Nimitt Consulting provides smart, cost-effective, and meaningful solutions for the health care industry. Nimitt’s expert services enhance our clients’ ability to implement and thrive under the wide range of regulatory initiatives and emerging technologies that affect the health care environment.

We specialize in helping domestic and international providers, governments, drug and device manufacturers, and other stakeholders respond to the evolving health care marketplace by providing advisory and advocacy services, case-mix development, and focused education and training programs.

Our philosophy is simple: we believe that implementing sustainable organizational change requires education, information, and open communication. We begin by helping decision-makers and front-line staff articulate their challenges and concerns. We then conduct analyses using quantitative and qualitative methods to create measurable solutions tailored to each client’s unique circumstance. We work with our clients every step of the way so they can successfully implement changes that improve health care delivery, quality, access, revenue, and compliance.

“Nimitt” means catalyst or change agent; our mission is to help our clients make lasting changes to their operational processes, resulting in a positive impact on both the patients they care for and their bottom line.


Jugna Shah, MPH, President & Founder

Jugna Shah is a nationally recognized expert in health care policy, with more than 20 years of experience addressing the complex challenges of U.S. and international health care financing, payment, and regulatory systems.

As President of Nimitt Consulting, Jugna helps U.S. hospitals, health care organizations, and industry organizations understand and address the on-going challenges of existing and new Medicare payment systems. She helps clients address their clinical operations and financial management needs as a result of her deep knowledge of prospective payment systems, bundled payment systems, and new and innovative initiatives. She conducts operational and financial impact analysis; performs coding, billing, coverage, and compliance reviews; and helps clients leverage existing technology and business intelligence solutions to create sustainable processes and achieve appropriate and compliant reimbursement.

Jugna works with medical organizations, patient advocates, and drug and device manufacturers to identify reimbursement strategies for personalized medicine technologies, including gene, cellular, and CAR-T therapies. She assists key stakeholders to identify the full spectrum of ICD-10 and CPT codes required to effectively capture these innovative technologies. She is also involved in the process to develop new codes to report and reimburse these rapidly evolving medical processes.

Jugna is also an international authority on designing and implementing case-mix based financing systems. She has led numerous technical assistance initiatives that have resulted in several foreign governments changing their health care financing systems. She is also the former Vice President of Patient Classification Systems International (PCSI), the leading international organization on case-mix systems.

Jugna is a popular and dynamic educator who regularly writes and presents on a wide range of topics related to coding, billing, and reimbursement. She frequently writes about these and related topics and contributes to several leading publications on Medicare’s outpatient prospective payment system. Jugna is also a popular speaker at local, regional, national, and international conferences, including those coordinated by AHIMA, Audio-Educator, HCPro, HFMA, Ingenix, and PCSI.

Prior to founding Nimitt Consulting in 2001, Jugna was a Senior Manager with KPMG’s Assurance-Based Advisory Services Practice and an Ambulatory Care Product Marketing Manager at 3M Health Information Systems.


Valerie A. Rinkle, MPA, Principal

Valerie Rinkle brings more than 30 years of expertise in management consulting, finance, Medicare and Medicaid payment systems, reimbursement, coverage, compliance, and hospital operational knowledge.

Valerie leads operational and strategic change management projects to ensure clients receive complete and compliant reimbursement. She has managed numerous revenue cycle optimization projects, including patient access, financial assistance and up-front collections, charge capture, Charge Master standardization, and various back office enhancements like lock-box and outsourcing.

Valerie has advised hospitals, health systems, and manufacturers on Centers for Medicare & Medicaid Services’ (CMS) reimbursement issues and the operational practices needed to achieve accurate and defensible payment. She has experience leading compliance due diligence in support of mergers and acquisitions, and defense strategies surrounding Office of the Inspector General (OIG), Department of Justice (DOJ), Recovery Audit Contractors (RAC), state Medicaid, and other audit agencies. She has also served as an expert witness in litigation.

In addition to her extensive work with providers, Valerie aids device, drug and cellular therapy companies that are bringing new procedures and therapies to market. She advises them on market access and reimbursement strategies for Medicare and Commercial payers at both strategic and detailed levels. She is adept at using data analytics to assess the most appropriate coding, new technology, and pass-through payment applications and reimbursement strategies for each client product.

She frequently speaks at regional and national conferences, including the American Health Lawyers Association Institute of Medicare and Medicaid (MMI). She also writes and presents on numerous reimbursement and regulatory issues.

Valerie served as a health care system revenue cycle director for 10 years and as a consultant for Navigant Health Revenue Assurance Associates. On the Federal level, she held positions at the U.S. Department of Health and Human Services, including with the Assistant Secretary for Management and Budget (ASMB), Assistant Secretary for Planning and Evaluation (ASPE), and HCFA (now CMS).

Susan K. Flinn, MA, Business Analyst

Susan K. Flinn has more than 25 years of public health experience in research, writing, editing, meeting management, and program coordination.

The author of numerous publications, Susan researches, drafts, and edits materials for a range of audiences, including policymakers, providers, and the general public. Her work has been published by Federal agencies, advocacy organizations, and public health associations. Susan is also an accomplished editor who has worked with non-profit and for-profit organizations to enhance their communications.

Susan helps clients hold effective meetings and capture the meeting outcomes. She plans agendas, objectives, and content; coordinates event invitations and logistics; provides on-site meeting oversight; and drafts reports and summaries of the proceedings.

Prior to forming her own company, Susan was a Federal lobbyist for a reproductive health organization, and a research assistant for a National Institutes of Mental Health (NIMH) study.

Amy Rinkle, Senior Policy Analyst

Amy is a Policy Analyst with Nimitt, focusing on innovative breakthrough therapies such as CAR-T.  She tracks new therapies, helps with understanding and communicating to the Nimitt team their mechanism of action, analyzing the coding and reimbursement implications, and she performs data collection and analysis to support Nimitt’s clients when examining payment implications, ROI, and policy impacts on commercialization plans.
Amy also focus on analyzing MIPS QPP reporting requirements and implementation for providers, CMMI and Alternative Payment Models comparison and developments, and assists with coding and billing review projects.

Amy specializes in process flow documentation and optimization, and has five years experience serving in business analysis roles.