HEALTHCARE CONSULTING GROUP · We have extensive experience delivering tailored services to...
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HEALTHCARE CONSULTING GROUP Mazars USA LLP is an independent member firm of Mazars Group. MAZARS USA LLP WWW.MAZARS USA .COM 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.
Transcript of HEALTHCARE CONSULTING GROUP · We have extensive experience delivering tailored services to...
HEALTHCARE CONSULTING GROUP
Mazars USA LLP is an independent member firm of Mazars Group.
MAZARS USA LLP
W W W.MA Z ARSUSA .COM
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.
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, valuableinformation and insights into policies, best practices and industry developments. Our entire team is committed, diligent, and dedicated. We’re on the front line, buildingsuccessful outcomes. We thrive on developing deep, personal relationships with our clients.
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.
MAZARS USAHEALTHCARE CONSULTING GROUP
CONTACT
Managed Care
Improve top line revenue through strategic market alliances and innovative reimbursement methodologies
Information Technology
Enhance security and significantly increase savings through the use of appropriate technologies
Revenue Cycle
Drive bottomline revenueimprovementto help meetincreasingdemands andlower margins
Performance Improvement
Deliver efficiencies by transforming process, people, and technology to deliver efficiency
Data Analytics
Advancedanalytics forcritical decisionmaking
OUR EXPERTISE
Due Diligence
RegulatoryComplianceNavigate and implement state and federal regulations by increasing awareness and reducing risk
Provide market based reviews and feedback to address issues before a transaction is finalized
Gil Enos, Principal | Healthcare Consulting Group Leader | (P) 916.696.3667 | (E) [email protected]
The Mazars Healthcare Consulting Group offers a continuum of services designed to help our clients reach their full potential and achieve their business goals.
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.
PayorsAs 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.
HOW WE HELP OUR CLIENTS
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
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
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• M&A/divestiture planning & execution • Buy/sell-side transaction analysis• Valuation services• Financial modeling• Technology & process evaluation• Organizational & operating model
assessment • Retained executive search
Physicians & AncillariesWe 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.
Private EquityUnprecedented 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.
Hospital/Health SystemsWe 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 PEOPLE Over 150 years of experience providing quality, hands-on expertise to healthcare organizations across the country.
Doug has 30 years of demonstrated Revenue Cycle “Turn-Around” skills serving in various senior leadership roles for large, international financial services firms and numerous financially distressed providers, including hospitals, ancillary and physician groups. Doug is known for building collaborative relationships, and developing highly functioning Revenue Cycle and Consulting teams.
Ira has over 30 years of experience in managed care on both the payor and provider side of healthcare delivery, including provider and payor network development, strategy and implementation, reimbursement methodologies and contract negotiations for capitation, risk, and fee-for-service. He also has extensive experience working with Government Programs, private equity offerings, and analysis of clinical outcomes for providers.
Mark has over 25 years of experience in senior leadership roles with Health Plans, IPAs and MSOs with a track record of improving results and developing strate-gies for healthcare organizations through senior management oversight, long-range planning, strategic direction, manage-ment of operations, communication, negotiation, contract relationships, client management and cost management.
Laura has over 10 years of experience of delivering operational leadership, support and project management to a variety of healthcare organizations. She specializes in operations, performance monitoring and management, public policy, compliance, audit, project management, enterprise risk management, program evaluation, process improvement, and fraud, waste and abuse. Laura is Certified in Healthcare Compliance (CHC) and a Certified Fraud Examiner (CFE).
Steven has over 10 years of experience providing advisory services to payer and provider clients in the healthcare indus-try. He specializes in strategic planning, designing and executing value-based con-tracts, developing new plans, providing dy-namic payer-provider operational support, relationship management and contracting strategies, and has an unparalleled ability to integrate regulatory requirements with innovative growth strategies.
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 negoti-ations, and implementation of a wide array of clinical, financial, and ancillary systems.
Marc Grossman
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.
Sheila StephensSenior Advisor(P) 916.696.3662 | [email protected]
Senior Advisor(P) 212.375.6526 | Marc.Grossman@MazarsUSA.
Gil has over 25 years of proven experience 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.
Gil Enos Doug Barry Ira GottliebHealthcare Consulting Group Leader (P) 916.696.3667 | [email protected]
Principal (P) 916.696.3668 | [email protected]
Principal (P) 212.375.6591 | [email protected]
Mark Marten Laura H. PethPrincipal (P) 323.763.6211 | [email protected]
Principal (P) 916.696.3675 | [email protected]
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.
Russ FosterSenior Advisor(P) 916.696.3663 | [email protected]
Steven HerbstPrincipal(P) 212.375.6508 | [email protected]
Marc GrossmanSenior Advisor(P) 212.375.6526 | [email protected]
Gil Enos, Principal | Healthcare Consulting Group Leader | (P) 916.696.3667 | (E) [email protected]
Mazars USA LLP is an independent member firm of Mazars Group.
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FOR MORE INFORMATION
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 23,000 professionals in 89 countries.
Locally and internationally, we build lasting relationships with our clients by addressing their particular needs, creating value and optimizing their organizational performance.
ABOUTMAZARS USA
