Next Wave (NWI) is a health policy research, management consulting, and evaluation firm founded in 1984.  We provide technical expertise to all sectors of the healthcare industry, promoting access to safe, high quality, and cost-efficient care.  We utilize a common sense approach combined with valid information and experience across all settings and stakeholders. 

We assist our clients in balancing their competing demands within a rapidly changing healthcare marketplace, including recent projects at the:
▪       Practice level (at the point of care, documenting, coding, billing,
                    reporting) and
▪        Policy level (national/state policy, provider/payor management
                    strategies, practices/procedures, and budget forecasts). 

                                        PRACTICE
Support for Reimbursement, Payment, and Quality System Implementation (Providers, Clinicians, Government, Payors, Facilities)                                                                                           (click for more details)Next Wave is proud of its track record of providing value to our clients: better treatment outcomes, higher staff satisfaction, lower costs, and improved revenues – many times all four.

• Hospital Diagnosis Related Group (DRG) Payments
• Skilled Nursing Facility Resource Utilization Group (RUG III) Payments
• Long Term Care Service Configuration Strategies
• Free-Standing Clinic Payment Reviews
• Physician Office Practice Payment Reviews
• Malpractice Risk Assessment       
• Health System Due Diligence Support for Attorneys
• Insurer Claims Review Process Evaluations

                                          POLICY
Evaluation Support for Development and Refinement of Payment and Quality Measurement Concepts, Legislation, Regulations, Roll-Out, and Oversight                                                        (click for more details)
Next Wave is proud of its track record of implementation of our suggestions and recommendations for system refinements by national and state legislators, regulators, payors, and report card developers. 

• Evaluate Appropriateness of Hospital DRG Payment Category changes
• Refinements to ICD-9-CM Diagnosis and Procedure codes – Administrative Data
• Evaluate Appropriateness of Medicare RUG III for Current Medicaid Population
• Evaluate Value-Based Purchasing (VBP) and Pay for Performance (P4P) Proposals
• Prepare Formal Policy and Technical Evaluations to Support Client Issues

                              RESOURCES AND TOOLS
Management, Medical Record, and Health Information Professional Services (Providers, Clinicians, Coders, Billing Staff, Practice Managers)                                                                                       (click for more details)
Next Wave is proud of its ability to measure or estimate significant components of the issues we address.  This evidence-based decision making makes our recommendations valid and consistent.

·         Benchmarking and Data Expertise
·         Information, Management, and Decision Support
·         ICD-9-CM Coding Expertise
·         CPT Coding Expertise