DeBrunner & Associates provides a broad range of health care policy consulting and advocacy services at the federal and state levels of government, focusing primarily on Medicare and Medicaid reimbursement.

Federal Government Relations and Advocacy

DeBrunner & Associates helps our clients understand, anticipate, respond to, influence, and ultimately benefit from the actions of the federal government, which is their most important regulator and often their biggest payer.  Understanding federal health care policies – and when and how to seek to change them – is essential to success in health care.

We help our clients identify their federal health policy issues; manage those issues; define, track, and analyze them to determine their potential impact; communicate their concerns to federal officials – both their own congressional delegations and executive branch officials; and engage in successful advocacy.

At the heart of our effectiveness is our relationships:  in addition to our deep health care policy expertise DeBrunner & Associates’ federal advocates have spent years on Capitol Hill, cultivating relationships through regular interaction and working with elected officials and staff in Congress and the administration and on both sides of the political aisle.  Politics matters in Washington and our advocates understand Washington politics and use that understanding for our clients’ benefit through highly persuasive advocacy.  We know whom to call when our clients bring us new challenges while also helping our clients speak up persuasively and ensuring that we reach the right people with the right messages at the right time.  Through these efforts we help our clients gain federal laws, regulations, and programs that better meet their needs.

The federal government also is an important source of supplemental funding for many health care organizations and we help our clients pursue these funds through project, demonstration, and research grants and earmarked appropriations.  In support of such efforts we provide strategic and technical advice on funding applications, assist with the preparation of those applications, and make and follow through on the many political contacts involved in the selection of highly sought-after grants and appropriations.

Finally, our understanding of the actions – and anticipated actions – of the federal government makes us a valuable contributor to our clients’ strategic planning.  We advise them on the policy and political environments in Washington, sharing with them the directions our experience and relationships tell us federal officials will turn next in their never-ending effort to make and remake government health care policy.  Often, our clients call upon us to brief their senior management teams and even their boards on emerging public policy issues, trends, and challenges and to recommend government relations strategies that will make life better for their organizations.

Medicare Policy

DeBrunner & Associates helps health care providers – hospitals and health systems, academic medical centers, post-acute-care providers, long-term-care providers, specialty providers, provider associations, health care technology companies, and others – address their Medicare policy and reimbursement challenges.  Much of our work focuses on helping providers maximize their revenue from Medicare – often their single most important payer.  They hire us to ensure that they are paid appropriately for the care they deliver.

Working hand in hand with clients, we assess their challenges and needs, formulate responses for addressing those needs, and develop strategies for achieving our objectives.  Supporting those strategies are careful analysis, supporting data (when needed), creative policy proposals, and our hallmark forceful, persuasive advocacy.  Also supporting such efforts:  long-standing relationships with officials in the executive branch and members of Congress and key congressional and committee staff.

The range of Medicare issues organizations bring to us is broad and includes reimbursement needs; regulatory challenges; Medicare wage index issues; legislation clients seek or proposals they wish to support or oppose; concerns about their Medicare disproportionate share payments (Medicare DSH), medical education, and 340B; changes in hospital designation (critical access hospital, Medicare-dependent hospital, sole-community hospital, rural emergency hospital); pursuing federal grants and earmarks; and more.

Finally, we track regulations and legislation, model the potential impact of proposed Medicare reimbursement policy changes on clients’ Medicare revenue, and contribute to their policy awareness and strategic planning by identifying future trends and likely changes.  Through these combined efforts we help our clients speak up effectively and ensure that they reach the right people with the right message at the right time, thereby maximizing the likelihood that they will achieve their federal health policy goals.

To learn more about how DeBrunner & Associates can help you and Medicare work better together, contact us.

National and State Medicaid Issues

Medicaid is a state and federal partnership that varies greatly across the country.  DeBrunner & Associates’ mix of clients ensures that the firm maintains the necessary expertise to interact on every level of Medicaid policy development, having worked on issues ranging from the county level to state fee-for-service and waiver-based Medicaid all the way up through federal rulemaking and congressional action.

