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Value based health care & value based payment

HSG is the nation’s premier firm when it comes to value-based payment and contracting. The firm helps clients navigate the complexities associated with value-based contracting and often serves as the lead negotiator for many of its clients. The details really matter in value based health care and HSG is the go-to firm for making sure those details are fully understood before contracts are signed and new care models are implemented.

In addition to contracting support, HSG assesses organizational readiness for value based care and recommends how best to fill any gaps that might exist. HSG helps its client up-date their business models and operations to ensure value based care success. This review includes key clinical, operational and technology components, and goes as deep as the client requires.

Specific services include:

• Bespoke trainings to understand the value-based ecosystem & the opportunities within

• Creating value-based payment strategies for organizations on the road to value

• Developing value propositions to share with potential payers/partners including highly persuasive pitch decks

• Crafting and negotiating value-based contracts

• Review existing VBP contracts to understand why providers are under-performing and provide recommendations for how to either enhance performance or re-negotiate the contracts

• VBP strategic audit to assess organizational readiness for value-based contracting including strategies for filling organizational gaps to ensure effective implementation

• Comprehensive data infrastructure & analytics to support successful move to value including highly sophisticated claims, encounter, EHR, assessment data aggregation, analysis, and presentation

Social care alignment with health care 

There is a growing realization that the health and social care sectors need to work together to address the most challenging issues facing individuals, providers, payers, and communities.  While many organizations say they understand the social sector, HSG’s team has actual experience in the sector and has helped create meaningful partnerships that have led to measurable improvement in outcomes.  HSG is especially well placed to help social care providers get into contract with health plans and providers so that they can build on their mission as well as provide meaningful value to their healthcare partners. HSG helps its social care client speak “health care purchaser” as well as helps plans and providers speak “CBO”.

Specific services include:

• Training opportunities for social care providers to understand the health care ecosystem

• Develop CBO contracting strategies for health plans and at-risk health care providers

• Value proposition development & pitch for CBOs and local governments seeking contracts with health plans and providers

• Implementation support to ensure success & growth

Organizational optimization, growth, and development

HSG helps its client improve and grow. The world is constantly changing with new challenges appearing on a regular basis. HSG helps its client navigate fast changing environments including the fluid government regulatory and reimbursement landscape that often vexes health care providers. HSG brings experience in strategic planning, improvement science, and regulatory affairs to its clients to help them adapt and thrive in an ever-changing world. HSG has provided these services for organizations ranging from health plans to providers to CBOs and even local governments.

HSG also helps its clients enter new markets. This includes helping overseas companies enter the US health care market as well as helping clients identify and enter other state/regional markets which may have seemed opaque and confusing in the past.

Specific services include:

• Strategic planning & futureproofing

• New market entry analysis and introductions

• Integration initiatives

• Improvement science & implementation science to improve outcomes

• Rapid Cycle Continuous Improvement Training and Facilitation

• Large scale change design & management

Program evaluation and design

HSG and its data team are experts in program evaluation and design. Whether the client is a local government seeking to apply for federal funding and needs an independent evaluator or is a health care provider seeking to launch a new pilot program and needs serious data chops to ensure they can demonstrate impact to health plans in the future HSG can help.

In addition to designing the evaluation, HSG helps its clients collect and analyze the data and present the results to key stakeholders. HSG helps make sure that key lessons are learned, and the most compelling arguments are made so that clients get the most out of each evaluation.

Specific services include:

• Designing & implementing program evaluation efforts

• Evaluation design for federal agency funding

• Startup evidence generation

• Evaluation design and implementation for pilot VBC programs

CMMI Innovation Models

Health care providers need to stay ahead of the game when it comes to federal health policy. One of biggest drives of innovation at the federal level is the Center for Medicare and Medicaid Innovation. HSG tracks the institution closely and includes several key organizational leaders in its network. With HSG as its guide, clients can quickly assess new programs and participate if it makes business sense.

HSG has gone very deep on CMMI’s latest big initiative – ACO REACH. This new program is the first major effort by CMMI to address health equity and is a significant opportunity for providers as well as vendors that are well positioned to help improve outcomes and lower costs for historically marginalized groups. HSG uses its expertise in this program to advise a wide array of clients on how to make the most of this new initiative.

