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?
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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:
Amit is an international health care business leader with 15 years of experience in solving key business and clinical questions. He has led health care projects in 10 countries, across Canada and in 30 US states. Amit has been with Sg2 since 2004.
As a lead on Sg2’s Consulting team, Amit manages complex strategic engagements in the United States and Canada with academic medical centers, national health systems, regional health systems/community hospitals, industry clients and the investment community. As a trusted advisor to many health care executives, Amit answers challenging questions related to market relevance, sustainable growth, strategic partnerships, major investments and innovation.
Amit previously led consulting and advisory work at Sunnybrook International, a part of Sunnybrook Health Sciences Centre in Toronto, Canada. His work focused on supporting governments, private investors and health care providers to enhance existing clinical capabilities, build new facilities/infrastructure and deliver education/training. He also was a picture archiving and communication system (PACS) project manager with McKesson Medical Imaging Group in Vancouver, BC, Canada, where he led health care IT implementations for hospitals and health systems in Canada, the US and Europe.
Amit earned an MS in biomedical engineering from Northwestern University and a BS in electrical engineering from The University of Western Ontario. He enjoys playing sports, reading, watching movies, and exploring new places with his family and friends.
As an Sg2 veteran of 11 years, Catherine provides operations oversight and talent management development for the Sg2 Consulting and Intelligence teams, leveraging more than 20 years of health care and professional service experience. Previously, Catherine led consulting engagements as well as thought development for strategic topics, including ambulatory strategy and facilities planning.
Prior to joining Sg2, Catherine led the Leadership Excellence NetworkTM—a membership-based program combining the efforts of high-performing health systems to advance leadership excellence within organizations—at the National Center for Healthcare Leadership. She also served as vice president at Kaufman Hall, a health care financial strategy consulting firm. While there, she led consulting engagements with a focus on growth strategy across the care continuum, ambulatory strategy and service line planning.
Additionally, the breadth of Catherine’s hospital experience includes strategic planning and business development positions at NorthShore University HealthSystem and the University of Pittsburgh Medical Center. She was also a research professional at McKinsey & Company, where she developed financial valuations and managed business research projects.
Catherine holds an MBA in finance and international business from Wright State University, where she also completed her BS in management information systems. In her free time, she enjoys traveling and spending time with her family, especially her 12-year-old daughter, Katalin.
Chris has more than 30 years of experience in health care consulting and has worked with hospitals, health systems, physician practices and suppliers within the industry. His consulting focus has included financial management, strategic planning, marketing/communications plan development and implementation, hospital-physician managed care negotiation, hospital-physician alignment, market growth, program development, facility space planning, and interim service line management. He has led the implementation of more than 250 consulting engagements across the nation and maintains proven abilities in key areas such as physician relations, presentation and communications skills, project management, and proposal development. He has also presented at many society gatherings including the Society of Thoracic Surgeons, Orthopaedic Trauma Association, Healthcare Financial Management Association and state associations.
Chris has worked on every Medicare-sponsored bundled payment initiative, from the Medicare Participating Heart Bypass Demonstration in the 1990s to the current Bundled Payments for Care Improvement (BPCI), BPCI Advanced and Comprehensive Care for Joint Replacement (CJR) initiatives. He led the implementation process for all of Medicare’s Acute Care Episode demonstration sites and is currently working with over 25 BPCI-, BPCI-A– and CJR-affected hospitals. He has also personally written more than 30 unique responses to bundled payment applications and has participated in numerous commercial and private payer bundled efforts.
Before beginning his health care consulting career, Chris spent 12 years in the travel business on both the airline and travel management sides of the equation. He attended the School of Travel Industry Management in the College of Business Administration at the University of Hawai’i, Manoa and graduated with a BS degree in international business from the University of Colorado, Boulder.
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 lead on the Sg2 Consulting team, Karl leverages nearly 20 years of experience in life sciences to develop strategies for health care systems and life sciences companies.
