Healthcare Management Consulting Services

Aspira Health Global is a healthcare services and management company that specializes in managed care consulting, offering a range of healthcare services and technology solutions designed to enhance the healthcare delivery system. We provide comprehensive tools and resources to support Employers, prime contractors, Payers, Providers, and various organizations. Our efforts lead to over a 42% improvement in clinical outcomes, a reduction in total healthcare costs, enhanced quality of healthcare performance, and improved health and wellbeing for the members we serve.

With over 30 years of experience in executive healthcare management, consulting, strategic planning, and program development on a national scale, we specialize in enhancing healthcare services. Our experts will guide you in developing customized strategies and programs to improve your healthcare delivery system, ultimately enhancing the health and wellbeing of your staff and the communities you serve. We also offer managed care consulting to further support your improvement efforts.

The Aspira Technology team and partners possess strategic advisory expertise, healthcare analytical capabilities, and operational experience essential for helping clients optimize their healthcare delivery system. We assist in determining which insights to derive from their analytics, the actions needed to enhance healthcare services, and how to effectively prioritize and plan for success in managed care consulting. Our solutions encompass clinical integration, health data analytics and modeling, provider and patient portals, virtual health, and more.

We are a high-performance healthcare management and consulting company with 30 years of experience in managed care consulting, healthcare operations, technology solutions, and provider payment strategies. Our Vision is to improve the healthcare delivery system by creating a more efficient, cost-effective, and clinically focused system through our creative process improvements, efficient management, and innovative technology solutions.  

Currently, we manage over 20 hospitals nationwide, have opened 10 new hospitals, and oversee other provider types, totaling over 1,000 contracts while credentialing over 300 providers across all payer types (commercial, MCOs, Medicaid, Medicare). We have developed and managed provider networks for United Healthcare, Scott & White Health Plan, and our own Aspire High-Performance Provider Networks on local, statewide, regional, and national scales, enhancing the range of healthcare services provided.

Our expert consulting team specializes in the healthcare delivery system by developing, analyzing, negotiating, and managing payer contracts, terms, and provider payment structures for all types of healthcare services, including Hospitals, Physicians, Ancillaries, Health Plans, Employers, ACOs, Networks, TPAs, and related businesses. We offer customized pricing options designed to ensure our clients achieve a significant return on their investment. Our flexible services can support your contracting or managed care team, or we can act as your Managed Care Director or Payer Contracting Manager.

Our highly experienced team members facilitate contract negotiations and conduct legal and financial analyses to assess the feasibility of each managed care contract and reimbursement terms. Additionally, we provide comprehensive contracting support, including direct employer contracting services, technology solutions, contract performance monitoring, contract management, workflows for the contract approval process, and credentialing services.

We will work with our client to develop a customized strategic plan where our Managed Care System (MCS) serves as the backbone of our healthcare delivery system. The MCS facilitates the coordination of all functions associated with reimbursements from Payers while ensuring alignment with them. We categorize each function of the MCS into the following areas: a) alignment, relationship, collaboration, b) contracting, c) credentialing, d) medical management, and e) revenue cycle management.  

Payers are defined as any entity providing financial compensation for healthcare services rendered by healthcare providers or delivery systems. We classify each Payer by product type: a) Commercial b) Medicare c) Medicaid d) Tricare-Military. Our goal is to effectively establish the Managed Care System (MCS) to optimize reimbursements, enhance authorizations, and reduce denials from all Payers across various locations.  

The MCS efficiently coordinates and manages all functions related to these objectives. Through these operations and process improvements, we aim to increase our reimbursements from all Payer sources throughout our healthcare services system. The assessment process will indicate percentage increase goals, ensuring continuous advancement in managed care consulting.