Dr. Dennis Mihale, MD, MBA, CHCQM
Founder and Chief Medical Officer, Chelsea Management Group
Dr. Dennis Mihale leads the Chelsea Management Group (CMG) Practice with over 30 years of experience as a physician executive in value-based care, in-home physician services, and managed care. Throughout his distinguished career, he has founded two HMOs and two healthcare technology firms, and has held executive roles at leading organizations such as IBM and Intelliclaim (McKesson). Dr. Mihale has served as Chief Medical Officer for eight health plans and practices, and as a consulting Medical Director to nine firms, including Risk Adjustment Medical Director for a $1.6 billion Medicare Advantage Plan.
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As the CMS Physician Champion for ICD-10 in Florida, Dr. Mihale has been instrumental in helping plans and practices build value-based care programs, develop risk adjustment strategies, and implement quality and patient safety programs. He has a strong focus on educating physicians about proper documentation, compliance, and the role of EMRs in avoiding fraud, waste, and abuse. His work in building Version 28 Risk Adjustment programs has positioned him as a leader in developing strategies that improve financial outcomes and patient care.
Areas of Expertise
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Version 28 Risk Adjustment Programs
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Value-Based Care & Full-Risk Practice Development
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In-Home Physician Services
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Telehealth & Facilitated Virtual Care
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Fraud, Waste & Abuse Prevention
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Physician Documentation & Education
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Medicare Risk Adjustment
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Quality, Patient Safety, and STAR Ratings
Executive and Leadership Roles
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Chief Medical Officer, Upward Health (In-home Full-Risk Practice)
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Chief Medical Officer, IntelliClaim (McKesson)
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CMO, CHP/Wellfleet (Berkshire Hathaway Company)
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Founder of two managed care firms and two healthcare technology firms
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Chief Medical Officer for revenue cycle firms and physician education programs
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Office of the Mayor, City of New York: Health & Hospitals Corporation
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CEO/CMO for auditing firm specializing in documentation, ICD-10 & E&M coding
Affiliations & Accomplishments
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CMS Physician Champion for ICD-10, Florida
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Assistant Professor, USF College of Medicine
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Major (retired), US Army Reserve, Medical Corps
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Former CMO and consultant for numerous health plans, including United Health Plan, Amerigroup, Horizon BCBS, and CareCentrix
Licensure
Dr. Mihale holds active medical licenses in the following states:
Florida
New Jersey
Rhode Island
Michigan
Arizona
Ohio
Illinois
New York
Massachusetts
Pennsylvania
Wisconsin
Georgia
Texas
Dr. Mihale’s expertise in healthcare strategy, risk adjustment, and value-based care makes him a trusted leader in guiding healthcare organizations through the complexities of modern healthcare delivery. His comprehensive knowledge and hands-on approach have helped countless clients achieve success in improving care and optimizing financial performance.