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海角社区 News

New experts join 海角社区 in July 2023

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海角社区 is pleased to welcome new experts to our family of companies in July 2023.

Zach Davis – Senior Consulting Actuary
Wakely

Zach has a wide range of actuarial experience helping both payers and providers manage risk. . 

Vicki Loner – Principal
海角社区

Vicki Loner has nearly 30 years of dedicated experience as an executive leader, registered nurse, and certified healthcare administrator with expertise in clinical nursing, case management, quality improvement, managed care and accountable care organization (ACO) healthcare operations.

Ryan Paul – Associate Principal
海角社区

Ryan Paul is an accomplished leader experienced in federally qualified health center (FQHC)/rural health clinic (RHC) contracting, value-based contract management, negotiations, regulatory compliance, vendor relationships, request for proposal (RFP) development, strategic planning, project management, process improvements, financial modeling, and budgeting. 

Ann-Marie Price – Senior Consultant
海角社区

Ann-Marie Price is a seasoned healthcare expert with more than 20 years of experience spanning policy development and implementation, government and community affairs, and strategic and operational administration in hospitals, clinics, federally qualified health centers, managed healthcare plans, and telemedicine.

Kaya Tith – Senior Consultant
海角社区

Kaya Tith is a senior consultant with over a decade of experience working in the fields of maternal and child health, community-based health services, and prevention and early intervention.

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Ryan Paul

Associate Principal

Headshot of Kaya Tith

Kaya Tith

Senior Consultant

海角社区 News

New experts join 海角社区 in June 2023

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海角社区 is pleased to welcome new experts to our family of companies in June 2023.

Anthony Federico – Senior Consultant
海角社区

Anthony Federico is a seasoned government and non-profit leader with 12 years of expertise in housing, homelessness, and healthcare. He excels in developing and implementing innovative programs, executing Medicaid waivers, and cultivating cross-sector partnerships.

Melanie Johnson – Senior Consultant
海角社区

Melanie Johnson is a seasoned public healthcare professional with over 15 years of experience working in federal and state government roles. Melanie鈥檚 expertise includes Medicaid state plan and waiver development, continuous quality improvement, and ongoing monitoring of policies and operations of federal and state programs.

Marcel Loh – Principal
海角社区

Marcel Loh is an accomplished healthcare executive and leader with extensive experience collaborating with government leaders, insurers, and stakeholders to deliver value and achieve results.  His expertise extends to many diverse hospital structures including military, for profit, not for profit, religious, rural, urban, large systems and safety net hospitals.

Erin Russell – Principal
海角社区

Erin Russell is a dedicated harm reduction expert with an unwavering commitment to public health and equity.  

Andrew Schalk – Senior Consultant
海角社区

Andrew Schalk is an accomplished professional with extensive experience in Medicaid programs and hospital reimbursement policy.

Andrew Schwarze – Consulting Actuary
Wakely

Andrew Schwarze is an actuary with expertise in Medicaid rate analysis and risk adjustment. .

Zach Sherman – Principal
海角社区

Zach Sherman is an Affordable Care Act (ACA) expert and Health Insurance Marketplace leader with extensive experience with start-ups and turnarounds. He is a strategic organizational leader who excels in building and enhancing team performance and has an impeccable ability to foster consensus among government leaders, insurers, and stakeholders to deliver value and achieve results.

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Anthony Federico

Senior Consultant

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Marcel Loh

Principal

Headshot of Erin Russell

Erin Russell

Principal

Headshot of Andrew Schalk

Andrew Schalk

Senior Consultant

Headshot of Zach Sherman

Zach Sherman

Managing Director

海角社区 News

海角社区 pre-conference workshop focuses on behavioral health innovation and new solutions at the intersection of health and human services

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The demand for behavioral health services has never been greater than it is in 2023. Broad focus on mental wellness and pandemic-driven trauma have increased demand for lower acuity care, while significant spikes in overdoses and suicides have increased demand for higher acuity care, including inpatient treatment. Dramatic increases in government funding and policies to expand access have run up against an overburdened and fragmented behavioral health delivery system and a shortage of clinicians, creating an urgent need for innovative workforce and technology solutions that better integrate behavioral, physical, and public health systems. 

