HEALTHCARE CONSULTING GROUP

Transcription

1 MAZARS USA LLP HEALTHCARE CONSULTING GROUP As one of the nation s leading professional service firms, Mazars USA provides the resources, experience and global expertise to help you adapt in a dynamically changing healthcare landscape. Mazars USA LLP is an independent member firm of Mazars Group.

2 MAZARS USA HEALTHCARE CONSULTING GROUP Building Dynamic, Forward-Thinking Solutions. Navigating today s turbulent healthcare landscape demands experienced insight and dynamic solutions. As a leading change facilitator in this era of sweeping healthcare reform, the Mazars Healthcare Consulting Group offers healthcare payors and providers a powerful combination of service and results-oriented strategy to help them meet their business goals, overcome challenges, and improve performance. With decades of experience in the healthcare industry, we provide timely, valuable information and insights into policies, best practices and industry developments. Our entire team is committed, diligent, and dedicated. We re on the front line, building successful outcomes. We thrive on developing deep, personal relationships with our clients. OUR EXPERTISE Mazars USA, gives you the expertise and deep resources of a firm with national reach, paired with the ongoing client service and feel of a boutique. We are your nimble, partner, delivering actionable strategies that address your particular challenges. When retaining us, you can be confident in your choice, knowing that we have delivered success to other companies and can help you achieve similar benefits. Managed Care Information Technology Revenue Cycle Performance Improvement Data Analytics Due Diligence Regulatory Compliance Improve top line revenue through strategic market alliances and innovative reimbursement methodologies Enhance security and significantly increase savings through the use of appropriate technologies Drive bottom line revenue improvement to help meet increasing demands and lower margins Deliver efficiencies by transforming process, people, and technology to deliver efficiency Advanced analytics for critical decision making Provide market based reviews and feedback to address issues before a transaction is finalized Navigate and implement state and federal regulations by increasing awareness and reducing risk CONTACT Gil Enos, Principal Healthcare Consulting Group Leader (P) (E) Gil.Enos@MazarsUSA.com

3 HOW WE HELP OUR CLIENTS Our long-standing relationships with providers and payors in all segments of the healthcare industry are a testament to our value as their trusted business advisor. Hospital/Health Systems We help drive long term financial, operational and market success for hospitals and health systems through revenue maximization, technology implementation, system alignment, process improvement, data analytics and payor contracting. Our focus is on delivering sustainable outcomes for hospital executives facing transformational change. OUR SERVICES Managed Care Performance & risk based contracting Outsourced managed care contracting Provider credentialing Integrated delivery system development End-to-end network development Fee schedule/capitation analysis Vendor carve-out negotiations Narrow network design Unit cost reduction strategy Contract review & payment compliance Strategic alignment contracting The Mazars Healthcare Consulting Group offers a continuum of services designed to help our clients reach their full potential and achieve their business goals. Information Technology Strategy IT governance IT strategic planning Cybersecurity Data governance Network & telecommunications assessment & planning System evaluation & selection Contract review & negotiations System optimization & process workflow improvement Meaningful use & regulatory requirements Interim Leadership (CIO, CTO, PMO) Revenue Cycle Revenue cycle assessment & transformation Point of service collections Cash position improvement Charge master review Charge capture optimization & system alignment Strategic repricing of services Compliance & self-disclosure reviews Collection agency/external vendor analysis Denial management and mitigation Claims audits Interim CFO management services Inpatient & outpatient coding & documentation improvement Physicians & Ancillaries We have extensive experience delivering tailored services to physician groups, skilled nursing & rehabilitation facilities, urgent care centers, ambulatory surgery centers, home care agencies and social services organizations, helping to firmly position them within the changing healthcare landscape. Our goal is to provide support in contracting initiatives, clinical and operational process improvement and strategic planning for payor and provider alignments. Payors As a leading change facilitator in this era of sweeping healthcare reform, we provide full-service consulting to national and local payors; Managed Medicare and Medicaid, Public and Private Exchanges, Workers Compensation/No Fault and Commercial Plans. We guide payors through end-to-end regulatory reviews, network expansion, reimbursement transformation, unit cost reduction and clinical/operational process improvements. Regulatory Compliance Monitoring services for CMS & state regulatory bodies Readiness assessment surveys and audits Corrective Action Plan (CAP) development & implementation Telephone/on-site surveys State & federal filings for new or expanding networks Interim management & staffing resources Expert witness testimony Organizational readiness assessment Performance Improvement Organizational assessment & design Operational analytics & benchmarking Supply chain optimization Cost analysis & containment Operating model assessment & transformation Complex project management Executive coaching & development Retained executive search Data Analytics Prescriptive analytics CMS & state exchange risk modeling Value based modeling & reporting Descriptive & comparative analytics (utilization, financial, quality) Predictive analytics (re-admission, early identification of high utilizer) Dashboard development Business intelligence & maintenance Due Diligence Private Equity Unprecedented consolidation in the healthcare market means that many companies will become part of a private equity portfolio. Our team understands both the buy and sell side of the transaction, giving us the ability to provide effective transactional support in valuations, financial modeling, integration and market based due diligence. M&A/divestiture planning & execution Buy/sell-side transaction analysis Valuation services Financial modeling Technology & process evaluation Organizational & operating model assessment Retained executive search

