An integrated health system in the New York metropolitan area with eight hospitals, 7,200 physicians and 13 freestanding joint-venture centers.
The health system came to Baker Tilly expressing a desire to optimize and modernize its orthopedics, cardiology and oncology service lines. Specifically, it wanted a review to be conducted about its service delivery approach to make sure it was staying competitive with other organizations in the industry. This included a five-year projection of care delivery in these service lines. It also requested a contract review with its managed care organizations (MCOs) and contracted payers.
Baker Tilly conducted an assessment of the health system's orthopedics, cardiology and oncology service lines to determine how they were currently performing from a revenue and cost perspective, what they were doing well, what needed to be changed, and additional adjustments that might be needed to make the health system more competitive going forward. Baker Tilly also assessed the compensation agreements with the health system’s contracted MCOs and payer organizations to ensure it was being reimbursed at a competitive market rate.
At the end of the engagement, Baker Tilly identified more than $150 million in revenue opportunities through the assessment of its managed care relationships. In addition to recognizing the incremental revenue potential, Baker Tilly assisted the health system to identify significant opportunities to grow its market share by delivering its services in a more progressive way, leading to a more competitive outlook with its prioritized service lines.