海角社区鈥檚 6th annual conference, 鈥淚nnovations in Publicly Sponsored Healthcare: How Medicaid, Medicare, and Marketplaces Are Driving Value, Equity, and Growth鈥 is putting a special focus on behavioral health through a half-day pre-conference workshop as well as topics throughout the regular conference sessions that highlight how these services and programs are becoming more integrated.聽

Pre-Conference Workshop 

Join us on Sunday, October 29th at the Fairmont Chicago, Millennium Park for a deep dive into how behavioral health sits at the intersection of health care and the social services that are critical to achieving positive health outcomes:聽

  • An opening panel on behavioral health system redesign and how states are leveraging new policies, waivers, and funding streams to improve access to services. This panel will feature from SAMHSA and leaders from Massachusetts, Iowa, and New York. 
  • A panel on complex populations and how states are connecting these patients to address health related social needs that can impede progress. This panel will feature examples from Ohio, Wisconsin, New York, and California. 
  • The preconference will feature two World Caf茅 style discussions where participants break into groups to explore new solutions around the behavioral health workforce and how states are redesigning systems to improve network adequacy.  

More Insights and Expertise 

In addition, our main conference will feature a session on crisis system development and sustainability, looking at how states are creating and funding crisis systems to reduce disparities in access to behavioral health services, featuring case studies on newly implemented 988 hotlines, mobile crisis units, and other innovations in crisis stabilization. 

We are looking forward to hearing from panelists about the important work they are doing to bring forward new solutions, new collaborations, and new uses of federal funds to better serve the behavioral health needs in our communities across America. We鈥檒l create a follow up blog on the learnings and insights shared in both sessions.  

To learn more about 海角社区鈥檚 efforts to support behavioral health, contact Gina Lasky or Gina Eckhart, managing directors of 海角社区鈥檚 behavioral health team, and be sure to register by July 31 to get the early bird rate. For additional insights, join the conversation with #海角社区Con2023.聽

海角社区 News

New experts join 海角社区 in May 2023

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海角社区 is pleased to welcome new experts to our family of companies in May 2023.

Elvia Delgado – Principal
海角社区

Elvia Delgado has over 20 years of government programs experience and has served in various leadership roles throughout the healthcare industry.

James Schroeder – Managing Principal
海角社区

James Schroeder is an experienced clinical, strategic, and operational leader with over 20 years of experience in healthcare and a passion for improving communities and the lives of individuals, particularly the most vulnerable.

Leah Montgomery – Senior Consultant
海角社区

Leah Montgomery is an expert in Medicaid and other federal needs-based programs such as Temporary Assistance to Needy Families (TANF), Supplemental Nutrition Assistance Program (SNAP), and Supplemental Security Income (SSI). 

Kelly O’Brien – Associate Principal
海角社区

Kelly O’Brien is a highly accomplished healthcare executive with over 25 years of experience in executive leadership and C-Suite roles specializing in clinical and practice operations, revenue integrity, and transformation.

Zee Cui – Senior Consulting Actuary
Wakely

Zee specializes in reserving, forecasting, regulatory reporting, rate advocacy, risk adjustments, trend analysis, modeling and pricing actuarial work in both commercial and Medicaid sectors. . 

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Elvia Delgado

Principal

海角社区 News

More than 20 Medicaid, Medicare, marketplace plan executives are confirmed speakers at 2023 海角社区 conference

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C-suite executives from AmeriHealth Caritas, Centene, Community Health Choice of California, Health Care Service Corp., Humana, UnitedHealthcare, and UMPC Health Plan are scheduled to speak on trends in publicly sponsored healthcare at 海角社区鈥檚 Sixth Annual Conference, October 30-31 in Chicago.

They join keynote speaker Alan Weil, editor-in-chief of Health Affairs, and other experts in addressing innovation, value, equity, and growth opportunities and challenges facing Medicaid, Medicare, and Marketplaces across multiple and varied plenary, breakout, and panel sessions. See below for a list of confirmed speakers to date.

The conference also will feature a preconference workshop on October 29, during which 海角社区 behavioral health leaders will address national trends and challenges for system redesign and serving complex populations. Participants will work on solving provider and population challenges during group activities.

