Five service lines. Each one ends in something your organization can operate.
We work in small senior teams and stay through implementation. If a piece of this is better done by your own people, we will tell you that.
Managed care & value-based contracting
We sit on your side of the table. Rate and term benchmarking, negotiation strategy, and — when you want it — we lead the negotiation ourselves or coach the person who will.
Real leverage is rarely power. It is creativity, nuance, and reframing the problem — using the dominant payer's own strengths against the position they have taken.
Clinically integrated networks & risk-bearing entities
Forming the entity is the easy part. We build the governance, the participation agreements, and the incentive model that keeps independent physicians and employed physicians in the same boat three years in.
An ACO is a path, not a destination. If your CFO cannot see how the gain-share math survives reduced inpatient revenue, the model will not hold.
Population health operations
Care management runs on limited resources against enormous demand. We design the model around that constraint instead of pretending it away — staffing ratios, escalation logic, and the technology that actually reaches the rising-risk population.
Most programs spend their entire capacity on the top few percent and call it population health. The next evolution is reaching the people who are not yet expensive.
Social drivers of health & community networks
Screening for social need without a network to refer into is a data-collection exercise. We develop networks of human-services organizations, the referral infrastructure between them, and the funding case that keeps them standing. We built one of the three regional sites of North Carolina’s Healthy Opportunities Pilot — the first program in the country to let Medicaid pay directly for food, housing, and transportation — from planning through live operations.
The patient who cannot get to the pharmacy is a transportation problem that arrives on your ledger as a readmission.
Direct-to-employer solutions
Employers in your market are already buying around you — through carriers, point solutions, and out-of-market networks. Going direct means selling your own care to the people who live next door to it, without a payer in the middle taking the margin and setting the terms.
We are the general contractor. We convene the pieces, build the entity, get it selling, and hand you the keys. We have done this for a health system before — and the entity we built is still operating today, years later, under a different name.
Rent before you buy. A health plan does not reach economies of scale until roughly 100,000 members — so we contract for scale on a per-member basis and prove the concept before you commit capital to it.
Three engagements. No client names.
A client pays us to help them, not to become a line in our pitch. So you will not find logos here. We are the back-stage crew — nobody knows our name except the client, and that is the arrangement we prefer. What follows is the work, told without them.
Eighteen weeks to build something that had never been built.
A foundation won the grant and found out over Memorial Day weekend. Good news. The bad news was the deadline: the program had to be live on October 1. It was a first-of-its-kind Medicaid pilot — no people, no processes, no technology, no plan, and no precedent anywhere in the country to copy. What existed was a large vision to meet the most basic needs of a population with great needs.
We acted as general contractor. Built the operating plan, recruited and stood up the human-services network, designed the referral and payment workflows, selected and deployed the technology, hired and trained the team, and ran the thing until it ran itself.
Live on October 1. On time, on budget, fully operational.
Six payer contracts, one compressed window, no margin for error.
After years of delays, managed Medicaid finally arrived in the state. A health system with no dedicated contracting resources suddenly had to negotiate six new payer agreements in a matter of months — under a new regulatory framework, a new compensation model for care coordination, a fee-for-service structure to preserve, and six insurers each with their own policies and procedures.
We ran all six negotiations. Built the modeling to understand what each proposal actually did to reimbursement, set positions and walk-away points, and worked the six tracks in parallel against a fixed deadline none of them would move.
All six executed on time, with the operational and financial integrity of the client’s reimbursement preserved through the transition.
Their managed care department, without the department.
The client wanted two things that usually pull against each other: lower administrative cost and better payer contracting. Carrying a full internal managed care function is expensive, and a small one rarely sees enough deals to stay sharp.
We became their managed care department. Contract calendar, benchmarking, negotiation, and language review handled by a team that does this every day across many markets — at a fraction of the cost of staffing it internally.
About half the cost of staffing the function internally, with better contracts — because the work moved to people who see the whole market instead of one organization’s renewals. The engagement is active today.