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Description of Firm

A Getzville, New York-based consultation firm, HMS Associates specializes in network development, health related care analyses, and multi-organizational development. Our clients include clinics, community organizations, state and local government, community mental health agencies, academic medical centers, private practitioners, group practices and award-winning rural hospitals.

HMS Associates was founded by Greg Bonk to assist rural communities and special needs service providers in managing change through collaborative efforts. He has worked with organizations in the northeast and south over the past twenty years in a variety of capacities. He has made presentations on network development at meetings of the National Rural Health Association, American Hospital Association, and in Georgia, Massachusetts, New York, Pennsylvania, Washington, and West Virginia. HMS has pioneered the development of methodologies for capitation forecasting of Medicaid special needs populations and Physician Analytics, a provider compliance benching marking system.

HMS Associates was established in 1990 and Greg has been an adjunct instructor at the State University of New York at Buffalo, School of Medicine and Biomedical Sciences since 1988 and has authored and contributed to many reports and publications on health related issues.

Qualifications and Expertise

Contents

• Organizational restructuring, development, or redesign
• Knowledge of human services system, state managed care policy and state and local government structure
  • New York's Human Service System
  • State Managed Care Policy
  • Managed Care/Information Systems
  • Local Government Structure
• Skilled in developing a sequential framework for ensuring timely deliverables
• Ability to work closely with leadership throughout project duration and modify project scope as appropriate and necessary
• Ability to work aggressively and prudently within budgetary constraints during project development
• Resourcefulness and enterprising approach to project development and completion

A. Organizational restructuring, development, or redesign

• Redesign of the organizational structure of the Tri-county Maternal and Child Health Council into the Southern Tier Prenatal/Perinatal Council - A multi-county structure for governance and participation
• Establishment of the Southern Tier Rural Health Care System - A multi-county multi-organizational corporate structure with heavy emphasis on hospital participation
• Establishment of Article 28 - Central Service Facilities - Advised NYSDOH/on the regulatory requirements of these reimbursement eligible multi-organizational-county rural health network corporate structures designed to serve managed care functions among others
• Re-engineering of the Niagara Falls Memorial Community Mental Health Center - New organizational/management structure for this CMHC
• Privatization of Community Action Program - Assisted a rural county convert a branch of county government to a private not-for-profit tax exempt entity
• Managed Care Plan Structure - Assisted Medina Memorial Hospital, Medina , NY in the design of its managed care plan organizational and operational corporate structure - interface with commercial HMO - potential self-insurance relationship
• Health and Human Service Network Development - Redesigned a JD/PINS multi-organizational structure in a rural county which encompassed social services, probation, mental health, local law enforcement and the courts - Evaluated the effectiveness of fourteen rural health networks organizational structures for the New York State Department of Health
• Multi-organizational Network Development - Published a document on multi-organizational network development in rural communities in New York State which has been sold in 35 states - Lectured on network development in New York State, Pennsylvania, and West Virginia

B. Knowledge of human services system, state managed care policy and state and local government structure

New York's Human Service System

• JD/PINS have worked with multi-organizational Task Forces covering social services, probation, law enforcement, youth bureau, mental health, substance abuse, the courts in reducing JD/PINS placements Medicaid Managed Care
• Experience as County Department of Mental Health Planning Coordinator covering mental health, substance abuse, developmental disabilities
• Assisted a county in exploring the development of a human services plan
• Worked on a variety of statewide Task Forces in mental health and health care
• Assisted an ARC chapter in Medicaid managed care contract negotiation
• Assisted in the establishment of a not-for-profit community action organization
• Contracted with the NYSDOH relative to multi-organizational network development

State Managed Care Policy

• Assisted a rural county in the development of its county managed care plan required by the New York State Department of Social Services
• Completed analyses of NYSDSS adjudicated claims data related to utilization forecasts for Medicaid manage care plan related initiatives
• Assisted in a study conducted by the SUNYAB in managed care and network development in New York State for the federal government
• Designed a Medicaid partial capitation plan and reconciled financial projections with NYSDOH requirements
• Assisted a rural county in the implementation of its Medicaid managed Care Plan and eventual inclusion of a psychiatric special needs population
• Conducted analyses on the utilization of psychiatric services by Medicaid eligible individuals in eight counties in New York State
• Developed models for forecasting per member per month utilization targets and costs for special needs populations
• Conduct seminars on Medicaid managed care contracting and Service Delivery Implementation in New York State
• Developed fee structures for physician contracting for partial capitation services
• Developed a 9,800 CPT fee structure for contracting with a HMO
• Expertise in utilizing NYSDSS Medicaid databases
• Currently developing a behavioral health encounter reporting system which monitors resource use of psychiatric patients and therapist productivity

