Strategy, Value-Based Care & Cost Reduction

Pinnacle is a recognized leader in healthcare strategy, operations, cost reduction, and transitional leadership services.  Pinnacle partners with hospitals, medical groups, ambulatory surgery centers, and other healthcare organizations nationally to develop effective and proven healthcare strategies for long-term top performance, growth, and sustainability. Developing effective strategies, aligning with physicians and perfecting operational efficiencies are critical to the vitality and success of healthcare providers more than ever before as organizations struggle to remain competitive in an ever-evolving market.

Pinnacle specializes in helping healthcare organizations address these and other complex challenges. Our consultants help clients create sustainable business strategies that achieve and sustain robust clinical, operational, and financial results. From promoting physician engagement to eliminating unnecessary supply chain spending, Pinnacle partners with clients to devise effective solutions.

Strategic Planning & Service Line Development

Pinnacle assists clients in evaluating the clinical, structural, governance, and business requirements of high-profile service lines including cardiovascular, neurosciences, oncology, nephrology, and orthopedics that are highly competitive and a key driver of the organization’s success.

Physician Alignment & Transactional Support / Mergers & Acquisition

Pinnacle provides clients with development, negotiation and implementation services including employment, professional services agreements, hospital quality and efficiency programs, joint ventures,  co-management agreements, and tailored solutions for the parties involved to achieve clinical integration, patient satisfaction and quality objectives.

Impact Analysis

In the ever-changing healthcare environment, even small changes in Medicare policy can have dramatic implications to an organization, both operationally and financially.  Pinnacle review these changes on a daily basis and provides impact analysis and strategic recommendations on how to respond to changes regarding the professional fee schedule, work RVU values, and other changes to CMS regulations and policies.

Reimbursement Analysis (Black Box Pricing Comparisons)

As organizations explore their options when considering a transaction with another organization, it is critical to evaluate the potential impact to revenue.  Although anti-trust regulations and confidentiality concerns preclude most organization from reviewing the specifics of payor rates for other organizations, Pinnacle is able to act as an independent third party that understands payor contracts and is able to provide a meaningful analysis using historical volumes and reimbursement and comparing them to forecasted values under different pricing terms or contract arrangements

Value-Based Care Services

Healthcare is the most dynamic and complex industry in the U.S. and achieving success requires continuous innovation, precise planning, and timely execution. Pinnacle assists clients in evaluating and enhancing their value-based care strategy which includes assisting in the organizational structure development and preparing applications for various programs, including but not limited to, Medicare Shared Savings Programs, Commercial Contracts, Medicare Advantage plans, etc.

We work for you and help you navigate through the complexities and rapid changes to develop a comprehensive strategy and detailed plan to help bring your vision to life. Whether you’re a healthcare provider or health system exploring risk-based programs, a health plan or a healthcare service organization looking for growth opportunities in new market segments, or a value-based care entity looking for best practices and process improvement, we can help you identify your opportunities, develop a detailed plan of how you’ll seize countless opportunities, and continue achieving your goals.

Pinnacle skillfully engages stakeholders and teams through strategic roadmaps, program execution, and entire project development. Top performing healthcare organizations use Pinnacle for:

  • Value-based entity strategic planning and execution
  • Value-based care contracts and negotiation
  • Health policy interpretation
  • Value-based care analytics and platform solutions
  • ACO program and operations management
  • ACO applications
  • Value-based care positioning and go to market strategies for products/platforms

Physician Practice Management

Pinnacle’s Medical Practice Advisory services can also set up, assess, or provide ongoing or transitional practice management services. This can range from the development of a practice plan to providing a practice fractional leadership to either guide them through a transition or serve as a long term practice leader.

Physician Preference Item Cost Reduction

Pinnacle maintains a large proprietary database of physician preference items to drive cost reduction activities while aligning physician participation through gainsharing, value-based entity set up and design, co-management, and other programs that participate in shared savings. Pinnacle also assists organizations in assessing contract terms, price benchmarking, recommending critical contract terms, and audit contract terms with invoiced pricing.

Ambulatory Strategy Development

Pinnacle assists medical groups and hospitals by developing, syndicating, and managing ambulatory surgery centers. This can include single or multi-specialty ASCs, single owner, or multi-equity partners. Pinnacle will also pursue models that include participation in equity or limited to management fee only structures.

  • Outpatient Network Development
  • Imaging
  • Surgery Center Development & Management

Physician Needs Assessment

Pinnacle assists clients in evaluating physician supply and projected demand within the market based upon critical factors such as existing provider complements and associated sociodemographic factors, population characteristics and projected disease incidence rates, availability of advanced practice providers, and evolution/implementation of novel technologies and techniques that influence care delivery.  Based upon analysis of compiled market data, Pinnacle works with clients to calculate and project physician needs in support of strategic recruitment, program development, and in support of population health.

Transitional / Interim Leadership

Pinnacle assists clients anticipating or responding to a change in executive leadership, by providing interim CEO services, permanent CEO recruitment and post-transition strategic planning, all in one package. By providing all three services in a deliberate, coordinated and cost-effective manner, Pinnacle helps hospitals bridge the transition from one leader to another while keeping the organization forward-moving, engaged and focused on achieving its goals.

Interim CEO Services

Pinnacle helps clients transition or effectively “bridge” between leaders, through the placement of an experienced interim CEO. This highly qualified individual provides operational oversight for all services and a reassuring presence to employees, medical staff, boards and communities, that the highest quality care will be maintained. The interim CEO will also lead the organization and executive team through a facilitated strategic planning process, while identifying the right positioning and plan to implement for long term success. By advancing these critical services through a Pinnacle interim CEO, the hospital contracts for a comprehensive solution at lower costs.

Permanent CEO Recruitment

Pinnacle assists clients in finding the most-qualified candidates nationally for an open CEO position. Under the leadership of the interim CEO, the search for the new, permanent CEO will be conducted by a hospital-based search committee. The interim CEO provides an insider’s perspective of the role, conveying an accurate depiction of the organization’s needs to prospective candidates. As an experienced operator, the interim CEO can also more effectively communicate specific strengths, weaknesses and needs of candidates back to the search committee. This insight, an essential function commonly overlooked in CEO searches, provides greater assurance the organization will find the best candidate for the permanent CEO position (best fit and most likely to stay).

Post-Transition Strategic Planning

Pinnacle facilitates a “warm handoff” and ongoing support (as needed) by having the interim CEO create the foundation of a strategic planning process before the new CEO has started. This process ensures the organization will focus on new or existing issues identified during the transition. This activity not only increases the effectiveness of the CEO recruitment by providing the focus the organization’s needs, it also provides a framework to evaluate the effectiveness of the new CEO during the crucial initial 18-24 months.

Mock Surveys

Surveys conducted by the Centers for Medicare and Medicaid Services (CMS) are unannounced and it is crucial for your facility to be prepared for these inspections. Mock surveys allow you to identify opportunities for improvement and mitigate deficiencies before the surveyors knock on your door.

  • Mock surveys simulate CMS or accreditation reviews, utilizing the agendas and evaluation tools used by actual surveyors.
  • A Tracer Methodology is used, following patients from admission to discharge.
  • Provide guidance, coaching, mentoring and preparation activities.
  • For more information on mock surveys, click here.