About No World Borders

We help leading companies respond to change and challenges posed by a rapidly evolving economic and regulatory environment.

We are experts in healthcare data, regulations and economics.

We advise clients on disruptive regulations and disruptive technology in health care.  Our name is not political. Our company name springs from the idea of borderless health care; the name is inspired by Complexity Theory and Adaptive Systems in economics. Complex systems typically have fuzzy boundaries. The borders we speak of are the silos in the U.S. healthcare system.  We believe that biomedical informatics and bioethics are the future: patient autonomy is empowered by access to data; similarly transparency in healthcare economics for all stakeholders is fueled by standardization.  

 We provide medical bill review services for leading insurance companies such as AIG, Hartford, and other liability and health insurers.  We are balanced in our retention, also serving leading hospitals such as the Harvard Health System and Cleveland Clinic as well as advisory to the largest payors and self-insured ERISA / Taft-Hartley Trust employment plans in the U.S.  We also serve as litigation consultants to plaintiffs and defendants. Our founder has served in a number of class actions and has been affirmed as an Expert by Federal Judges. Our firm has served the U.S. Department of Justice and U.S. Department of Transportation.

Our expertise includes medical billing expert witness and medical coding, data privacy and cybersecurity under regulations such as HIPAA expert witness, HITECH Act, and Electronic Health Record Expert Witness and GDPR, Medicare fraud, insurance damages, damages calculations in criminal fraud sentencing guidelines, and medically necessary care billed to insurance.

Biomedical Informatics Perspective

      • Informatics is the logic of healthcare. Digital information has made knowledge infinitely larger and more available for clinicians, but contextual knowledge is often unavailable.
      • Clinicians now are in a knowledge management crisis – getting the right information to health care administrators, clinicians, IT personnel and others at the right time is the challenge.
      • Biomedical Informatics seeks to discern the difference between data, information, knowledge and wisdom by increasing sharing and comprehension.
      • The world is aging and there are increasing numbers of people with chronic disease; it is recognized that a key sustainable strategy is planning and delivery of healthcare through technology innovation.

Our Qualifications

Our founder and other members of our team have worked in hospital systems having performed direct observation of front-line clinical staff, which means we understand how care is delivered, not just about the administrative back office. Our Clinically Integrated Solutions facilitate coordination between the siloes to improve health care quality and value while complying with HIPAA Privacy and Security and Meaningful Use Personal Health Information safeguards.

We’ve worked in health plans, helping set the strategy on medical policy plan design, EDI, insurance exchanges, claims first pass rate, ICD-10, HIPAA 5010, out of network claims and more.

We’ve worked in investment firms, performing diligence on large-scale investments in life science and health IT totaling over $4.5 billion in enterprise value.

We’ve worked in pharmaceutical and medical device firms, helping them with regulatory and strategic issues.

We deal directly with legal teams, having served as experts on landmark health IT cases in Federal court. Our team includes former Federal employees who helped set the mandates for the Centers for Medicare and Medicaid (CMS), Office of the National Coordinator for Interoperability (ONC) reporting to the U.S. Department of Health and Human Services (HHS).

Our team members are established experts in value based care for Accountable Care Organizations and Medicare Advantage health plans.

And, we deal every week with regulatory compliance teams.

Health Care Transition Consulting

Our company name springs from the idea that we support borderless health care. Our Clinically Integrated Solutions facilitate coordination between the siloes to improve health care quality and value.

    • We are led by a group of experienced executives who understand large public organizations, not for profit health plans and hospitals.
    • We bring our entrepreneurial culture and strong Silicon Valley roots and experience to create a unique, high value, agile set of solutions.
    • We integrate a $billion balance sheet, over 5,000 consultants, thought leadership, subject matter expertise, and execution and delivery capabilities under one brand with unmatched health care expertise from clinical to regulatory, HIT process and business perspectives.
    • Our clients and team experience include:
      • Fortune 10 self-insured employer
      • One of the three largest health plans in the U.S.
      • One of the largest teaching hospital systems in the U.S.
      • One of the largest hospital systems by the number of licensed beds.
    • Leading-edge health care clients include:
      • A premier venture capital firm that invested in an Accountable Care Organization and analytics solutions business
      • A children's hospital striving to be the 'hospital of the future' by integrating HIT solutions; funded by a Fortune 50 endowment
      • A Medicare Advantage Health plan that is leveraging technology to optimize 5-Star Ratings

We provide a proven end– to–end assessment, governance, risk management, and compliance (GRC) methodology. In addition, our training, implementation planning, HIT application modernization and remediation, testing strategies, test services and test data for complete transition solutions. (See health care expertise below).

