Case Study | SCALE Healthcare

Payer and Regulatory Research

Case Study- Payer and Regulatory Research

Payer & Regulatory Research – Family Care Services

Client Profile

Overview – SCALE was engaged by an investment banking firm to complete a market assessment and regulatory analysis for the acquisition of multiple rural health clinics in the southeastern US.

Client Profile

Overview – SCALE was engaged by a Dental Services Organization (DSO) participating with a Managed Care Organization (MCO) providing dental services to Medicaid recipients for which a rate reduction was imminent. The engagement included providing financial analyses to quantify service line impact, payer contract review and strategy development to improve their rate position.

Payer Strategy – Dental (DSO)

Payer Strategy – Behavioral Health MSO

Client Profile

Overview – SCALE was engaged by a Behavioral Health Management Services Organization (MSO) to assist with payer contract review, contract strategy development, and contract renegotiation with multiple payers across their Commercial lines of business.

Client Profile

Overview – SCALE was engaged by a home health service provider specializing in post-acute care to assist with payer contract review, rate negotiation, and market positioning across Medicare Advantage (MA) and Commercial lines of business.

Payer Strategy – Home Health Provider

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