Healthcare

Healthcare

ABTV assists a wide variety of healthcare providers and healthcare industry support companies. Our healthcare clients include for-profit and nonprofit organizations that are challenged by the impact of constant regulatory change and the need to maintain or improve operating results. They must anticipate their near-term and long-term financing needs, and constantly assess their relevancy in a rapidly-changing healthcare marketplace. ABTV’s team of experienced healthcare operations and finance professionals is able go beyond the numbers, providing the industry, operating and management insights that transform our collective experience into the high-value solutions our clients have grown to expect.

In this time of tremendous change in the industry, ABTV is poised to assist with the unique challenges that healthcare organizations are facing.

Essential stresses being placed on provider operating margins, cash flows, access to capital, and long-term financial stability

  • Changes in provider reimbursement
  • Payer mix changes driven by the ACA, the expansion of Medicaid, and ongoing regulatory changes
  • Insurance contracting and network access
  • Increased capital needs targeting medical information technologies and systems interoperability
  • An effective response to value-based reimbursement systems
  • Movement toward population health management

Healthcare industry consolidation is changing the way healthcare is managed and delivered

  • Industry consolidation is occurring on three fronts: hospitals, physicians and health insurers
  • Hospital consolidations may be increasing the cost of care, and the Department of Justice is challenging health insurer mega-mergers
  • Consolidation is a market and strategic challenge for providers such as physicians, surgery centers, emergency and urgent care centers, and other standalone providers seeking to grow referral networks and remain positioned for success
  • Rural hospitals are facing multiple challenges:
    • How to strengthen operating performance while remaining “on offense”?
    • How to establish substantial and remote clinical affiliations, while delivering superior clinical care and patient outcomes locally?
    • How to arrive at strategic clarity and underwrite the long-term success of a community-centered health system?

ABTV has the healthcare experience, knowledge and industry insights necessary to:

  • Strengthen your operations while you pivot toward key opportunities
  • Guide you through an investment in advanced data and reporting systems
  • Advise your Board and management on the development, financing and execution of a growth strategy

Our historic success has been achieved by working closely with companies seeking a return to sustainable profitability. Our focus is on the application of solid business fundamentals to the financial and operational complexities of your organization, taking each step purposefully to help you reach your strategic and operating goals.

Healthcare Services

INTERIM EXECUTIVE MANAGEMENT

We are uniquely experienced to successfully augment your Executive Team. ABTV’s professionals are former C-level executives whose careers are characterized by successfully leading organizations through the challenges that healthcare entities and other businesses face. Regulatory uncertainty, market expansion, health policy integration, financial restructuring, operational turnaround, capital access, merger integration, and growth are all challenges for Healthcare-provider management teams. ABTV interim executives provide our clients with the leadership capacity necessary to fill unexpected gaps in the organization’s continuity and act opportunistically. Our team, when working alongside your team, assists with identifying the opportunities for innovation, strategic management and entrepreneurial execution. Our services include:

  • Executive transitions related to succession, leadership continuity, and board advisory
  • Tactical transactions associated with joint ventures, vendor partnerships, and health information technologies
  • Strategic transactions to pursue growth and operating affiliations, and related merger/acquisition, and financing
  • Corporate renewal via restructuring, operational turnaround, and bankruptcy

OPERATIONAL & PROFITABILITY IMPROVEMENT

Our Healthcare provider experience spans a thirty-five-year period and includes Hospitals, Physician Practices, Home Health, stand-alone Clinics, Surgery Centers, Imaging Centers, Urgent Care Centers and Long-Term Care (Nursing Homes, Assisted Living and Skilled Nursing Facilities). We bring C-level operating experience and a focus on operating margins to operational and profitability improvement. Our structured results open the door for accelerated realization of the operating and profitability goals of an enterprise. Our services include:

Cash Flows, Working Capital & Process Improvement:

  • Cost management and related processes, controls and productivity
  • Reimbursement, including payer contract negotiation and contract review
  • Revenue cycle management, including charge capture, coding, claims submission, and remittance
  • Working capital controls, management, and reporting

Capital Structure:

  • Identifying an efficient capital structure using innovative capital models for joint ventures, partnerships, and clinical affiliations
  • Balance sheet restructuring and working capital assessments
  • Financing

HEALTH REGULATION

Our Health Regulatory experience includes deep knowledge of the required reporting and compliance processes for Medicare and Medicaid reimbursement and reporting. We have direct knowledge and experience in identifying the costs and optimizing the reimbursement for Health Systems, including the delivery of Graduate Medical Education. We have identified the Costs of Pediatric Care and the impact upon the long-term financial stability of Children’s hospitals, and have led engagements in the design and development of Medicaid reimbursement strategies for Long-Term Care facilities. Additionally, we have 20 years of C-level experience leading these facilities through their operating, regulatory, financial and clinical reporting and compliance challenges. Our services include:

Health Regulation – Operating Integration & Compliance:

  • Survey preparation
  • Directed Plan of Correction and related in-service education
  • Re-survey preparation and compliance recovery
  • Orientation and training for C-level management
  • Financial training and financial management tools, including metrics, benchmarks, and dashboards
  • Risk management, including assessment of clinical records
  • Interim executive for crisis management
  • Minimizing the impact of denial of payment for new admissions
  • A & I investigations (with or without reporting)

Healthcare litigation support, including defenses of Certificate of Need (CON) applications

CORPORATE RENEWAL

ABTV’s reputation as a leader in the management of corporate transitions was built over its 30-year history. Insights gained through deep business experience, entrepreneurial execution, and innovative solutions are the primary drivers of our work for distressed companies. Our services include:

  • Operating turnarounds
  • Restructuring
  • M & A integrations
  • Finance