On a day-to-day basis, Karl is either actively involved in advising health systems on future-focused strategies to capture smart growth, or working with pharma, medical technology and diagnostic firms to better understand trends impacting health care providers and align strategies to meet the needs of their customers. He has particular expertise in enterprise, service line and ambulatory strategy development, as well as specific interest in market and health system segmentation and strategy development to support innovative partnerships between health care providers and suppliers.
Karl earned a PhD from the University of Oxford in the United Kingdom, where he developed cell culture models to study HIV drug targets. He received a BSc in biochemistry and pharmacology from King’s College London.
Karl is married with two sons and lives in Chicago, IL. He enjoys teaching his sons 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.
As leader of Sg2’s orthopedic and spine service line team, Kristi directs intelligence and forecasting development, and analytics interpretation in orthopedics, spine and rehabilitation. As a thought leader and national educator, she offers expert insight on payment innovation and guides leadership teams in developing strategic growth plans, ambulatory strategies and physician alignment initiatives, and in preparing for bundled payment by improving performance across the System of CARE.
With 18 years of health care consulting, management and clinical experience, Kristi helps hospital and health system executives and suppliers maximize their current orthopedics strategies and prepare for the future, which typically includes establishing robust ambulatory service offerings, executing forward-thinking physician alignment strategies and developing a measured game plan to succeed in an increasingly value-based environment. She frequently speaks throughout the country at a variety of physician and health care leadership conferences.
Before joining Sg2, Kristi was an orthopedic service line consultant collaborating with physician groups and hospital organizations to develop and implement orthopedics, spine and rehabilitation strategic plans. Liaising between hospital administration and physicians, she facilitated the completion of higher-level physician engagement strategies such as comanagement agreements. Early in her career, Kristi worked as a physical therapist in inpatient, outpatient and management positions.
Kristi holds master and bachelor degrees in physical therapy from the University of North Dakota, maintaining her license to practice physical therapy in Colorado. She is an active member of the Healthcare Financial Management Association.
Susan Douglass Quirk has more than 25 years of experience partnering with a multitude of health care organizations and multispecialty groups to overcome a myriad of issues related to alignment and productivity of the executives, physicians and clinical care teams in a manner focused on achieving the mission, strategies and joint goals from the board level to the front line.
The focus of many of Susan’s recent engagements has been to diffuse the inherent mistrust between physicians and the c-suite, so each can do what is necessary to position for value-based care as partners.
In addition, Susan works extensively on the design and implementation of workforce and physician recruiting and retention strategies; physician compensation redesigns to reflect value-based metrics; and physician alignment strategies geared toward improving the quality, safety and patient experience metrics of an organization.
Prior to joining Sg2, Susan was a partner in Mercer’s Healthcare Vertical, had her own firm focused on physician alignment and HR strategy and was involved in senior roles in Ernst & Young’s and Willis Towers Watson’s national health care practices. She speaks nationally, leads webinars and authors articles on all her consulting topics.
Susan is a member of the American College of Healthcare Executives and the American Society for Healthcare Human Resources Administration and serves on the Alumni Board of Trustees for Rollins College in Winter Park, FL. Susan has a bachelor of arts and a masters of business administration from Rollins College.
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.
As a member of the Sg2 Consulting team, Ted focuses on strategic planning and business growth engagements. He has worked for more than 20 years as a consultant and community builder on behalf of health care providers.
Prior to joining Sg2, Ted served as executive director of InSight, the independent user community for McKesson Provider Technologies. He also worked as vice president of product management at the Healthcare Financial Management Association. In both roles, he worked with volunteer leaders to craft and execute strategies to enhance community value and engagement.
Previously, as a management consultant, Ted served as team leader and client relationship owner at APM/CSC Healthcare and Tiber Group. His work on behalf of clients encompassed both strategic and operational performance improvement, and touched a wide variety of organizations, ranging from small community hospitals to major academic medical center networks. Earlier in his career, Ted served as a facility chief executive in long-term care and retirement housing, where he specialized in turnarounds of underperforming businesses.
Ted earned an MBA in finance, marketing and health services management from the Kellogg School of Management at Northwestern University and received a BS degree in hotel administration from the Whittemore School of Business and Economics at the University of New Hampshire.
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5250 Old Orchard Road
Skokie, IL 60077