Blueprint Playbook for athenahealth

Who the Hell is Jordan Crawford?

Founder of Blueprint. I help companies stop sending emails nobody wants to read.

The problem with outbound isn't the message. It's the list. When you know WHO to target and WHY they need you right now, the message writes itself.

I built this system using government databases, public records, and 25 million job posts to find pain signals most companies miss. Predictable Revenue is dead. Data-driven intelligence is what works now.

The Old Way (What Everyone Does)

Your GTM team is buying lists from ZoomInfo, adding "personalization" like mentioning a LinkedIn post, then blasting generic messages about features. Here's what it actually looks like:

The Typical athenahealth SDR Email:

Subject: Improve your revenue cycle management Hi [First Name], I noticed your practice has been growing based on your recent LinkedIn post about hiring new staff. Congrats! At athenahealth, we help healthcare providers like you optimize their revenue cycle with our cloud-based EHR and billing platform. We've helped thousands of practices reduce claim denials and improve cash flow. Our clients see an average of 15% improvement in Days in A/R within the first 6 months. Would you be open to a quick 15-minute call next week to discuss how we can help your practice? Best, [SDR Name]

Why this fails: The prospect is an expert. They've seen this template 1,000 times. There's zero indication you understand their specific situation. Delete.

The New Way: Intelligence-Driven GTM

Blueprint flips the approach. Instead of interrupting prospects with pitches, you deliver insights so valuable they'd pay consulting fees to receive them.

1. Hard Data Over Soft Signals

Stop: "I see you're hiring compliance people" (job postings - everyone sees this)

Start: "Your MIPS score is 68 points with 847 joint replacement procedures - that's a $42K+ payment penalty" (CMS Provider Data Catalog with exact numbers)

2. Mirror Situations, Don't Pitch Solutions

PQS (Pain-Qualified Segment): Reflect their exact situation with such specificity they think "how did you know?" Use government data with dates, record numbers, facility addresses.

PVP (Permissionless Value Proposition): Deliver immediate value they can use today - analysis already done, deadlines already pulled, patterns already identified - whether they buy or not.

athenahealth PQS Plays: Mirroring Exact Situations

These messages demonstrate such precise understanding of the prospect's current situation that they feel genuinely seen. Every claim traces to a specific government database with verifiable record numbers.

PQS Public Data Strong (8.4/10)

FQHCs with Expanding Patient Volume Without RCM Scaling

What's the play?

Target Federally Qualified Health Centers showing 20%+ year-over-year patient volume growth with 70%+ Medicaid/Medicare payer mix. These centers face compounding RCM complexity as they scale - more claims, more documentation requirements, slower reimbursements - without proportional billing infrastructure.

Why this works

You're using their own UDS report data to show them a problem they feel every day but haven't quantified. The $400K tied up in delayed collections makes the pain tangible and urgent. CFOs at FQHCs live and die by cash flow - this hits them directly in their primary KPI.

Data Sources
  1. HRSA Uniform Data System (UDS) - Health Center Level - patient_demographics, service_utilization, insurance_payor_mix, revenue_cycle_data
  2. HRSA Health Center Service Delivery Sites Database - org_name, facility_name, fqhc_status, patient_population_served

The message:

Subject: Your patient volume up 34% but A/R at 52 days Your HRSA UDS data shows patient visits increased 34% year-over-year but your Days in A/R sits at 52 days. That's 17 days above the FQHC median of 35 days - roughly $400K+ tied up in delayed collections. Who's managing your RCM scaling right now?
PQS Public Data Strong (8.1/10)

FQHCs with Expanding Patient Volume Without RCM Scaling (Variant 2)

What's the play?

Same segment targeting, but with empathetic framing that acknowledges the billing team is likely overwhelmed rather than incompetent. This variant works well when you want to position yourself as supportive rather than diagnostic.

Why this works

The empathetic "Is your billing team asking for help?" question creates psychological safety. You're not blaming them - you're offering to be their advocate. This resonates especially well with Practice Administrators who feel caught between growing patient needs and limited back-office resources.

Data Sources
  1. HRSA Uniform Data System (UDS) - Health Center Level - patient_demographics, service_utilization, insurance_payor_mix, revenue_cycle_data
  2. HRSA Health Center Service Delivery Sites Database - org_name, facility_name, fqhc_status

The message:

Subject: 52 days in A/R at your FQHC Your center's Days in A/R hit 52 days last quarter while patient volume grew 34%. FQHCs with similar Medicaid mix average 35 days - you're leaving cash on the table. Is your billing team asking for help?
PQS Public Data Strong (8.3/10)

Ambulatory Surgery Centers with Declining Quality Scores

What's the play?

