Toney HealthCare Consulting provides advisory services, hands-on leadership and staff augmentation in clinical operations, regulatory and compliance, quality and accreditation for health plans. Our team of over 350 professionals are former leaders and operators from health plans. We bring best practices across the spectrum of healthcare services and population types (Medicaid, Medicare, SNP, Commercial), especially those being served by ACAP plans. Our services include:

Insource Partnership
A dedicated, non-delegated team (including management and frontline staff) assumes full responsibility for a specific service for a LOB or a defined population that may be new, expanding or underserved. The team works on the plan’s system, advises on and follows the plan’s policies and procedures, and trains on the plan’s curriculum. We support:
• Utilization Management – Medical and Behavioral
• Case Management – Medical, Behavioral, Integrated
• Population Health Management

Consulting and Process Optimization
Advisory services in the areas of:
• Strategy
• Clinical Operations/Care Management
• Regulatory and Compliance
• Quality
• Accreditation
• Risk Adjustment
• Payment Integrity
• Appeals & Grievances
• Behavioral Health Insourcing and more.

Staff Augmentation
Short term clinical and administrative leadership, management and front-line operational support of essential health plan functions such as Utilization Management & Physician Review, Case Management, Quality Improvement/Assurance, Accreditation, Risk Adjustment, medical directorship and overall plan leadership (CMO, COO, etc.). We provide resources for medical and behavioral health.

We are a Gold-level Preferred Vendor who has proudly served ACAP plans for over 7 years.

Please visit for more information.

Mike Miniati
Chief Growth Officer
16629 Sedona de Avila
Tampa, FL 33613