Transcription
Healthcare Consulting PracticeBuilding Dynamic, ForwardThinking Solutions
As one of the nation’sleading professionalservice firms, Mazars USAprovides the resources,experience and globalexpertise to help you adaptin a dynamically changinghealthcare landscape.2MazarsHealthcare Consulting Group
Contents46Mazars USA Healthcare Consulting PracticeOur peopleBuilding Dynamic, Forward-Thinking SolutionsMazars3
Mazars USA Healthcare Consulting PracticeBuilding Dynamic, Forward-Thinking SolutionsIn today’s changing healthcare landscape, payers, providers andother stakeholders must successfully navigate regulatory andmarket challenges in order to transform their businesses into moreprofitable and effective organizations.The Mazars Healthcare Consulting Practice iscommitted to developing and maintaining a “trustedadvisor” relationship with our clients – offeringcreative and comprehensive solutions to your mostpressing needs.How Mazars can helpOrganizations need the support of experiencedprofessionals to navigate strategic planning,complex contracts and uncertainty in the near term. Drive long-term financial, operational andmarket successPayer-provider advisoryIn today’s environment of transformational health care change payers and providers need timely insightinto industry developments, actionable strategiesto address challenges and an approach that deliverssustainable outcomes.We have decades of expertise helping healthcareentities meet the challenges of the future, and workclosely with plans, providers and risk-bearing entities. Strategic Planning Market Expansion Strategies Provide full-service, tailored services Managed Care Plan Development Focus on delivering sustainable outcomes Value & Risk-Based Contracting Provide insight into policies and best practices Value & Risk-Based Modeling & Reporting Position you firmly within the changinghealthcare landscape Network DevelopmentOur powerful combination of service and resultsoriented strategy helps clients meet theirbusiness goals, overcome challenges, and improveperformance. Provider Data Management Delegated Credentialing Integrated Delivery System Development Fee Schedule/Capitation AnalysisPayer-provider advisory Vendor Carve-out NegotiationsValue-added insight on the strategic, operational,clinical and analytical elements that impact you most. Narrow Network DesignRegulatory compliance Contract Review & Payment ComplianceHelping clients to successfully navigate regulatorychanges and implement new state and federalregulations – increasing awareness and reducing risk. Strategic Alignment ContractingOperational & financial performanceimprovement Unit Cost Reduction Strategy IPA Development Financial Forecasts & AnalyticsComprehensive advisory services, organizationalrestructuring and interim senior leadership toimprove clinical and financial outcomes.4MazarsHealthcare Consulting Practice
Regulatory complianceHealthcare executives need timely insight on newregulations, industry trends, and their potentialimpacts in order to successfully overcome challengesand meet their organizational goals.In an era of unprecedented change in the healthcareindustry, payer-provider organizations need valueadded advice from experienced professionals.We have decades of expertise helping healthcareentities meet the challenges of the future. Wework closely with plans, providers and risk-bearingentities, delivering value-added insight on thestrategic, operational, clinical and analytical needsthat most impact our clients.When choosing Mazars, you can be confident inyour decision based on our track record of deliveringactionable strategies that address specific clientchallenges. State & Federal Managed Care Plan Licensure State & Federal filings – New or ExpandingNetworks State & Federal Regulatory Services Survey & Audit Readiness Assessments Corrective Action Plan (CAP) Development& Implementation Comprehensive Organizational, Operational,& Structural AssessmentOperational & financial performanceimprovementIn a competitive marketplace, operational excellenceis a key driver of strategic advantage and profitability.To achieve it, management must first assess theirbusiness strategy, systems, processes and people,identify gaps in performance and opportunities forimprovement, then take the tactical steps necessaryto drive higher value and greater efficienciesthroughout their organization. Comprehensive Turnaround Management& Implementation Revenue Cycle Assessment & Transformation Cash Position Improvement Charge Master Review & Market Pricing Analysis Executive & Staff Training, Coaching &Development Interim Management & Staffing Financial Modeling Vendor Management & PerformanceImprovement Charge Capture Optimization & System Alignment Cost Analysis & Containment Strategic Repricing of Services Compliance & Self-Disclosure Reviews Policy, Procedure & Programmatic Development Collection Agency/External Vendor Analysis Fraud, Waste & Abuse Programmatic Development& Evaluation Denial Management & Mitigation Expert Witness TestimonyBuilding Dynamic, Forward-Thinking Solutions Claims Audits Inpatient & Outpatient Coding & DocumentationImprovementMazars5
