Steve Clark |

Steve Clark, Senior/Founding Partner, helped establish SCA in 1994. He provides policy and technical consultation on hospital financial and reimbursement issues. Steve’s expertise in the health care industry is recognized by the major hospital associations, both at the state and federal level, which utilize his services in evaluating and responding to regulatory and legislative proposals and mandates.

Mr. Clark also helped establish the District Hospital Leadership Forum (DHLF) in 2009, which represents California’s District hospitals on matters of finance and reimbursement. In his capacity as the Executive Director of the DHLF, Steve leads the management team and provides guidance and direction to the member hospitals on technical, policy, and advocacy issues.

Prior to beginning SCA in 1994, Mr. Clark served as vice president of Finance at the California Hospital Association (CHA) for eight years where he represented California hospitals before various governmental, third-party payers, and other interest groups. He has worked closely with high-level officials in the Medicare Program through the Medicare Technical Advisory Group (M-TAG) to address and resolve numerous systemic problems affecting providers. Improvements in the Medicare cost reporting and audit processes have resulted from his leadership in this arena.

Steve has acted as a technical expert witness in OIG investigations, state administrative hearings and court proceedings on behalf of both hospitals and health care associations. He also has been instrumental in assisting various hospitals become network providers in county operated Low Income Health Programs.

David Vance |

David Vance is a Senior Partner with SCA. David is a leading expert in identifying, analyzing, and reporting data for the Medi-Cal Disproportionate Share Hospital (DSH) and Hospital Quality Assurance Fee (HQAF) programs.

Relative to Medi-Cal DSH, he provides hospitals with years of experience and expertise working with state officials and key hospital staff to ensure that hospitals qualify for and receive their entitled level of funding. Specific to HQAF, he provides hospitals with direction and focus of the key data elements that are used in deriving both the fee and payment components. He works with the state, hospitals and health insurance plans to ensure data accuracy in order to achieve appropriate levels of funding under this key supplemental payment program.

Mr. Vance also works with individual District hospitals to analyze their various supplemental payment program dollars to help them determine how their payment levels under each program can best be achieved to ensure that they do not exceed federal payment limits. He also provides hospitals with consultation regarding their charity care policies, practices and procedures to ensure compliance with OSHPD accounting and reporting requirements. David also works on various data and reimbursement projects for the District Hospital Leadership Forum (DHLF).

Prior to joining the firm, David was the Finance Manager of Daniel Freeman Hospitals, Inc. Mr. Vance has a BS in Finance from Brigham Young University, Utah and an MBA from Pepperdine University, California.



JEFF CLARK is a partner with SCA. He analyzes hospital data that is specifically used in determining hospital eligibility for the Medi-Cal disproportionate share (DSH) program and provides corrections as necessary to ensure that hospital’s qualify for the DSH funding as appropriate.

Jeff works with clients to analyze data that is used in determining the hospital fee that is paid under Hospital Quality Assurance Fee (HQAF). In addition, he reviews various other key data elements reported to OSHPD that are used in deriving the hospital payment components of HQAF that include the “directed payment” and the “passthrough payment” aspects of the HQAF. This requires an in-depth audit of source data that supports the information being reported to OSHPD.

Jeff also oversees staff responsible for the preparation of OSHPD hospital accounting and disclosure reports where he also acts as an intermediary between OSHPD, hospital clients and other SCA staff when questions arise regarding cost center determinations and reporting requirements. Jeff manages the firm’s work with the state audits of hospital disclosure reporting data and /or practices and responds to requests from DHCS Medi-Cal division related to various program analyses, including the AB 915 reporting.

In addition, Jeff assists hospitals by providing services for special projects of a financial or operational nature. He has contributed in the review of accounting processes and patient accounting and general ledger systems alignment to ensure accurate reporting of financial data.

Jeff has a BS in Finance from  California State University, Sacramento.


Nathan Davis is a Partner with SCA and the Senior VP of Finance for the District Hospital Leadership Forum (DHLF).  Nathan specializes in providing hospitals with reimbursement expertise under multiple Medi-Cal supplemental payment programs including the Hospital Quality Assurance Fee (HQAF) managed care directed payments and Medi-Cal DSH payments. He also works with state officials and key hospital staff ensuring that hospitals both qualify for and receive the level of funding for which they are entitled.

Prior to joining SCA, Mr. Davis was the Vice President of Finance for the California Children’s Hospital Association (CCHA) for seven years. While at CCHA he developed finance policy, analyzed proposed legislation, and assisted hospitals with reimbursement issues.

Prior to joining CCHA, Mr. Davis worked for the Department of Health Care Services (DHCS) as the Policy Advisor to the Deputy Director of Health Care Financing. At DHCS he led the Department’s successful effort to replace the multiple Medi-Cal reimbursement methodologies for hospital acute care inpatient services to one system based on payment by Diagnosis Related Group (DRG). Mr. Davis also oversaw numerous supplemental payment programs including Medi-Cal DSH, HQAF, private hospital supplemental fund, and various others.

Before joining DHCS, Mr. Davis was appointed by Governor Schwarzenegger to the California Medical Assistance Commission (CMAC) as a senior negotiator. Mr. Davis also worked at the Office of Statewide Health Planning and Development (OSHPD) as a Senior Loan Specialist in the Cal-Mortgage Loan Insurance Division. At Cal-Mortgage he analyzed financial statements for credit determination, reviewed health care providers turnaround plans, attended board meetings, and presented credit reviews to the Cal-Mortgage insurance committee.

Mr. Davis has a BS in Finance with a minor in Economics from California State University, Sacramento.