We鈥檙e excited to welcome hundreds of attendees from health plans, providers, state and federal government, investment firms, and community-based organizations to enjoy top-notch content, interface with leading experts, make new connections, and garner fresh ideas and best practices. Last year鈥檚 event drew more than 500 healthcare professionals.

Early bird registration ends July 31.

Confirmed Speakers to Date

Keynote Speaker

Alan Weil, Editor-in-Chief, Health Affairs

Managed Care Speakers to Date (in alphabetical order)

Karen Dale, Chief Diversity, Equity, and Inclusion Officer, AmeriHealth Caritas

Mitchell Evans, Market Vice President, Policy & Strategy, Medicaid & Dual Eligibles, Humana

John Lovelace, President, Government Programs, Individual Advantage, UPMC Health Plan

Eric Mattelson, Chief Actuary, Zing Health

Anne Rote, Medicaid President, Health Care Service Corp.

Tim Spilker, CEO, UnitedHealthcare Community & State

David Thomas, CEO, Markets & Medicaid, Centene

Jaimie White, SVP, Medicaid Operations, Humana

Lisa Wright, President and CEO, Community Health Choice

State Medicaid Directors to Date (in alphabetical order)

Jacey Cooper, State Medicaid Director, Chief Deputy Director for Health Care Programs, California Department of Health Care Services

Kelly Cunningham, Medicaid Administrator, Division of Medical Programs, Illinois Department of Healthcare and Family Services

Drew Snyder, Executive Director, Mississippi Division of Medicaid

Stacie Weeks, Administrator/Medicaid Director, Nevada Department of Health and Human Services Division of Health Care Financing and Policy

Healthcare, Provider, Policy Leaders to Date (in alphabetical order)

Richard Ayoub, CEO, Project Angel Food

Lynn Carr, Chief, Agency Operations, Medical Care Services, County of San Diego Health and Human Services Agency

Liz Goodman, Chief Legal and Public Affairs Officer, Commonwealth Care Alliance

Jesse Hunter, Operating Partner, Welsh, Carson, Anderson & Stowe

Monica Johnson, Director of the 988 & Behavioral Health Crisis Coordinating Office, SAMHSA

Peter Lee, Health Care Policy Catalyst; former Executive Director, Covered California

Kate Massey, Executive Director, MACPAC (Medicaid and CHIP Payment and Access Commission)

Julie Morita, MD, Executive Vice President, Robert Wood Johnson Foundation

Bryan Buckley, Director for Health Equity Initiatives, National Committee for Quality Assurance

James R. Stringham, VP/CEO. Banner Government Health Plans, Banner Health

海角社区 offers attractive group rates and government discounts as well as sponsorship opportunities that help strengthen brand awareness and provide invaluable exposure and access to healthcare sector leaders. Visit the conference website for a complete list of sponsorship opportunities.

颁辞苍迟补肠迟听Carl Mercurio聽for details.

海角社区 News

海角社区 Acquires Crestline Advisors

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Jay Rosen, founder, president, and co-chairman of 海角社区 (海角社区), today announced the firm鈥檚 acquisition of Crestline Advisors, an Arizona based healthcare consulting firm.

Founded in 2013, supports health plans, provider organizations, and state agencies with an array of services designed to help them navigate the changing healthcare landscape. The company鈥檚 team of independent consultants has an extensive track record of developing successful RFP responses, provider networks, and business development strategies to fuel client success.

鈥淐restline Advisors brings an impressive mix of expertise and relentless client focus 鈥 that delivers results 鈥 to 海角社区,鈥 Rosen said. 鈥淭heir ability to consistently develop winning proposal responses for Medicaid managed care organizations (MCO) complements our extensive MCO supports as we continue to expand the ways in which we serve our clients.鈥

In addition to Crestline鈥檚 proposal response development and MCO network management and operations support services, the company also assists clients with regulatory and contract compliance, accreditation, and strategic planning for business development.

“Crestline has demonstrated a commitment to supporting health plans, providers, and states to improve healthcare for Medicaid beneficiaries,鈥 said Crestline CEO Susan Dess. 鈥淲e firmly believe that as part of the 海角社区 family of companies we will bring even more success to our clients and drive continued growth and development in Medicaid healthcare delivery.鈥

Dess and Tim Mechlinski will continue to lead Crestline Advisors, an 海角社区 Company, as managing directors. Terms of the transaction were not disclosed.

