Take Action on Payer Mix Erosion
Sg2 Take-Action Guide_Payer Mix Erosion Health systems nationwide are seeing their proportion of commercial volumes slide. Is there a way to regain lost ground?
Sg2 Take-Action Guide_Payer Mix Erosion Health systems nationwide are seeing their proportion of commercial volumes slide. Is there a way to regain lost ground?
Our multidisciplinary experts—including clinical leaders, strategists and former health care executives—work with leading hospitals and health systems around the globe to provide innovative, actionable business solutions. Read more about our team:
Eric is a member of the Sg2 Executive Committee and managing principal of the Los Angeles office. He brings more than 30 years of experience in the health care industry where he has worked with a broad range of health care provider organizations, including multi-hospital systems, independent hospitals (eg, community, tertiary, academic) and physician groups.
As a trusted advisor, Eric counsels senior executives and boards of directors on difficult problems and issues. His areas of expertise and professional skills include enterprise strategic planning, meeting/process facilitation, transactional assistance (mergers/acquisitions/affiliations), hospital service line planning, valuation and fairness opinion, short- and long-term facility planning, physician/provider manpower needs, physician compensation and contract negotiation, physician/hospital alignment structures, and board education. He is a speaker and facilitator, and he has published numerous articles in various health care publications pertaining to issues on strategic planning, service line development, physician/hospital alignment, and facility planning for hospitals and ambulatory centers. He is active in various health care industry organizations.
Prior to joining Sg2, Eric was a principal for MDS Consulting LLC. He has held previous senior-level positions with other national consulting firms, including The Camden Group and Ernst & Young.
Eric received his bachelor of arts degree from Claremont McKenna College in Claremont, CA.
As the leader of Sg2 Consulting’s Chicago-area practice, Jay advises hospitals, health systems, academic medical centers, medical groups and life sciences companies in several practice areas, including enterprise strategy, value-based care strategy, physician alignment and community health improvement. He is a frequent speaker and author for national organizations and publications, an advisor to not-for-profit organizations, and a leadership and strategy mentor to health administration students.
Prior to Sg2, Jay served in leadership roles for other national consulting firms (including Kaufman Hall, The Camden Group and Tiber Group/Navigant) and has served as a senior executive or advisor for hospitals, health systems, medical groups and innovative start-up organizations.
Jay received master’s degrees in business administration and health services administration from the University of Michigan and a bachelor of arts degree from Dartmouth College.
Jim provides leadership and strategic direction for Sg2 Consulting, overseeing the development of strategies for health systems and medical groups to drive growth and elevate the value of care provided.
Jim’s health care career spans more than 25 years and includes significant nationwide consulting engagements with health systems and physician practices. He has led more than 350 engagements at some of the country’s largest and most respected institutions, focusing on the areas of physician alignment, strategic planning and value-based care initiatives. Additionally, Jim has more than 2 decades and industry leading experience in bundled payments strategy, analytics and physician sharing models. His strengths include a proven track record in physician relations, project management, communication skills, team building and financial analysis.
Jim was a founding member and managing partner of TRG Healthcare Solutions from 2001 to 2014, focusing exclusively on physician alignment, service line strategy and bundled payments. Prior to that, he led the consulting division of GE Medical Systems focused on clinical and operational performance improvement.
A recognized national speaker on hospital-physician alignment models, bundled payments and value-based care strategies, Jim has addressed such organizations as Healthcare Financial Management Association, American College of Healthcare Executives, American College of Cardiovascular Administrators, American Medical Group Association, Vizient National and Regional Collaboratives, The Health Management Academy, and The Society of Thoracic Surgeons.
Jim graduated from the University of Colorado with a degree in finance and lives in Denver with his wife and 2 children.
As a member of Sg2’s Consulting team, Tod focuses on leading health systems through the transition to a value-based care delivery model. Tod has 25 years of experience in creating and delivering consulting and analytics solutions within the health care industry. He has led hundreds of teams through successful health system and physician-focused projects designed to reduce costs and improve both quality of care and patient experience.
Prior to joining Sg2, Tod started his own software company to help physicians successfully transition to, and compete in, a value-based care marketplace, and before that he served as senior vice president of client operations at Healthgrades. In this role, he started the consulting and client services organization for Healthgrades and built it up over the next 12 years. Additionally, he led a team of 60 people, which was instrumental in helping health systems improve their quality and patient experience performance. Tod also was a senior consultant at GE Healthcare and at LBA Healthcare, and he led cardiac, pulmonary, vascular and orthopedics service line projects designed to implement evidence-based clinical pathways and reduce length of stay and costs.
Tod earned his bachelor of science degree from the University of Colorado Boulder. He is a Colorado native and enjoys taking advantage of his home state’s outdoors.
Drawing upon 20 years of experience in health care management and strategy, Tawnya collaborates with health systems and payers to develop innovative and detailed plans for future growth. She has advised clients on strategies for mergers/acquisitions and the development of clinically integrated networks, strategies for provider-owned health plans, and overall strategies to enable organizations to transition to value-based payment and evolving delivery system structures.
