical specialties.
Notable Quote:
“Think of us as a one stop shop turnkey solutions provider for medical groups.”
[02:54]
Current Challenges in Ambulatory Care
The conversation delves into the primary challenges faced by healthcare leaders in ambulatory settings, as identified by Sri:
- Staffing Shortages: Persistent difficulties in recruiting and retaining staff, exacerbated by wage inflation.
- Reimbursement Pressures: Increasing denials from both commercial and government payers.
- Technology Costs and Complexity: Rapid advancements in AI and automation tools posing cost and integration challenges.
- Regulatory Pressures: Ongoing certification requirements and compliance mandates.
- Consolidation Pressures: Continuous mergers and acquisitions driven by private equity and health systems.
- Patient Engagement: The shift towards a more retail-like healthcare model, emphasizing patient retention and acquisition.
Notable Quote:
“Leaders, in one word, Scott, I’m hearing anxiety... the efficiency imperative is the imperative of the day.”
[04:02]
Strategies for High-Performing Practices
Sri outlines key strategies that differentiate high-performing practices from their peers. These strategies involve a portfolio approach to efficiency, targeting multiple levers simultaneously to drive measurable gains in revenue and patient throughput.
Key Efficiency Levers:
-
Revenue Cycle Optimization:
- Reducing charge entry lag to under five days.
- Minimizing denial rates to below 5%, potentially increasing patient revenue by 5-10%.
Quote:
“Best practice practices are able to reduce their charge entry lag by less than five days.”
[06:09] -
Scheduling Optimization:
- Decreasing patient no-show rates to below 5%.
- Managing follow-up appointments to reduce missed opportunities by over 10%.
Quote:
“Every missed primary care appointment per doctor translates into almost $15,000 of lost revenue per year.”
[06:48] -
Physician Efficiency:
- Implementing AI-assisted documentation to save 45 minutes to 2 hours daily per physician.
- Enabling 2-3 additional appointments per doctor.
Quote:
“They are able to cut that time down by 45 minutes to 2 hours per day per doctor on average.”
[07:20] -
Referral Management:
- Reducing loss of patient revenue due to improper referrals by 10-30%.
Quote:
“Nearly 10 to 30% of annual net patient revenue for medical group is lost because patients are either going to the wrong places or not showing up where they're supposed to.”
[08:15] -
Contract Optimization:
- Utilizing analytics and AI to maximize value from payer contracts.
Quote:
“Actively using analytics and more recently now, AI models to determine whether you’re getting exactly what you should out of the contracts.”
[09:10] -
Site Optimization:
- Efficiently managing staffing and resources to reduce payroll costs by 8-14%.
Quote:
“Practices that are doing this well are seeing almost an 8 to 14% reduction in payroll costs.”
[09:45]
Technology and Workflow Redesign for Resilience
Scott probes into how technology and workflow redesign can help organizations stay resilient amidst changing reimbursement landscapes and regulatory environments. Sri highlights the role of AI and automation in overhauling revenue cycle management, from charge capture to claim disposition.
Notable Innovations:
- AI Models for Clean Claims: Enhancing accuracy to reduce denial rates.
- Automated Denial Handling: Utilizing bots to manage and resolve denials efficiently without relying on outsourced teams.
Quote:
“AI and automation to do the disposition of these denials... ensures that denial is appropriately handled and disposed.”
[15:53]
Private Equity Perspective: Opportunities for Investment
Given NextGen’s private equity backing, Sri discusses the intersection of private equity firms and healthcare practices. He identifies key opportunities where private equity-backed groups can invest in efficiency for long-term ROI:
- Scalability: Supporting rapid growth and acquisitions with scalable platforms.
- EBITDA Optimization: Standardizing processes to minimize variability and leverage shared services.
- Contract Flexibility: Transitioning from legacy licensing to subscription models for better adaptability and innovation.
Quote:
“Standardizing and taking variability out of their clinical protocols, their processes... gives you an immediate bang for the buck.”
[17:00]
Conclusion and Final Thoughts
Sri wraps up by urging support for independent medical groups and community health centers, emphasizing their crucial role in the healthcare ecosystem. He directs listeners to NextGenHealthcare.com and their social media channels for more information and impact stories.
Final Quote:
“Supporting independent medical groups stay resilient... is a critical part of our healthcare ecosystem.”
[19:28]
Scott Becker thanks Sri for his valuable insights and expresses gratitude to the listeners, highlighting the podcast's recent milestone of over 7 million downloads and its top ranking in the Apple Business News Podcast charts.
Learn More:
- NextGen Healthcare Website: NextGenHealthcare.com
- Social Media: Follow NextGen on LinkedIn and Twitter for the latest updates and success stories.
This episode offers a wealth of knowledge for healthcare leaders, private equity professionals, and anyone interested in the intersection of healthcare technology and business efficiency. Sri Vellimore’s expertise provides actionable strategies to navigate and thrive in the evolving ambulatory care landscape.