We believe that past performance is the best indicator of future success.
Here are just a few examples of the kind of experience and perspective we bring to each assignment.
Here are just a few examples of the kind of experience and perspective we bring to each assignment.
Engagements
- The Strategic Health Group team was hired by a large regional commercial health plan to prepare a study to explore the pros and cons of entering the Medicare Advantage market in ten California counties. As part of this assignment, SHG performed detailed demographic and enrollment analysis, compared the client’s existing provider network against those of potential competitor’s and reviewed benefit packages being currently being offered. One significant deliverable was a summary enrollment and financial projection prepared by SHG. The results of this study were presented by SHG leadership to the client’s board of directors.
- The Strategic Health Group leadership team is continuing to provide strategy, operational, and financial consulting services to support a Midwest regional Medicare Advantage/Medicaid health plan explore its strategic options for expanding its business opportunities, including exploration of possible strategic partners and launching a Medicare Advantage special needs plan for Dual Eligible beneficiaries. SHG has also provided strategic planning assistance and interim executive management services.
- The Strategic Health Group leadership team and our strategic partners have provided strategy development, operational, compliance and financial consulting services to assist a regional integrated delivery system obtain a state license with the California Department of Managed Health Care (DMHC) and a Medicare Advantage contract with the Centers for Medicare and Medicaid Services (CMS) for three California counties.
- Strategic Health Group principals have recently completed an engagement to assist a major Western U.S. academic medical center obtain a state license with the DMHC and position the new plan for obtaining a contract with CMS for a Medicare Advantage plan in Northern California. SHG’s contribution to the development strategy and financial modeling resulted in no comments from state regulators on the relevant portions of the state license application.
SHG leadership has assisted a major regional integrated health system on multiple strategic initiatives in response to the business opportunities resulting from the Affordable Care Act. These initiatives include the further development of the system’s physician clinical integration strategy, the development of new strategic alliances, and strengthening the system’s population management expertise. SHG’s leadership played a key strategic and financial role in the system’s approval from the CA DMHC of a Knox Keene Plan to Plan license for both Medicare Advantage and commercial lines of business.
- Strategic Health Group is currently assisting a successful geographically based health plan evaluate the potential business opportunities in a developing state program to provide integrated care for Dual Eligible Beneficiaries. The plan currently serves more than 250,000 commercial, Medicare and Medicaid members. SHG’s engagement will assist the plan’s leadership to develop a Medicare Advantage Dual Eligible Special Needs Plan and structure the organizational components necessary to succeed in serving the complex and challenging needs of Dual Eligible Beneficiaries
- Strategic Health Group has assisted a successful Medicare Advantage health plan explore strategic options for expanding their footprint into a competitive MA market. This assessment included evaluation of strategies for aligning the interests of hospitals and physician groups to enhance the opportunity for successful market expansion. Our actuarial and financial teams conducted an assessment of the financial, clinical and operational structure necessary to succeed in the current Medicare environment.
- Our leadership team has provided continuing strategic planning assistance to the leadership team and Board of a regional Medicare Advantage health plan concentrated in a competitive regional market. The plan continues to grow as it expands its service area and offer new competitive products.
- Strategic Health Group has recently provided strategic assistance to a private equity firm as it seeks to enter the Medicare Advantage special needs plan space. Our team worked with the firm’s principals to aid their understanding of the intricacies of the Medicare Advantage program and the market and environmental challenges facing institutional special needs plans. We assisted the firm to complete a detailed transaction due diligence of a potential acquisition and guidance to the firm’s Board relative to execution strategies.
- SHG assisted the clinical leadership of a Midwestern academic medical center evaluate potential strategies for the commercialization of their successful care management system for the coordination of care for frail elderly. Our team assisted the leadership identify its business objectives and determine strategies to protect the institution’s intellectual property.
Other Successes
- Dennis Eder and Hank Osowski, Founders and Managing Partners of SHG, co-authored an article for the March 2014 issue of Executive Insight relative to Provider Sponsored Health Plans. In the article, they identified their five key requirements for executives to consider before the launch of a strategic initiative to develop a successful health plan.
- Our leadership team has provided critical executive guidance to more than a dozen market expansion and growth efforts in multiple states around the country. Services have included start-up research and planning, organizational development, state licensing. Medicare Service Area Expansion filings and state Medicaid procurement bids.
- Our Principals served as key executives in the turnaround of a regional health plan’s financial and operational performance. The organization went from “near death” to dramatic growth and profitability, adding over $1 billion in retained earnings over six years. New business and product growth enabled revenue and membership to grow by more than 50%.
- The leadership of our Principals enabled investors to realize a significant return on investment through the sale of a subsidiary and portfolio companies to strategic investors. Among these sales were a regional commercial and Medicare HMO to a large “Blue” plan and the sale of a nationally renowned TPA.