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

13 days ago

This year marks the 30th 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.

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

829 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.

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

1011 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.

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

1020 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.

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

1033 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.

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PCG Awarded CMS Quality Improvement Organization-like Recertification

1111 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.

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Meet Our Team

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Michelle Simmons

Manager / Education

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David Flores

Chief Technology Officer / Human Services

As the Chief Technology Officer (CTO) for the firm’s Human Services practice, David Flores oversees the development and implementation of the software systems and technical processes used in service of PCG’s human services clients. 

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Dr. Jack McLaughlin

Manager / Education

Dr. McLaughlin comes from a proud family tradition of service in public education. He has served as school teacher and chief administrator in New York and California. In California, he served as...

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Rich Maguire

Corporate Director / Corporate

Mr. Maguire's role includes strategic planning, client development, partnership creation, product development, and organizational development for PCG's global consulting services businesses that...

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Sylvia Mitchem

Director / Technology Consulting

Sylvia Mitchem joined PCG in 2020 and serves as a director of the Technology Consulting team. In this role, Sylvia is responsible for project management and business development activities, primarily in the public health and healthcare domains. 

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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...

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Alicia Stewart

Manager / Education

Alicia Stewart, a manager in PCG’s Nashville office, has over 20 years of experience in the education field including six statewide implementations. Her focus at PCG, for the past 16 years...

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Peter Cheesman

Manager / Health

Peter currently directs PCG Health’s systems integration center of excellence, which specializes in the design and deployment of creative technical and data solutions

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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...

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Yvonne De la Rosa

Vice President / Technology Consulting

Yvonne De la Rosa joined PCG in 2008 and serves as a Vice President of the Technology Consulting team. In this role, Yvonne is responsible for providing project management and oversight of independent verification and validation (IV&V) projects...

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Jessica Rod

Associate Manager / Education

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Lauren English-Mezzino

Associate Manager / Education

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Jon Kanter

Chief Financial Officer / Corporate

Jon Kanter joined PCG as CFO in January 2022, with responsibility for ensuring the effective running of the company’s Corporate Finance team and providing strategic thought leadership and counsel to the company’s executive leadership and shareholders. Prior to joining PCG Jon spent the prior five years as CFO of a rapidly growing global law firm, where he had previously spent four years as the Firm’s Managing Director of Financial Planning & Analysis. Prior to that Jon spent over a decade working at a global management consultancy as their Head of Consulting Commercial Finance, where he honed his business partnering and strategic analytical skills. A chartered accountant by training, Jon initially worked is way up to Audit Manager for an international accountancy firm. Over his career Jon has lived and worked in four cities across three continents (London, Sydney, Washington D.C. and Boston).

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Heather Baker

Manager / Human Services

Heather Baker leads PCG's child welfare and youth services practice, helping state, county, and community-based agencies invest in programs, people, and technologies that improve the lives of children and families. She leads a team of individuals with vast experience in delivering and managing child and family services and programs.

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Stephen Rafoul

Vice President of IT Cloud Infrastructure and Operations / Corporate Technology

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Tatiana Vybornova

Chief Information Officer / Education

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Megan Morris

Associate Manager / Health

Ms. Morris, an Associate Manager with the firm’s Health Care Financing Solutions team, is an experienced project manager primarily focused on health and Medicaid-based programs. A certified Project Management Professional (PMP)...

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Jill Reynolds

Associate Practice Area Director / Human Services

Ms. Reynolds leads PCG’s Aging and Disability Services Center of Excellence. She provides strategic leadership and support for human services projects involving Home and Community Services, Vocational Rehabilitation, disability services, employment support programs, and other programs serving elders and people with disabilities...

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Paul Wertheim

Vice President / Technology Consulting

Paul Wertheim joined PCG in 2011 and serves as a vice president of the Technology Consulting team. In this role, Paul is responsible for project management and delivery of independent verification and validation (IV&V) services to state and local governments...

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Katie Bright

Associate Manager / Human Services

Katie Bright is an associate manager within the Human Services’ Child Welfare and Youth Services team. Katie’s career at PCG began in 2002 when she started working within the Massachusetts Department of Children and Families (DCF) revenue management unit. Her role has since expanded to include work with child welfare agencies across the U.S.

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