PCG’s Health practice offers in-depth programmatic knowledge and regulatory expertise to help state and municipal health agencies respond to regulatory change, improve access to health care, maximize program revenue, improve business processes, and achieve regulatory compliance. Using industry best practices, PCG’s Health team helps organizations deliver quality services with constrained resources to promote improved client outcomes.

What We Do

For State Health & Medicaid Agencies

See how we can help you increase program revenue, cut costs, and improve compliance with state and federal regulations.

For State Insurance Departments

Let us help you navigate the regulatory landscape, including the Affordable Care Act (ACA), and implement changes and new requirements with confidence.

For Provider Organizations

Boost your financial performance and compliance with our proven approach to improving claiming practices and operations management.

For Health Plans

Optimize your plan’s performance and compliance without sacrificing patient outcomes with our program integrity services.

News & Perspectives

CMS issues guidance on Medicaid behavioral health delivery system reform

30 days ago

On November 13, 2018, the Centers for Medicare and Medicaid Services (CMS) released a letter to state Medicaid directors outlining a wide range of opportunities for states to design innovative delivery systems for adults and children with serious mental health conditions.

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Proposed Medicaid managed care rules issued

32 days ago

As expected, the Centers for Medicaid and Medicare Services (CMS) issued proposed changes to the regulations governing Medicaid and Children’s Health Insurance Program (CHIP) managed care last week. The changes follow a comprehensive overhaul of the regulations in 2016. CMS announced that the newest proposals seek to rollback certain changes made in 2016 in an effort to provide more flexibility for states.

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Twelve Massachusetts Disproportionate Share Hospitals (DSH) win $6 million in Medicare reimbursement in federal district court

45 days ago

On October 26, 2018, Judge Ketanji Jackson of the U.S. District Court for the District of Columbia ruled that certain patient days for individuals in the Commonwealth Care program should be included in calculating DSH Medicare reimbursement for 12 Massachusetts hospitals serving large numbers of poor patients. 

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Legislation enacted to address the opioid crisis

45 days ago

On October 24, 2018, the President signed H.R. 6, the Support for Patients and Communities Act. The new legislation contains amendments to Medicaid, Medicare, and other federal laws to address the opioid crisis.

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U.S. Supreme Court agrees to hear appeal of decision against HHS concerning past Medicare DSH reimbursement to certain hospitals

75 days ago

On September 27, 2018, the U.S. Supreme Court agreed to take up an appeal of a decision by the U.S. Court of Appeals for the District of Columbia against the Department of Health and Human Services (HHS) concerning certain past payments to a number of mostly non-profit hospitals under the Medicare Disproportionate Share Hospital (DSH) program.

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Maryland Attorney General sues federal government to protect the ACA

87 days ago

On Thursday, September 13, 2018, Maryland Attorney General Brian Frosh filed a lawsuit in federal district court in Maryland requesting a declaratory judgment that the Affordable Care Act (ACA) is constitutional, and a court order preventing the federal government from taking any action is inconsistent with that conclusion.

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Meet Our Team

team-member

Thomas Aldridge

Manager / Health

Mr. Aldridge is a Manager with Public Consulting Group (PCG) and has been with the firm for more than 20 years. Throughout his tenure, he has managed dozens of engagements within Health and Human Service agencies across the country...

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Joe Weber

Associate Manager / Health

Mr. Weber, PMP, has been with PCG for 13 years. Mr. Weber helps lead the Health Care Financing Solutions (HCFS) Center of Excellence with over twelve years of public sector consulting focusing on publicly funded healthcare programs including Medicaid...

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Jay Peck

Associate Manager / Health

Mr. Peck has been with PCG for over 13 years, specializing in Medicaid Program Integrity, Quality Improvement, and Beneficiary Due Process. He has successfully led the implementation of large-scale projects, such as a Provider Oversight effort in Ohio...

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Tony Curatola

Associate Manager / Health

Mr. Curatola, an Associate Manager with PCG and certified PMP, has more than 29 years of experience in the Information Systems industry with over 22 years in project management and 18 years in Medicaid.  He has extensive project management experience in both the public and private sectors including: state government, property and casualty Insurance, healthcare insurance, and banking.

