ABOUT

Who need Damea?

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• Physicians who wan to thrive in the emerging payment models

  • Medicare

    • Primary Care First

    • MIPS/MACRA

    • Direct Contracting Entities

    • ACOs

• Commercial – Including Medicare Advantage

  • Risk Based – Partial to Global

  • Financial Responsibility Allocations

  • Administrative Responsibility Allocations

• Lead their market in care effectiveness and efficiency

  • Your Market Specific Challenges

  • Your Position in the Market – Nimble Niche filler or Major Market Mover

• Assure they are anticipating competitors’ actions

  • Competition and teaming is heating up.

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• Protect their practice from the downsides of financial risk

• Drive progress in their market.

 

What we have delivered

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• Medicare ACOs and Emerging Models

1. Collaboration strategies within STARK and AKS Waivers

2. Financial analysis of revenue and expense for emerging models vs current

3. Competitive Market Positioning

• Policy and Market Analysis for Major Pharma

1. Strategy for Risk Bearing Organizations

2. Review/Revision of Company Developed Material

3. Focus Group of Key Decision makers

4. Parameters for New Economic Models

• Strategic and Economic Analysis for Provider Sponsored ACOs

1. Interpretation of Medicare ACO rules and options

2. Evaluation of Medicare Advantage options

3. Local Market Analysis of Patient Populations

4. Collaboration Models with Local Provider Constituencies

• Physician group market optimization

1. MA and MSSP strategies

2. MIPS vs. MACRA

3. Medicare Advantage Contracting

4. Growth and Consolidation Strategies

• CIN Strategy Development

1. Financial and Operational Integration Topics

2. Financial and Clinical Alignment Strategies and Programs

3. Market Forecasts

4. Risk Management Strategies

• Payer Contract Analysis

1. DETAILED Medicare Advantage Contract Review

2. Risk Pools and Value Based

3. Target MSR

4. Included/Excluded Expense Items

• Acquisition Analysis

1. Due diligence of operations

2. Payer contract review

3. Forecast follow on business development

4. Immediate opportunities values

5. Analysis of risk performance

References are always available upon request.  Our client appreciate their privacy, but also appreciate the value we have provided.

 

Our Methodology

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History has several examples of those who believe they have read enough to venture where they have not been before.  You might have read about this effort:  Well researched, everyone was doing it, how bad could it be, we could stop if we needed to, and most the usual questions.  Who was this?  It was the Donner Party.  The cost of a guide and scout seemed so expensive……. Hindsight provides much insight and clarifications.  You want someone who has actually done it before, perhaps even done it in several markets.  Healthcare and politics always seem to be a local phenomenon. 

The best use of a consultant is focused, with clear objectives and deliverables.  Get the best outcome at the most effective and efficient cost through focus.  A consultant that allows you to lose focus is simply not a good consultant.

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Key Areas:

 

Financial Risk – Organizational and Strategy:

Many believe “risk” is new to health care.  Well it might be new to providers.  It is most certainly not new to payers.  Lloyds of London started in 1680… While we don’t back quite that far, our executives have held positions as CEO, CFO, Medical Director, CTO, as well as several middle management positions in payers, providers, hospitals, and ancillary providers.  And we did provide key insights to a Lloyds underwriter for their product offerings to the ACO industry.

 

Making sure your total risk is understood, anticipated and managed.  Many a hospital strategy was waylaid because the hospital could take a large hit, but the risk pool was bankrupted and the physicians disappointed.  Structuring the layers is important.  Lastly, we have seen aggregate risks explode as each payer contract has downside – there is a portfolio theory to be applied, but there is limited equivalent diversification when a flu season, or natural disaster strikes.

 

Operational Strategies and Care Redesign:

We have answered “Now that all the money is in the pool, how do we keep it there?” From reinsurance strategies, care interventions, social determinants, and new clinical programs. From the granular to the policy.  Even the most experienced risk providers lean on experts from time to time. 

 

Federal Policy is the Driving Force:

 

If not us, please make sure your consultant is current on both policy and knows the difference between bleeding edge vs safely in front of the bear.  We are all trying to stay in front of the bear, just make sure you don’t run into a dead end.

There is so much change happening in healthcare strategy being driven by Medicare initiatives.  The reason may be that Medicare is the largest payer and only getting larger.  Medicare if facing daunting funding requirements in a double whammy, aging population and fewer employed individuals paying the taxes.  Click here to see the current forecast. [Link to Blog]

 

About the founder

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Founded by Mike Barrett, perhaps best known for cofounding the National Association of ACOs.  Mike has assembled a team of consultants which bring literally centuries of current experience to your challenges.  Not only multidisciplinary, but fully peer reviewed.  We often look at mission critical requirements and establish redundant fail-safe systems.  Most people don’t realize that redundant systems have to be three inputs – to break a tie when one system fails.  Recommendations and conclusions will be vetted by at least three seasoned executives to make sure all the issues are addressed and considered. 

 

From ACO to PCP and all the three letter acronyms in between.  The common denominator is the desire to anticipate and participate in the evolution of care delivery in their market.  From clinical processes to financial structures,

Our Differentiation is application of direct experience to your specific circumstances.

All of our consultants have actually done it.  We provide both the expertise and the application of expertise.

 

Our Philosophy

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We expect our consultants will care for their client as a physician cares for their patient.  In a fashion of a “Noble Profession.”  What is in the best interest of the client, even if it is engagement ending.

As a patient we want the doctor to be thorough, complete and explain to us all of the options available.  Then we can make the fully informed decision about what is bests for us.  Velox is founded on the same principle; All that you need, when you need it, and only what you need. 

As organizations make the transition from Fee for Service to Value Based compensation model many paradigms are changed out.  Mission critical skills and capabilities are added far faster than long standing processes abandoned resulting in an unavoidable expansion of complexity.

There are times when the learning curve is steeper than your current staff can accommodate and recruitment of additional staff faces long timelines, uncertainty of the business plan create a shortage of available talent.  Only in these situations does it make sense to establish a transitional outsourcing plan.  The transition is to eliminate the outsourcing of all mission critical elements of your business.  We do not believe in long term partnership of mission critical capabilities.