Brian E. Hoyt

Managing Director

Tel 202.480.2762Fax 202.419.1844

Brian Hoyt’s consulting career spans more than twenty-five years and has focused on the healthcare industry.

He provides thorough analysis that identifies and establishes meaningful connections, often across disparate datasets, departments, and documents. Combining this approach with his healthcare industry expertise, he provides insight-driven strategies that give clients the confidence to advance to what lies ahead.

Mr. Hoyt is a managed care expert. He has conducted projects and studies for healthcare providers, hospitals, and health systems; health insurers, managed care organizations, and other third-party payers; pharmacy benefit managers; and regulators.

Mr. Hoyt has conducted numerous projects and studies pertaining to health insurance and managed care; healthcare claims submission and payment; provider network adequacy; provider directories; utilization review; pharmacy benefits and pricing; actuarial analysis; and premium rate setting.

Mr. Hoyt provides expertise related to the Patient Protection and Affordable Care Act and to federal healthcare programs including Medicare and Medicaid. He has been identified as an expert witness in the Federal Employees Health Benefits Program (FEHBP).

Mr. Hoyt has testified as an expert and has been selected as an independent monitor of enforcement decrees pursuant to both state and federal investigations.

Education

University of Colorado
MBA, Finance

Ohio State University
Six Sigma Black Belt, Healthcare

George Washington University
B.A., Economics

Case Work

Health Plan Monitoring and Corrective Action Plans

State departments of insurance and departments of managed healthcare have retained BRG experts to serve as interim officers and monitors for financially troubled managed health plans.

Provider and Payer Disputes

BRG experts have worked on engagements for hospitals or health providers involved in disputes over reimbursement rates for both contracted and non-contracted services.

Out-of-Network Reimbursement

BRG has been retained in several cases relating to payments made by health insurers to providers that are not in their provider networks (out-of-network reimbursement).

Brian E. Hoyt

Brian Hoyt’s consulting career spans more than twenty-five years and has focused on the healthcare industry.

Education

Community/Civic Involvement

Case Work

Areas of Expertise

Related Insights from Brian

Don’t You (Forget About Me)—Recent Requirements for Provider Directories in an Era of Consumer-Directed Health Care

Making Provider Directories Accurate Is Hard

Can California Regulations Fix Medical Provider Directory Accuracy?