The Westchester Consulting Group was founded in 2002 to provide long-term health care and disability-related research, consulting, and technical assistance services to public and private sector organizations. Our cross-disciplinary expertise is well suited to address a full range of long-term health care and disability issues. Our goal is to assist clients in developing, implementing and evaluating the effectiveness of innovative and effective policies, programs and solutions to current long-term health care issues.

The Westchester Consulting Group serves a diverse group of clients in both the public and private sector including:


Susan A. Flanagan, M.P.H., Ph.D. is the Founder and Principal of the Westchester Consulting Group. She is responsible for all research, consulting, and technical assistance services provided to clients; for marketing, financial operations, quality assurance, and for the strategic direction of the organization.

Dr. Flanagan has over 39 years’ experience with long-term health care and disability program, finance and quality assurance issues on the federal, state and corporate levels. A significant portion of her work has been in designing, implementing and evaluating Medicare and Medicaid payment systems for nursing facilities and intermediary care facilities for individuals with intellectual and developmental disabilities. Dr. Flanagan was the Director of the Bureau of Long-Term Care at the Massachusetts Rate Setting Commission and a co-principal investigator responsible for developing and implementing the Medicaid prospective case-mix payment system for 580 Massachusetts nursing facilities. While with the MEDSTAT Group, she was a member of the evaluation team for the Centers for Medicare and Medicaid Services' (CMS) Medicare Nursing Facility Prospective Case-Mix Payment System Demonstration with Abt Associates.

Dr. Flanagan is a national leader in developing, implementing and evaluating Federal, Medicaid and state-funded participant-directed (also known as self-directed and consumer-directed) service (PDS) programs for individuals of all ages with disabilities and chronic conditions and has provided technical assistance to over three dozen state Medicaid and county agencies. She was a technical assistance consultant for the CMS Technical Assistance for Self-directed and HCBS Project with Acumen, LLC and New Editions Consulting from 2009-2017 and for the Robert Wood Johnson Foundation National Cash and Counseling Demonstration and Evaluation National Project Office at Boston College Graduate School of Social Work from 1998 - 2008. From 2014-2015, Dr. Flanagan designed and provided technical assistance to the DC Department of Health Care Finance in designing and implementing the District’s Medicaid Services My Way participant-directed service program.

Dr. Flanagan also has conducted six national studies related to PDS, four for the U.S. Department of Health and Human Services Office of the Assistant Secretary for Planning and Evaluation (DHHS/OASPE): Consumer-Directed Attendant Services: How States Address Tax, Legal and Quality Assurance Issues (1994); Using ISOs to Facilitate the Use of CD-PAS: Key Operational Issues for State Program Administrators (1997) with Pamela S. Green; ASPE Consumer-Directed Support Service Program Inventory (2001), Accessing Workers' Compensation Insurance for Consumer-Employed Personal Assistance Workers': Issues, Challenges and Promising Practices (2004), and two for CMS: Agency with Choice (AwC) Financial Management Services (FMS): Key Characteristics, Quality Assurance and Liability Issues (2014) and Self-Direction and the Direct Service Workforce (2020).

Dr. Flanagan is working with The Lewin Group, Atlas Research and PFS to support the Veterans Health Administration (VHA) with the national roll-out of the Veteran Directed Care (VDC) program (previously known as the Veterans-directed Home and Community-based Services (VD-HCBS) Program). She is the Financial Management Services (FMS) Readiness Review Lead and also has conducted research and prepared several ad hoc reports for VHA including: “Report to Inform the VD-HCBS Market Research and Communications Plan” S. Flanagan, J. Rollison, M. Williams, G. Zimmerman and T. Waterman (2016); “Veteran Spending Under VD-HCBS” S. Flanagan, M. Williams and J. Anthony (2017); and “VA LTSS Needs Assessment for Veterans Residing in Rural and Highly Rural Areas” J. Anthony, S. Flanagan, A.J. Damian & M. Williams (2017).

Dr. Flanagan has worked on a number of projects related to evaluating states' long-term care systems and rebalancing efforts. She was a subject expert for the CMS National Balancing Indicators Project with Abt Associates and the project director for Phase II of the project at IMPAQ International.

Dr. Flanagan was a state lead and member of the national evaluation team for the CMS FY’05 and FY’06 Systems Transformation Grants National Evaluation (2005-2011) and the project director for CMS Person-Centered Planning Implementation Grants Evaluation with Abt Associates (2007-2011). Finally, Dr. Flanagan also was a subject expert for the CMS Money Follows the Person Demonstration Grants Project from 2010 - 2015 with New Editions Consulting, Inc.

Dr. Flanagan also has worked on projects related to the direct service workforce. She was a subject matter expert and member of the project team for the CMS Direct Service Worker Resource Center with the Lewin Group from 2005 - 2014.

Dr. Flanagan was a subject matter expert on the CMCS Medicaid Innovation Accelerator Program IAP Medicaid Delivery System Reform DSR Framework Project with Atlas Research and MITRE from 2017 - 2018. A description of the projects cited here and related tasks can be found in the Services section of this website.

Dr. Flanagan received a B.A. in Biology and Chemistry from Skidmore College and a M.P.H. in Health Systems from Boston University School of Medicine. In addition, she was a Pew Fellow and received a Ph.D. in Social Policy from Brandeis University's Heller School of Social Policy and Management. Dr. Flanagan was an adjunct assistance professor at Boston University School of Public Health from 1989-2009 where she taught the course LTC Finance and was awarded an Excellence in Teaching Award (1994).

Prior to founding The Westchester Consulting Group, Dr. Flanagan held several key positions in the area of long-term health care policy and research. She was a Senior Manager at Ernst & Young, LLP were she was responsible for initiating and managing their New England Long-term Health Care Practice; Program Manager at The MEDSTAT Group; an Assistant Director in the Division of Health Financing and Systems at the U.S. General Accounting Office where she was awarded an Above and Beyond Award for efforts in researching and preparing the GAO Report, Impact of the Medicare Home Health Interim Payment System on Agency Closures and Access to Services; and the Director of the Bureau of Long-term Care at the Massachusetts Rate Setting Commission where she was a principal investigator designing and implementing a prospective case-mix payment system for Massachusetts nursing facilities.