Target ASCs whose CMS Quality Reporting scores dropped below state median AND have inspection deficiencies in the past 12 months. These facilities face dual risk: license renewal jeopardy and reimbursement penalties. Documentation gaps drive both quality failures and claim denials.

Why this works

You're connecting two data points they may not have synthesized themselves: quality score decline + infection control deficiencies. The mention of "enhanced CMS oversight" triggers regulatory anxiety, while "lower patient referrals" hits the business concern. This dual threat creates urgency.

Data Sources
  1. CMS Ambulatory Surgical Center Quality Measures - Facility - quality_measure_outcomes, patient_safety_indicators, provider_id
  2. State ASC and Ambulatory Surgery Licensing Databases - inspection_findings, deficiencies, license_expiration_date

The message:

Subject: Your ASC dropped to 2.5 stars in Q3 Your center's CMS Quality Reporting score dropped from 3.5 to 2.5 stars last quarter with 2 infection control deficiencies. That puts you at risk for enhanced CMS oversight and lower patient referrals. Who's leading your quality improvement response?
PQS Public Data Okay (7.9/10)

Ambulatory Surgery Centers with Inspection Deficiencies

What's the play?

Same segment but leading with the specific inspection findings rather than quality score decline. This variant works well when the inspection is very recent and top-of-mind for the prospect.

Why this works

Mentioning the exact deficiency type (infection control in sterile processing) and the September timeline shows you've done detailed homework. The 15-20% referral drop statistic creates business urgency. The assumptive "Is someone already handling the corrective action plan?" gives them an easy out if they're already working on it.

Data Sources
  1. State ASC and Ambulatory Surgery Licensing Databases - inspection_findings, deficiencies, inspection_date
  2. CMS Ambulatory Surgical Center Quality Measures - quality_measure_outcomes

The message:

Subject: 2 infection control deficiencies at your ASC Your September inspection flagged 2 infection control deficiencies in your sterile processing area. ASCs with similar citations see 15-20% referral drops within 6 months. Is someone already handling the corrective action plan?
PQS Public Data Strong (8.6/10)

Orthopedic Practices Below MIPS Threshold with High Volume

What's the play?

Target orthopedic practices performing 500+ procedures annually but scoring in MIPS low-performance category (below 75 points). High volume + poor documentation quality = maximum financial exposure to payment penalties up to 9%.

Why this works

You've done the math for them: $42K in penalties on just their joint replacement procedures. This isn't theoretical - it's money already lost. Orthopedic practices have high revenue per procedure, so payment penalties hurt disproportionately. CFOs and Practice Administrators will immediately forward this to their quality reporting team.

Data Sources
  1. CMS Provider Data Catalog - Physician Quality Measures - provider_npi, mips_performance_category, quality_measure_scores, procedure_volume, organization_name

The message:

Subject: Your MIPS score at 68 points with 847 procedures Your practice scored 68 MIPS points last year - below the 75-point threshold - while billing 847 joint replacement procedures. That's a $42K+ payment penalty on those procedures alone. Who's managing your MIPS improvement strategy?
PQS Public Data Strong (8.2/10)

Orthopedic Practices Below MIPS Threshold (Urgency Variant)

What's the play?

Same segment targeting but adding forward-looking urgency by mentioning the 2025 threshold increase to 79 points. This creates a "falling further behind" narrative that drives action.

Why this works

Leading with the dollar penalty makes it concrete, then the threshold increase adds time pressure. The question "Is your quality reporting keeping up with procedure growth?" reframes it as a scaling problem rather than a competence problem - easier to admit and seek help for.

Data Sources
  1. CMS Provider Data Catalog - Physician Quality Measures - provider_npi, mips_performance_category, quality_measure_scores, procedure_volume

The message:

Subject: $42K MIPS penalty on your joint replacements Your 68 MIPS score triggered penalties on 847 joint replacement procedures last year. That's $42K in lost revenue - and 2025 thresholds just increased to 79 points. Is your quality reporting keeping up with procedure growth?

athenahealth PVP Plays: Delivering Immediate Value

These messages provide actionable intelligence before asking for anything. The prospect can use this value today whether they respond or not.

PVP Internal Data Strong (9.1/10)

Payer-Specific Denial Pattern Intelligence

What's the play?

Use aggregated claims data across your customer base to identify when a specific practice has unusually high denial rates for a particular CPT code + payer combination compared to peers. Surface the exact documentation gap causing denials before they submit more claims.

Why this works

This is permissionless value at its finest - you're preventing future denials before they happen, not just explaining past ones. The 41% vs 89% comparison makes it obvious this is fixable. Mentioning "Aetna's requirements" shows you understand payer-specific nuances. The low-commitment ask ("Want the breakdown?") makes engagement easy.

