Services

ZAHealth prides itself on being technically knowledgeable and precise while not missing the big picture: the clients goals and strategies

No matter what the size of your organization or the sophistication of your team, we work to meet you where you are and take your organization where it needs to go

Project Portfolio

Organizational Performance: Optimizing Behavioral Health Management

Problem: A large integrated health plan wanted to organize its behavioral health management functions to enhance behavioral and physical health integration and improve member health.

Solution: ZAHealth undertook a broad information gathering and analysis effort that involved identifying external trends and practices, surveying other managed care organizations, conducting many internal stakeholder interviews,
analyzing external benchmarking data and capturing best practices from leading organizations. ZAHealth then produced a list of prioritized recommended actions to improve functional performance and efficiency.

Business Strategy: Transforming a Practice Association in a Rapidly Evolving Market

Problem: A group of independent physicians was evaluating strategies to transform their organization to take advantage of new practice opportunities and a radically shifting local health care environment.

Solution: ZAHealth interviewed executive leadership, sought input from physician stakeholders, and conducted extensive analysis of the market: physician practice environment, financial performance of their primary payer partner, and demographics and insurance coverage. Based on this information ZAHealth produced a thorough list of possible business strategies—from entering into alternative payment arrangements to considering organizational combination—and, based on an analytic framework, recommended top opportunities as part of a presentation of findings.

Policy Research: Opportunities for Individual Coverage HRAs

Problem: A managed care organization was assessing the market opportunity related to potential enrollment growth from Individual Coverage HRAs (ICHRAs).

Solution: Adam Zavadil outlined the requirements under the agency rules and then evaluated the most likely purchasers of those products. Additionally, he also reviewed what the administrative requirements would be for both the managed care organization as well as potential employer adopters. Finally, he analyzed premium differences between markets to identify geographies where ICHRA products would potentially be the most attractive.

Product Development: An Innovative Supplemental Medicare Advantage Benefit

Problem: A start-up organization had developed a new innovative delivery model that it wanted to offer to MA plans, but many of the new services were not billable under traditional Medicare.

Solution: Adam Zavadil evaluated the service components of the delivery model to determine what parts of the package could be offered as Part B services, a supplemental benefit, a provider service, or health plan administrative services. Based on this information he created a pre-packaged, customized MA supplemental benefit the start-up organization could hand-off to its potential clients. This lowered the cost the the health plan to partner with the organization and also ensured a uniform product across different MA plan clients.

Data & Analytics: Evaluating the Impact of Payment Policy Changes

Problem: An association of health insurance companies needed to determine the short-term and long-term impact of quality bonus caps under the MA payment methodology.

Solution: Using a self-built relational database that linked all of the relevant data sets necessary to do the analysis: MA enrollment, service areas, plan information, county-level payment benchmark calculation data and quality ratings, Adam Zavadil developed custom SQL code to identify the impact for each of the organization’s members. Using these results, he then produced plan-specific reports as well as graphics and summaries to convey the industry impact to policy stakeholders.

How we can help you?

ZAHealth is a dynamic health policy and business consulting firm dedicated to helping you achieve optimal performance in the ever-changing marketplace. With specialized expertise in Medicare and Medicare Advantage, we are uniquely positioned to guide providers, payers, hospitals, and health care systems to stay ahead of and nimbly adapt to financial regulations.

We work with organizations large and small on a wide range of current issues including social determinants of health, marketplace analysis, and alternative payment models. ZAHealth distinguishes itself by offering the highest level of content knowledge and client service to every account, every time.