Areas of Practice

Provider Network Optimization

Problem: Fragmented networks undermine care coordination and cost targets.
Our Solution:

  • Network Adequacy Audits: Map gaps in specialty coverage or geographic access.

  • Performance Benchmarking: Compare providers on cost, quality, and outcomes.

  • Contract Alignment: Negotiate value-based terms with high-performing providers.

HFMA Conference Insight :

"Top health systems use AI to match patients with in-network providers, reducing leakage by 22%."

Value-Based Care Strategy & Implementation

Problem: Transitioning from volume to value requires rewiring clinical, financial, and operational workflows.

Our Solution:

  • Risk Contract Design: Structure payer agreements that balance risk and reward.

  • Population Health Analytics: Identify high-risk cohorts using AI-powered insights (AHA 2025 Report ).

  • Care Model Redesign: Embed protocols that reduce ED visits and readmissions.

Case Example:

"Partnered with a 200-physician ACO to implement AI-driven risk stratification, achieving a 15% reduction in per-member costs within 18 months."

AI & Technology Integration

Problem: Health systems struggle to operationalize AI without clinician burnout.


Our Solution:

  • Use Case Prioritization: Focus on high-ROI areas like prior auth automation and denial prevention.

  • Governance Frameworks: Adopt Atrium Health’s model for ethical AI vetting .

  • Workflow Redesign: Pair ambient documentation tools with staff training.

Toolkit Highlight:

Cleveland Clinic’s sepsis prediction AI-3x faster detection, 18% lower mortality .

Why Us – The Boutique Advantage

Precision Over Scale
Unlike generalist firms, we focus exclusively on VBC and network strategy.

Proven Methodologies
Our frameworks are informed by:

  • AHA’s 2025 AI Implementation Guidelines

  • HFMA’s Value-Based Payment Benchmarks

  • Mayo Clinic’s Health Equity Blueprint

Agile Partnership
As a single-consultant firm, you get:

  • Direct access to senior expertise (no junior teams).

  • Flexible engagements (project-based or retainer).

  • Iterative feedback loops for rapid course correction.

Insights – Leading the Value Transition

Featured Analysis

1. AI’s Role in Closing Care Gaps (AHA 2025 Report )

"Systems using AI to analyze SDoH data achieve 40% higher preventive screening rates in underserved populations."

2. Revenue Cycle Automation Trends (HFMA Conference )

"Denial rates drop by 17% when AI predicts coding errors pre-claim submission."

3. Network Design for Risk Contracts

"Narrow networks with performance-based incentives reduce total cost of care by 12% (vs. broad networks)."

CTA: Download Our “VBC Readiness Checklist” →