A Nashville-headquartered healthcare services organization operating 140 outpatient care centers, specialty clinics, and physical rehabilitation facilities across 22 states runs a distributed operating model in which each care center functions as a semi-autonomous cost center, managing its own day-to-day operational purchasing – from clinical supplies and office consumables to patient refreshments and facility maintenance – creating a chronic and growing challenge: how to fund and control routine, low-dollar operational purchases across 140 geographically dispersed locations without creating unacceptable financial, compliance, and reputational risk.

For years, the organization’s standard practice was to maintain petty cash boxes at each care center, funded by direct bank transfers to local center managers, with monthly paper receipts reconciled by a central AP team in Nashville. This approach was simple to understand but catastrophic in practice. Internal audits between 2019 and 2022 identified cumulative cash mismanagement and unexplained variances totaling $1.1 million across the network. In three cases, variances were large enough to require formal HR investigations. The reputational and regulatory risk, particularly given the organization’s status as a Medicare and Medicaid provider subject to CMS compliance oversight, was deemed intolerable by the Board’s Finance & Audit Committee.

In Q2 2022, their CFO initiated a formal procurement process to identify a technology-enabled alternative to petty cash. After evaluating six vendors, PurchaseAnywhere® Reloadable Prepaid Cards was selected as the platform of choice and deployed across all 140 centers between September and November 2022.