Expertise

We understand the full value chain of the healthcare industry – the key functions that each segment plays, and how value is delivered to different stakeholders. Our resources have experience in the trenches at large national and regional payers, have worked with hospital systems and small provider groups, and have a grasp on emerging technologies that impact the industry. This expertise enables us to help clients navigate the critical issues that face the healthcare system today.

Providers

Providers
Providers are in the midst of transition to a new era, where a variety of shared risk options are being pursued as the industry shifts to accountable care. While provider steerage, stratification, and value based benefits are not new terms, the supporting capabilities available today can support innovative models for care that previously could not be achieved. This includes a wide range of partnerships with the payer community, as well as provider organizations establishing their own health plans.

In addition to the evolution of reimbursement methodologies, providers are constrained more than ever to bring down administrative costs , and find more efficient ways to manage their practice or facility.

We embrace these challenges as we help provider organizations navigate the changing terrain ahead of them.

Health Plans

Health Plans
The healthcare insurance industry is at a crossroads and the role of payers, both commercial and government, is rapidly changing. Payers are faced with changing business models, healthcare reform, increased consumerism, and other actions that threaten traditional ways of doing business. They need to adapt or suffer the continuing consequences of an eroding business.

We understand payers and these challenges that they are faced with today. There is an abundant need to simplify administrative activities and scale properly to do more with less, make the determination to dive headfirst into new and changing risk sharing models with providers, and investigate untapped markets for where strategic investments should be made.

We help payers identify and assess all of these areas, to ensure the correct set of opportunities is being pursued for where the industry is going.

Technology

Technology
Technology is helping create and support change across the entire healthcare ecosystem. On an almost daily basis, new offerings are flooding the market to support clinical delivery and care management, simplify administrative tasks, and connect various stakeholders from patients, to providers, to payers. These offerings aim to better manage health and reduce costs across the system, but can be overwhelming to know where to start and what tools should be used in different situations. Many times, technologies are selected and implemented without first assessing the true value they can provide prior to an investment being made, which many times can be sizable.

In addition to understanding the impacts of new technology offering, focus must also be put on what to do with legacy applications that are usually not flexible enough to incorporate change quickly.

We live and breathe healthcare technology - our resources have tackled large scale, transformational technology programs at the country's biggest health plans, have evaluated and recommended technology solutions to both payers and providers in support of the move to accountable care, and are ready for the coming waves of continued technology enhancements.