Health - PCG | Public Consulting Group

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 COVID-19 Health Services

Together, we can implement the innovative solutions necessary to help public health systems rise to the challenges of COVID-19.

For Health Plans

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

For Fire and EMS Provider Organizations

Helping fire and emergency medical service agencies improve operational performance, reduce costs, and deliver better outcomes to those in need.

News & Perspectives

National Public Health Week: Celebrating 30 Years of Public Health Progress

7 days ago

This year marks the 30^th anniversary of National Public Health Week (NPHW), the theme of which is “It Starts Here.” In honor of this milestone, Public Consulting Group (PCG) celebrates the public health progress made in the last 30 years and reflects upon some key public health topics that are critical to continuing this momentum.

PCG hosts “Translating Fire & EMS Operational Challenges into Financial Needs” Webinar

823 days ago

As more fire and EMS departments have been expressing the need for additional funding, countless have struggled through referendums and challenging budget meetings to justify every penny of increase. Public Consulting Group (PCG) is here to provide support to fire and EMS administrators on how to step back from challenges, consider the perspectives of the community, and determine how to communicate operational needs into simple and actionable requests that anyone can understand.

U.S. Supreme Court Ruled That HHS Wrongfully Cut Medicare Reimbursement for Certain Drugs to Hospitals Serving Low-Income Beneficiaries

1006 days ago

On Wednesday, June 15, 2022, the U.S. Supreme Court unanimously held that the U.S. Department of Health and Human Services (HHS) improperly cut more than $1 billion per year since 2018 in Medicare payments for certain drugs to hospitals serving low-income communities.

U.S. Supreme Court Decides That States Can Seek Reimbursement for Future Medical Expenses from Medicaid Beneficiaries’ Injury Settlements

1015 days ago

On June 6, 2022, the U.S. Supreme Court held, in a seven-to-two decision, that the Medicaid statute permits a state to seek reimbursement from settlement payments allocated for future medical care.

U.S. Supreme Court Declines to Hear Appeal by UnitedHealth Group, Inc. Requiring Return of Medicare Overpayments Based on Faulty Diagnoses

1028 days ago

On Tuesday, June 21, 2022, the U.S. Supreme Court rejected an appeal by UnitedHealth Group, Inc., leaving in place a federal rule requiring Medicare Advantage plans to return overpayments based upon wrongful diagnoses.

PCG Awarded CMS Quality Improvement Organization-like Recertification

1106 days ago

Public Consulting Group (PCG) is proud to announce its five-year recertification as a Quality Improvement Organization-like (QIO-like) entity by the Centers for Medicare and Medicaid Services (CMS). A QIO-like entity consists of health quality experts, clinicians, and consumers who work together to improve the quality of care delivered to Medicare and Medicaid beneficiaries.

Tony Ong

Business Development Manager / Human Services

Tony Ong believes in better government. As the leader of Public Consulting Group's (PCG) business development in the human services sector, Tony is driving the development of...

Brooke Bell

Associate Manager / Education

Kelly Pinion

Director / Technology Consulting

Kelly Pinion joined PCG in 2021 and serves as a Director in the Technology Consulting team. In this role, she is responsible for project management and oversight of independent verification and validation...

Dan Wistman

Manager / Education

Mr. Wistman has more than 25 years of information systems experience, including extensive experience in software development and project management of enterprise application implementations...

Ladd Van Devender

Manager / Education

Mr. Van Devender oversees more than 150 North Carolina education projects and Student Success Planning solutions throughout NC. These services include the implementation and ongoing...

Mitch Dobbins

Practice Area Director / Technology Consulting

Mitch Dobbins joined PCG in 2008 and serves as practice area director of the Technology Consulting team. In this role, Mitch is responsible for providing strategic direction, oversight of operations and business development, and client delivery.

Ezra Sykes

Associate Manager / Human Services

Mr. Sykes has led numerous complex projects in the public sector that include elements of process improvement, organizational effectiveness, and change...