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What We Do

Beyond the Box Consulting offers focused, high-impact engagements for small and mid-sized provider practices who want to improve their Medicare quality performance without adding full-time staff.

Every engagement is led personally by Jaime Ortez. No hand-offs, no junior consultants, no cookie-cutter playbooks. Just clear analysis, practical recommendations, and real accountability.

Services

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HEDIS & STAR Gap Assessment

Best for: Practices who want to know exactly where they stand before measurement year closes.

We audit your open care gaps across key HEDIS measures, identify the highest-impact opportunities, and give you a prioritized action plan your team can execute immediately. You'll know exactly which members need outreach, which measures are within reach, and what documentation changes will move your scores.

Investment: Starting at $1,000 — priced by practice size and panel volume.

$1,500.00
Ongoing Quality Performance Retainer

Best for: Practices who want consistent, expert support throughout the year — not just at crunch time.

Monthly engagement covering HEDIS measure tracking, staff coaching, CAHPS and HOS preparation, PQA medication adherence monitoring, and strategic guidance as CMS specifications evolve. Think of this as having a quality director on call without the overhead of a full-time hire.

Investment: Starting at $1,200/month for smaller practices. Mid-size and larger practices priced on a Per Member Per Month (PMPM) basis — the same model your health plan uses, scaled to your panel size.

$1,200.00
Staff Training Workshop

Best for: Practices whose teams need hands-on education on documentation, coding, and member outreach best practices.

Half-day or full-day sessions delivered on-site or virtually. We cover HEDIS measure documentation requirements, how quality scores are calculated, and practical strategies your front desk, nurses, and care coordinators can implement starting the next day.

Investment: Starting at $1,000 per session — priced by practice size and session length.

$1,000.00
CAHPS / HOS Readiness Review

Best for: Practices who want to improve patient experience scores before survey season.

We walk through every patient touchpoint in your practice — scheduling, wait times, communication, follow-up — and deliver a practical improvement plan focused on the specific domains that drive CAHPS and HOS scores. No guesswork. No generic advice.

Investment: Starting at $750 — priced by practice size.

$750.00
Chart Abstraction and Datamining

Best for: Practices who need accurate, actionable data pulled from their EMR to identify care gaps, validate HEDIS measure compliance, or prepare for audit season.

We dig into your clinical data so you don't have to. From chart abstraction for HEDIS hybrid measures to mining EMR data for unreported care gap closures, we surface the information that moves your quality scores — and make sure documented care actually gets counted.

Investment: Starting at $750 — priced by practice size and project scope.

$750.00

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How Pricing Works

We believe in transparency. All engagements are priced based on your Medicare Advantage and/or ACO panel size:

  • Smaller practices (under 500 members): Flat fee pricing — predictable, accessible, and designed to help you build strong quality habits from day one.

  • Mid-size practices (501–1,500 members): PMPM-based pricing, the same model your health plans use — scales with your panel so pricing always makes sense relative to your risk.

  • Larger practices & group practices (1,501+ members): Full PMPM model with expanded scope and deeper engagement.

Not sure which tier fits your practice? That's exactly what the free consultation is for.

Schedule your free consultation

Ready to Get Started?

Send us a quick note and let’s explore how we can tackle your next business challenge together.