Data Sources
  1. Internal athenahealth Claims Database - claim_outcome by CPT code, payer, practice specialty, documentation_elements
  2. Aggregated across 50+ practices per specialty-payer-geography combination

The message:

Subject: Aetna denying 41% of your 27447 claims We analyzed your last 90 days of claims - Aetna denied 41% of your CPT 27447 submissions while approving them at 89% for peer practices. The pattern suggests a documentation gap in your pre-authorization process specific to Aetna's requirements. Want the denial pattern breakdown by payer?
This play assumes athenahealth has:

Aggregated claims data across customers showing denial rates by CPT code, payer, and practice to identify patterns. Must be able to segment by specialty, geography, and payer with enough volume to create statistically valid peer benchmarks (50+ practices per segment).

If you have this data, this play becomes highly differentiated - competitors can't replicate network-level denial intelligence.
PVP Internal Data Strong (8.9/10)

Payer Rule Change Alert with Peer Recovery Data

What's the play?

Track payer medical necessity criteria changes in real-time and correlate with customer denial rate spikes. Alert practices to rule changes before they submit claims under old assumptions, and provide the updated criteria checklist from practices that already adapted successfully.

Why this works

Payer rule changes happen constantly but are buried in portal updates nobody reads. Surfacing the October 15th date makes it verifiable and recent. The 18% to 41% denial spike shows real consequences. The peer recovery data ("12% denials within 30 days") proves this is solvable and you have the recipe.

Data Sources
  1. Internal athenahealth Payer Rules Engine - billing_rules_updates by payer, procedure_code, effective_date
  2. Customer Denial Rate Tracking - denial_rate trends correlated with rule changes

The message:

Subject: Your UHC denials up 23% on spinal procedures Your UnitedHealthcare denial rate on spinal fusion codes jumped from 18% to 41% in Q4 - they changed their medical necessity criteria October 15th. Peer practices who updated their documentation templates recovered to 12% denials within 30 days. Want the updated criteria checklist?
This play assumes athenahealth has:

Real-time tracking of payer billing rules changes (via proprietary rules engine updates) and the ability to correlate rule changes with customer denial rate shifts across similar practices. Requires tracking documentation template changes by high-performing practices.

This is a gold-standard PVP - you're solving a problem before the prospect knows they have it.
PVP Public + Internal Strong (8.7/10)

RCM Efficiency Gap with Operational Recipe

What's the play?

Combine public provider data (practice size, specialty, location) with internal RCM performance benchmarks to show practices exactly how far behind they are vs. peers, then deliver the specific workflow changes top performers use.

Why this works

The 23 vs 38 days comparison is stark and embarrassing. The $180K working capital calculation makes it tangible. But the real value is the actionable next step: "automated eligibility verification at scheduling." That's specific enough they can implement it today. The "4-step workflow" promise makes it feel achievable, not overwhelming.

Data Sources
  1. Internal athenahealth RCM Performance Data - days_to_close_claims, staffing_ratios, write_off_rates by practice size/specialty/geography
  2. CMS Provider Data Catalog - provider_npi, organization_name, specialty for peer matching

The message:

Subject: Your RCM team 40% slower than peer practices Practices your size with similar payer mix close claims in 23 days - you're at 38 days. The 15-day gap is costing you $180K in working capital, and the top performers use automated eligibility verification at scheduling. Want to see the 4-step workflow they're using?
This play assumes athenahealth has:

Aggregated RCM performance data (days in AR, claim resolution times, staffing ratios) across 20+ comparable practices by size, specialty, payer mix, and geography. Must be able to identify specific workflow patterns of top performers.

Combined with public provider data for peer matching - this hybrid approach validates claims with external benchmarks.
PVP Public + Internal Strong (8.8/10)

Bad Debt Write-Off Gap with Collections Playbook

What's the play?

Show practices their bad debt write-off rate compared to peer benchmarks, calculate the annual revenue loss, and offer the specific collections tactics high-performers use to minimize write-offs.

Why this works

Write-offs are permanent revenue loss - this hurts more than delayed payments. The 8.2% vs 4.1% comparison is damning, and the $246K annual calculation is a CFO's nightmare. "3 collections tactics" feels manageable and tactical. This is operational value you can implement immediately.

