Health IT
HIT Connect 2021
May 17-21

Myers and Stauffer has been a leader in providing services to government health care programs for more than 40 years. We are a certified public accounting and consulting firm specializing in health care technology (health IT), program integrity, and operational support services to public health care and human service agencies.

Our services include:

Health IT

Consulting and Compliance

Fraud, Waste, and Abuse Detection

Electronic Clinical Quality Measure (eCQM)

Delivery System Consulting and Compliance

Social Determinants of Health (SDoH)

Payment Reform

Claims Reviews

Risk Assessment

Health IT

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Health IT is a proven tool that can support state healthcare transformation efforts and improve population health. Myers and Stauffer’s consultants provide insight, innovative solutions, and achievable strategies to best leverage health IT to improve healthcare administration, quality, and outcomes across all state programs. We can assist with every aspect of the health IT adoption and utilization life cycle, from concept, planning, and policy, to implementation and evaluation. Our health IT related services include:

  • Health information exchange evaluation and assessment
  • Health IT services and technical roadmaps, and strategic planning
  • Data and health IT governance redesign and implementation
  • Stakeholder engagement, landscape assessment, and change management
  • Compliance with federal regulations
  • HITECH funding transition planning and Medicaid funding

Consulting and Compliance

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Myers and Stauffer has the knowledge and experience to assist you in developing and implementing a comprehensive APM compliance approach that will function effectively and efficiently within your already-established health care oversight program. We can help you develop and implement appropriate policies and procedures to ensure compliance at every tier of the model. With our broad knowledge and expertise in all aspects of the development of myriad value and quality-focused payment models, we understand risks inherent in these models and are able to provide assistance at every level of the program. Our team is able to help assess risk within the various types of models from a “data out” perspective that comes with accounting and compliance backgrounds, coupled with our unique knowledge designing and implementing these models. This expertise provides our clients an advantage over those unscrupulous individuals seeking to exploit potential vulnerabilities — and helps you ensure you have effective compliance procedures.

Fraud, Waste, and Abuse Detection

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Myers and Stauffer’s robust fraud, waste, and abuse detection services have identified and recovered millions of dollars in inappropriate payments. Our loss prevention, auditing, and recovery services have prevented unnecessary program expenditures, and evaluated corrective action initiatives to ensure the future integrity of the programs. We also provide fraud investigation and litigation support to help state and federal agencies recover and investigate health care fraud cases.

Electronic Clinical Quality Measure (eCQM)

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The evolution of risk-based managed care, as well as a shift towards value-based purchasing (VBP) models, results in a greater need to track and measure quality and performance outcomes in order to re-align financial incentives to reward providers for delivering coordinated, high-quality healthcare. As states are moving from fee-for-service to VBP models, creating and implementing an eCQM program becomes necessary. Myers and Stauffer has the experience needed to successfully develop and implement your state’s eCQM program.

Delivery System Consulting and Compliance

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Myers and Stauffer has provided consulting services for some of the nation’s most effective health care delivery system and payment transformation initiatives. We understand that these initiatives require more than a simple restructuring of the current system. They require a true reengineering effort and a new way of thinking. Transformation must focus on the value of results in the health care system over the quantity of services provided. Our delivery system services include:

  • Section 1115(a) Waiver Consulting, Design, Implementation, and Evaluation
  • Delivery System Reform Incentive Payment (DSRIP) Program Models
  • Mental Health Parity
  • Integrated Care

Social Determinants of Health (SDoH)

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Mapping population outcomes to treatment approaches can help identify best practices and opportunities for improvement. Our team has extensive experience developing quality improvement projects with associated measures that monitor the effectiveness and health care outcomes of those projects, including SDoH. The SDoH issues such as safety, food insecurity, homelessness, and transportation issues are increasingly being addressed through comprehensive patient treatment plans. We have helped states in coordination with our health IT team to identify resources that can be aligned and leveraged to address SDoH and improve population health.

Payment Reform

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State Medicaid programs are increasingly introducing alternative payment models (APMs) to promote smarter spending, better care, and healthier people. We have expertise in designing, evaluating, and recommending methods to advance APM models in use by states. We also have expertise in developing quality improvement projects designed to build capacity for APMs that are reflective of the provider environment. Our payment transformation services include:

  • Value-Based Purchasing Programs
  • Alternative Payment Models
  • Managed Care Organization Supplemental Payment Phase Out

Claims Reviews

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Our professionals have the post-payment review and expert witness experience to help you successfully close cases, achieving significant return on your investment, and providing the case support expertise you need. When you have complicated health care claims review needs, Myers and Stauffer can help. We are prepared to assist you in a variety of situations, including:

  • Reviewing state managed care claims for correct coding.
  • Reviewing complex neonatal intensive care unit (NICU) claims.
  • Providing clinical expert witnesses.
  • Upcoding case analysis.
  • Tracking cases, damage estimation, and recovery support.

Risk Assessment

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Myers and Stauffer is focused on protecting the integrity of Medicaid and Medicare payments, processes, and systems. We specialize in providing risk assessment, error rate measurement, loss prevention, and specialized auditing services to support public health care and social service agencies.

For more information

Reach out to any of our specialists for more information on how Myers and Stauffer can assist your program.

Kelly Gonzalez, MS, PMP, CUA
Director, Health IT Solutions & Innovation

KGonzalez@mslc.com
678.900.2190

Toni L. Prine, RPh, CIG, CPC, AHFI
Senior Manager

TPrine@mslc.com
404.524.0775

Kimberly K. Forrest, RHIA
Senior Manager

KForrest@mslc.com
317.846.9521

Amy Caron, MPH
IT Senior Manager
ACaron@mslc.com
404.524.0775

Ben Griscom
Manager
BGriscom@mslc.com
303.694.3605

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