We are a private equity-backed firm with engagement experience on three continents. We were founded in 2000, and provide services to some of the most successful companies in the world. We help solve issues of concern to senior management for clients who wish to refine and achieve their business strategy via superior service, unparalleled expertise, and process transparency.


Helping Companies Save Money and Manage Change in the Perfect Storm of HIPAA and HIT Mandates

There are now unprecedented levels of investment, unprecedented risk, and unprecedented opportunity in health care. CMS HIPAA mandates and the Patient Protection and Affordable Care Act (PPACA or HR 3590, aka "Obamacare") create a perfect storm of change. This perfect storm will grow over the next five years. We believe it is imperative to map out the process for organizing and achieving change.

Companies need to make sure that there is sufficient urgency within the organization to drive change forward, not just in clinical, informatics and health IT, but enterprise-wide. We help clients take ownership of the process to enable change and innovation, achieve business goals, and comply with regulatory compliance mandates.

Principles

    1. We assist in injecting creativity, flexibility, and a partnership focused on innovation. The ability to manage and embrace change is critical for effective organizations that are globally distributed or that have grown via acquisition.
    2. Empowerment is one thing, but letting your employees know that they are encouraged to help tweak your company and develop new products, services and strategies are more empowerful. By encouraging people to "fix things" as well as tweak the company, companies can more efficiently translate vision and strategy into reality and action. The US Navy has employed this technique to transform the worst ship in the Pacific Fleet into the winner of the prestigious Spokane Trophy, which is awarded to the ship with the best combat readiness in the fleet.
    3. The most winning companies in the world, regardless of size, industry, or state in their evolution, have universal characteristics: a focus on core competencies, and a repeatable method for delivering excellence. Usually, achieving excellence requires coordinating people, process, and technology effectively.

Value Proposition

  • Having worked with the Fortune 1000, the Big Four, traditional consulting firms, as well as early-stage companies, we provide clients with access to broad business knowledge, deep industry proficiency, and strong execution capabilities. With an average of more than 12 years of experience, our professionals are problem solvers with management skills, judgment and adaptability.
  • Operating as part of your team, we provide the intellectual capital and execution capability to help managers drive internal change and regain control of their strategic initiatives.
  • By infusing client teams with accomplished professionals, we help solve problems and execute initiatives, and we also transfer knowledge building a team's capability to operate in new ways. Whether centralizing global processes into a shared service, moving supply chain logistics offshore, or accelerating a financial reporting process that spans currencies and continents, our professionals work on-site to support business leaders and their global operating teams.
  • Clients control the investment, direction, and outcome of their initiatives.
  • And by sharing insights and lessons learned across our global professional community, our professionals and clients are kept apace of the trends driving internal initiatives.

In these ways, we are able to help leading companies respond to change and challenges posed by a rapidly evolving economic and regulatory environment.

High Client Satisfaction

No World Borders delivers quality work, with deeper, valuable, actionable insights.

Our consulting teams have already seen -- and solved -- the issues our clients are facing. We deeply understand the business problems facing our clients and our teams don’t have to learn anything on the client’s dime – we add value on the first day.

The company has affiliate relationships world-wide and serves a variety of industries including health care, financial services, apparel, retail, real estate, government, and higher education.

Executives

photo of michael arrigo
Michael Arrigo

Mr. Arrigo is affirmed as an expert by Federal Judges and has led diligence efforts on over $8 billion in enterprise value of healthcare industry merger and acquisition transactions.  Mr. Arrigo has been quoted in The Wall Street Journal, National Public Radio, the New York Times, Los Angeles Times and other publications.

His areas of expertise include Health Care Mergers, Health Care Private Equity and Venture Capital Investments, Antitrust and Competition Policy in the Health Care, Cost-Benefit Analysis in Health Care, Health Care Sector Modeling, Molecular Diagnostics, Health Care Insurance Services, Medical Device, Pharmaceuticals, Physician Services, Public Policy and Health Care Payment Reform. In addition, he has a decade of experience in enterprise software, social media, and eCommerce as well as financial services. He has spent time directly observing clinical staff deliver care to high acuity patients in hospitals, so he brings a care delivery perspective to the firm.