About 海角社区

Founded in 1985, 海角社区 is an independent, national research and consulting firm specializing in publicly funded healthcare and human services policy, programs, financing, and evaluation. Clients include government, public and private providers, health systems, health plans, community-based organizations, institutional investors, foundations, and associations. With offices in more than 20 locations across the country and over 500 multidisciplinary consultants coast to coast, 海角社区鈥檚 expertise, services, and team are always within client reach. Learn more about 海角社区 at healthmanagement.com, or on and .

About Crestline Advisors

Established in 2013, Crestline Advisors, LLC is a consulting company designed to support the needs of health plans, provider organizations, and state agencies. Crestline specializes in helping large and small organizations operate successfully and grow despite the constant operational, financial, and political challenges they face. Crestline uses its current understanding of industry drivers to strategize with our clients so they can respond timely and effectively to small, large, or enormous market-place changes. Learn more about Crestline Advisors at .

海角社区 News

海角社区 acquires Lovell Communications and establishes Nashville office

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Jay Rosen, founder, president, and co-chairman of 海角社区 (海角社区), today announced the firm鈥檚 acquisition of Lovell Communications, a leading strategic communications and change management firm that exclusively serves the healthcare industry.

Founded in 1988 and based in Nashville, Tenn., award-winning provides communication solutions and strategies for healthcare organizations across the country. Lovell has helped clients of all size manage crises, navigate change, maximize brand potential, and grow business. Services include creation of corporate communication programs, marketing and media strategies, transaction support, and helping clients navigate complex operational, reputational and regulatory issues.

鈥淟ovell鈥檚 strategists have an impressive track record of helping healthcare clients overcome challenges and seize opportunities,鈥 Rosen said. 鈥淭hey are a natural addition to our company as we open a Nashville office and continue to expand the depth and breadth of services we offer our clients and partners.鈥

Lovell CEO Rosemary Plorin will continue to lead the firm, which will operate as Lovell Communications, an 海角社区 Company. In addition to serving integrated health systems, hospitals and providers across the country, Lovell鈥檚 clients include healthcare suppliers, consultants, associations and innovators throughout the industry.

鈥淎s the pace of transformation in healthcare continuously increases, the need for effective, strategic communications has never been greater,鈥 Plorin said. 鈥淲e are honored to offer our expertise in support of 海角社区鈥檚 clients and look forward to what we will accomplish together as we pursue a shared commitment to making healthcare more accessible, equitable and effective.鈥

海角社区鈥檚 new Nashville office is co-located with the Lovell office in the Westpark Building at 3212 West End Ave.

About 海角社区

Founded in 1985, 海角社区 is an independent, national research and consulting firm specializing in publicly funded healthcare and human services policy, programs, financing, and evaluation. Clients include government, public and private providers, health systems, health plans, community-based organizations, institutional investors, foundations, and associations. With offices in more than 20 locations across the country and over 500 multidisciplinary consultants coast to coast, 海角社区鈥檚 expertise, services, and team are always within client reach.

About Lovell Communications

For 35 years Lovell Communications has served as strategic counsel and trusted partner to health care providers and suppliers across the country. Publicly traded companies, not-for-profit systems, early stage and mature companies draw upon the firm鈥檚 vast communications expertise to support them through phases 鈥 or just moments 鈥 when it is crucial to persuade audiences or influence decision makers. Learn more about the firm at聽, or on , or the company .

海角社区: /

Lovell Communications:

海角社区 News

Leavitt Center for Alliances, an 海角社区 Initiative, Drives Collaboration and Solutions

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Today, 海角社区 (海角社区) launched the Leavitt Center for Alliances, an 海角社区 Initiative, which aims to elevate the national discourse on healthcare and help healthcare organizations solve their most complex challenges through consensus-based alliances.

The is home to expert conveners who have decades of experience in the private sector and government. They have spent years fine tuning the process for building successful alliances that bring multi-sector stakeholders to the table with a commitment to reaching consensus, real-world solutions. Governor Mike Leavitt served as Secretary of the United States Department of Health and Human Services (HHS). Rich McKeown, served as Chief of Staff at HHS. The two of them founded Leavitt Partners, where they advanced the science of alliance building. Their book mapped out eight crucial elements of successful alliances, providing a framework for the work and resources that now serve as the foundation for the Leavitt Center.

