Ledger & Oak
SERVICES / DECISION SUPPORT

Know what it costs to deliver care.

Large health systems know what every service line costs them. Most rural hospitals do not, because the tools and analysts that answer the question were priced for enterprise budgets. We close that gap as a service.

THE PROBLEM

Decision Support and cost accounting

A critical access hospital with one administrator wearing every hat cannot staff a Decision Support team. Without one, contracts get negotiated blind, service lines get judged on revenue instead of margin and budgets cannot flex with volume.

We do the heavy lifting. We extract data from your general ledger, EHR and payroll systems, reconcile it back to the source, load it into a Decision Support platform and deliver a monthly executive packet that answers the questions your board is already asking.

THE WORK

What an engagement can include.

Scope is set in writing before we start. Most clients begin with one piece and add others once the first one proves out.

  • Data extraction from GL, EHR and payroll with reconciliation to source
  • A hospital data warehouse you own and can report from in Power BI or Tableau
  • Cost accounting at the procedure and service-line level
  • Flex budgeting and variance analysis
  • Benchmarking and payer contract modeling
  • Monthly executive packet and dashboard
  • Ad hoc analysis when a board question cannot wait

HOW IT RUNS

Four steps, in writing.

01

Compatibility check

We review your systems before anything is signed so data barriers surface early.

02

Implementation

We handle extraction, transformation and platform setup with minimal lift from your staff.

03

Monthly product

Your leadership receives a reconciled packet and dashboard on a fixed calendar.

04

Ongoing support

We maintain the data pipeline and answer the questions the numbers raise.

PROOF

Our furthest-along pilot is Hamilton General Hospital in Texas, with a second rural hospital in Mississippi in progress.

More results →

Start with a conversation, not a proposal.

Tell us what’s on your desk. If we are not the right fit, we will tell you.

Start a conversation → Or call 806.239.2188