We are Gentry Consulting
Gentry Consulting was established in 2006 to provide strategic and tactical support to healthcare organizations navigating complex challenges. For nearly two decades, the firm has operated as a trusted partner to other consulting firms, often serving a significant role in clients’ most critical engagements. This experience has demonstrated Gentry Consulting’s ability to deliver independently, with a high degree of accountability, professionalism, and subject matter expertise.
Now, as part of a strategic relaunch, Gentry Consulting is expanding its direct-to-client presence, bringing its proven capabilities, deep industry knowledge, and flexible consulting model to a broader audience. Led by a principal consultant with over 30 years of experience in managed care and healthcare operations, the firm offers tailored, high-impact solutions that are both scalable and grounded in real-world insight.
Gentry Consulting’s strength lies in its ability to operate across functions, bridge gaps between business and technical teams, and deliver results in complex, high-stakes environments. Clients often engage the firm for targeted support, such as project management or operational planning, and quickly discover broader strategic value. Over the years, Gentry Consulting has supported initiatives such as launching Medicare Advantage health plans, standing up Consumer Operated and Oriented Plans—CO-OPs under the ACA, Risk Adjustment Accuracy and Audit support, and leading enterprise-wide process redesigns. Whether navigating regulatory complexity, optimizing operations, or aligning cross-functional teams, the firm brings clarity, execution, and results, making it a trusted partner for healthcare organizations facing transformation or uncertainty.
Example Engagements (by service offering):
Strategy Execution Support
Path for getting state licensure approval to operate as Managed Care Organization—becoming a payer. Experience working with regulatory agencies in multiple states
Guidance on application process for contracting with CMS to offer Medicare Advantage (Part C and D) plans.
Contract and certification with HHS to operate on ACA exchanges.
Evaluate build versus buy decisions according to the client's targeted timelines.
Criteria for identifying, evaluating, selecting, and contracting with core systems and service vendors.
Network adequacy consideration per CMS for Medicare Advantage and HHS for ACA requirements.
CMS Medicare Advantage bid submission, review, and approval, including plan benefits package, benefits design, and cost-sharing compliance.
Claims and benefits administration vendor implementations.
Regulatory compliance—privacy, security, fraud, waste, and abuse.
Migration and/or implementation of benefit administration systems, third-party administrators (TPA), ancillary applications, and vendors.
Medicare Advantage, Managed Medicaid, and ACA Risk Adjustment accuracy, compliance, and audit response programs.
Business Process Efficiency
Medical coding, clinical documentation improvement, and audit response workflows to ensure accurate, and compliant Risk Adjustment in Medicare, Medicaid, and ACA programs.
Evaluation and redesign of processes, technology, and staffing to produce outcomes that improve efficiency and reduce friction—provider data and directories, network adequacy, Risk Adjustment, medical record and chart reviews, audit response, and compliance improvement.
Incorporating automation technology, like AI, data integrity, and data integration, to bridge business process logic to workflows and queues.
Project Oversight
Health Plan start-ups for integrated health systems so they could enter the Medicare Advantage and ACA exchange markets.
MCO licensing required by state insurance regulators.
Risk Adjustment Validation Audit (RADV) response.
Risk Adjustment medical record accuracy reviews.
Provider network development, health service delivery, and network adequacy.
Contracting with CMS.
Business process services outsourcing implementation.
Business and system migrations and integration related to M&A.