鈥淣ow more than ever, alliances offer a proven way forward, beyond the divisiveness, partisanship and uncivil discourse that too often stagnates momentum toward tangible progress,鈥 said Leavitt, 海角社区 co-chairman and Leavitt Partners chairman, Board of Managers. 鈥淥ur approach to multi-sector consensus-based alliances, rooted in collaboration, has consistently helped organizations identify and develop solutions to some of the most complicated issues. It is a roadmap for bridging divides and realizing results.鈥

The Leavitt Center guides stakeholders through each step of the process to form alliances, develop consensus within those alliances, and then put a strategic plan into action that drives results. Expertly convened alliances solve the tough problems that are too big for individual organizations to tackle alone, leverage shared resources and expertise, and provide for 鈥渟trength in numbers.鈥

鈥淭he expertise our Leavitt Center colleagues have when it comes to both the art and the science of creating and deploying alliances to develop innovative solutions is unmatched,鈥 said Jay Rosen, founder, president, and co-chairman of HMA. 鈥淚 see great potential for combining that know-how with our on-the-ground experts throughout all of 海角社区 to expand this proven alliance approach beyond the federal landscape and into communities across the country.鈥

Leavitt Center experts have helped more than 50 alliances achieve impactful outcomes, including the Dual Eligible Coalition founded in 2017 to develop actionable, long-term policy and programmatic solutions to improve the delivery of care and outcomes for the dual eligible population. Other alliances include the CARIN Alliance, focused on improving access to digital health information, the Pharmaceutical Distribution Security Alliance (PDSA), and the COVID Patient Recovery Alliance. Other examples of alliances in action can be found . Currently Leavitt Center experts are drawing from their past decade of alliance work to share insights in a new book, scheduled for release in 2023.

Founded in 1985, 海角社区 is an independent, national research and consulting firm specializing in publicly funded healthcare and human services policy, programs, financing, and evaluation. Clients include government, public and private providers, health systems, health plans, community-based organizations, institutional investors, foundations, and associations. With offices in more than 20 locations across the country and over 500 multidisciplinary consultants coast to coast, 海角社区鈥檚 expertise, services, and team are always within client reach.

Leavitt Center for Alliances:

海角社区 News

Adaptation Health to Become Part of 海角社区

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Today, Jay Rosen, founder, president, and co-chairman of 海角社区 (海角社区), and David Kulick, co-founder of Adaptation Health, announced that Adaptation Health is joining HMA. It will continue to operate as Adaptation Health, an 海角社区 Company.

Founded in 2017, Adaptation Health is an innovation consultancy and incubator based in New Orleans that works with state Medicaid programs and managed care organizations (MCOs) to drive adoption of new delivery and engagement solutions. Adaptation brings together leaders from these sectors to solve systemic problems in publicly funded healthcare.

鈥淟ike 海角社区, Adaptation Health has innovation in its DNA,鈥 Rosen said. 鈥淚鈥檓 excited to pair 海角社区鈥檚 unmatched Medicaid expertise with Adaptation Health鈥檚 creative approach and laser focus for tackling the complex challenges related to Medicaid to benefit those the program serves.鈥

Adaptation Health has worked across dozens of states and MCOs to build private market innovation through expert vendor sourcing, diligence, and deployment driving improvements in member care, acceleration of equity, and supporting positive evolution in public market delivery. They have directly worked with over 500 startups and early Medicaid-focused companies to enable best-in-class solutions for the public good.

鈥淲e are very excited to join 海角社区 as they are pre-eminent Medicaid experts. We believe that through this partnership Adaptation Health can continue to support states and MCOs across the country in accelerating Medicaid performance, value, and innovation.鈥 Kulick said.

Kulick will continue to lead Adaptation Health, an 海角社区 Company. Terms of the transaction were not disclosed.

Founded in 1985, 海角社区 is an independent, national research and consulting firm specializing in publicly funded healthcare and human services policy, programs, financing, and evaluation. Clients include government, public and private providers, health systems, health plans, community-based organizations, institutional investors, foundations, and associations. With offices in more than 20 locations across the country and over 500 multidisciplinary consultants coast to coast, 海角社区鈥檚 expertise, services, and team are always within client reach.

