Hugh Larson Email & Phone Number

San Diego

Greater San Diego Area

I lead a team of experts that helps provider organizations (i.e., physician organizations, health systems, and hospitals) succeed under alternative payment models. This includes guiding organizations in the transition from a fee-for-service environment to a value-based environment.My team brings a broad range of skills to our consulting engagements.

• As a principal and co-owner of Optimized Health Care Decisions, LLC, I worked on a broad range of projects for healthcare provider organizations. Some of my representative projects are:
• Assisted a specialty hospital in evaluating a bundled payment contract proposed by a regional insurer
• Helped a multi-site hospital system evaluate the feasibility of implementing Medicare Shared Savings Programs (MSSP) in multiple geographic regions
• Developed an MSSP “tutorial” presentation for a hospital's senior management
• Reviewed the Bundled Payment for Care Improvement models 1 through 4
• Developed logic and model for utilizing state and municipal employers’ health care cost, plan design and enrollment data collected by a large actuarial consulting firm

• I provided consulting services to employers, hospitals and insurers. I was a lead negotiator representing AT&T, Lucent Technologies and several other employers in purchasing health care services from United Health.
• Assisted employers in developing RFPs, analyzing supplier’s proposals and recommending suppliers for medical plans, dental plans, vision plans and prescription drug plans
• Represented an employer coalition of Fortune 500 companies in negotiating a comprehensive prescription drug contract
• Analyzed hospital and physician cost and quality data to assist clients in selecting hospitals and physicians for a proposed provider network
• Assisted employers in analyzing claim utilization patterns to develop effective utilization management protocols
• Developed, implemented and evaluated health care vendor performance standards addressing the broad services provided by vendors including claim processing, provider network, customer service and customer satisfaction

Consultant and actuarial student. Provided health and welfare benefits/actuarial consulting services to large employers.