CMS Hospital Consulting & Healthcare Reimbursement Strategy
TEFRA, PPS, Cost Reports, Waivers, and Reimbursable Funding
J2R VETS provides specialized CMS hospital consulting services to rural, state-owned, territorial, and private healthcare facilities navigating complex reimbursement, compliance, and funding challenges. Our work focuses on restoring underpaid reimbursement, correcting legacy errors, and positioning hospitals for long-term financial sustainability under federal payment systems.
We support engagements involving the Centers for Medicare & Medicaid Services, state Medicaid agencies, and CMS contractors, delivering audit-defensible analysis and execution.
Healthcare Consulting Capabilities
TEFRA to PPS Strategy & Transitions
TEFRA base-year analysis and validation
Forward and backward rebasing strategy development
PPS transition modeling and financial impact analysis
Support for hospitals considering or exiting TEFRA status
Alignment with applicable CMS regulations and precedent
Medicare Cost Report Review & Audit Support
Comprehensive cost report reviews and recalculations
Identification of underreported reimbursable costs
Support for cost report reopenings, adjustments, and appeals
Coordination with MACs and CMS contractors
Audit preparedness and documentation packages
CMS Waivers & Demonstration Programs
Section 1115 waiver strategy and financial justification
Support for state, territorial, and hospital-specific waiver initiatives
Reimbursement modeling tied to waiver objectives
Coordination with policy, legal, and operational stakeholders
Reimbursable Funding & Grant Support
Identification of reimbursable funding opportunities
Federal healthcare grants and special funding pathways
Alignment of funding strategy with CMS reimbursement rules
Financial modeling to support sustainability and compliance
Regulatory & Financial Advisory
CMS compliance risk assessments
Support for legacy reimbursement corrections
Executive-level advisory for CFOs, CEOs, and boards
Integration with modernization, IT, and cybersecurity initiatives
Who We Support
Rural hospitals and critical access facilities
State-run and territorial healthcare systems
Private hospitals with complex reimbursement challenges
Government stakeholders responsible for healthcare funding oversight
Why J2R VETS
Deep expertise at the intersection of policy, finance, and operations
Experience with high-dollar reimbursement corrections and recovery strategies
Veteran-led discipline with documentation-first execution
Designed for CMS scrutiny, audit survivability, and long-term impact
We do not offer generic consulting.
We deliver regulatory-grade analysis that stands up to CMS review.
Typical Outcomes
Increased Medicare and Medicaid reimbursement
Correction of historical underpayments
Improved audit and compliance posture
Sustainable financial planning aligned to federal programs
Is your hospital underpaid, restricted by legacy reimbursement structures, or facing CMS-driven financial pressure?
Engage our healthcare consulting team for a confidential assessment.
→ Request CMS Hospital Consulting Support
(Executive and board-level consultations available.)