Our peopleOver 150 years of experience providing quality, hands-on expertiseto healthcare organizations across the country.Gil EnosHealthcare Consulting Practice Leadergil.enos@mazars.comGil has over 25 years of proven experience in building, scaling and leadingsuccessful healthcare technology and services organizations, and drivingsignificant revenue growth. During his career, Gil has gained a uniqueunderstanding of all the stakeholders in the healthcare continuum, havingworked with Payers (Commercial, Blues, State/Federal), PBMs, Providers,Health Systems and Vendors.Lori HackPrincipallori.hack@mazars.comLori has over 25 years of experience with hospital, clinic and health planoperations, most recently on state level initiatives for clinical integrationactivities for EHR implementation, business intelligence analysis andoperational workflow planning and implementation. She has extensiveexperience with compliance, privacy and security of health information andhealth information exchange.Steven HerbstPrincipalsteven.herbst@mazars.comSteven has over a decade of experience providing an array of advisory andtactical services to both payer and provider clients throughout the healthcareindustry. He specializes in strategic planning, designing and executing valuebased contracts, developing new plans, providing dynamic payer-provideroperational support, relationship management and contracting strategies.Mark MartenPrincipalmark.marten@mazars.comMark has more than 25 years of experience in senior leadership roleswith Health Plans, IPAs and MSOs with a proved track record of improvingresults and developing strategies and vision for healthcare organizationsthrough senior management oversight, long-range planning, strategicdirection, management of operations, communication, negotiation, contractrelationships, client management and cost management.Laura PethPrincipallaura.peth@mazars.comLaura possesses nearly 15 years of experience in the areas of operations,performance monitoring and management, public policy, compliance, audit,project management, enterprise risk management, program evaluation,process improvement, and fraud, waste and abuse. She is an innovative leaderwith a proven track record of delivering operational expertise, implementationsupport and project management to a variety of healthcare organizations.6MazarsHealthcare Consulting Practice
Russ FosterSenior Advisorruss.foster@mazars.comRuss has over 30 years of experience in development and managementof healthcare systems, including expertise in capitation agreements, ratedevelopment methodology, and business plan development. Specializingin financial modeling and analysis, he works with clients nationwide infinancial modeling and analysis relating to IPA and MSO development andenhancement, capitated reimbursement programs, design and analysis ofutilization and cost structures, and all other aspects of managed care systems.Ira GottliebSenior Advisorira.gottlieb@mazars.comIra has over 30 years of experience in managed care on both the payor andprovider side of healthcare delivery, including provider and payor networkdevelopment, strategy and implementation, reimbursement methodologiesand contract negotiations for capitation, risk, and fee-for-service. He alsohas extensive experience working with Government Programs, private equityofferings, and analysis of clinical outcomes for providers.Marc GrossmanSenior Advisormarc.grossman@mazars.comMarc has worked extensively with a wide range of healthcare providersincluding integrated delivery systems, academic medical centers, communityhospitals, physician organizations, public health agencies, and home healthagencies. He has performed information technology (IT) strategic planning,system selection, contract negotiations, and implementation of a wide array ofclinical, financial, and ancillary systems.Sheila StephensSenior Advisorsheila.stephens@mazars.comSheila has 30 years of experience in the health care field, with specificexpertise in the development and administration of patient care services, andrelated systems and structure to support both financial management andquality improvement. She has extensive experience in program developmentacross the health care continuum, including clinic and outpatient services,acute and long term care, home health and hospice care.Building Dynamic, Forward-Thinking SolutionsMazars7
ContactsGil Enos, PrincipalHealthcare Consulting Practice Leadergil.enos@mazarsusa.comMazars USA LLP is an independent member firm ofMazars Group, an international audit, tax and advisoryorganization with operations in over 90 countries.With roots going back to 1921 in the US, the firm hassignificant national presence in strategic geographies,providing seamless access to 26,000 professionalsaround the world. Our industry specialists delivertailored services to a wide range of clients acrosssectors, including individuals, high-growth emergingcompanies, privately-owned businesses and largeenterprises.www.mazars.us
Gil Enos, Principal Healthcare Consulting Practice Leader gil.enos@mazarsusa.com Mazars USA LLP is an independent member firm of Mazars Group, an international audit, tax and advisory organization with operations in over 90 countries. With roots going back to 1921 in the US, the firm has significant national presence in strategic geographies,
