Consulting Engagements

View Sample Clients

A representative list of current and previous consulting engagements includes:

 

• Design of health-care delivery and financing systems for public and private health-care organizations -- including development of Medicaid and Medicare HMOs

 

• Analysis of the feasibility of establishing HMOs in various market areas

 

• Analysis of reasonable and customary value for various health services

 

• Statistical analysis underlying audits

 

• Development of capitation rates and risk sharing arrangements according to provider type

 

• Assessment of the community impact of proposed hospital closures

 

• Antitrust analysis of proposed provider networks

 

• Evaluation of county health programs, from the perspectives of health delivery, economics, organization and indigent access

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• Evaluation of conditions for conversion of not-for-profit healthcare organizations to for-profit status

 

• Strategic planning studies for individual hospitals, hospital systems, provider networks and HMOs, with emphasis on market competition, provider incentives and economic constraints

 

• Feasibility analysis of establishing various health programs, services and facilities

 

• Economic impact analysis of individual hospitals on their local economies

 

• Evaluation of county medically indigent services programs and projections of resource requirements, resource availability and program expenditures under alternative scenarios

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• Establishment of service areas for Medi-Cal contracting and projection of capacity requirements

 

• Assisting hospitals in payment negotiations, and development of negotiating strategies, with emphasis on market position

 

• Expert witness services as an economist and health policy expert in the areas of:
  • Medicare and Medi-Cal reimbursement (class action litigation and administrative appeals)
  • Personal injury, wrongful death and medical malpractice (economic damages, including lost earnings and future cost of medical care)
  • Statistical analysis underlying audits
  • Reasonable and customary value for out-of-network services
  • Complex business litigation
  • Contract arbitration
  • Health-care antitrust (liability and damages)

• Development of approaches to assess hospital effectiveness for purpose of evaluating competing hospitals and for developing provider networks
  

 

• Policy advice and analysis of the impact of public-policy alternatives in the areas of Medicare, Medi-Cal, uncompensated care, long-term care, Workers' Compensation, and health-care reform for the California Hospital Association

 

• Participation in numerous retreats and educational sessions for hospital administrative staffs, medical staffs and trustees

 

Current and previous clients include:

View Sample Consulting Engagements

 

• Health insurers, health maintenance organizations and preferred provider organizations -- including Blue Cross of Southern California, Preferred Health Network, Essential Healthcare Network, National Health Plans, Blue Cross-Blue Shield of Georgia, Contra Costa Health Plan, Santa Clara Family Health Plan, Care 1st Health Plan, Community Health Group, and Partnership Health Plan of California

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• Major for-profit and not-for-profit hospital systems -- including HCA, AMI, NuMed, HealthWest, Baptist Medical System, Intermountain Health Care, Alexian Brothers, Alta Bates Corporation, Tenet Healthcare Corporation, Sutter Health, Catholic Healthcare West, Scripps Health, and Universal Health Services, Inc.

 

• Major teaching hospitals -- including University of California, Stanford University, Loma Linda University and University Medical Center of Southern Nevada

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• Individual hospitals of all ownership types

• Medical Groups

• Federally Qualified Health Centers

• County governments -- including San Bernardino, Los Angeles, Sutter, Sacramento, Contra Costa, Ventura, Alameda, San Joaquin, Riverside, Santa Clara and Stanislaus

• California State Government -- Governor's Office of Special Health Care Negotiations (Medi-Cal "czar"), Department of Corrections, Office of Statewide Health Planning and Development, Department of Managed Health Care, and Department of Insurance

• Other government – Maryland Health and Higher Education Facilities Authority, City of San Jose and City of Livermore

• Health-care trade associations -- California Hospital Association, Hospital Council of San Diego and Imperial Counties, California Association of Rehabilitation Facilities, Nevada Hospital Association, California Association of Health Facilities, California Association of Public Hospitals and Health Systems, Healthcare Association of Southern California, Hospital Council of Northern and Central California, Association of California Healthcare Districts, United Hospital Association, American Hospital Association, Federation of American Hospitals, Association of American Medical Colleges, California Association for Adult Day Services, Community Clinic Association of Los Angeles County, California Association of Physician Groups, and California Association for Health Services at Home

• Major law firms

 

 

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Consulting