Engagements
Our approach to building engagement teams with associates enables us to deliver top quality results for any size project. The following is a select list of recent engagements.

Public/Private Partnerships

• Facilitated the development of a multi-stakeholder governance entity to provide oversight to key clinical, technical, financial and legal (privacy) aspects of a statewide Health Information Exchange (HIE)
• Coordinated development of the Strategic and Operational Plans for expansion of statewide Health Information Exchange (HIE) in response to ONC cooperative funding agreement using a series of highly integrated stakeholder work groups
• Converted laboratory results from 3 different practices into standardized LOINC codes to enable clinical outcomes reporting – Enabled the use of 20 pre-selected outcomes measures to evaluate the impact of health information exchange (HIE) and electronic health records (EHR) in three Massachusetts communities
• Conducted research to identify leading practices in obesity treatment
• Developed obesity benefit design including actuarial analysis*

Health Insurers/Managed Care Organizations

• Conducted medical management (utilization management, case management, disease management) performance evaluation against external benchmarks
• Developed integrated medical management strategy
• Developed and presented strategic options for profitable growth to the board of directors for a $100 million national PPO network provider – Aligned $300M in investments with strategic direction
• Led 30 executives in development of and agreement on 3-year plan for performance improvement in 5 key areas:  claims, utilization management, provider service, member service, enrollment
• Conducted project management evaluation to determine likelihood of success for a project – led to redefinition of role of project manager
• Facilitated 40 business and technical participants in the development of a conceptual model and draft specifications for a medical cost forecasting model*
• Led team of 80 people from different parts of organization to develop an integrated condition analysis approach*
• Streamlined and integrated medical management, PBM and disease management approaches for medication management into a comprehensive pharmacy management program*
• Conducted feasibility analysis for a payer in response to the the CMS Medicare Modernization Act, Part D – Identified core competencies, market considerations, revenue potential, investment requirements for becoming a standalone Prescription Drug Plan (PDP)
• Identified medical management leading practices and performance benchmarks
• Created request for proposal and evaluation tool to support medical management vendor selection
• Conducted system selection for claims, automated document generation and product configurator systems
• Standardized and streamlined business operations for a $20 billion national health insurer through process redesign, system modification and organizational restructuring – Increased effectiveness and efficiency and improved customer service capability.
• Achieved performance improvement from system implementation through process redesign, business specification/system modification and organizational restructuring for multiple applications, including claims, medical management, sales, customer reporting.
• Developed several multi-product, multi-state, implementation plans designed to accelerate realization of benefits and minimize disruption to operations while implementing new processes, procedures, systems, and organizational structures

Providers

• Guided the development of pay for performance measures sets for 3 national specialty physician organizations in response to the CMS Physician’s Quality Reporting Initiative (PQRI) program
• Designed and developed web-based Practice Improvement learning tool for specialty physician association to support American Board of Internal Medicine Maintenance of Certification requirements
• Supported change management for Oracle/PeopleSoft implementation for a state university and medical school

*Denotes engagements accelerated using Large Team Facilitation