IPA Management Company Audit
Commissioned by the medical center and an affiliated physician group to audit the operations of the physician group’s third party administrator. Detailed accounting of all facets of the operations and evaluation of the skills of the staff and systems in place for each functional work area. Los Angeles, CA
Specialty Group Formation & Development
Developed strategy and operational plan to formulate a specialty management services organization to manage the operations of specialty independent practice associations who accept managed care patients under contracted financial “risk” arrangements. This included the development and coordination of all stock documents, facilitation of stock sale and follow up of all documents including stock certificates. Central Coast, CA
Development of Healthplan Educational Materials
Commissioned to assist in the development of educational and audit tools for franchised Healthplans of a national senior Healthplan. Tools included the template managed medical organization questionnaire and the rational accompanying each section. This document is meant to be a tool for education and evaluation for contracted entities. Orange County, CA
Transition Management for Multi-Specialty IPA From Publically Traded Physician Practice Management Company (PPMC) Back To Self-Management
Assisted IPA with 70,000 lives transition from management by publically traded physician management organization to self-management, including staff recruitment, operations development, and systems implementation. Los Angeles, CA
Business Strategy
Market review, business analysis of current contracting strategies and facilitation of board of director retreat for strategic planning purposes. Developed business plan for medical group. Central Washington, WA
Staffing Level and Productivity Analysis
Staffing evaluation and work flow analysis of a private non-managed care staff model medical group, with recommendation for new processes, human resource organization and work flow recommendations to boast productivity, staff satisfaction and reduce fixed costs. San Fernando Valley, CA
Operational Assessment of Developing PHO
Development evaluation through physician interview process of the progress of an emerging physician hospital organization. Review of contracting strategy and endeavor to launch new business and integrate physicians. Made recommendations for contracting strategy, developed percentage of premium contract methodology to facilitate risk contracting and assisted the group with both actuarial consultants and third party administrator evaluation. Little Rock, AK
Analysis of New Provider-Healthplan Opportunities
Commissioned by nonprofit HMO to determine new and innovative means of the healthplan and their providers to work together. Conducted provider interviews, formulated outside opinion of healthplan value and suggestions regarding solidifying existing relationships through new partnership programs. Presented to Healthplan CEO and COO with recommendations being accepted and implemented within 120 days. Los Angeles, CA
Hospital Business Development Analysis
Assist Specialty Hospital in the development of strategic plans that support corporate directives and initiates development of new provider entity as well as exploration of new business opportunities. Facilitated business strategy sessions to foster teamwork and collaborative action on the part of the hospital leadership. Los Angeles County, CA
Review of Business Opportunities of Rural Independent Physician Association
Facilitated informational meetings that would ascertain the interest of employers, payers and physicians in the development of an integrated physician group in a rural setting. Assisted the physicians through the decision making process by facilitating board of director retreat. Developed management agreement, job descriptions and the negotiation of management agreement with a third party administrator. Central Montana, MT
Development of Third-Party Recovery-Unit Bid for Services
Developing contracting strategy for third party recovery company specializing in Medicaid identification and recovery of monies due to hospital system for indigent patients. Central Orange County, CA
Review of Operations, Provide Interim Management — National For-Profit Hospital Chain’s Physician Association
Acted as interim management for national hospital chain physician organization. Facilitated efficiency planning, contract review and update, renegotiated all Healthplan contracts. Developed contact capitation methodology for the payment of specialists in a multi specialty IPA medical group model. Developed Provider Reference Materials. Central and South Orange County, CA
Liaison for the Transition from Third-Party Management to Self-Management
Assisted IPA medical group from a third-party out-of-state management arrangement to an in-house management arrangement including, but not limited to the development of job descriptions, provider education and reference manuals, interview and hiring of staff, payroll set up, facilitation of termination transition and the collection of corporate records as well as three years of medical claims data. Ventura County, CA
Assisted Knox-Keene Licensed Organization Negotiate Physician Contracts
Developed, in conjunction with payor organization, a new physician friendly provider agreement, designed with the full intention of assisting the organization with realizing their cost goals. Santa Barbara, CA
Facilitate Hospital Based Multi-specialty Group to an Independent IPA
Assisted the physicians with the business analysis including major employer interviews, hospital delivery system review, and business plan development. Assisted the organization with the hiring of staff and third party administrator to manage day to day affairs. Negotiated first risk contracts for prepaid health care patients. Cincinnati, OH
Assist Orthopaedic Medical Group With the Development of a Corporate Managed Care Strategy
Worked with physicians and lay leadership to develop corporate strategy that would compliment the practice acquisition strategy already underway and correct past non-managed care friendly demeanor in a largely managed care populated service area. Developed contracting strategy, formal request for consideration for risk contracting to local multi-specialty management service organizations. Central Coast, CA
Expert Witness
Evaluation of corporate complaints involving physicians, hospitals and third party payers. Served as expert witness for both plaintiff and defendant clients. Assist non-healthcare counsel understand the ramifications of managed care contracts in place. Northern California, Southern Orange County, CA