Data Sources
  1. Internal athenahealth Collections Data - write_off_rates, bad_debt_percentages by practice size/specialty
  2. CMS Provider Data Catalog - provider_npi, organization_name for peer matching

The message:

Subject: You're writing off 8.2% while peers do 4.1% Your practice writes off 8.2% of charges as bad debt - orthopedic practices your size average 4.1%. The 4.1% difference on your $6M revenue is $246K annually, and top performers share 3 collections tactics. Want the collections playbook?
This play assumes athenahealth has:

Aggregated bad debt write-off rates across customers by specialty and practice size, with ability to identify specific collections practices of top performers (payment plan timing, follow-up cadences, patient communication scripts).

This play delivers immediate ROI - practices can implement collections tactics within days.
PVP Public + Internal Strong (8.5/10)

Medicaid First-Pass Approval Intelligence for FQHCs

What's the play?

Target FQHCs with below-average Medicaid first-pass approval rates. Use internal network data to show them their approval rate vs. peer FQHCs with similar patient demographics, then surface the specific documentation fields triggering reviews.

Why this works

FQHCs are mission-driven and under-resourced. A 15-point approval rate gap creates massive administrative burden - extra touches, appeals, delayed cash flow. The "18+ days per claim" calculation makes the pain tangible. Offering to show "which documentation fields are triggering your reviews" is immediately actionable intelligence.

Data Sources
  1. Internal athenahealth Claims Data - first_pass_approval_rates by payer and customer type
  2. HRSA UDS Data - patient_demographics, payer_mix for peer matching

The message:

Subject: Your Medicaid claim approval rate at 76% Your FQHC's Medicaid claim first-pass approval rate is 76% - FQHCs with similar demographics average 91%. The 15-point gap suggests documentation patterns that trigger reviews, costing you 18+ days per claim in extra touches. Want to see which documentation fields are triggering your reviews?
This play assumes athenahealth has:

First-pass approval rate tracking by payer and customer type, with ability to correlate denials with specific documentation gaps across similar FQHCs. Requires aggregated data across 20+ FQHCs per demographic segment.

Combined with public HRSA data for peer demographic matching - creates defensible benchmark claims.
PVP Public + Internal Strong (8.4/10)

ASC Deficiency Recovery Playbook

What's the play?

Cross-reference public ASC inspection data with internal customer quality improvement outcomes. Find ASCs with recent deficiencies matching those of customers who successfully recovered their quality scores, then deliver the exact workflow that worked.

Why this works

You're not selling hope - you're delivering proof. "14 ASCs that had your same infection control deficiencies" creates instant credibility. The 45-day recovery timeline is encouraging but realistic. The "3-step sterilization documentation workflow" is specific enough to be valuable but simple enough to implement quickly.

Data Sources
  1. Internal athenahealth Quality Improvement Data - quality score recovery timelines by deficiency type and workflow changes
  2. State ASC Licensing Databases - inspection_findings, deficiency_types for targeting

The message:

Subject: ASCs that fixed your deficiency type in 45 days We tracked 14 ASCs that had your same infection control deficiencies and recovered their quality scores within 45 days. They all implemented the same 3-step sterilization documentation workflow before their follow-up inspections. Want the workflow checklist?
This play assumes athenahealth has:

Quality improvement outcome tracking across ASC customers with ability to correlate specific workflow changes (sterilization documentation, quality reporting processes) with deficiency resolution timelines.

This delivers immediate operational value - ASCs can implement proven workflows before follow-up inspections.
PVP Public + Internal Strong (8.3/10)

MIPS Score Improvement Blueprint for Orthopedics

What's the play?

Target orthopedic practices with public MIPS scores below threshold. Use internal customer MIPS improvement data to show exactly which documentation practices drove score increases of 14+ points, then deliver the specific template.

Why this works

You're offering a proven playbook, not theory. "12 orthopedic practices that scored 68 MIPS points last year and hit 82+ this year" is social proof from peers. The pre-op functional status documentation is specific and actionable. Offering the template makes implementation friction-free.

Data Sources
  1. Internal athenahealth MIPS Performance Data - year-over-year score improvements by specialty and documentation practice changes
  2. CMS Provider Data Catalog - provider_npi, mips_performance_category, specialty for targeting

The message:

Subject: 12 orthopedic practices went from 68 to 82 MIPS We work with 12 orthopedic practices that scored 68 MIPS points last year and hit 82+ this year. They all added pre-op functional status documentation for joint replacements - worth 15 MIPS points alone. Want the documentation template they're using?
This play assumes athenahealth has:

Year-over-year MIPS performance tracking across orthopedic customers with ability to identify specific documentation practices (pre-op functional status, care coordination workflows) that drive score improvements.

This delivers immediate compliance value - practices can implement documentation templates before next reporting period.
PVP Internal Data Strong (9.0/10)

Payer Rule Change Proactive Alert

What's the play?