He has in-depth experience in medical coding and medical billing, civil and criminal fraud matters, HIPAA Privacy, the HITECH Act and Patient Protection and Affordable Care Act (PPACA) and is a published author of peer-reviewed material. He is a regular speaker. He consults with clients regarding HIPAA 5010, ICD-10, revenue cycle management, Meaningful Use of Electronic Health care Records, quality measures for Medicare Advantage Hospital Value-Based Purchasing and Medicare Advantage HEDIS 5-Star Ratings for health plans. He is an expert in participatory social media for building brands and crowdsourcing solutions. Mr. Arrigo was recently quoted in the Wall Street Journal Venture Capital Dispatch regarding venture-backed information-technology companies that serve hospitals and health insurers and Wall Street Journal Health Blog. He performed a macroeconomic analysis of the reimbursement shifts in the international classification of diseases, version 10 (ICD-10) that was published in Healthcare IT News. He performed diligence work for the premier venture capital firm in the U.S on their investment in medical analytics, a health plan, physician group, and accountable care organization solutions.

In his prior work as an SVP of eCommerce at Fidelity and at CoreLogic, he led innovative eCommerce and consulting business groups that were instrumental in transforming both companies’ strategy from a siloed services to integrated exchanges using the software as a service (SaaS) platforms. He led one of the largest and most complex Sarbanes Oxley audits in the U.S. for a Fortune 100 firm, involving multiple lines of business, disparate financial systems, application controls and general controls. His team served financial services firms such as JP Morgan and Wells Fargo. Prior to that, he was CEO of Erogo (acquired by Citrix) a SaaS billing company. He led the development of the asset acquisition strategy and launch of LeadersOnline, a Heidrick & Struggles backed early social media venture and assisted in the IPO of Heidrick, adding over $100 million to the market cap at the time of the IPO. Prior to that, Mike served in consulting, executive, strategy, sales and marketing, and product management positions at Borland, Hewlett Packard, Symantec, and Oracle.

He has been a guest lecturer at Loyola and the University of California, Irvine. He earned his degree in Business Administration from the Entrepreneur Program at the University of Southern California (USC), studied computer science and economics at the University of California, Irvine (UCI) and attended the University of Pennsylvania’s Wharton School executive management program. He studied Biomedical Informatics at Stanford Medical School and earned his certificate in Bioethics at Harvard Medical School. Mr. Arrigo is certified in Lean Manufacturing and Six Sigma methodologies have been a member of the Workgroup for Electronic Data Interchange (WEDI) for health care information and the Southern California Chapter of the Health Information Management Systems Society (HIMSS). He writes for Government Health IT, Healthcare Finance News, mHealth News, Healthcare IT News, and our corporate blog. He is an advanced youth soccer coach and an avid road cyclist. In October 2007, Mr. Arrigo competed in the U.S. Olympic Sailing Team Trials.

photo of Zach Carroll
Zach Carroll

Zach guides health plan clients with an eye toward collaborative success with health care providers, having worked for some of the top payors and providers in the industry. His prior work includes Director of Strategy at Health Alliance in Cincinnati for Electronic Health Records, HIPAA 5010, and ICD-10. Prior to that, he was a consultant at Allscripts where he helped to improve the interoperability strategy and execution of acquired companies.

He worked at Wellpoint, in application development, managed eCommerce initiatives at Aetna, and served on a team at United Health that built medical policy design and IT rules implementation. Prior to that he worked in Revenue Cycle Management at Ascension Health, a leading provider of health care, and Dignity Health. He proudly served as a Lieutenant in the US Airforce. He has resided in Ohio and currently lives in Philadelphia, PA.

Zach graduated from the University of Texas at Austin.

Matt brings health plan and IT experience as well as experience helping to build electronic health record systems, clinical documentation improvement and coding quality to leading health care providers across the U.S.

He worked for Blue Cross Blue Shield, WellPoint a top three health plan, Accenture a leading consulting firm, Epic Systems a leading electronic medical records company, and HCA, a leading health care provider with over 160 hospitals across the U.S.

