About No World Borders
We advise clients on disruptive regulations and disruptive technology in health care. Our company name springs from the idea that we support 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.
- Our current U.S. health care delivery system creates silos that do not efficiently work together to control cost and optimize services
- Lack of alignment in risk/rewards amongst the parties stifles cooperation and innovation
- Approach to quality is intra-institutional rather than across continuum of care
- Transition across care continuum frequently done in isolation with multiple hand offs and limited patient follow-up
Therefore, we believe that disruptive regulations (HITECH Act, PPACA, ICD-10 and others) and global events in healthcare (Ebola and other events) 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.
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 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 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.
Sustainable facilities and LEED certified consultants in health care facilities management.
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.
- All organizations face change. We help you embrace it. 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.
- We believe in helping companies create value through
empowerfulinnovation. 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 is 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.
- We help you focus on core competencies and development of repeatable methods for delivering excellence. 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.
- At No World Borders, our people are uniquely qualified to advise clients on health care reform and financial services regulatory change. 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.
- Our mission is to help business leaders execute their initiatives with excellence. 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.
- We help our clients identify and address their people and process challenges and match our professionals’ capabilities with culture, operating environment and intellectual capital requirements of each individual enterprise. 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.
- Our operating model supports hourly and monthly retainer billing, giving clients greater flexibility managing costs. Clients control the investment, direction and outcome of their initiatives.
- We maintain an entrepreneurial culture that frees us to focus on clients’ strategic and operational agendas. 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.
Engagement Approach with Our Clients
- Long-term philosophy – Base your management decisions on a long-term philosophy, even at the expense of short-term financial goals. People need purpose to find motivation and establish goals.
- The Right Process Will Produce the Right Results. Create a continuous process flow to bring problems and opportunities to the surface. Build a culture of stopping to fix problems, to get quality right the first time.
- Add Value to the Organization by Developing Your People. Grow leaders who thoroughly understand the work, live the philosophy, and teach it to others. Without constant attention, the principles will fade. The principles have to be ingrained, it must be the way one thinks. Employees must be educated and trained: they have to maintain a learning organization.
- Continuously Solving Root Problems Drives Organizational Learning. Go and see for yourself to thoroughly understand the situation.
How is No World Borders Different?
Like the largest consulting firms, our projects are managed by talented Partners, Principal Consultants, and Senior Managers. Unlike the largest consulting firms, we create value through project teams and by finding synergies. We are nimble. The synergies we offer are between people, companies, clients, products, services, technologies, and investors with expertise drawn from a network of thousands of consultants, partners, service providers (legal, accounting, computing infrastructure, outsource and near shore software development, call centers), venture capital firms, and private equity firms.
Unlike the largest consulting firms, we do not place the most talented partner on your business, only to have them depart after the first few weeks of the project. We are agile, with a lower cost of doing business and we pride ourselves in providing senior consultants throughout the process.
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.
High Client Satisfaction
Most importantly, we pride ourselves on our consistent achievement of High Client Satisfaction. We know we’ve achieved High Client Satisfaction when our clients not only ask us to continue with our business relationship, but strongly recommend us to their peers.
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.
Michael Arrigo, CPHIT, CPEMR – Managing Partner, Health care Practice
Mr. Arrigo recently served as an expert in a Federal Trade Commission case regarding ICD-10, Computer Assisted Coding, electronic health records, access to clinical data, data transparency, and the macro economic impact of various competitive issues.
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 HIPAA mandates, the HITECH Act and Patient Protection and Affordable Care Act (PPACA) and is a published author and regular speaker. He consults to 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 crowd sourcing 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 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, disparite 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) an 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 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 is a candiate for a Masters in Informatics at Stanford Medical School. Mr. Arrigo is certified in Lean Manufacturing and Six Sigma methodologies, has 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.
Zach Carrol – Partner, Health Plan Strategies
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 aquired 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.
Matthew James – Partner, Provider Strategies
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.
Robert Francis – Partner, eHealthcare Practice- State Medicaid Infrastructure
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.
Alex Nesbitt – Health Care Strategy
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.
Alex specializes in working with senior executives who are frustrated that their organizations are not successfully managing change and need to overcome competing 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 proposed acquisition of $1 billion target company. Planned post merger integration.
- $27 billion Pharmaceutical Distributor. Designed service delivery value chain for pharmaceutical dispensing technology division. Developed 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 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.