How Carolyn Swanson Built a Steadfast Revenue Cycle Team at Aveanna

How Carolyn Swanson built a steadfast revenue cycle team to benefit Aveanna Healthcare

The ever-changing healthcare industry often provokes a transient workforce, and that’s why revenue cycle leader Carolyn Swanson considers her team’s dedication at Aveanna Healthcare among the top accomplishments of her twenty-five-year career. Since her arrival in 2015, Swanson’s team has achieved almost all quarterly cash goals, even during several mergers.

“There is a lot of pressure to make sure we bring in enough money to pay and support our nurses who are taking care of fragile babies,” she says. “At the same time, our company is growing so rapidly that if you have constant staff turnover it just will not happen.”

Carolyn Swanson, Aveanna Healthcare

Today Aveanna provides high-quality care for more than forty-seven thousand patients and their families across twenty-three states each year. In addition to skilled nursing and therapy for all patients, Aveanna offers autism and developmental services for children as well as personal care and behavioral health services for adults. Its home medical solutions span enteral nutrition, respiratory, specialty pharmacy, and medical supplies.

Aveanna formed last year when Epic Health Services merged with PSA Healthcare to create the largest pediatric home health provider in the United States. Prior, Epic had grown exponentially in 2016 through acquisitions in Michigan (Pediatric Special Care), Virginia (Rehabilitation Associates), and Georgia (Pediatria Healthcare for Kids).

That process redoubled her conviction that strategic leadership is crucial to company-wide success in an era when it’s likely generations are more loyal to each other than the organization.

“It’s easy for individuals to lose their identity when they’ve watched people come and go so quickly during consolidations,” she says. “My grandfather’s generation stayed because they loved the company, but nowadays people follow the leaders they respect and can learn from.”

The generations at work now pursue added goals on a more personal level, not just company-driven initiatives, according to Swanson, who explains that this dynamic differs from the historical precedent.

Therefore, now more than ever it is crucial that leaders are the leaders of the future for their companies. By mentoring them into strong directors or managers within an organization, businesses are guaranteed the stability that each team needs to succeed with its goals, Swanson says. The key is to mentor and keep the strong candidates focused on outcomes and success both personally and professionally.

For the vice president of revenue cycle, scaling that goal-oriented mind-set inspired her to restructure her own department to develop and retain talent.

She revamped the flat organizational chart and bonus structure, creating a rotational system for staff members to grow upward within the company. Coordinator roles hone their specific expertise, and it cultivates a pipeline of effective leaders. The new arrangement also significantly reduced staff turnover. She explains that formerly people trained in a silo for a few years before moving to another company for a promotion.

“Now we create roles that both support the company’s direction and allow them to move up,” says Swanson, adding that her team comprises about a hundred individuals just in the Dallas market alone. “And you don’t necessarily need someone with a master’s in healthcare administration. One staff member came from a management position in retail. His drive and the environment we’ve created to elevate him here allowed him to succeed.”

Swanson, who also presents insights as a revenue cycle leader at forums for the Healthcare Financial Management Association and the American Association of Healthcare Administrative Management, benefited from her own multifaceted career path.

She earned a bachelor’s degree in business from Montreat College before starting her career as a director for the Hospital Corporation of America before moving to Novant Health. Then she joined CHS as director of PFS before arriving at Tenet Healthcare, where after six months she was promoted from regional director to senior revenue cycle service director at subsidiary Conifer Health Solutions. Later, she served as the corporate director of client services at Medical Data Systems.

“My path working in several states helped me better understand the different dynamics of patient care across the country,” she says. “What I have found in every environment is that it boils down to good leaders within the organization who work together as a team.”

In 2014, Swanson founded C Swanson Consulting. As an independent revenue cycle consultant, she equipped hospital facilities with AR management processes for maximum cash flow.

Her efficiency caught the eye of the former Epic leadership a year later. The company, entering high-growth mode at the time, sought top talent to fortify its infrastructure for seamless acquisitions. Swanson came aboard as the vice president of revenue cycle services and strategic planning at the Dallas, Texas, headquarters.

In her first year, Swanson focused on setting up the revenue cycle department for positive outcomes. She created key performance indicators and hired a senior analyst to design and translate revenue cycle reports. In her first three years at the company, Swanson’s revenue cycle department met eleven out of twelve goals established by the CFO each quarter.

“Only once have we not made our goal, which is unheard of in healthcare regarding cash goals,” she says. “If you are good to your team and encourage them to improve their skill sets, it is amazing what you can do together.”

During her tenure, the company has doubled in size with little change in the amount of people Swanson has hired to support Aveanna’s more than 150 branches. She strives to ensure the right people are in the right positions, and she highlights how a positive attitude has been key to empowering her team to keep achieving its goals.

“We have a wonderful blend of genders, nationalities, and generations on our team,” she says. “It creates the open-mindedness and trust needed so we can help each other get to the next level. It’s not just about me or you; the team is what makes a great company.”

Photo by Ash Wright


Waystar is the combination of Navicure and ZirMed, two top-rated providers of revenue cycle technologies. Waystar simplifies and unifies the healthcare revenue cycle with innovative technology allowing clients to collect more with less stress and cost, so they can focus on their goals, patients, and communities.