NEW! 

Be sure to check out our new MEDIA page!

It's complicated...don't go it alone.
Healthcare Management Solutions, Inc.:
working with you to develop innovative strategies to meet your competition head-on

Healthcare Management Solutions is a real-world, results-oriented, managed care consulting firm that brings providers and payers together to build something better. Payers and providers are not natural allies, but are interdependent in most markets. We build solutions that avoid the screaming matches, blistering advertisements, and patient disruption that come with managed care combat. We can play that way too, if necessary. But a more lasting and stable solution is to find ways for payers and providers to collaborate without either party taking a beating.

 

On this website, you'll find information about the many ways in which we can help you via the extensive range of services that we offer.  Included are links to information about some of our more recent projects and clients for whom we've provided assistance.  There is information on this website about some of our more recent speaking engagements, and we've also included an archive of some of our healthcare articles and other publications, which will help to inform you about our approach to dealing with various industry issues.   We've also added a Media page, where you'll find excerpted and full videos and other media formats from some of our more recent media, webinar, and conference interactions.  And finally,  we're excited to share with you information on our own "think tank" inspired events:  "CLIFF'S CONFABS".

 

As you tour our website, take note of our experience, and the solutions that we have built addressing problems in various markets around the country. Know that we are focused on delivering solutions that lead to positive results, and that change the dialog between providers and payers. As an example, we ask payers "what clinical areas are problematic and how can we providers address those needs?" And we ask providers "what hassles can we eliminate in the administrative process to keep physicians and hospitals focused on patient care and outstanding outcomes?"

 

We can help you to help your providers manage managed care. Feel free to call us (904) 874-6134, or to get in touch via the "Contact Us" link found at the bottom of each of this website's pages, with any questions you may have about any aspect of our services, and to find out specifically how we can help you.  Let’s go build something great!

SERVICES

 

Healthcare Management Solutions, Inc. offers a wide range of services including:

 

  • Forming networks of providers for the purposes of building Clinically Integrated Networks

  • Negotiating Shared Savings agreements for provider networks with commercial, Medicare Advantage, and managed Medicaid payers

  • Developing provider at-risk models that limit provider risk exposure

  • Designing capitation models for providers

  • Performing data analysis of provider utilization patterns

  • ...and more.

 

 

 

Click below to learn more about our services.

PROJECTS

 

Here are a few of the projects and programs that Healthcare Management Solutions, Inc. has developed and implemented in recent years:

  • Managed a capitated provider network with 40,000 covered lives

  • Built and manage a successful ACO with 35,000 attributed lives

  • Negotiated a thaw between a payer and major specialty group in SE market

  • Renegotiated provider agreements with BUCA payers for major pediatric center

  • Assessed market dynamics and managed care strategy for community hospitals

  • Assessed physician group culture, and identify processes to build a more dynamic group norm

  • ...and more.

Click below to learn more about some of our more recent projects.

 

CLIENTS

Healthcare Management Solutions, Inc. has assisted countless healthcare providers--large and small-- in developing and implementing customized programs to meet various needs.  Examples include:

 

  • Shore Medical Center – developed managed care strategy, built ACO, negotiated shared savings with payers

  • Centivo – built new model of provider network for large self-insured employers

  • Vermont Managed Care – Turned around and operated a 2,000 provider capitated network for 40,000 commercial lives

  • Connecticut Childrens’ Medical Center – negotiated long term agreements with major payers

  • Borland Groover Clinic – restarted negotiations with major payer, offer solutions to cultural roadblocks

  • Palos Medical Center – negotiated payer agreements including commercial ACO agreement with large commercial payers

  • ...and more.

 

 

More client information available upon request. Click below to contact us.

 

© 2018-2019 Cliff Frank, Healthcare Management Solutions, Inc.