MARC MERTZ

HEALTHCARE

CONSULTANT

SKILLS

ABOUT MY SKILL SET

Healthcare Alignment

I am an experienced healthcare leader with more than 17 years of success in a variety of settings. As a former medical practice administrator I have been recognized by MGMA for operating one of the Best Performing Practices in the United States. During more than 17 years in healthcare consulting, I have helped physician groups, hospitals, academic medical centers, hospital-affiliated medical practices, and top-10 largest US health systems achieve new levels of success.

My consulting experience includes hospital/physician relationships and alignment, strategic planning, physician compensation model development; clinical integration; ACO feasibility analysis and development; medical group operational improvement; practice acquisitions, mergers, and start-ups; managed care contract negotiation; the implementation of new practice management and EMR systems; reimbursement and billing (IP and OP); physician coding and documentation; customer service; patient centered medical homes; and fair market value opinions.

I am highly experienced in all aspects of physician practice management, having managed small private groups, departments of academic medical centers, and large hospital-affiliated medical practices. In addition, I am a Fellow in MGMA's American College of Medical Practice Executives. I have published articles on a variety of healthcare subjects, and I frequently present at national healthcare conferences. I am a Vice President with The Camden Group, based in Los Angeles. Thanks for visiting my site!

Qualifications

17 years of nationwide hospital/physician consulting experience
14 years of comprehensive physician/medical practice administration experience
14 years of management experience, supervising up to 110 employees
12 years of healthcare consulting leadership, responsible for obtaining new clients, overseeing multiple projects, supervising consulting teams, and ensuring the highest level of client satisfaction
3 years of hospital reimbursement consulting and auditing experience
Management of consulting projects for clients ranging from 1 physician to leading health systems of 40+ hospitals
Exceptional record for dramatically improving the financial and operational performance of a variety of organizations
Consistent ability to build and motivate cohesive teams through inclusive management style and the establishment of a clear vision and measurable goals
Published author and national speaker on a variety of subjects related to healthcare administration
Current California Office of the Attorney General Ethics Certification (AB 1234)

EMPLOYMENT

2008 - PRESENT DAYTHE CAMDEN GROUP, Vice President

Senior level consultant and thought leader with this leading healthcare consulting firm serving leading health systems, hospitals, and physician organizations throughout the United States. Areas of focus include physician/hospital alignment, physician practice design, medical group performance improvement, clinical integration strategies, medical group mergers, acquisitions, and start-up, physician compensation plan design, fair market value opinions, accountable care organization (ACO) development and operations, strategic planning, MSO and IPA operations, and physician practice management.

www.thecamdengroup.com

May 2004 – 2013Med-Track, Owner and President

Customer relationship management (CRM) system designed specifically for hospitals and healthcare organizations that rely on strong relationships and partnerships with physicians. The system is delivered via application service provider (ASP) and can be securely run from any PC with internet access. The software allows for the capture of key contact information as well as dynamic encounter documentation. Reporting capabilities are almost unlimited.

2005 - 2008HEALTH CHECK, INC., President

National managed mare auditing and recovery firm with more than 50 employees in three states. Responsibilities included oversight and full decision-making authority for all aspects of operations, including: Information Technology, Human Resources, Finance and Accounting, Budgeting, Sales and Marketing, Contract Analysis, Administrative Support, Managed Care Auditing, Quality Assurance, Client Reporting, hospital reimbursement (DRG/ICD-9/CPT) analysis and Call Center Operations. Managed leadership team and participated as member of Board of Directors

www.hcaudit.com

1997 - 2005THE HORIZON GROUP, Vice President

National Healthcare Consulting Firm. Responsibilities included managing the daily operations of the firm, supervising the consulting and billing staff, marketing the firm’s services, project management, business development, client relations, and directly providing professional services including: management consulting, strategic planning, physician practice start-ups, outsourced/turnaround management, billing and reimbursement, physician relations, practice staffing, mergers and acquisitions, customer service, provider documentation and coding (CPT/ICD-9), physician recruitment, performance improvement, medical staff development, MSO development and management, information technology feasibility/deployment (billing and EMR systems), practice divestiture planning, physician compensation modeling, and accounting and finance support to clients throughout the United States.

