Project Abstracts

Roach Consulting’s recent projects demonstrate a diverse range of engagements that all have common outcomes—aggressive turn-around times met, quality work produced, and high-impact results delivered.

Provided large provider system with ACO strategic business development and launch schedule. Services included, TCOC financial modeling, identified continuum-of-care service alignment and health management focus areas, data analytics, metrics, and reporting needs, direct contracting product options, and organizational design required to support ACO structure.
Directed Business Process Outsourcing (BPO) vendor RFI/RFP research and distribution, selection, and vendor contract negotiation processes for a Midwest regional health plan, worth $100 million and producing a range of cost saving across product lines of between 21–32%.
Conducted a detailed feasibility analysis in six weeks for a new High Technology Diagnostic Imaging Decision Support process and presented findings and recommendation to Board of Directors in time for the Board to take decisive action.
Simultaneously built a Regional Medicare Advantage Medical Management program for a large health plan and responded to an RFP to provide these services—winning the TPA contract valued at $58 million. Program services included:

Primary nurse delivery model for case management, utilization management, and disease management services
Health risk assessment tool selection, results stratification, and intervention protocol
24/7 nurse phone line
Quality management
HEDIS reporting and analysis

Created strategic framework for the integration of a large commercial health plan’s Medical Management program that drove decision to move to an integrated IT platform and delivery system producing a cost reduction of 30%.