He graduated from the London School of Economics.

photo of Bob Francis
Robert Francis

Robert has extensive experience in health care and management consulting having worked as a consultant at Deloitte as well as with Cerner Corporation and Pfizer. He is a subject matter expert on State Medicaid solutions including enrollment and eligibility and was a member of the team that developed the first Service Oriented Architecture based State Eligibility system for the state of Pennsylvania (COMPASS). He has deep expertise in Medicare architecture, ITIL, and MITA.

He has led State, Federal, and private sector engagements in ICD-10, Meaningful Use of Electronic Health Records, and process improvement for health plans and hospital systems. Prior to that Mr. Francis worked at Bank of America where he played a key role in rolling out the company's eCommerce system.

Prior to that, he worked at Netscape, Cisco, and Microsoft in a variety of engineering and product management positions.

He is a graduate of UC Berkeley where he earned his Bachelor of Science in Economics and his Masters in Computer Science. In addition, he holds a Masters in Informatics from Northwestern University.

photo of alex nesbitt
Alex Nesbitt

Alex Nesbitt helps companies lead change. He is a former partner with The Boston Consulting Group, where he led BCG’s west coast health care practice. He has been involved in helping hospitals, academic medical centers, payers and health care suppliers for over 25 years. Educated at Stanford, Alex specializes in working with senior executives who are frustrated that their organizations are not successfully managing change and need to overcome competing for functional agendas and cross-functional processes that suffer from poor communication and distrust. He is responsible for conducting Business Roadmap development with health plans for HIPAA 5010 and ICD-10 engagements.

Examples of his work include the following health care engagements:

  • $1 billion Academic Medical Center. Post-merger integration of two $500 million academic medical centers.
  • Regence BlueShield. Led post-merger integration of King County Medical Blue Shield and Pierce County Medical Bureau to form Regence Blue Shield. $20 million in cost reductions identified.
  • $7 billion Pharmaceutical Manufacturer. Performed strategic and financial due diligence in support of the proposed acquisition of a $1 billion target company. Planned post-merger integration.
  • $27 billion Pharmaceutical Distributor. Designed service delivery value chain for pharmaceutical dispensing technology division. Developed a service strategy to optimize revenue realization.

Alex is also the author of a number of articles and white papers in the health care sector including:

  • Managing for a Wired Health Care Market
  • Unlocking the Value of Health Care Information
  • Service Lines: Assuring Leadership for Academic Medical Centers, and
  • The Four Essential Elements of a Growth-Oriented Culture

Alex graduated from Stanford University with a Bachelor of Science in Industrial Engineering.

Thought Leaders, Physicians, Electronic Health Record, Regulatory Experts

In addition to its business and strategy consulting, No World Borders brings some of the strongest physician and regulatory perspectives in the business. Its team includes Physicians with clinical data expertise and regulatory consultants with experience gained from decades of work in the U.S. Department of Health and Human Services (HHS) and Centers for Medicare and Medicaid (CMS) in senior Health Care IT roles.

Our team includes some of the thought leaders in the industry on the reimbursement impacts of the shifts in regulations and standards, Diagnosis Related Groups (DRGs) and other areas, which are core to the shifts in health care payment reform and the move to comparative effectiveness as the guide for physicians.

We are experts in the selection and implementation of Electronic Medical Record (EMR) / Electronic Health Record (EHR) solutions and meaningful use. Our team has in-depth experience in quality measures and how they will shift quality bonus payments under Medicare Advantage in the future.

Who Is No World Borders

Our company name springs from the idea that we support borderless health care. We help our clients improve their outcomes and find strategic advantages regarding disruptive regulations and disruptive technology in health care.

Kaiser Health News quotes expert Michael Arrigo regarding medical coding medical billing and healthcare economics

No World Borders advises clients regarding disruptive regulations and disruptive technology in health care. We are a team of nationally recognized experts, physicians, published authors, regulatory, economic and policy advisors and health IT people who have worked in care delivery, health plans and for the U.S. Government. We have a growing expert witness practice because of our in-depth knowledge of regulatory and resulting economic issues.

Healthcare Y2K Problem
Healthcare Y2K Problem

Our company name springs from the idea that we support borderless health care and is inspired by Complexity Theory and Adaptive Systems in economics. Complex systems typically have fuzzy boundaries. The "borders" we speak of are the silos in the U.S. healthcare system. Therefore, we believe that disruptive regulations and global events in healthcare mean that in many cases, traditional ways of “getting our heads round the problem” are no longer appropriate. We provide an independent advisory service to help our clients improve their outcomes and find strategic advantages.