4 OUR PEOPLE Over 150 years of experience providing quality, hands on expertise to healthcare organizations across the country. Gil Enos Doug Barry Ira Gottlieb Marc Grossman Healthcare Consulting Group Leader Principal Principal Principal Steven Herbst Principal Gillie McCreath Principal Russ Foster Senior Advisor Sheila Stephens Senior Advisor Gil has over 25 years of proven experience in building, scaling and leading successful healthcare technology and services organizations, and driving significant revenue growth. Gil has gained a unique understanding of all the stakeholders in the healthcare continuum, having worked with Payers (Commercial, Blues, State/ Federal), PBMs, Providers, Health Systems and Vendors. For 30 years, Doug has demonstrated extensive Revenue Cycle Turn- Around skills serving in various Senior Leadership roles for large international financial services firms and for numerous financially distressed providers, including hospitals, ancillary and physician groups. Doug is known for his ability to build collaborative relationships, and for the ability to develop highly functioning Revenue Cycle and Consulting teams. Ira has spent over 30 years in the managed care market segment on both the payor and provider side of healthcare delivery. Ira s areas of expertise include provider and payor network development, strategy and implementation, reimbursement methodologies and contract negotiations including capitation, risk, and feefor-service. He also holds extensive experience working with Government Marc has worked extensively with a wide range of healthcare providers including integrated delivery systems, academic medical centers, community hospitals, physician organizations, public health agencies, and home health agencies. He has performed information technology (IT) strategic planning, system selection, contract negotiations, and implementation of a wide array of clinical, financial, and ancillary systems. Steven has over a decade of experience providing an array of advisory and tactical services to both payer and provider clients throughout the healthcare industry. He specializes in: strategic planning, designing and executing value-based contracts, developing new plans, providing dynamic payerprovider operational support, relationship management and contracting strategies. With an unparalleled ability to integrate regulatory requirements with innovative growth strategies, his guidance is relied upon by C-suite executives, board members and industry experts. Gillie has more than 25 years of experience delivering effective consulting services to the healthcare industry and providing strategic information technology solutions; including strategic planning and operations review to a diverse healthcare client base. His extensive background includes directing teams in designing and implementing improvement strategies, creating strategic options for growth via acquisitions and consulting on technological advancements for cost transparency. Russ has over 30 years of experience in development and management of healthcare systems, including expertise in capitation agreements, rate development methodology, and business plan development. Specializing in financial modeling and analysis, he works with clients nationwide in financial modeling and analysis relating to IPA and MSO development and enhancement, capitated reimbursement programs, design and analysis of utilization and cost structures, and all other aspects of managed care systems. Sheila has 30 years of experience in the health care field, with specific expertise in the development and administration of patient care services, and related systems and structure to support both financial management and quality improvement. She has extensive experience in program development across the health care continuum, including clinic and outpatient services, acute and long term care, home health and hospice care. (P) Gil.Enos@MazarsUSA.com (P) Doug.Barry@MazarsUSA.com (P) Ira.Gottlieb@MazarsUSA.com (P) Marc.Grossman@MazarsUSA.com (P) Steven.Herbst@MazarsUSA.com (P) Gillie.McCreath@MazarsUSA.com (P) Russ.Foster@MazarsUSA.com (P) Sheila.Stephens@MazarsUSA.com CONTACT Gil Enos, Principal Healthcare Consulting Group Leader (P) (E) Gil.Enos@MazarsUSA.com

5 ABOUT MAZARS USA Mazars USA LLP provides insight and specialized experience in accounting, tax and consulting services. Since 1921, our skilled professionals have leveraged technical expertise and industry familiarity to create customized solutions to overcome client challenges. As the independent U.S. member firm of Mazars Group, we have a global reach of 20,000 professionals in 86 countries. Locally and internationally, we build lasting relationships with our clients by addressing their particular needs, creating value and optimizing their organizational performance. FOR MORE INFORMATION Mazars USA LLP is an independent member firm of Mazars Group.