Specific services include:

• ACO REACH training, support, and implementation

• Develop APMs for submission to CMMI

• Evaluation and recommendations regarding new CMMI initiatives to help clients make strategic decisions regarding application and participation

Start-Up & Early Stage Company Support

HSG helps early-stage health care companies grow. Leveraging its extensive network and deep domain knowledge, HSG has helped a wide array of start-ups increase topline revenue and enter new markets.

HSG also has strong relationships with Venture Capital and Private Equity firms which can be leveraged when early-stage companies need to raise funds. HSG team members serve on Corporate Boards and Advisory Boards for multiple companies, so the team has first-hand experience helping these entrepreneurs grow and succeed.

Lastly, HSG is willing to work for promising early-stage companies at reduced rates in exchange equity in the company. This approach has worked well for multiple companies that are pre-Series A and as a result can’t afford the normal HSG charges.

Specific services include:

• Advise early-stage companies in service/product development

• Support new market entry, especially U.S. market entry for companies based outside the U.S.

• Make introductions to potential clients as needed to help grow the business

• Navigate complex regulatory and public policy barriers to market entry and growth

• Support in fundraising through introductions to investors with investment approaches consistent with company objectives

• Pitch support in fundraising

Data infrastructure and advanced analytics

Value-based health and social care must be data driven. HSG has a highly experienced data and analytics team that helps its clients get the most out of their data as well as prepare them so that they can achieve meaningful insights from data they have never seen before. May health and social care providers have never seen claims data and yet that data will determine success or failure in value-based contracts. HSG helps those providers accept, analyze and present that data so that is both insightful and actionable.

HSG serves as the “data shop” for some of its clients. In this role, HSG helps clients identify strategies to improve outcomes and lower costs as well make the case to potential funders relative to impact of new or existing programs. Data is power and HSG helps its many clients harness that power.

Specific services include:

• Data infrastructure audit

• Digital transformation design & implementation

• Large-scale data set design & management

• Complex analysis & predictive analytics

• Building data-driven organizations

Advisory services for investors

HSG provides strategic advice and support for health care and life sciences investors. HSG has advised some of the nation’s largest Private Equity funds during the critical investment due diligence process. Whether researching specific key questions or attending management team briefings, HSG team members have proven valuable additions to the PE due diligence team.

HSG is especially excited about its work for Venture Capital firms. HSG supports due diligence as well as helps firms find emerging companies looking for early-stage funding. HSG advises a wide array of early-stage companies and has its pulse on where health care is going which makes the firm a great VC partner.

Specific services include:

• Venture capital advisory

• Private equity advisory

• Due diligence support

• Targeted due diligence research

• Deal flow for VCs

• Trainings and thought leadership

Delivery system reform for states & nations

HSG is truly a global firm with staff on three continents and experience working across many different health systems. The firm is a proud partner to government agencies that are working hard to transform their health care delivery systems. HSG team members have led large system change efforts and are looked to for their expertise by agencies around the world. The firm has been involved in a wide array of projects in regions as far afield as Europe, the Middle East, Australia, and Africa. HSG has also worked with state agencies supporting state-based innovation in the US.

Specific services include:

• Advisory services for states & nations interested in delivery system reform

• International comparisons & exchanges

• Large scale change design and implementation support

• Data and analytics support

• Stakeholder management

Social determinants of health strategy & development

While other firms like to talk about SDOH, HSG has first-hand experience designing and implementing major initiatives that improve outcomes and lower health care costs. HSG helps its social care clients enter meaningful contracts with health care payers and providers so that they can expand their mission and impact. HSG also helps health care payers and providers develop effective SDOH strategies that will help them achieve the business objectives.

Lastly, HSG helps social care providers improve their organizational effectiveness. Whether through organizations assessments, strategic planning services or helping to develop targeted interventions that will get funded, HSG is well positioned to help social care providers to make the world a better place.

Specific services include:

• Understanding the social sector

• Crafting SDOH strategies for payers

• Building networks of social care providers

• Deep dive organizational assessments