Strategic
Healthcare Solutions is a California based
healthcare consulting firm with offices in Los Angeles
and Sacramento, CA. We specialize in
the development and implementation of innovative
and cost-effective business solutions designed
to enhance and support organization and industry-wide
strategic performance. The organization was
established in 2002 in response to the needs
of health maintenance organizations (HMO), risk-bearing
provider organizations (RBO), and the California State
Department of Managed Health Care (DMHC) regarding
provider fiscal solvency and HMO oversight within the managed
care system. Our mission began simply as an
avenue to provide technical and oversight
support to HMOs and RBOs with specific focus on streamlining
processes, eliminating redundancies, and increasing
the value of administrative resources. While continuing
this mission, we have since expanded our services to meet
the broader needs of the health care community. Currently,
Strategic Healthcare Solutions offers an array of interim and
project-based finance, IBNR, claims, and management
services designed to enhance operational efficiencies and
cost-effectiveness in the health care industry.
As most
health care administrators and practitioners have experienced, the cost associated
with operational, contractual, and regulatory oversight in California has become an
increasingly burdensome administrative reality at all levels of the health care delivery
system. HMOs, RBOs, and individual practitioners have experienced higher demand
for streamlining and compliance-related resources across the spectrum of their operations.
Strategic Healthcare Solutions provides these resources on an interim-based, project-based,
or long-term basis to meet the demands of
tactical and strategic operations,
analytic and assessment needs,
state and federal examinations,
health plan audits,
accreditation audits,
interim executive management, and
other quality-based finance and operations improvements.
The seemingly endless stream of cost-cutting, rate reductions,
and contractual and regulatory audit engagements
endured by plans, provider organizations,
and MSOs has had a significant impact on organizations’
administrative resources with a direct impact
on operating margins.
Strategic Healthcare Solutions is committed to providing high-quality management,
analytic, audit, and oversight services to the health care industry in a cost-effective
manner for our business partners. Our experience with health care accounting, finance,
claims & operations, and compliance practices has allowed us to streamline small and large
scale processes and procedures to realize economies for HMOs, RBOs, MSOs, and other provider organizations.
Most of our initiatives are developed to enhance
quality improvements and
operating efficiencies
and can be tailored for and scaled-to-fit most
health care organizations. Improvements can be developed to support organizations from
small practices to large HMOs.
Strategic
Healthcare Solutions initiatives can be easily
implemented to ensure that your organization
receives the results necessary to demonstrate
superior, cost-effective business practices,
and compliance with contractual and regulatory
standards.
Strategic
Healthcare Solutions has staff with broad
experience in the health care industry. Our
staff includes CPAs, MBAs, and PhDs with years
of experience in finance, accounting, claims & operations,
and application and interpretation of the California
Health & Safety Code, Knox-Keene Act of
1975, and California Code of Regulations.
Our experience also covers HMO and
provider organization contract administration
including commercial, Healthy Families Program,
Medicare, and Medi-Cal lines of business.
Years
of successful performance have helped the
management of Strategic Healthcare Solutions
forge a strong network of working relationships
with leadership at the Department of Health Care
Services (DHCS), Department of Managed Health
Care (DMHC), and many of California's HMOs,
risk-bearing organizations (RBO), and management
service organizations (MSO). These relationships
have provided us with the ongoing communications
necessary to ensure continual feedback regarding
our management solutions, policies, practices,
guidelines, and expectations. In addition,
they have provided us with the opportunity
to demonstrate the effectiveness of many well-coordinated
and highly successful regulatory audit engagements
with continued outstanding results.
Strategic
Healthcare Solutions is the practical and
affordable solution to your finance/accounting, operations,
and compliance needs.
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