Managed Care/Information Systems

• Developing the RFP requirements for a central registry of health insurance benefits for 180,000 employees in the State of Wisconsin
• Directing management information systems for Physicians Plus Insurance Corporation in Madison, Wisconsin
• Directing management information systems for a 300 physician, 23 specialty private medical group practicing in twenty-five locations
• Negotiating and awarding service contracts for a group model HMO with 60,000 members with an annual experience of $151 million in claims per year
• Developing a reporting system for affiliated university physicians for over 800 physicians with an estimated $83 million in billing per year

Local Government Structure

• Contract with local government for a range of health, special care and social services consultative services
• Made numerous presentations to county legislatures, boards of supervisors, and legislative committees - Human Service Committees, Board of Health, Community Services Boards
• Redesigned an urban county Mental Health Department's local governmental unit planning process
• Knowledge of Institutional Cost Reports, Uniform Budget Reports, Consolidated Fiscal reports
• Conducted several needs assessment which included county social services departments, mental health departments, probation departments, youth bureaus, health departments

C. Skilled in developing a sequential framework for ensuring timely deliverables

All of the above referenced projects required the development of workprograms and completion of such within agreed upon time tables which ranged from three month to three years. Virtually all of these projects involved multiple participants and synchronization of schedules and deliverables. Several projects involved schedule adjustments associated with changes in state mandated time frames.


D. Ability to work closely with leadership throughout project duration and modify project scope as appropriate and necessary

The vast majority of HMS' projects involve association or network leadership and advisory committees. For example, we developed as Core Database with the Western New York Hospital Association to be used by eleven of its members in completing state mandated hospital community service planning responsibilities. The Core Database was tailored to needs of the association and participating members. Other network responsibilities involved as many as over 100 organizations or as "few" as six. We believe that we have an uncommon capacity for finding common ground among organizations which in other arenas are fierce competitors. We are an unbiased neutral party with a track record of identifying win-win-win scenarios for multi-organizational networks. In one instance we helped a large coalition move from spending hours disagreeing over the contents of minutes to implementing a electronic centralized information system.

Part of our success at meeting deliverable responsibilities lies in the flexibility we bring to our clients. For example the first step of any process involves the review of contractual workplan and modification as needed. We do not move until consensus is present. And we recognize that consensus often changes as external forces pivotal to success change. The priority and capacity assessment component of our work plans provides the framework within which course corrections can be made without having to start from scratch. If we find external forces to be unpredictable, we tailor our services to deliverables which strengthen our clients abilities to function under different scenarios.


E. Ability to work aggressively and prudently within budgetary constraints during project development

We have obtained certification approval from the New York State Public Health Council after lower levels of review, the New York State Hospital Review and Planning Council, and the Western New York Health Systems Agency recommended disapproval. Neither party sought a hearing on the proposed decision of the Council which favored our client.

Our services are on-time and within budget. We have never sought additional charges for contractual deliverables.


F. Resourcefulness and enterprising approach to project development and completion

HMS has been involved in many "firsts" and obtained funds for our clients essential for project implementation

• Assisted in the operation of the first Primary Care Hospital in New York State
• Created the first collaborative approach to needs assessment for the Western New York Hospital Association
• Assisted in the operation of the first hospital based Central Service Facility
• Obtained federal funding for the first rural primary care hospital in New York State
• Developed and operate the first Medicaid managed care psychiatric database in New York State
• Created the first comprehensive needs assessment methodology for mental disabilities in New York State
• Assisted the SUNYAB in obtaining designation from the Federal Agency for Heath Care Policy Research as a national Rural Health Research Center
• Develop the theory of incremental connectivity as a basis for network development in contrast to acquisition/merger models
• Obtained over $5M in funds for innovative projects

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