John Waltko


Vice President, Regulatory & Financial Reporting

John's areas of expertise are in the Medicare and Medicaid programs reimbursements to health care providers and developing federal health care policies. He actively monitors changes to federal regulations affecting Medicare reimbursements as well as legislative changes affecting health care providers.

ABOUT JOHN

John actively conducts cost report and reimbursement improvement studies as well as multiple other projects. John develops and presents Reimbursement Education programs including seminars and regulatory update webinars through the QHR Learning Institute for purposes of supporting existing QHR customers, as well as others within the health care industry. His consultations helps hospital systems improve financial performance via improved reimbursements and adopt to value-based purchasing models initiated by the Patient Protection and Affordable Care Act.

John has a vast experience within the health care industry working with multiple provider types to include safety net hospitals, academic teaching centers, community hospitals, for-profit hospitals, physician practices, critical access hospitals and sub-acute care providers. Due to vast range of provider types consulted with, he provides expertise in just about every Medicare reimbursement mechanism available to the health care industry to include residency programs (IME and GME), disproportionate share hospital reimbursements, Medicare bad debts, provider-based designations and other hospital payment mechanisms such as sole community hospital and critical access hospital designations. He has complete understanding of Medicare prospective payment systems, Medicare cost-based reimbursement systems, physician relative value-based system as well as developing payment models such as bundled payments, MIPS and other hospital quality incentive programs.

He has a wide range of knowledge in health care finance to include hospital pricing, financial forecasting, mergers and acquisitions, hospital and product line costing, hospital and service line feasibility studies and more.

AREAS OF EXPERTISE

Medicare & Medicaid Program Reimbursements

Education Programs

Financial Modeling to Include Net Revenue Modeling

Monitoring Regulatory & Legislative Changes

Product Line Costing

Hospital Pricing

Regulatory Issues Surrounding Mergers & Acquisitions

Litigation Support including Medicare Appeals

PREVIOUS EXPERIENCE

  • Blue Cross Blue Shield of Texas
    Senior Auditor
  • Ernst & Young
    Manager

EDUCATION

  • BBA, Accounting
    Ohio University

CERTIFICATIONS

  • Certified Public Accountant, 1984

ORGANIZATIONS

  • Healthcare Financial Management Association
  • Texas Society of CPAs