Strategy guides an organization to fulfill its mission—and it’s one of the most challenging areas to keep aligned with current activities. Some organizations have outdated strategic plans that need to be updated; others have a plan but need to cascade those organization-wide goals down into specific department-level tactics and activities to move forward; still others are facing a new strategic challenge and are unsure how to incorporate this into their current strategy. We can help you develop and execute your strategic vision.
Improving operations is key to decreasing costs and increasing efficiency. Many resource-limited organizations don’t have the internal expertise to redesign and improve current processes; some organizations are uncertain how to incorporate new services or workflows; others know that changes are needed but don’t have the bandwidth to create those solutions. We can help you improve your workflows and processes resulting in greater operational efficiency.
Revenue for many organizations is shifting from fee-for-service to value-based care, although it’s a long transition with competing priorities. Multiple payers have differing expectations. How do you focus on providing the right care while also maximizing revenue for these services? How do you implement population health activities today when the financial incentives often come 6-12 months after the care is delivered? We can help you create a holistic, integrated approach to care and services that will increase revenues.
Shane has 25 years non-profit experience, working in operational and advisory roles. He has deep experience in public sector healthcare, with ACOs and other payers, hospital systems, community health centers, and medical technology startups. He has provided pro-bono consulting and served on the boards of other human service organizations, including an arts & crafts school and a children’s residential program. Recent engagements include transformation work with Children’s Hospital Integrated Care Organization, the ACO anchored by Boston Children’s Hospital; a grant evaluation for the Massachusetts Department of Public Health; a webinar on Behavioral Health Integration through the Health Information Technology, Evaluation, and Quality Center; and advisory work with an Israeli startup on US market entry, focused on the Medicare reimbursement landscape. For three years he served as Vice President of Quality at a Boston community health center, where he implemented a Medicaid value-based care contract and led the successful effort for NCQA Patient-Centered Medical Home recognition. He has worked with clients in Massachusetts, Connecticut, New York, New Jersey, Virginia, Missouri, and Colorado. Shane holds a Bachelor of Science degree in Mechanical Engineering from Worcester Polytechnic Institute and an MBA from Kellogg School of Management at Northwestern University.
Debra has 30 years health care experience, holding operational and advisory roles serving government-sponsored and commercial members in New York and Massachusetts. She has significant experience in quality improvement, care management, network management, reporting, and analytics of complex populations, along with demonstrated success in regulatory and accreditation compliance. Debra and Shane first worked together in 1993 and have collaborated numerous times since then. Advisory engagements include evaluating Affinity Health Plan’s 2017 HEDIS/QARR data collection and hybrid measure audit process; annual HEDIS medical record abstraction training of Execu|Search temporary nurses; and streamlining Medical Management policies and procedures for CCM/Beth Abraham across three Medicare product lines. Debra’s current operational role is Program Director of Senior Products Clinical Services Strategy at Tufts Health Plan, where her responsibilities include multiple Clinical Stars Quality Improvement Campaigns and management of PIPs and the Dual SNP Model of Care. Throughout her career, she has held leadership roles at numerous payers, including Beacon Health Options, Fidelis Care, and NYC Health and Hospitals Corporation. Debra holds a Bachelor of Arts degree in Psychology from St. Michael’s College and studied Clinical Psychology at the graduate level at University of Nebraska-Lincoln.