Megan Roach Email & Phone Number

Minneapolis, Minnesota, United States

Successful independent consulting practice providing strategic leadership, innovative product/service development, and operations optimization services to the healthcare sector. Major payer/provider clients have between $3–9 billion in annual revenues. Manage complex engagements, working with diverse stakeholders to identify and achieve aggressive business deliverables, with recent focus on ACO/TCOC/VBHC/SDOH development, contracting, and population health initiatives. Jumpstarted multiple integrated delivery systems’ understanding of and responses to the ACA reform initiatives, providing timely strategic options, business models (ACO/TCOC/VBHC) and organizational readiness assessments. Drove consensus across stakeholders, ensuring market leadership positions for clients.  Assessed the feasibility of reaching a 0% healthcare expenditure trend in Minnesota for a statewide quality organization, by researching and modelling drivers and tactical cost savings measures needed to achieve that goal. Quantified and prioritized unnecessary care cost drivers and potentially preventable events (PPEs).  Designed and implemented multi-year strategy for a health plan to align its medical management services by moving to an integrated whole-person care approach. Strategy resulted in improved service delivery, a 25% reduction in costs, and an 18% growth in client’s market share. Developed innovative plan/provider/vendor network strategies and conducted contract negotiations resulting in favorable financial and quality terms.

Minneapolis, Minnesota, United States

Co-Practice Leader of the firm’s first national Medicare and Medicaid consulting service line. Established and built new service capabilities that generated annual client sales of $5 million. Created financial and care delivery models for new market entrants using industry knowledge to highlight the unique medical and social needs of the populations, and the importance of addressing these needs to ensure the programs financial viability and the delivery of quality services.  Created practice strategy, sales collateral, and marketing plan and rolled it out to Deloitte’s national practitioners. Provided ongoing training and expert guidance on the unique requirements of state and federal contracts, the complex clinical and social needs impacting these populations and the healthcare delivery systems required to provide optimal care for them. Built feasibility models to test market entry.  Developed strategic business plans and products with clients in the health plan, provider, and employer sectors, including product design, market feasibility studies, contract negotiations, and operations implementation. These plans resulted in increased enrollment market share of between 20% and 35%.

Bloomington, Minnesota, United States

Headed Government Programs Division (Medicare, Medicaid, and private programs for the uninsured) with $140 million in annual revenue. Led Division through two corporate mergers (health plan and hospital), successfully creating a new shared culture and market vision to serve business and community interests. Spearheaded policy and legislative changes resulting in substantial improvements in member benefits, plan reimbursement rates, and health outcomes.  Identified Medicare and Medicaid policy issues and drove legislative and reform initiatives. Worked with national associations, CMS, and Congress to improve program benefits, funding, and regulatory processes. Chaired committees on Minnesota HMO Council and worked with HMOs nationally. Succeeded in securing multiple pilots and demonstrations with many program components being adopted legislatively.  Designed, formed, and co-led Corporate Geriatric Committee and Senior Consumer Advisory Committee. Provided strategic leadership and developed innovative care delivery protocol and pilot demonstration programs. Developed and implemented Community Health Plan (joint venture with HealthPartners, Fairview Health Services, and Lutheran Social Services), a unique private healthcare and social services program for uninsured individuals. The positive program results demonstrated the need for and viability of these services, galvanizing the state to develop a statewide public program, MinnesotaCare.

Minneapolis, Minnesota, United States

Managed member services phone center for Share HMO which merged with PHP to become Medica. Introduced a data-driven performance management system.