The Joint Operations Teams

 Financing and Alignment Framework

Our Finance and Medical Affairs Operating Partner works to create full alignment in order to maximize value for our clients.

The team supports medical practices, hospitals, and ambulatory surgery centers (ASCs) with unpaid and underpaid claims that have been recorded as lost revenue. Applying an asset‑monetization lens, we diligence claims and structure investments focused on efficient recovery and successful outcomes.

Our business executive and physician leader brings more than 20 years of experience building, scaling, and leading physician services organizations. This includes deep, hands‑on experience partnering with clinicians, management services organizations (MSOs), and healthcare operators across complex care delivery environments.

Business experience includes national  leadership roles within one of the largest specialty practices, collaborating across business development, investment banking, legal, revenue cycle management, payer contracting, clinical integration, IT, compliance, marketing, and clinical operations. This experience informs our ability to architect creative, aligned deal structures across the full transaction lifecycle—from diligence and negotiation through post‑investment value creation.

Clinical and operational insight is grounded in prior board‑level leadership at one of the nation’s largest independent medical practices, with direct responsibility for clinical quality, healthcare technology, and regional care delivery and business operations. 

The team has supported successful clinical programs operating under value‑based contracts, pay‑for‑performance frameworks, and healthcare facility gainsharing arrangements.

Complementing this operational experience is specialized legislative and regulatory expertise. With two decades of leadership at both state and federal levels— including national society advocacy and PAC leadership —we bring deep knowledge of healthcare regulation, with particular focus on the No Surprises Act and the Independent Dispute Resolution (IDR) process.

Legal Support Framework

Our Legal Strategy Operating Partner provides specialized support to identify, evaluate, and monetize unpaid and underpaid claims.

We deliver differentiated value to both companies and law firms by combining deep legal expertise with disciplined case assessment and financial oversight. To contribute meaningfully, we conduct our own independent, substantive analysis—developing a clear view of case strengths, risks, timelines, and likely resolution outcomes.

 The decision to engage our legal expertise always remains with clients. Operating within an ethical framework that preserves legal independence, we can support law firms and clients by providing:

• Expert testimony support
• Review and strategic commentary on briefs and filings
• Pre‑trial preparation, including motion strategy, litigation positioning, and evaluation of proposed settlements
• Budget and capital management to support a disciplined, efficient path to resolution using allocated case funding

Specialized Legal Expertise

Our in‑house legal team brings deep experience representing individuals, medical providers, and businesses in disputes against major insurance carriers—particularly matters involving underpaid and wrongfully denied claims. 

The team has litigated extensively against some of the largest insurers in the country and is experienced in holding carriers accountable to both contractual and statutory obligations.

Core experience includes:

• First‑party property claims
• Health insurance reimbursement disputes
• Out‑of‑network benefits litigation
• Pre‑suit recovery strategies and complex litigation designed to maximize recoveries

Over the past 18 years, the team has recovered more than $100 million in outstanding insurance benefits that were wrongfully denied or underpaid. Prior experience includes the filing of more than 8,000 lawsuits against large national insurance companies to collect underpaid claims—an approach that led several insurers to substantially renegotiate compensation terms with clients.

Known for a strategic and results‑driven approach, the team pairs rigorous policy analysis with a deep understanding of insurer tactics. The focus is not only efficient resolution, but ensuring insurers comply with applicable laws and pay what is rightfully owed.

Payor Negotiations Framework

Our Payor Negotiations Operating Partner engages directly with the most powerful health insurance companies in the country—bringing insider knowledge and senior‑level credibility built over more than 20 years operating at the highest levels of payor relations.

He previously led state Network Development for Blue Cross Blue Shield, directing network strategy, provider contracting, and provider alignment across one of the most complex healthcare markets in the Midwest. That experience provides a rare advantage: a firsthand deep understanding of how payors assess leverage, risk, network stability, and financial exposure—from inside the organization.

With experience that spans Fortune 500 healthcare organizations, multi‑state physician enterprises, and independent practices, we are retained by organizations seeking more than incremental rate adjustments—those that require strategic repositioning within their markets.

Notable experience includes leading a comprehensive payor relations strategy for a national physician specialty platform. Through disciplined leverage, planning, and executive‑level negotiations, he secured more than $1 billion in payor contracts.

We combine this institutional insight with long‑standing executive relationships across the health insurance industry to drive transformative financial outcomes for our clients.

For platform physician groups, MSOs, and financial sponsors, our team operates as a strategic asset—enhancing EBITDA, strengthening payor positioning before and after transactions, and materially improving enterprise value. 

Engagements may range from negotiating a single high‑impact contract to restructuring an organization’s entire payor portfolio.

This is not a tactic to sporadic rate renegotiation, but a part of a holistic strategy for positioning healthcare organizations for sustained financial solvency and long‑term operational viability.