Our Approach
Most consulting firms sell senior expertise and deliver junior staff. Strategic was built on the belief that this model is wrong — and for nearly 50 years, we've operated differently.
Here's what that means in practice: how we staff engagements, how we show up for clients, how we structure our fees, and what you can expect from day one through final resolution.
Staffing
Every Strategic engagement is staffed exclusively with senior executives — not junior associates managed from a distance.
Leverage is the standard consulting business model: a senior partner closes the deal, then a pyramid of less experienced staff does the actual work. It's profitable for the firm. It's rarely good for the client.
Strategic was deliberately built without that model. Our consultants average more than 20 years of direct Medicare reimbursement experience — many having worked for Medicare Administrative Contractors before joining Strategic. When you hire Strategic, the people you meet in the pitch are the people working your engagement.
This isn't a selling point we discovered. It's been the foundation of how we operate since our founding, and it's why our client relationships tend to be measured in decades rather than engagements.
Typical Consulting Firm
Strategic Reimbursement Group
On-Site Work
Accurate reimbursement starts with understanding your organization — not a checklist sent from an office 500 miles away.
The Medicare cost report reflects the actual operations of your hospital. Getting it right means knowing how your departments are structured, what your staffing looks like, how your square footage is allocated, and where the nuances in your patient population show up in the data.
That kind of understanding can't come from a request for information. It comes from time on-site: interviewing department heads, walking the facility, understanding the year's operational changes, and reviewing what changed since the last filing.
Every Strategic engagement includes direct on-site involvement. We treat your organization as a partner, not a data source — and we think the quality of our work reflects that difference.
Department Head Interviews
Direct conversations with the people who know how operations actually work — not just how they're documented.
Operational Context
Understanding what changed during the year — new programs, staffing shifts, facility changes — before a single number is entered.
Year-Over-Year Continuity
The same consultants return each year, so context isn't rebuilt from scratch — it's built on.
Audit-Ready Documentation
Every position is documented from first principles, not reverse-engineered after an audit notice arrives.
What to Expect
We begin every engagement with a thorough review of your current reimbursement situation — recent cost reports, settlements, open appeals, and any areas of concern flagged by prior audits. This gives us a baseline and often surfaces immediate opportunities.
Before preparation begins, we spend time on-site. Department head interviews, facility walkthroughs, and operational reviews ensure the cost report reflects reality — not last year's template. We're looking for what changed, what's new, and what may have been missed.
Our senior consultants prepare the cost report and all supporting schedules — DSH, bad debts, wage index, square footage, and uncompensated care — with full documentation at every position. Every filing is reviewed internally before submission.
We manage the filing and handle all MAC coordination directly. Our consultants have worked with every MAC in the country and understand the procedural expectations and documentation standards each one applies in practice, not just in regulation.
When audits arrive, the same team that prepared the filing defends it. We respond to desk reviews and field audits, gather and present supporting documentation, and manage the process through to the Notice of Program Reimbursement.
Where settlements warrant it, we identify all appealable issues and guide you through the full PRRB process — filings, deadlines, administrative resolution, and legal coordination if needed. We stay with the engagement until you receive proper reimbursement.
Team Continuity
At many firms, consultant turnover is a fact of life. Engagements get handed off, context gets lost, and hospital finance teams spend the first month of every cost report season re-explaining their organization to someone new.
Strategic is a close-knit group. Many of our consultants have worked together for decades, and our client relationships reflect that stability. The consultant who prepares your cost report this year will be there next year — and the year after.
That continuity compounds over time. We know your organization's history, your MAC's tendencies, your prior appeal positions, and where the risk areas are. That institutional knowledge doesn't have to be rebuilt — it just deepens.
"The same people who start on your engagement see it through to resolution. You won't be re-explaining your situation to someone new each year — or finding out mid-audit that your original consultant moved on."
— Strategic Reimbursement GroupNo Knowledge Resets
Your organization's context, history, and open issues carry forward automatically — not from notes, but from the same people.
MAC Relationship Continuity
Our consultants maintain ongoing working relationships with every MAC in the country. Those relationships benefit your engagements directly.
Fee Structure
Strategic's lean operating model is intentional. No expensive corporate offices. No advertising budget. No layers of management between you and the people doing the work. That structure lets us offer senior-level expertise at rates that make sense for hospital finance departments.
We've never built overhead into our cost structure that exists to impress rather than serve. Our offices are functional, our team is lean, and our rates reflect that.
We define the scope of each engagement based on what your organization actually needs — not what generates the most billable hours. If something isn't necessary, we'll say so.
The standard tradeoff — senior expertise costs more than junior staff — doesn't apply here. Our structure means you get executive-level consultants without enterprise-firm pricing.
Senior staff, always
No junior associates. No leverage. The consultants you meet are the consultants who do the work.
On-site presence
Every engagement includes direct on-site time. We don't prepare cost reports from a distance.
Team continuity
The same consultants return year after year. Your context isn't rebuilt — it compounds.
Full-cycle accountability
We stay with every engagement from initial preparation through final audit resolution.
Honest scoping
We tell you what you need, not what's most profitable for us to provide.
Compliance first
We recover maximum reimbursement within the bounds of what the law legitimately allows. Nothing more, nothing less.
Get In Touch
A 30-minute conversation with a senior consultant is the fastest way to understand what working with Strategic actually looks like.
(630) 530-7100 Send an Email