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John Blowers

Associate Manager / Health

Mr. Blowers holds an MBA from Kelley School of Business and has more than 25 years of HR experience, with approximately 2/3rds of that time holding leadership roles with General Electric, India-based Crompton Greaves...

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James Waldinger

Associate Manager / Health

Mr. Waldinger, an Associate Manager at PCG, is an experienced Medicaid policy and reimbursement professional who focuses on healthcare operations, mental health and substance abuse policy and integration, and health care reform and its impact on Medicaid programs and providers.

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James Dachos

Associate Manager / Health

Mr. Dachos, an Associate Manager in our Healthcare Financing Solutions division, has 12 years of Medicaid and Healthcare experience with PCG. He leads PCG’s Emergency Medical Services (EMS) division...

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Dale McCourt

Associate Manager / Health

Mr. McCourt, Associate Manager, has been a member of the PCG team since 2011. Dale brings over 25 years of experience spanning many industries where he has served in a variety of roles including Chief Operating Officer, Project Manager, Manager...

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Peter Cheesman

Associate Manager / Health

Mr. Cheesman leads PCG Health's Member Eligibility Solutions group. In this capacity, he has overseen the implementation and operation of high-profile benefits eligibility verification systems and data broker solutions for health and human services...

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Aaron Holman

Associate Manager / Health

Mr. Holman has been working in health policy for the past decade, starting in the United States Senate working on Medicare, CHIP and Health IT areas for Senator Debbie Stabenow (D-Michigan) and the Finance Committee. Mr. Holman also worked as a lobbyist in Washington focusing on health IT financing and standards development...

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Rich Albertoni

Manager / Health

Mr. Albertoni has 16 years of experience working in state public health programming and Medicaid. He has held leadership positions in eligibility, budget and finance, and benefits and waivers.

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Tom Entrikin

Manager / Health

Mr. Entrikin has 45 years of experience with the Medicaid and Medicare programs. From 1981 to 1992, he was a Medicaid policy specialist with the US Health Care Financing Administration (HCFA), now the Centers for Medicare & Medicaid Services (CMS)...

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Rick Dwyer

Manager / Health

Mr. Dwyer, a Manager located in our Boston office since 1993, has over thirty years of experience in financial and operations management in corporate and healthcare provider and payer environments.  For providers, Mr. Dwyer has been actively involved...

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Kelly Gallagher

Associate Manager / Health

Ms. Gallagher has been with PCG for 10 years. Ms. Gallagher helps lead the Cost Allocation Center of Excellence, specializing in cost allocation, time studies, Medicaid and Title IV-E claiming programs, business process review, Targeted Case Management (TCM)...

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Sean Huse

Manager / Health

Mr. Huse (MBA, CHFP), a Manager at Public Consulting Group, is an experienced health management consultant who focuses on financial management, strategic planning, policy analysis, information...

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Lisa Lee

Associate Manager / Health

Ms. Lee has been with PCG for 1 year and helps lead the Health Innovation, Policy and Information Technology Center of Excellence, specializing in Medicaid, CHIP, and ACA policy. Project accomplishments include the creation of Mississippi’s 1115 Waiver Application...

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Matthew Sorrentino

Manager / Health

Mr. Sorrentino, a Manager and Center of Excellence (COE) lead for our Healthcare Financing Solutions division, is a management consultant with 15 plus years of extensive Medicaid and healthcare experience.

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Kevin Carlson

Chief Technology Officer / Health

Mr. Carlson has more than 20 years of experience in the health care technology sector. He has overseen the development and implementation of numerous electronic health record, revenue cycle management (RCM), business intelligence, and health...

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Marc Staubley

Practice Area Director / Health

Mr. Staubley is Practice Area Director (PAD) of PCG’s Health division and a PCG shareholder. In this role, he provides executive leadership to over 400 staff who manage a portfolio of over 200 projects that span across more than 35 states...

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Amy Ferraro

Manager / Health, Human Services

Ms. Ferraro has over 22 years of public sector consulting experience and has worked on a variety of revenue management, revenue optimization, and consulting engagements in more than 35 states across a variety of different agencies. She has also worked with...

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