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MedHOK Launches Healthcare Policy and Strategic Management Practice to Help Organizations Navigate Healthcare Reform

MedHOK Launches Healthcare Policy And Strategic Management Practice To Help Organizations Navigate Healthcare Reform

TAMPA, Fla. – July 6, 2011 – MedHOK, a leading provider of clinical and quality software to the healthcare industry, has launched the Healthcare Policy and Strategic Management Practice, providing expert resources to help organizations navigate a rapidly changing healthcare environment.

“Success in this evolving post-reform environment hinges on an organization’s ability to effectively and efficiently monitor quality outcomes, control costs and adapt to a new regulatory landscape. Our team of experts helps payers and providers fill knowledge gaps and design strategies for long-term success,” said Anil Kottoor, president and CEO, MedHOK.

The practice assists health plans and other payers, as well as accountable care organizations (ACOs), medical homes and other provider organizations, with strategic plans that will position them to survive and thrive under the sweeping changes ushered in by the Patient Protection and Affordable Care Act (PPACA). It is led by Marc S. Ryan, executive vice president and COO, who is responsible for the practice’s overall strategic direction, and Katie Zito, director of policy and regulatory affairs, who manages day-to-day administration.

Ryan served for several years as Connecticut’s budget, policy and management secretary, responsible for overall management of the state’s government. He focused much of his effort on creating and redesigning government healthcare programs and introducing managed care initiatives. Ryan has also held several executive leadership positions in the managed care field, including COO of one of the nation’s two chronic care HIV/AIDS Special Needs Plans.

Zito held numerous positions in Connecticut state government, including chief of staff for the former lieutenant governor. She also led state government affairs for a managed care plan. Zito then moved to operations, including spearheading the plan’s Dual Special Needs Plan (D-SNP) contract negotiations with Medicaid agencies in 12 states. She was also responsible for the overall implementation of health reform.

Under the direction of Ryan and Zito, the practice’s seasoned policy professionals conduct comprehensive impact assessments relating to PPACA, Medicare and Medicaid and design strategic road maps for compliance and retooling processes to achieve growth in the new environment. Services include:

  • Planning strategy and assessing the market for health plans, including working with state Medicaid agencies to obtain contracts for D-SNP plans
  • Designing business and product development and diversification strategies, including implementation of operational and product changes
  • Advising on Medicaid and Medicare requests for proposal responses and applications
  • Consulting on Medicaid, Medicare and commercial rate setting

The MedHOK Healthcare Policy and Strategic Management Practice also offers comprehensive services to ACOs designed to help them establish a solid foundation for long-term success. These include assessing and enhancing operational, financial, clinical, quality, IT and claims infrastructures to ensure physicians and hospitals have the right information to serve ACO members. The practice also drafts comprehensive business plans and structures financial relationships between physicians and hospitals.

Other ACO services include:

  • Preparing for National Committee for Quality Assurance (NCQA) certification
  • Undertaking financial modeling to clearly define challenges and opportunities
  • Preparing the Centers for Medicare & Medicaid Services (CMS) application to secure ACO designation
  • Continually assessing current and future CMS regulations governing ACO development and operations

“The Healthcare Policy and Strategic Management Practice leverages MedHOK’s deep understanding of the current regulatory environment and how it impacts all healthcare stakeholders,” said Kottoor. “From the expansion of Medicaid and changes to Medicare Advantage to establishing effective ACOs and creating products specifically for healthcare exchanges, the practice is well-suited to assist organizations in adapting to change in a way that positions them to succeed.”

About MedHOK

Based in Tampa, Fla., MedHOK (www.medhok.com) offers cloud-based software solutions that eliminate silos and organize client-specific patient/member data into relevant and actionable information that enables physicians, ACOs, PCMHs, payers and TPAs to manage and measure care against national quality standards for optimal outcomes. Information can be shared in real time with all healthcare stakeholders. MedHOK solutions address disease management and care coordination, clinical quality and utilization review, and quality and financial measures. ICD-10 compliant and HIE-ready, MedHOK solutions are web-based, rapidly deployed and securely accessible on any device.

Marc Ryan

Marc S. Ryan serves as MedHOK’s Chief Strategy and Compliance Officer. During his career, Marc has served a number of health plans in executive-level regulatory, compliance, business development, and operations roles. He has launched and operated plans with Medicare, Medicaid, Commercial and Exchange lines of business. Marc was the Secretary of Policy and Management and State Budget Director of Connecticut, where he oversaw all aspects of state budgeting and management. In this role, Marc created the state’s Medicaid and SCHIP managed care programs and oversaw its state employee and retiree health plans. He also created the state’s long-term care continuum program. Marc was nominated by then HHS Secretary Tommy Thompson to serve on a panel of state program experts to advise CMS on aspects of Medicare Part D implementation. He also was nominated by Florida’s Medicaid Secretary to serve on the state’s Medicaid Reform advisory panel.

Marc graduated cum laude from the Edmund A. Walsh School of Foreign Service at Georgetown University with a Bachelor of Science in Foreign Service. He received a Master of Public Administration, specializing in local government management and managed healthcare, from the University of New Haven. He was inducted into Sigma Beta Delta, a national honor society for business, management, and administration.

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