About Charlie Brown

Charlie works in ECG’s Managed Care practice, where he focuses on strategic health plan contracting, negotiation, and revenue recovery. With more than 18 years of healthcare management and consulting experience, he has been successful in improving the bottom line of clients’ financial and operational performance. He has assisted clients in complying with the intricacies of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and Sarbanes-Oxley §404 requirements. As a Director at a national consulting firm, he focused on managed care contracting, operations, and revenue recovery. His expertise was developed while he was Director of Managed Care/Vice President of Practice Operations at Founders Health Care (Allegheny Integrated Health Group) and an Operations Manager/Medical Center Administrator at FHP Inc. Charlie holds a master of business administration degree from The University of Utah and a bachelor of arts degree in biology from the University of Colorado.

The ICD-10 Transition: Updating Payor Contracts

One often overlooked but potentially critical step in the preparation for the now delayed April 2015 transition from ICD-9 to ICD-10 is updating agreements between providers and payors.  While the change is ultimately expected to be valuable due to the increased specificity and granularity of diagnosis coding, the potential for unintended financial consequences must not be understated.  Most providers are well under way with their operational transition plans, but many have not considered amending their payor agreements to mitigate the potential impact of problems that arise. Continue reading

Considering Partnerships with Federally Qualified Health Centers

Uncertainty surrounding public healthcare exchanges and the impacts due to approaching changes in Medicaid eligibility has caused many health systems to reexamine how they deliver care. Health systems that are seeking to provide greater value to their communities should consider collaborating with federally qualified health centers (FQHCs), given the special legal and financial status of these organizations and their experience treating populations with complex needs.

As a result of their expertise in caring for vulnerable and underserved populations, FQHCs are particularly well-equipped to deliver or coordinate primary care, diagnostic, and preventive clinical services for newly insured Medicaid patients. Continue reading