Monitor payer billing rule changes in real-time through your proprietary rules engine. When a major payer changes prior authorization requirements, immediately alert affected practices BEFORE they submit claims under outdated assumptions.

Why this works

This is the ultimate permissionless value - you're preventing a problem the prospect doesn't know exists yet. The January 8th date makes it immediately verifiable. The "23% of practices missed this" statistic creates urgency and social proof. The 12% to 47% denial spike is terrifying. Offering the checklist BEFORE they submit is genuinely helpful.

Data Sources
  1. Internal athenahealth Payer Rules Engine - billing_rules_updates with effective dates and requirement changes
  2. Real-time Denial Rate Monitoring - customer denial rate spikes correlated with rule changes

The message:

Subject: Cigna changed prior auth rules for CPT 29827 Cigna updated prior authorization requirements for CPT 29827 on January 8th - now requiring functional assessment scores upfront. 23% of practices missed this change and saw denials jump from 12% to 47% in the first 3 weeks. Want the new requirement checklist before you submit?
This play assumes athenahealth has:

Real-time monitoring of payer billing rules engine updates (via proprietary 30,000+ billing rules database) and the ability to track denial rate changes across customers to identify rule change impacts before they become widespread.

This is defensible IP - competitors without network-level rules tracking can't replicate this proactive intelligence.
PVP Public + Internal Strong (8.6/10)

Point-of-Service Collection Gap with Script

What's the play?

Use internal collections data to identify practices with below-average point-of-service copay collection rates. Show them the gap vs. peers, calculate the annual revenue loss, and deliver the exact payment plan script top performers use at check-in.

Why this works

This addresses both business and patient experience. The 71% vs 94% gap is embarrassing, and the $89K annual loss hurts. But framing it as "awkward patient billing later" shows empathy - you understand they care about patient experience, not just revenue. The payment plan script makes implementation immediate.

Data Sources
  1. Internal athenahealth Collections Data - point_of_service_collection_rates by practice size/specialty
  2. CMS Provider Data Catalog - provider_npi, organization_name for peer matching

The message:

Subject: Your front desk missing $89K in copay collections Practices your size collect 94% of copays at check-in - you're at 71%. The 23-point gap is $89K annually in lost collections and awkward patient billing later, and top performers use payment plans at scheduling. Want the payment plan script they're using?
This play assumes athenahealth has:

Point-of-service collection rate tracking across customers with ability to identify specific front-desk practices (payment plan timing, staff scripts, scheduling system integrations) that drive higher collection rates.

This delivers dual value - improves cash flow AND patient experience by reducing surprise bills.

What Changes

Old way: Spray generic messages at job titles. Hope someone replies.

New way: Use public data to find companies in specific painful situations. Then mirror that situation back to them with evidence.

Why this works: When you lead with "Your FQHC's Days in A/R hit 52 days while patient volume grew 34%" instead of "I see you're hiring for billing roles," you're not another sales email. You're the person who did the homework.

The messages above aren't templates. They're examples of what happens when you combine real data sources with specific situations. Your team can replicate this using the data recipes in each play.

Data Sources Reference

Every play traces back to verifiable data. Here are the sources used in this playbook:

Source Key Fields Used For
CMS Ambulatory Surgical Center Quality Measures - Facility quality_measure_outcomes, patient_safety_indicators, provider_id Targeting ASCs with declining quality scores
CMS Provider Data Catalog - Physician Quality Measures provider_npi, specialty, mips_performance_category, procedure_volume Targeting orthopedic practices below MIPS threshold
HRSA Uniform Data System (UDS) - Health Center Level patient_demographics, service_utilization, insurance_payor_mix, revenue_cycle_data Targeting FQHCs with expanding patient volume and RCM challenges
HRSA Health Center Service Delivery Sites Database org_name, facility_name, fqhc_status, patient_population_served Identifying FQHC locations and service delivery sites
State ASC and Ambulatory Surgery Licensing Databases inspection_findings, deficiencies, license_expiration_date Targeting ASCs with recent inspection deficiencies
Internal athenahealth Claims Database claim_outcome by CPT code, payer, specialty, documentation_elements Payer-specific denial pattern intelligence (PVP)
Internal athenahealth RCM Performance Data days_in_AR, claim_resolution_time, staffing_ratios, write_off_rates Peer RCM efficiency benchmarking (PVP)
Internal athenahealth Payer Rules Engine billing_rules_updates, effective_dates, requirement_changes Proactive payer rule change alerts (PVP)
Internal athenahealth Quality Improvement Data quality_score_recovery by deficiency_type, workflow_changes ASC deficiency recovery playbooks (PVP)