NPR
Listen to Natoinal Publlic Radio Story - Michael Arrigo comments on high cost healthcare charges

We've been covered in The Wall Street Journal, and our founder's articles have been published in Healthcare IT News, Gov Health IT, Mobile Health News, Financial Health News, Healthcare Financial Management Associations Strategic Financial Planning Newsletter.

Our founder is published in the Healthcare Financial Management Association, the premier association for healthcare financial executives

Healthcare IT News Trends
Keeping abreast of key healthcare regulatory, technology and economic trendsOur Qualifications

Our Qualifications

Our founder and other members of our team have worked in hospital systems having performed direct observation of front-line clinical staff, lead clinical record chart audits, and advised health plans. We  understand how care is delivered, documented and paid for -- not just about the administrative back office. Our Clinically Integrated Solutions facilitate coordination between the siloes to improve health care quality and value while complying with HIPAA Privacy and Security and Meaningful Use Personal Health Information safeguards.

Recent retention by the U.S. Department of Justice assisting in a $900 million False Claims Act investigation.

We've worked in health plans, helping set the strategy on medical policy plan design, EDI, insurance exchanges, claims first pass rate, ICD-10, HIPAA 5010, out of network claims and more.

We've worked in investment firms, performing diligence on large-scale investments in life science and health IT totaling over $4.5 billion in enterprise value.

We've worked in pharmaceutical and medical device firms, helping them with regulatory and strategic issues.

We deal directly with legal teams, having served as experts on landmark health IT cases in Federal court. Our team includes former Federal employees who helped set the mandates for the Centers for Medicare and Medicaid (CMS), Office of the National Coordinator for Interoperability (ONC) reporting to the U.S. Department of Health and Human Services (HHS).

Our team are established experts in value based care for Accountable Care Organizations and Medicare Advantage health plans.

And, we deal every week with regulatory compliance teams.

See our success stories / solutions / expert witness work

What We Do

We help health plans, self-insured employers, hospital systems, physician groups, medical device, pharmaceutical, health IT companies.

We help health plans, self-insured employers, hospital systems, physician groups, medical device, pharmaceutical, health IT companies. Our Value based care (including Medicare Part C and Accountable Care) Consulting team has broad expertise to help you. We have expertise in out of network claims, clinical documentation auditing and improvement, coding and billing, medical loss ratio, HIPAA Privacy and Security consulting, ICD-10, as well as Meaningful Use of Electronic Medical Records, Health Care Payment Reform, Quality Measures and usual, customary and reasonable cost of care consulting. Our firm works with health care providers and health plans throughout the U.S. as well as investors and law firms as litigation consultants.

Biomedical Informatics Perspective

  • Informatics is the logic of healthcare. Digital information has made knowledge infinitely larger and more available for clinicians, but contextual knowledge is often unavailable
  • Clinicians now are in a knowledge management crisis – getting the right information to health care administrators, clinicians, IT personnel and others at the right time is the challenge.
  • Biomedical Informatics seeks to discern the difference between data, information, knowledge and wisdom by increasing sharing and comprehension.
  • The world is aging and there are increasing numbers of people with chronic disease; it is recognized that a key sustainable strategy is planning and delivery of healthcare through technology innovation.

See our solutions page.

Where We Work

We have a nationwide presence and our offices are within the United States.

Nationwide

We have a national presence with offices throughout the U.S.

  • Providers and Payors - We work with startup to early stage Health IT companies as well as publicly traded firms. Our health care provider experience spans from small clinics to academic medical centers, and our work with health plans includes mid-sized state employee plans to regional and national payors and one of the largest self-insured employers globally.
  • Health IT technology experience includes electronic medical records, encoders, computer assisted coding, adjudication and utilization management systems, RIS / PACS for diagnostic imaging, ePrescribing, mobile health and cloud computing and SaaS based analytics solutions.
  • Investor experience includes venture capital firms, private equity firms, and firms that invest in public securities and debt.
  • Law firm experience includes civil and criminal matters at the local, state, and federal levels as expert consultants and testifying expert witnesses.

See our locations or contact us