www.medgroupstrategy.com

SELECTED ACCOMPLISHMENTS

Healthcare Consulting

Development of a comprehensive hospital-physician alignment strategy for an 8-hospital system in the Midwest. Strategies included expansion of an employed medical group, clinical integration, co-management in select specialties, and development of an accountable care organization (“ACO”) strategy
Assessment of a 650-physician medical foundation that resulted in recommendations for governance and organizational restructuring as well as nearly $9,000,000 in identified operational improvements
Assist in the development and launch of a regional ACO, including market strategy, funds flow, care model design, information technology, network development, and staffing
Practice performance audit/improvement projects for hospitals and health systems nationwide
Development of a system-wide physician group strategy and business plan for a major health system in the northwest employing more than 600 physicians
Led a health system’s acquisition of a 150+ provider multispecialty group, including due diligence, operational assessment, acquisition, and integration into the health system
Development of multiple hospital-sponsored MSOs
Care delivery model redesign, including patient centered medical home (“PCMH”) development
Turn around management of an East Coast hospital-affiliated primary care network
Managed care auditing services for a top-10 largest health system in the United States
Strategic planning, practice acquisition, compensation plan development, operational improvement, and finance/accounting services for a private physician group
Interim management, strategic planning, and performance improvement for hospital-owned multispecialty practices

Hospital/ Physician Relations

Formation of clinically integrated networks that bring hospitals, affiliated physicians, and independent physicians together to improve value by increasing the quality of care and reducing costs
Provided hospitals with strategic planning services related to the acquisition, management, expansion, and possible divestiture of physician practices
Established Management Services Organizations (MSO) to allow hospitals to provide management and billing services to community physicians
Conducted complete medical staff development projects, seeking to better align hospital resources with community needs, while protecting hospitals from competition

Physician Practice Management

Served as the Administrator of a private medical practice with 15 providers in seven locations. Two years after assuming the position, the practice was named one of the Medical Group Management Association’s Best Performing Practices
Development and implementation of physician compensation models for groups as large as 450 physicians, including models that incentivize value-based care
Performed practice operational audits in hundreds of medical practices throughout the US. Responsible for preparing and presenting recommendations to senior management or Board, as well as implementing the solutions and dramatically improving bottom-line performance
Partnered with dozens of physicians in new practice start-ups, overseeing all aspects of opening a new practice, including facility selection or design, staffing, physician compensation, funding, equipment, practice management/ EMR selection, and initial management
Served as Executive Director for a hospital-affiliated primary care network with 110 employees in multiple locations. Oversaw dramatic operational and financial improvement

Business Development and Client Service

As a senior member of multiple national consulting firms, responsible for promoting services, obtaining new clients, simultaneously overseeing multiple complex projects, and ensuring the highest level of client satisfaction
Led nationwide sales effort that increased client base by 100% within 18 months
Successfully launched healthcare marketing software application to national market

EDUCATION

2009 - 2011UNIVERSITY OF SOUTHERN CALIFORNIA, Los Angeles, CA

Master of Health Administration

1992 - 1996JAMES MADISON UNIVERSITY, Harrisonburg, Virginia

Bachelors of Science, Health Services Administration

PUBLICATIONS

ACTICLES THAT I HAVE PUBLISHED

“Getting it Right: The Right Compensation Plan for You”- with Mary Witt, AMGA Group Practice Journal September 2013

“The Cornerstones of Successful Medical Group Acquisitions” – Hospitals and Health Networks Daily December 8, 2011

“Rethinking Physician Compensation in an Accountable Care World”- with Laura Jacobs, AMGA Group Practice Journal September 2011

“The Impact of Clinical Integration on Joint Managed Care Contracting Among Independent Physicians” - USC School of Policy, Planning, and Development Review 2010-2011 Edition

“Policing Your Commercial Payments: Staying In (or Getting In) The Black”- HFMA’s hfm Magazine March 2008)

“Developing an Effective Physician Liaison Program”- PSR’s Possibilities in Physician Relations Volume 2005 No. 2

“Pay ‘em to Play- and to Stay- Developing an Effective Physician Compensation Plan”- MGMA's Connexion April 2005

"Negotiating Higher Reimbursement from an Insurance Company"- MGMA's Performance and Practices of Successful Medical Groups 2004 Report Based on 2003 Data

"Show me the Money: Negotiating Higher Reimbursement from an Insurance Company" - MGMA's Connexion October 2004

"Professional Customer Service" - VMGMA Practice Notes Nov. 2001

"What does Walt Disney Know about Patient Satisfaction?" - Family Practice Management - November/ December 1999

CONTACT ME

Please feel free to email me or to use the contact form below.

mgm@marcmertz.com

SOCIAL MEDIA

Check out my social universe!

Thank you for printing my resume. If you have any questions, please feel free to contact me.