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Today's ever-changing and increasingly complex
healthcare marketplace consistently presents new challenges
for providers and investors alike. At Sinaiko,
our deep industry experience can lend real world perspective
to the broad range of issues our clients face.
Whether evaluating a new or existing service line or seeking data and
analysis to evaluate the quality of an investment opportunity, today's
healthcare and financial organizations rely on strategic analytics to
empower key business decisions. Our consultants' deep industry
experience allows us to design programs and solutions that not only
produce this information but interpret it in a way that supports your
organization's unique goals and challenges.
From performing due diligence and financial analysis to developing
strategic business plans and pay-for-performance quality programs,
the experts at Sinaiko have worked with large provider systems,
academic medical centers, rural hospitals, health plans, lending
institutions, venture capital and private equity companies. Our superior
industry knowledge, research capabilities, analytical expertise and
strategic planning skills have allowed us to provide clients with the
information and guidance they need to succeed in today's increasingly
competitive environment. |
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Strategic Analytics Project Types: |
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Investor Services
Bridge between sources of capital and healthcare operations
Project Types: Due diligence, revenue/reimbursement analyses, credit
rating improvement, business plan development, regulatory impact
analysis, forecasting, capital budgeting, funding strategies, ROI analysis,
and risk assessment
A lending institution wished to underwrite the loans for a provider of healthcare administrative services. Sinaiko performed due diligence of the organization’s finance, operations and regulatory compliance and identified deficiencies in the organization’s billing processes that constituted substantial risks to government sanctions. The lender and company created a plan to address the deficiencies, and subsequently updated the pro forma financial statements. The result was an agreement to increase the rate of borrowing.
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read case study |
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New Ventures
Impact assessment and evaluation of steps necessary to expand or
initiate new ventures; implement best practices for optimizing financial
and operational outcomes.
Project Types: Facility and service line creation/expansion; purchase
or divestiture of facility and equipment; entry or growth within a market.
A venture capital firm invested in an innovative diagnostic technology and asked Sinaiko to conduct a study on how managed care systems would be impacted by using this technology. Through predictive modeling and cohort analysis, Sinaiko demonstrated that the new technology had the potential to reduce direct payor costs by an annual amount that exceeded the price of the diagnostic test by tenfold.
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read case study |
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Benchmarking Studies
Compare key performance metrics to similar facilities using multiple
data sources for meaningful comparisons.
Project Types: Comparison to support reimbursement rates,
compensation, staffing ratios, quality measures, and other financial and
operational metrics.
A multi - state, physician - owned health plan was receiving pressure from its member physicians to raise the reimbursement rates paid by the group. Sinaiko was engaged to conduct a benchmark analysis of how the plan’s rates compared to those paid by other payors in the market and summarized the findings for each specialty’s specific service mix. The report was effective not only in demonstrating that the group’s rates were already competitive, but also that certain specialties received reimbursement well above area averages.
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read case study |
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Strategic Solutions
Sinaiko believes the unique challenges of your enterprise can be
addressed with collaboration, insight, research, analysis and
perspective. Below are some examples of projects where Sinaiko
has been effective in helping clients achieve meaningful results.
Project Types: Reimbursement analysis, payor/provider relations,
market and financial forecasts, performance improvement, pricing
and contracting study, resource optimization, supply management,
new program development, licensing, facility relocation or conversion,
complex problem solving.
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Quality Services Management
Optimizing clinical quality and quality reporting initiatives
Project types: Assist medical groups with pay-for-performance (P4P)
systems; design system-wide quality of care management programs;
implement financial incentives for quality services on an organizational
level; monitor quality indicator results and/or identify analytics to direct
performance improvement for increased payment from CMS and private
payor quality initiatives; assist in compliance with JCAHO core measures.
A regional health system asked Sinaiko to assist its affiliated medical group and hospital in optimizing its participation in various CMS and private pay - for - performance systems. Sinaiko developed financial allocation/payment methodologies for bonus payments and practice income based upon pay - for - performance criteria. Additionally, Sinaiko designed and implemented clinical and process improvement activities, and created a system - wide quality program that included formal processes, policies, and procedures related to quality of care. Finally, Sinaiko tracked the quality indicator results and pay - for - performance payments including the generation of ongoing reports. The new quality and reporting initiatives helped increase the quality of care and quality incentive payments.
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read case study |
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Leadership Transition
Immediate interim executive staffing with recruitment and training
support to ensure smooth transition to newly hired senior leadership.
Project Types: Executive and senior level positions for finance,
accounting, health information management, compliance, patient
financial services, revenue cycle, reimbursement, business office,
payor contracting, audit, case management, risk management, patient
safety, performance improvement, network development, decision
support, admitting, coding and medical records.
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For more information about Sinaiko’s strategic analytics consulting services, please contact Adam Klein at adam.klein@sinaiko.com or Omid Toloui at omid.toloui@sinaiko.com. |
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A lending institution wished to underwrite the loans for
a provider of healthcare administrative services. Sinaiko
performed due diligence of the organization's finance... |
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A venture capital firm invested in an innovative diagnostic technology and asked Sinaiko to conduct a study on how managed care systems would be impacted by using this technology... |
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Separately, a prestigious private equity firm interested in funding multiple rehabilitation facilities hired Sinaiko to formulate a strategic business plan... |
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A multi-state, physician-owned
health plan was receiving pressure from its member physicians
to raise the reimbursement rates paid by the group... |
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A regional health system asked
Sinaiko to assist its affiliated medical group and hospital
in optimizing its participation in various CMS and private
pay-for-performance systems... |
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NOVEMBER 2007
Are doctors 'getting' pay for performance?
By Omid B. Toloui
Quoted in Healthcare Finance News |
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AUGUST 21, 2007
Teaching the Business of Medical Practice
By Dinh Nguyen
H & HN Online |
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SUMMER 2007
Sinaiko's Omid Toloui comments on the future of Pay for Performance programs at hospitals in the Summer 2007 issue of HealthLeaders
HealthLeaders - InterStudy, New England Health Plan Analysis, Vol. 6 No. 3 |
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APRIL 2007
A look at Four Specific Areas in Which Improved Quality Can Positively Impact an Organization
By Jeff Sinaiko and Omid Toloui
Compliance Officer |
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