海角社区: /

Adaptation Health:

海角社区 News

海角社区, The Focus Group Merging

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Today, Jay Rosen, founder, president, and co-chairman of 海角社区 (海角社区), and David Kulick, founder and managing director of The Focus Group, announced the merger of the two firms. The Focus Group will continue to operate as The Focus Group, an 海角社区 Company.

Founded in 2014, The Focus Group, based in New Orleans, helps healthcare clients navigate the intersection of healthcare policy, payment, and delivery by devising and implementing strategies that create change and fuel growth. Led by public market and business transformation experts, Kulick and Alex Rich have partnered with聽hundreds of company executives to solve complex challenges and deliver high-value projects. The Focus Group services include market intelligence, strategy development, business transformation, and go-to market execution for providers, payers, life sciences, health foundations, and private equity investors.

鈥淭he Focus Group brings extensive expertise across the healthcare spectrum, driving growth for a wide array of clients,鈥 Rosen said. 鈥淲e鈥檙e excited to add their unique approach to managing change and commitment to innovation to our impressive lineup of experts as we continue to expand the ways we can serve our clients and partners.鈥

鈥淲e are thrilled to merge with 海角社区 and drive greater value to our clients. This is a strategic opportunity to link 海角社区鈥檚 vast depth in healthcare policy and payment with our focus on commercial growth to lead the charge together for positive evolution in healthcare delivery,鈥 Kulick said.

Kulick and Rich will continue to lead The Focus Group, an 海角社区 Company, as managing directors. Terms of the transaction were not disclosed.

Founded in 1985, 海角社区 is an independent, national research and consulting firm specializing in publicly funded healthcare and human services policy, programs, financing, and evaluation. Clients include government, public and private providers, health systems, health plans, community-based organizations, institutional investors, foundations, and associations. With offices in more than 20 locations across the country and over 500 multidisciplinary consultants coast to coast, 海角社区鈥檚 expertise, services, and team are always within client reach.

海角社区: /

The Focus Group:

海角社区 News

海角社区 Acquires Medical Audit Resource Services, Inc.

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Today, Jay Rosen, founder, president, and co-chairman of 海角社区 (海角社区), announced the firm鈥檚 acquisition of Medical Audit Resource Services, Inc. (MARSI).

Founded in 1991, MARSI specializes in medical coding support, physician education and healthcare revenue cycle management. MARSI鈥檚 experts provide coding and auditing services for hospitals and physicians using inpatient, outpatient and risk adjusted reimbursement methodologies. Other clients include commercial fee-for-service plans as well as risk-adjusted plans.

鈥淢ARSI is recognized nationally for the expertise of its team and the results they deliver for clients. They will add enormous value to our healthcare delivery system, actuarial and revenue cycle work,鈥 Rosen said. 鈥淚 am excited to welcome such talented professionals to 海角社区 as we continue to expand the ways in which we can meet our clients鈥 current and emerging needs.鈥

MARSI has been a pioneer in several areas that are now standard operating procedure among healthcare providers and their contracted service providers, including over-code identification, physician queries, pre-bill auditing, coder and physician training, and clinical documentation improvement.

鈥淲e are excited to join an organization that shares our commitment to integrity and excellence,鈥 said Dr. Todd M. Husty, MARSI owner, founder, and chief medical officer. 鈥満=巧缜 is home to an unmatched breadth and depth of experience and expertise. We look forward to the new opportunities we will have to serve our clients and extend our reach.鈥

MARSI will continue to operate as Medical Audit Resource Services, an 海角社区 Company, under the leadership of Dr. Husty. Terms of the transaction were not disclosed.

Founded in 1985, 海角社区 is an independent, national research and consulting firm specializing in publicly funded healthcare and human services policy, programs, financing, and evaluation. Clients include government, public and private providers, health systems, health plans, community-based organizations, institutional investors, foundations, and associations. With offices in more than 20 locations across the country and over 500 multidisciplinary consultants coast to coast, 海角社区鈥檚 expertise, services, and team are always within client reach.

MARSI:

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