Manage Rising Costs and Sustain Health Plan Viability Rising healthcare costs combined with administrative overhead, expensive specialty drugs, and increased utilization are increasing financial pressures while regulators are simultaneously mandating significant cost controls. Freed helps health plans sustain financial health by implementing cost-containment strategies, optimizing provider partnerships, transforming lines of business, and applying alternative value-based payment models.
Navigate Regulatory and Compliance Pressures to Avoid Risk With healthcare regulations continually evolving at both the federal and state levels, health plans face increasing pressure to keep pace. Navigating these changes is essential to avoiding compliance risks, financial penalties, and operational disruptions. Freed partners with health plans to ensure regulatory adherence by translating complex policies into actionable steps, implementing necessary operational changes, supporting audit readiness, and addressing corrective action plans.
Elevate Quality to Improve Outcomes and Member Experience Health plans are under increasing member and consumer demand to deliver better access, affordability, quality and price transparency in coverage and services. At the same time, they must continuously enhance care outcomes and address evolving regulations and reimbursement models, driving the need for member-focused innovation and solutions. Freed helps health plans improve the member experience by enhancing digital tools, embedding quality metrics into operations, optimizing provider collaboration, and leveraging analytics to drive measurable improvements in care delivery, health equity, health outcomes, and member satisfaction.
Leverage AI and Technology to Unlock Efficiency and Innovation Health plans must keep pace with rapid technological advancements in healthcare while ensuring operational efficiencies, data security and regulatory compliance. Many health plans continue to struggle with infrastructure that slows innovation and creates inefficiencies in member and provider interactions. Freed helps health plans with systems selection, implementation, data governance, interoperability, modernization, and scalability. Additionally, Freed enables the adoption of AI-driven solutions that streamline administrative processes, address bias, enhance decision-making, and personalize member engagement.
Expand Behavioral Health and Community Care Coverage to Meet Growing Demand Rising demand for mental health and community health services, coupled with provider shortages and fragmented care, are straining health plans’ ability to provide comprehensive coverage. Freed supports health plans in integrating both behavioral and community health, assessing and scaling partnerships, improving network adequacy, and leveraging new funding sources to improve access and sustainability.
Matt Dutton Vice President, Client Solutions Brings 30 years of healthcare management consulting experience to health plans, providers, and vertically integrated delivery systems Helps clients realize the value of their strategic investments by using proven and agile methodologies, engaging with leadership, and establishing governance models to exceed expected outcomes Responsible for client programs focused on digital transformation and agile funding models, interoperability, pricing transparency, and data analytics Bio Detail
Chris Jaeger, MD Vice President, Client Solutions Over 20 years as a practicing physician, medical informatics expert, and executive leader Proven track record of leading successful large-scale, complex, multi-stakeholder transformational initiatives An experienced leader in using technology and data to transform payment and care delivery model Bio Detail
Carly Dunham Healthcare Consultant Specialist in digital health and transformation Record of success reinvigorating programs to improve value-based delivery, strengthen stakeholder relationships, garner strategic alignment, and foster continuous improvement Leadership experience spanning management of mega-program portfolios, delivery, finances, and governance Passion for coaching to supercharge the performance of clients and their teams Bio Detail
Yeeling Wu Healthcare Consultant Health plan operations subject matter expert who helps clients drive performance and achieve regulatory compliance Client partner who collaborates to identify and strategically pursue high-impact improvement opportunities within highly complex, matrixed organizations Strength in “connecting dots,” understanding dependencies between aspects of health plan functions and their impacts on member and provider experiences Bio Detail
Scott Walkiewicz Healthcare Consultant Navigates complex organizations to redesign provider contracting functions and lead the network management design for new products and services Combines health plan industry experience with analytical expertise to implement new solutions, organizational models, and process changes to support growth strategies Adept at working across functional teams to set clients up for immediate and long-term success Bio Detail
eBook Exceptional Consumer Experience Is Defining the New Era of Healthcare — Here’s How to Embrace It.
Point of View Community Based Organizations: Key Players for Health Plans to Maximize CalAIM Success.