We turn visit-level revenue and labor data into a single, actionable score.
About VVI
The Visit Value Index™ (VVI)- A framework for today's leaders and tomorrow's AI Agents.
As healthcare systems adopt AI-driven operational agents, most attempt to train them on fragmented financial indicators and blunt, lagging metrics.
The Visit Value Index™ (VVI) provides what those agents—and leaders—lack: a structured, interpretable framework that translates financial inputs into operational meaning.
- A single standardized efficiency score
- Clear revenue and labor sub-factors
- A 16-scenario diagnostic matrix
- Action pathways that can be automated
What the VVI Does
The VVI converts noisy financial statements into a single, interpretable score using three universal inputs:
- Visits
- Net Operating Revenue
- Total Labor Cost
With one number, VVI shows where value is created or leaking—and which lever to pull next. When two optional budget inputs are added, results adjust to your organization’s targets.
The outcome: a clear diagnostic view of performance, featuring tiered scoring, sub-factor analysis, and an expanded prescriptive matrix.
Simple. Actionable. Insightful.
A smarter way to see performance.
Why It Works
Developed by Bramhall Consulting, LLC, the VVI reframes traditional metrics—such as salary and wages as a percent of revenue—into a per-visit efficiency model built on the two levers you directly control:
- Net Revenue per Visit (NRPV): Your earning strength
- Labor Cost per Visit (LCV): Your largest expense
Together, these form an interpretable score revealing the balance between revenue, labor, and operational reliability.
The Four-Tier Scoring Model
Excellent — Strong revenue/labor balance. Maintain and monitor.
Stable — Operationally sound. Target small gains in weaker factors.
At Risk — Efficiency decline affecting margins. Investigate Revenue/Labor drivers.
Critical — Unsustainable performance. Immediate corrective action required.
This scoring model gives leaders a fast, reliable way to benchmark, compare, and prioritize support across clinics.
Diagnosis → Prescriptive Actions
Beneath the overall score are two deeper diagnostic layers:
- Revenue Factor (RF): How effectively each visit generates revenue
- Labor Factor (LF): How efficiently each visit is staffed
These layers pinpoint whether issues stem from front-end revenue leakage or back-end staffing inefficiency.
RF and LF combine to create 16 diagnostic scenarios, each paired with targeted prescriptive actions tailored to the pattern your scores reveal.
Why It Matters for AI
In short, VVI is the operational language, the framework, AI agents can understand, learn from, and act on. It bridges financial insight, human behavior, and algorithmic intelligence—ensuring tomorrow’s decision-support tools are trained with sharper instruments.
A Note from the Founder
I’ve always hoped the tools I’ve built have helped those I’ve had the privilege to lead—and now, I hope this one helps you.
— Michael Bramhall, Founder, Bramhall Consulting, LLC
predict. perform. prosper.
A special shoutout to the team at Tribytics for bringing the VVI calculator online. You truly provide clarity amidst complexity and precision in performance! Visit this innovative and talented team at: https://www.tribytics.com/
About the founder:
Michael Bramhall is a healthcare operations leader and consultant with more than 30 years of frontline and executive experience. Beginning his career as a medical assistant, Michael spent the next three decades rising through leadership roles across multi-state urgent care and occupational health networks. For the past 15 years, he has served in senior and executive positions overseeing hundreds of clinics, thousands of caregivers, and complex operational and financial performance portfolios.
Because he has worked at every level of healthcare—from rooming patients to steering multi-market operations—Michael brings a rare blend of analytical discipline and deep operational empathy. He understands the pressure operators face: unclear financial signals, rising labor costs, shifting volumes, staffing volatility, burnout, and the overwhelming flow of dashboards and reports that often lack actionable clarity.
This lived experience is what led him to develop operator-first tools such as the Visit Value Index™ (VVI), the VVI Performance Driver Assessment (VPDA), and the Predictive Coverage Model (PCM). These frameworks help leaders cut through financial noise, prevent staffing drift, stabilize operations, and build repeatable systems of performance that work across clinics, regions, and entire markets.
Michael’s work focuses on restoring clarity, structure, and predictability to clinical environments—so teams can perform at their best without being overwhelmed by operational chaos. Through Bramhall Consulting, he partners with organizations nationwide to build reliable, efficient, and financially strong clinics capable of thriving in today’s healthcare environment and tomorrow’s AI-enabled landscape.
predict. perform. prosper.
Services / Price List
You’ve Received Your VVI Diagnosis. Here’s What Comes Next...
The VVI Calculator gives you clarity—a score, a diagnosis, and targeted prescriptive actions. But turning those insights into execution, behavior change, and measurable improvement requires a structured plan and follow-through. That’s where Bramhall Consulting comes in.
VVI 12-Week Turnaround Plan (Plan Only)
Starting at $499
A structured, data-driven improvement program powered by the VVI framework and AI-supported analysis.
Includes:
- Defined 30-, 60-, and 90-day sprints
- Clear goals, milestones, and accountable owners
- Performance targets linked to VVI, RF, and LF
- Leadership cadence templates
- A blueprint for improving revenue integrity, labor efficiency, throughput reliability, and overall clinic performance
Perfect for organizations that want the plan—and will lead execution internally.
VVI 12-Week Turnaround Plan (plan + remote facilitation)
Inquire for pricing
A fully guided performance improvement program that integrates:
- PDA (Performance Driver Assessment): Comprehensive 10-point root-cause analysis.
- Weekly execution support: Turning insight into action.
- Leadership coaching: Strengthening daily discipline and decision-making
- Drift monitoring: Ensuring reliability improves week over week.
- Behavioral reinforcement: Embedding sustainable habits.
- Outcome tracking: Clear before-and-after results.
Ideal for organizations that want expert guidance.
VVI Dashboard by Tribytics
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A real-time analytics dashboard that integrates your EHR and financial data.
Features include:
- VVI score trending
- RF/LF factor analysis
- Performance Driver monitoring
- Automated alerts for drift
- Multi-clinic benchmarking
Developed by our technology partner, Tribytics.Visit: https://www.tribytics.com/
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