it takes three to thrive

Case Study | Ashe Memorial Hospital and AXIA Physician Solutions | North Carolina
  • Hospital bed and IV drip

    25-bed critical access hospital serving rural communities in North Carolina’s Blue Ridge Mountains 

  • Female Dr and male nurse

    3 physician practices with 13 physicians 

  • purple map of use with blue nodes

    Physician practices part of AXIA Physician Solutions MSO 


  • Used disparate EHRs and practice management systems across physician off ices  
  • At risk of closing within 14 months due to financial challenges  
  • Needed to quickly gain PCMH accreditation status  
  • Unable to meet the community’s specialty care needs 


  • athenaOne® 


  • Onboarded physician practices on athenaOne in 3.5 months  
  • 94% net matched collections (vs. 90% for top performers)  
  • 15% reduction in days in accounts receivable  
  • 54% increase in average daily charge  
  • Increased confidence in financial future supported new oncology and orthopedics service lines  
  • Improved financial performance supported the decision to build a new $1.9M emergency department 

A struggling hospital gets “one shot to turn it around” 

For 75 years, Ashe Memorial Hospital has served the people of Ashe County in the Blue Ridge Mountains in rural Jeff erson, North Carolina. But like many small hospitals across the U.S., the 25-bed critical assess facility had found itself on the brink of shutting its doors for good. 

The hospital was struggling with mounting bills, financial distress, lack of resources, and challenges attracting and recruiting physicians to the community. Patients went elsewhere to see specialists. For the county’s cancer patients, that meant driving up to an hour and a half away to Winston-Salem for treatment. CEO Laura Lambeth, RN, had a plan to improve the hospital’s financial situation but didn’t know if it would work. “We didn’t have a lot to lose and the hospital was going to close in 14 months…We had one shot to turn it around.” 

That is when the Ashe Memorial Hospital board of directors approved a new financial plan, including a partnership with AXIA Physician Solutions, a managed services organization within Novant Health. The hospital's physician offices were among the top priorities in this plan. Over the years, Ashe Memorial had acquired physician offices through both a desire to grow and as a safety net to private practice physicians considering closing their practices, which would have been catastrophic to the Ashe County community. 

But the hospital lacked a centralized platform through which to manage the physician off ices, which were using a variety of practice management systems and electronic health records. One of AXIA’s first initiatives was to partner with athenahealth to connect the physicians on the same comprehensive practice management, EHR, and patient engagement solution. 

A fast implementation connects physicians on an integrated platform 

As a newly formed MSO, AXIA sought a technology solution that would bring value to its members. AXIA assembled a team of ambulatory clinic experts to evaluate several EHR/ practice management systems, and they chose athenahealth because they found it to be “an easier install, and it’s most cost-effective and allows us to have a clear line of sight into the business,” according to Brian Pearce, Senior Director of AXIA Physician Solutions. Ashe Memorial was the first AXIA client to go live on athenaOne, and given the hospital’s financial challenges, it was important to move quickly. 

Partnering with athenahealth’s integration team, AXIA onboarded Ashe Memorial’s physician practices onto athenaOne within three and a half months, with little disruption. With low up-front capital required, there were no financial barriers holding Ashe Memorial back. And by joining athenahealth’s national network, which connects providers, patients, payers, labs, registries, and more on a single cloud-based platform, Ashe Memorial could benefit from thousands of existing interfaces. “It’s great having everything pre-built, ready to go, instead of trying to build it from scratch,” says Pearce, whose staff were able to spend more time working with the hospital on other priorities. 

A short implementation timeline also brought Ashe Memorial a quick win for one physician practice that was at risk of losing its Patient Centered Medical Home (PCMH) designation – and the high reimbursement that came with it. Because of the quality management workflows built into athenaOne, clients satisfy certain PCMH criteria just by using the EHR. In a matter of weeks, with the help of the AXIA team, the practice not only completed its application to retain its PCMH designation, but also advanced from a level one to a level two designation. 

Simplified data sharing across EHRs improves care coordination 

As providers became familiar with athenaOne, they also saw the benefits of being part of a network that makes sharing patient information seamless. Ashe Memorial’s physician practices used athenaOne’s patient record sharing functionality to access patient information from the hospital’s inpatient departments, on Meditech, through CommonWell and to coordinate care with other local hospitals, most of which are on Epic, through Carequality. 

Most importantly, sharing patient records through a combination of networks – CommonWell, Carequality, and athenahealth’s own – didn’t detract from the quality of care that Ashe Memorial aims to deliver. In fact, it proved beneficial to providing high-quality care, because in athenaOne, patient records are surfaced directly in the patient’s chart and providers are alerted when their patients receive care elsewhere, which can happen often if patients leave Ashe County to seek specialist care in a nearby city. 

Deep visibility enhances reporting and drives business results 

With a cloud-based system, Ashe Memorial has new visibility into its clinical and financial performance, and with the support of AXIA, the hospital established baselines for measuring performance. AXIA sends daily reports using data from athenahealth’s data warehouse feed, along with some pre-built reports. Ashe Memorial’s closest partner at the MSO, their “virtual practice administrator,” analyzes all the data to come up with actionable recommendations for the practices on how to improve collections, prioritize tasks in hold buckets, and more. 

During the providers’ first months on their new EHR, AXIA reviewed athenaOne’s reports to identify areas to improve clinical efficiency, as well. “We’ve been able to identify some providers that were not using the system as efficiently and send in our clinical quality nurse to work directly with those providers to get them more comfortable using the system,” says Pearce. 

Greater stability provides a foundation for growth 

Since going live on athenaOne, the hospital saw a 15 percent reduction in accounts receivable and a 94 percent net matched collections rate – improving the hospital’s financial stability and bolstering confidence in its future performance. 

Thanks to this transformation, Ashe Memorial was able to turn its attention to growth. The hospital revamped its emergency department and added the oncology and orthopedic specialists that its community needed. The $1.9 million emergency department renovation alone has helped Ashe Memorial increased its patient volume by 10 percent, Lambeth says.   

“With the service lines we’ve added, we now have a return on investment that has held steady,” Lambeth says. “It’s the best we’ve had in years. I think the community is embracing the hospital and they don’t want to go anywhere else.” 

Laura Lambeth, CEO, Ashe Memorial Hospital

* These results reflect the experience of one particular organization and are not necessarily what every athenahealth customer should expect.