[texasbigdata]

Real world example (slightly annonymized). You have a 50 FTE "billing and collections department". You can outsource, but at a certain scale it makes sense to build your own.

How do you motivate these people? Or manage their performance? Or manage a good outcome for the busieness, the payor and the client?

This wasn't a hospital setting. Much lower acuity. Upon joining they measured exactly this: CPT codes, bills, A/R, etc. 95% of the time those metrics correlate with their job: getting your complex insurance to reimburse for a procedure they administered.

It's a) not clear that's what you should measure, but let's assume it's not the worst thing in the world, b) straightforward how you can get the "evil" white board example you mentioned.

Not saying this is good or bad and American healthcare is arguably broken. But just another example to maybe calibrate your view.