US Healthcare Solutions is a Philadelphia-based healthcare consulting company established in August of 2004 with expertise in:

• Healthcare Strategy and Business Development
• Contract Negotiation and Implementation
• Population-Based Payment
• Pay for Performance
• Provider Gain-Sharing
• Network Development and Health Plan Management

Our Consultants Have Successfully:

• Built health delivery networks nationally and locally
• Negotiated contracts with physician groups, hospital systems, ancillary providers and professional associations
• Integrated networks and developed market specific and national network strategy for merged health plans
• Converted one-sided risk contracts negotiated throughout the US into physician gain-sharing arrangements benefiting payors and providers
• Developed, negotiated and implemented alternative reimbursement arrangements for payors and providers including Pay for Performance (P4P) programs and physician gain-sharing arrangements
• Negotiated national laboratory and home healthcare contracts

Our management team members have backgrounds in hospital administration, managed care, information technology, health plan operations, and health insurance billing and coding, providing our clients with a unique perspective and appreciation of the strategic, financial, technological, and operational requirements of hospitals, providers, provider groups and payors. 

As experienced managed care executives, our consultants have played key roles in developing and implementing network strategy, and in the integration and consolidation of network field operations and network management functions with merged health plans.

Leadership:

Jeff Danilo, President - has over 25 years of experience in the field of healthcare administration, management, and network development.  Before founding US Healthcare Solutions in 2004, Jeff held executive management positions with Independence Blue Cross (2002-2004), Aetna US Healthcare (1990-2000) and New York City’s Health and Hospitals Corporation (1980 – 1990). Jeff’s payor experience has been in provider contracting, network development and management, provider reimbursement model development including Pay for Performance (P4P) and Gain-Share contract development, national contracting, risk contracting, and in the development of practice management strategies. 

While at Aetna US Healthcare, Jeff served on the integration teams as Head of Core Network Management with responsibility for developing and implementing network integration strategies and network policy after the Aetna/US Healthcare merger and the NYLCare and Prudential acquisitions.  During this time he also played a senior role in the development and oversight of Aetna’s Strategic Contract Management System.  

Rick Doyle, Consultant – has over 20 years of diverse industry experience including management, contract administration, network development, service operations, and clinical operations.  His managed care experience includes executive management positions with O2 Solutions (2006 – Present), Humana (2004-2006), Aetna (1996-2001) and Value Behavioral Health (1991-1996). 

Rick is an experienced network developer and contract negotiator.  He is well known throughout the industry for his ability to build, redesign and lead contracting teams, and for building and stabilizing provider networks.

Fred Rosenstein, Consultant – has over 35 years of industry experience with a significant concentration in hospital affairs most notably in management, operations, network development, managed care strategy, hospital provider joint ventures, and in the creation and development of a 30 site primary care network with 250 primary care physicians and over 750 specialists.  Fred’s hospital experience includes executive management positions with Montefiore Medical Center (1988-2000), North Central Bronx Hospital (1976-1988), and Morrisania Hospital (1969-1976).

Rick Kelly, Consultant – a fellow of the Society of Actuaries with over 18 years' experience in healthcare finance, pricing, underwriting, network development, service operations and management.  During his tenure with Aetna, Rick had responsibility for all aspects of risk deals including pricing, development, strategy, negotiation and management. While at Aetna, Rick successfully transitioned the risk deal team and the affiliated risk deals from combative relationships to mutually advantageous partnerships.

Robert Jameson, Consultant – is a board registered medical laboratory professional. He has over 25 years' experience in the area of clinical laboratory science, management, medical management, claims analysis, software development, sales management, strategic planning and business development.  Bob’s industry experience includes senor management positions with Lab Corp (1995-2003) and National Health Laboratories (1988-1995).  From 1975 to 1988 Bob held a number of clinical, financial and operational positions with several hospital systems.

Kent Kelley, Consultant - has over 30 years experience in IT development and operations with over 20 years in healthcare reimbursement systems. He is a Certified Information System Auditor (CISA). Kent's industry experience includes management positions with LabCorp (1995- 2002) and National Health Laboratories (1989-1995). Since 1974 Kent has designed and built medical management software for both healthcare providers and claim adjudicators. He has been successful with both application users & IT teams at all levels in several organizations. Kent effectively addresses every aspect of change & project management within the culture of the host company.