Medical Advantage Group
Vendor Review for Medicaid Vendor Partner Readiness
- Overall Assessment
- Basic Info
- Relevant Leadership Experience
- Brand Perception
- Clarity of Value Proposition
- Scalability
- Funding Model
Overall Assessment
Summary
- Physician practice / revenue cycle management firm attempting to pivot into Medicaid space, but with unclear offering to Medicaid plans.
- Extensive healthcare experience across leadership team. Moderate Medicare experience; Limited /unknown Medicaid experience.
- No observed Medicaid payer client base. Some pilot efforts at provider practices.
- Unclear what is offered to MCOs beyond intermediary services between MCOs and physician practices.
Scoring
Composite
Leadership Medicaid Experience
Scalability
Brand Perception
Category
Consulting (Revenue cycle management)
What they do
Physician practice management consulting with a focus in Medicare.
current vendor logo (for identification purposes only)
Self-stated value proposition
Medical Advantage Group is a leading healthcare consulting and management company that provides practice transformation services and integrated custom solutions in performance improvement, technology, patient-centered medicine, and accountability to assist clients to achieve clinical integration and the Triple Aim (improve quality of care, increase health of community, and decrease costs).
The Medical Advantage Group has more than a decade of experience developing the largest patient-centered provider network in Michigan and one of the ten largest in the United States.
Founded
1996 (Acquired by The Doctor's Company - TDC Group- In 2014)
Annual Revenues
Estimated @ $30M (TCD Group); MAG unknown, estimated @ <$5M
# employees
Estimated @ 130
Points Possible: 212
Points Earned: 53
click to enlarge
Role | | |
|---|---|---|
CEO |  Paul McLellan | Click for Bio (self-reported)Paul MacLellan is an industry leader in health care quality improvement, value-based contracting, and population health management. He has a deep understanding of how to successfully integrate technology with process improvement methodology to drive positive health care delivery system outcomes, helping solve the many health care business challenges health plans and delivery systems face today. As chief executive officer at Medical Advantage Group, Mr. MacLellan expanded the company into new markets and doubled revenue while generating millions in value-based care incentives for physicians. Through his leadership, Medical Advantage Group is now a nationally recognized health care solutions company serving health plans, health systems, physician groups and practices. Before joining Medical Advantage Group, Mr. MacLellan was a director at Blue Cross Blue Shield of Michigan (BCBSM) where he was responsible for leading IT and analytics for the Value Partnerships and the Chief Medical Officer. In this role, he was a key architect in the development of the first fully integrated data solution to support clinical analytics and reporting at BCBSM and provided the platform for its nationally acclaimed Physician Group Incentive Program and Patient-Centered Medical Home initiative. He also created a process for the National Committee for Quality Assurance HEDIS accreditation of a 2.2 million-member PPO health plan. Mr. MacLellan’s experience also includes the launch of two start-up companies, Route One LLC, where he managed an indirect lending product for automotive finance, and RealAge, Inc., where he developed a web-based health risk appraisal system. Mr. MacLellan holds a Bachelor of Mathematics degree from the University of Waterloo, Ontario Canada. |
Operations Executive (or similar) |  Greg Laidlaw | Click for Bio (self-reported)Mr. Laidlaw’s business expertise is the foundation of Medical Advantage Group’s high-quality client services as well as company growth. He understands the critical role of informational technology in achieving cost-effective processes and services. An expert in technology implementation, Mr. Laidlaw is adept at managing cross-functional teams that develop and use software to achieve challenging market and organizational goals. Prior to joining Medical Advantage Group, Mr. Laidlaw was a senior manager at Blue Cross Blue Shield of Michigan (BSBSM). At BCBSM he managed a $12 million annual budget and the design, development and implementation of analytical and reporting platforms for a large-scale, pay-for-performance program and statewide patient-centered medical home project which included a data center for member and patient populations that processed millions of member records and claims per month. |
Information Systems Executive (or similar) |  Chad Anguilm | Click for Bio (self-reported)I assist health systems to deliver healthcare faster, better, safer and cheaper. By integrating technology into clinical optimization to improve efficiency, we can focus on closing gaps and succeeding in value-based reimbursement contracts. The future of healthcare technology will allow clinicians to have a conversation with their patient and voice recognition software will build their chart note. Those same words will be pulled through artificial intelligence which will make recommendations to the clinician based on billions of data points. For this to work the systems need to be set up for success, or “optimized”. Workflows need to be revamped and policies and procedures need to be understood by all staff. Finally, there needs to be buy-in from everyone within the organization. I help healthcare administrators to take the bull by the horns and revamp their organization to be successful in this new model. |
Sales Executive (s) |  Kevin Burke | Click for Bio (self-reported)Mr. Burke’s expansive career includes more than 20 years of sales, marketing, and general management experience, with noted accomplishments in growing revenue and achieving financial and operational excellence. Prior to joining Medical Advantage Group, Mr. Burke held various senior leadership positions, most recently as senior vice president and market leader with Accretive Solutions. Prior to Accretive, he assisted in creating a service desk cloud offering for TechTeam Global and CA. He also closed 42 new accounts in three years during his time with TechTeam Global. |
 Dawn Zito | Click for Bio (self-reported)Dawn Zito is a business development executive with over 20 years of experience leading successful consultative engagements with health plans and provider groups nationwide. In her career, Ms. Zito has helped a range of organizations achieve success in the transition to value-based care. As Vice President of Business Development at Medical Advantage Group, Ms. Zito leads the growth initiatives for consultative engagements across health plans, provider groups, and health systems. Before joining Medical Advantage Group, Ms. Zito held executive positions in sales and business development within the health care industry. Most recently, she was Vice President of Development at Summit Strategic Solutions, Knoxville, TN assisting provider groups with their transition from fee-for-service to value-based care. Previously, Ms. Zito was Vice President of Sales at DST Health Solutions working with health plans and health systems to optimize their population health platforms. Ms. Zito holds a bachelor’s degree from Rutgers University, and an MBA from the University of Miami with an advanced focus on health care administration. | |
Product/Solution Executive (or similar) |  Tom Wolff | Click for Bio (self-reported)Mr. Wolff has been part of Medical Advantage Group since its inception in 1996 and has been instrumental in its growth by fostering the success of its diverse clients including physician practices, physician organizations, and accountable care organizations. He is a proven change agent who is adept at engaging physicians in cost and quality initiatives that yield positive, tangible results. He is highly experienced in negotiating and effectively implementing contracts with commercial health plans, Medicaid plans and Medicare Advantage plans. His successful management of Medical Advantage Group client organizations has helped physicians transform deficits into surpluses and to earn millions of dollars in surplus sharing payments and incentive payments from HMOs and BCBSM. |
Finance Executive (or similar) | Dan Crowley | Click for Bio (self-reported) |
Points possible: 95
Points earned: 35
Analyst Notes
- No observed Medicaid (payer) client base
- Low brand visibility
- No negative press or litigation in past 3 years
Points possible: 60
Points earned: 20
Analyst Notes
- Positioning as intermediary between plans and providers but no case studies or success metrics available
- General use of buzzwords and non-unique value messaging
- Unclear who benefits from solutions
Points possible: 50
Points earned: 22
Analyst Notes
- Experience of delivery team layer rated as limited-moderate
- Staffing trends declining
- Low annual revenues
Analyst Notes
Ownership model
Owned by The Doctors Company
Stage
N/A
Trend in funding rounds
N/A
Major investors
N/A
