CertaGrid Health
Healthcare research and forensic analytics
Structural analysis of consolidation in American healthcare delivery
CertaGrid Health is a healthcare research and forensic analytics firm focused on the structural reality of consolidation in American healthcare delivery.
The firm operates across three pillars: a weekly analytical publication examining the architecture of healthcare consolidation arrangements; a two-volume series presenting the firm's structural and operational verification methodology in instrument form; and analytical services for healthcare attorneys, institutional investors, health systems, and journalism that require document-level structural analysis where public disclosure does not reach.
The firm's analytical posture is forensic rather than evaluative. The methodology characterizes what consolidation arrangements operationally do, distinguishing representational language from operational reality, and surfaces the structural questions that document-level review must address.
The Healthcare Structural Review
The Healthcare Structural Review is published weekly on LinkedIn. Recent editions have examined the disclosure architecture of payer-owned ambulatory surgery center platforms, the document-level structure of value-based care partnerships between investor-backed platforms and physician groups, and the gap between representational language at IPO and operational reality across multi-year disclosure cycles.
Read the current edition and archive on LinkedIn.
The two-volume series
The firm's first two-volume series will be available in June 2026: Structural Verification of ASC Consolidation Arrangements and Operational Verification of ASC Consolidation Arrangements. The series presents the firm's verification methodology — the Reserved-Powers Risk Checklist and the Partnership-Reality-Gap Audit — in instrument form for application by counsel, investors, and operators evaluating consolidation arrangements at the document level.
Additional series examining value-based care and management services organization (MSO) arrangements are in preparation.
Early access
The quarterly brief
The Quarterly Healthcare Structural Intelligence Brief launches in Q4 2026 as the firm's institutional subscription product, delivering original structural analysis of healthcare consolidation arrangements on a quarterly cadence.
Independent engagements
Alongside the firm's published research, I take a small number of independent engagements. The work is structural verification of consolidation arrangements: examining whether an arrangement operates as its documents represent. Most parties to these arrangements cannot answer that question disinterestedly. Counsel drafts the structure and represents a side, operators carry the growth thesis, and advisers on both sides are paid for the transaction to close. The independent reading is the one no participant is positioned to give, and it is the only role I take.
The value of this work depends on its independence. I do not advise both sides of a transaction, sit on deal teams, or participate in negotiation, and I do not accept contingent or success-based fees; my compensation never depends on a transaction closing or on any particular finding. Engagements are confidential and accepted selectively.
The work takes a few specific forms.
Independent transaction diligence. When an investor, acquirer, or health system is evaluating or recapitalizing an ASC, physician, or dental platform, or a hospital-physician partnership, I provide the structural read that no party with a stake in closing can: whether the control, economics, and governance operate as the transaction represents, and how the arrangement is likely to behave once the founding clinicians are paid out and the terms are tested. The work product is a written assessment of where representation and operational reality diverge.
Pre-signing structural review. When counsel or a counterparty is finalizing an ASC, MSO, joint-venture, or value-based arrangement, I read the documents against the operational reality they produce, locating the specific points at which the reserved powers, compensation, exit, and cash-flow terms depart from what the agreement represents. The review is delivered before signature, while the terms can still change.
Independent analysis in disputes. When an arrangement is contested, and the question turns on whether control was real or merely papered, I provide independent structural analysis of the substance-over-form record for counsel, separate from the litigation and without a position in its outcome.
Standing structural research. When an institution needs to follow a sector rather than a single transaction, I provide retained structural research on consolidation arrangements and the enforcement landscape, including bespoke analysis of specific platforms or sub-sectors as questions arise.
This is independent structural analysis. It complements legal and financial counsel and is not legal advice, a legal opinion, or investment advice. Engagements are scoped individually, and inquiries may be directed to founder@certagridhealth.com.
About the founder
CertaGrid Health was founded by Scott C. Williams, who serves as President and Founder. Williams brings more than 20 years of healthcare strategy and operations experience, including leadership roles at Kaiser Permanente (Hawaii and Georgia Regions) and PeaceHealth. His analytical framework — what the firm refers to as structural ethnography — draws on training in anthropology and on extensive operational experience inside health systems and payer organizations. Williams is a former United States Marine Corps officer.
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