DeBrunner & Associates provides extensive consulting assistance on federal Medicaid reimbursement policies – a vital consideration for many providers for which Medicaid is a major payer that can make or break their overall financial performance.  We help providers and associations understand how to navigate complex federal Medicaid policies, regulations, and laws – and to oppose or support new proposals that could affect them.  We track policy developments to keep clients apprised of potential changes that may affect them and help them respond to those that have not yet been adopted and develop strategies for adjusting to changes that have taken effect.  We also help them forge relationships with their congressional delegations and administration officials and give them a voice in those changes while engaging in our own persuasive advocacy on their behalf.

DeBrunner & Associates also helps providers address Medicaid issues at the state level.  Frequently working alongside their own government relations staff or consultants, we help clients understand proposed and existing Medicaid regulations and policies at the state level – and advocate change when they believe change is needed.  We model proposed changes in state Medicaid plans and reimbursement practices and suggest and develop alternatives to advocate when appropriate; help providers encourage their states to pursue federal Medicaid waivers that could bring additional resources to their states; and help clients understand state proposals to levy provider assessments – and develop, model, and advocate alternative approaches to assessments if our analysis suggests proposed assessments would be harmful.

Between our Medicaid work at the state and federal levels, DeBrunner & Associates helps inform our clients’ strategic planning, enabling them to move forward with confidence that their future plans reflect a realistic understanding of what they can achieve in the policy environment at any given time.

To learn more about how DeBrunner & Associates can help you with Medicaid issues, contact us.

Commonwealth of Pennsylvania Government Relations and Advocacy

DeBrunner & Associates has a special practice dedicated entirely to working with health care interests in Pennsylvania:  hospitals and health systems, provider associations, long-term and acute-care providers, LIFE (PACE) organizations, biopharmaceutical companies, behavioral health care and rehabilitation providers, and more.  For these organizations we provide expert counsel, creative solutions, and highly effective advocacy while working on their behalf with state agencies to address reimbursement, regulatory, licensure, and other concerns; interpret new state Medicaid policies; and identify opportunities to pursue state research, program, and demonstration grants.

With our years of experience with all things health care in Harrisburg, DeBrunner & Associates helps health care organizations with everything from state budgets to regulations to proposed legislation, ensuring that state government understands their needs before it makes decisions that affect them.  Much of this work involves Medicaid, one of the most important payers for most of our Pennsylvania clients, and we work closely on our clients’ behalf with the Department of Human Services, which administers the state’s Medicaid program, as well as with the governor’s office – regardless of the political party of the governor in office at any given time – the Health Department, Department of Drug and Alcohol Programs, and Insurance Department.

In support of these efforts we help our clients identify their state public-sector objectives and then work with them to craft strategies designed to achieve those objectives.  Those strategies involve helping them cultivate relationships with decision-makers in the state’s executive and legislative branches of government; developing creative proposals that address our clients’ specific needs; and engaging in the informed, effective advocacy for which we have become known in Harrisburg since our founding in 1996.  Most important, we understand where health policy is made in Pennsylvania and have strong, long-standing relationships with policy-makers – relationships that extend to both the executive and legislative branches of state government and on both sides of the political aisle – that we regularly leverage on our clients’ behalf.

Through all of the endeavors we track administrative actions and legislation, manage issues, and contribute to our clients’ strategic planning by helping them understand how Pennsylvania Medicaid policies and practices will affect their financial health.  We work with their executives and government relations staff, keep them apprised of the political and policy environments in Harrisburg, brief their boards, and make other valuable contributions that have left countless Pennsylvania health care clients over the years in better financial health than when they first turned to us for assistance.

To learn more about how DeBrunner & Associates can ensure that you’ve got a friend in Pennsylvania, contact us.