Tawnya’s areas of focus and expertise include health care reform, market forces and strategic analysis, specifically around hospital-physician alignment, emerging reimbursement and incentive models, performance optimization, payer strategy, and the intersection of health policy with delivery system transformation.
As a nationally recognized speaker on health care market trends and insights, Tawnya frequently presents at industry conferences on the financing and delivery of care. She has authored many articles for industry-leading publications on health system strategy and the conversion to value-based reimbursement.
Previously, Tawnya was a vice president in the population health and strategic advisory practices for GE Healthcare Camden Group. Before entering consulting, she spent over 10 years with Western Reserve Health System (OH) and its affiliated multispecialty medical group and management company as vice president and chief operating officer. For Summa Health Network (OH), she led network contracting and provider relations. She has additional experience overseeing underwriting for a health plan.
Tawnya holds a doctorate in health administration from the Medical University of South Carolina, a master of science in applied economics from Georgia Southern University, a master of science in health law from Nova Southeastern University Shepard Broad College of Law and a master in health care administration from the University of North Carolina at Chapel Hill. She received her bachelor of business administration in economics from Kent State University. Strengthening her ties to Kent State, she has served as an adjunct instructor of the economics of health care and managerial economics for health care managers and was also a member of the health care executive MBA task force. She is currently a member of the economics advisory board for the department of economics at Kent State University.
David DiLoreto is a principal at Sg2 and a physician executive with 2 decades of experience in health system, physician practice and managed care strategy and operations.
Prior to Sg2, Dr DiLoreto provided health care consulting and advisory services as senior vice president at GE Healthcare. Additionally, he served as corporate CMO at Presence Health in Chicago, IL, and he was simultaneously CEO of both SmartPlan Choice and Medicare Value Partners. He also served as the chief clinical officer at Baptist Health Care in Pensacola, FL.
Furthermore, Dr DiLoreto worked at the Louisiana State University (LSU) School of Medicine in New Orleans where he was a tenured faculty member before founding the university’s faculty group practice in 1995. During his 15-year career as an orbital and ophthalmic plastic surgeon at LSU Healthcare Network, he performed over 5,000 major surgical procedures and received numerous clinical and teaching awards.
Dr DiLoreto is a diplomate of the American Board of Ophthalmology and serves as a director on the boards of health systems, professional societies, national trade associations, and early-stage IT and analytics firms.
After receiving his undergraduate degree from Loyola University New Orleans and medical degree from the University of Florida, Dr DiLoreto completed an ophthalmology residency at California Pacific Medical Center in San Francisco, CA, as well as fellowship training at the University of British Columbia in Vancouver, Canada, and an MBA from Emory University in Atlanta, GA.
As the lead on the Sg2 Life Sciences and Industry team, Karl leverages nearly 20 years of life sciences experience to develop strategies and solutions for biopharma, medical device, distributors, health IT and finance services. On a day-to-day basis, he helps position Sg2 as a strategic advisor in partnerships between leading health systems and life sciences firms. He brings extensive experience from his prior role as Sg2 consulting principal, wherein he worked with leading US and global health care providers affiliated with several of Sg2’s 1,700 client health systems. Karl also spent 5 years working out of Sg2’s international office in London, England, where he supported clients in the National Health Service, South East Asia, Hong Kong, Australia and the Middle East.
Karl earned a PhD from the University of Oxford in the United Kingdom, where he developed models using stem cell technologies to study HIV drug targets. He received a BSc in biochemistry and pharmacology from King’s College London.
Karl is married with 2 sons and a daughter and lives in Chicago, IL. He enjoys teaching his children Swedish, being an amateur photographer and expressing his scientific curiosity through cooking.
Kevin is responsible for business development and client relationship efforts. He has more than 24 years of health care–related experience delivering solutions across a broad spectrum of hospital based initiatives, which include project leadership related to physician alignment, quality improvement, patient satisfaction, service line strategy and market development, as well as cost reduction initiatives at some of the country’s largest hospitals and health systems.
Prior to joining Sg2, Kevin worked for TRG Healthcare Solutions in Denver, CO. He helped the firm double in size by offering entrepreneurial solutions to hospitals that were seeking better physician relations, with solutions that included employment models, professional service agreements, comanagement programs, bundled payment initiatives and other joint venture opportunities.
Prior to TRG, Kevin worked for several well-known health care companies including JD Power and Associates, GE Medical Systems, HCIA and LBA Healthcare Management in Denver, CO. Leveraging his experience across multiple service line settings—including cardiovascular, orthopedics and women’s health—Kevin provided insight and leadership while helping his clients improve physician relations and quality. He also gained extensive experience in cost management, market share development for new service lines, physician alignment initiatives, consulting management, product development and direct sales.
Over the years, Kevin has enjoyed speaking publically to numerous health care associations, including American Alliance of Orthopaedic Executives, American College of Cardiology, American College of Healthcare Executives, Medical Group Management Association and Society for Healthcare Strategy & Market Development. While at GE Medical Systems, Kevin was also certified in Six Sigma.
