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Hospital Explores Asymptotes to Improve Metrics



Alisha Pickens, M.B.A., Ph.D. chief financial officer at Mitchell Lipton Hospital in Reno, NV created a new quality-based philosophy birthed from mathematics. She calls it the Asymptote Principle. In mathematics an asymptote is a line that a curve approaches as it moves towards infinity. So, the curve gets infinitely close to the line without intersecting.


According to Pickens, too many medical processes are complicated. “With Asymptotes, we just focus on getting better. We have a common goal. The goal isn’t perfection – the asymptote -- but we aim for it. We label the line, so everyone knows what the goal is,” says Pickens.


When Pickens introduced the idea to Mitchell Lipton’s revenue cycle committee, Jeff Polls, committee chair, had an immediate reaction. “Wow! Whoa! Be careful with those three syllables. What did you say we’re going to be toting around ?!”

Pickens kindly explained, “We are really toting excellence. The idea of the health system collectively making its way to a common goal is awesome.”

The revenue cycle committee was confused. According to Polls, “The committee has questions. Is this a vertical, horizontal or oblique asymptote? I mean, we need to know what side of the x or y axis we are on. We don’t want our financial goals to go into negative infinity!" exclaimed Polls.


The Asymptote Principle brought even more concern. When the goal of a health system continues to reach into infinity, does the hospital make an infinite budget?

Polls brought the revenue cycle meeting to a recess, as the idea of infinite financial goals would set the hospital into a financial spin. After reviewing a math text, Polls thought, “So, you mean that an asymptotic approach to our financial goals makes that goal definitely and infinitely out of reach?!!!”


Pickens thought about how one of her teachers used rhyme as a mnemonic and to relieve anxiety about a topic. Pickens encouraged the revenue cycle committee to invest in the concept of the goal. “Open a math book. Expand your mind. Embrace the asymptotic goal. Give it some time,” said Pickens.


Many members of the committee didn’t want to delve deeply into math. But they were agreeable to examine Pickens’ goal for an asymptotic path.

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