CONSULTING SERVICES

Kotula International's Healthcare Practice is, headquartered in the San Francisco Bay area, is directed by its President who is responsible for the formulation, development and implementation of our Firm's services to the healthcare industry. The President responds to technical inquiries, monitors current developments in the industry, oversees communications and training efforts and maintains the high quality of our services.

The healthcare consulting team for our Firm is coordinated by Henry Kotula, who served for seventeen years in both consulting and management capacities to the healthcare industry. Before founding Kotula International, he served as an internal consultant to senior management of a large multi-hospital system and for nine years in the healthcare consulting practices of two international public accounting firms with clients throughout the country.

Our professional staff provides personalized service to each client. We recognize the uniqueness of each organization and develop recommendations which are specifically tailored to meet the organization's needs. An engagement is carefully reviewed at the outset and a team is assembled with expertise to match the specific needs of the client. We emphasize real issues and workable solutions, and our approach is process as well as outcome oriented. Our objective is to provide approaches which are practical, worthwhile and both understood and agreed upon by the client.

Kotula International's extensive healthcare experience provides the understanding and skill necessary to design, develop, negotiate and implement successful business relationships and arrangements.

The following is a representative list of areas in which we conducted consulting engagements for our healthcare clients.

Interim Management
Provide interim financial and administrative management services to healthcare provider and management service entities.

Business Planning
Prepare prospective financial statements, debt capacity analyses, financial feasibility studies, and business planning documents. Develop sophisticated financial planning models to assess varying scenarios.

Strategic Financial Planning
Facilitate the board and management in evaluating organizational mission and developing goals and objectives; develop strategies to expand service opportunities, improve market position, and increase quality/cost-effectiveness.

Integrated Delivery System Development
Provide financial planning assistance related to integrated delivery system development including acquisition of medical group practices, development of management service organizations, non-profit medical foundations, physician/hospital organizations, and inpendent physician practice associations.

Capitation Contracting, IBNR Estimation , & Risk Pool Financial Reporting
Assess the profitability of managed care risk contracts. Estimate IBNR claims liability reserve for institutional and professional risk pools. Documentation of IBNR methodology and related calculations in support of financial and internal audits. Development of risk pool financial reporting, including: full and shared risk revenue, reinsurance expense and recoveries, third-party liability recoveries, subcapitation payments, medical expenses, and coordination of benefits. Development of claims payment lag studies.

Program and Service Line Planning
Facilitate the development of new programs; provide financial, operational, and strategic assessment of existing programs to improve market position, financial performance, and increase effectiveness; develop business plans and operating budgets.

Joint Ventures, Partnerships, Corporations, and Limited Liability Companies
Evaluate organizational goals and alternative arrangements for acheiving them; develop governance structures; negotiate terms and conditions; provide business review of legal documentation.

Acquisitions, Mergers and Affiliations
Evaluate and assist in creating opportunities; assess alternatives; design conceptual frameworks; develop strategic approaches; negotiate terms and conditions; and assist in the review of related documentation.

Business Valuations
Assess business value of independent, single and multi-specialty physician group practices and related ambulatory care provider entities.

Negotiation and Facilitation
Encourage collaboration and facilitate team approaches to problem solving and strategic planning; negotiate and facilitate the building of positive business relationships.

Business Agreements
Design and negotiate relationships and requirements; business review of existing agreements and recommend changes.

Litigation Support, Due Diligence Assistance and Agreed Upon Procedures
Provide due diligence assistance; evaluate business plans and supporting assumptions; assist in business fact finding; provide industry and service specific research on regulatory, operational, market, financial and strategic trends. Investigate and analysis of the financial and operational operating activities of an entity (Target) in connection with a proposed transaction that would result in a significant change in ownership or capital structure of the Target; perform agreed upon procedures to the nature and extent to effectively satisfy information needs.