Our Team

Fred Horton, M.H.A.

Fred Horton

Fred Horton is President of AMGA Consulting. Fred is a dynamic healthcare advisor, who possesses industry experience, market insight, exemplary capabilities managing diverse and challenging projects, and the ability to create tangible results on behalf of his clients.

Fred has over 20 years of experience working inside the healthcare industry. He has the ability to efficiently distill complex issues and create realistic plans that lead to clients’ success. He brings his operational, strategic, and financial acumen to his clients in order to create effective and market-sensitive solutions to their challenges.

Fred’s special qualifications include:

  • Physician/hospital governance models
  • Physician/hospital alignment strategies
  • Physician practice operational improvement plans
  • Turnaround and start-up management
  • Physician compensation plan development and implementation
  • Board and leadership presentation development

Wayne Hartley, M.H.A.

Wayne Hartley is the Growth and Service Line Development Officer and VP Consulting Services at AMGA Consulting.  He has worked in the healthcare industry for 20 years, beginning in operations and later focusing on consulting in physician services.  His operational roles were in large, integrated delivery systems including Allina Health in Minneapolis, and HealthEast in St. Paul, MN, where his responsibilities included physician practice management, mergers and acquisitions, clinical service line development and revenue cycle improvement.

Prior to joining AMGA, his experience included positions with two major physician compensation consultancies where he worked with a variety of academic and community-based health systems focusing on compensation assessment, compensation philosophy and plan design, fair market value (FMV) and governance issues.  He has spoken at national and regional conferences on FMV, physician transactions, population health, and healthcare industry trends for organizations including AHLA (American Health Lawyers Association), AMGA and HFMA (Healthcare Financial Managers Association).

Wayne holds a bachelor’s degree with distinction from Cornell University in Ithaca, NY, and a Master’s of Healthcare Administration from the University of Minnesota.  He completed an administrative fellowship at Barnes-Jewish Hospital at Washington University School of Medicine in St. Louis, MO.  He resides in the Miami area.


Rose Wagner, R.N., M.H.S., FACMPE

Rose Wagner is the Chief Operating Officer at AMGA Consulting. Rose is recognized as a proven medical practice executive, having years of experience working inside both private practice and integrated delivery systems. She possesses strategic and tactical expertise that results in successful financial, operational and clinical outcomes. She is a collaborative leader and applies this style working with complex teams of internal and external stakeholders.

Rose has more than 25 years of experience providing leadership in the healthcare industry, including serving as Senior Vice President of Operations for a health system sponsored medical group that was part of a large integrated health system in Kansas City, Missouri. Rose also has significant medical group consulting experience, working with numerous groups across the country. She is responsible for assessing and directing physician practice management engagements to improve overall performance and operational efficiencies.

Rose’s special qualifications include:

  • Medical group practice assessment, development and implementation of practice optimization plans to improve operational efficiency
  • Subject matter expert in patient access to care within medical groups
  • Operational process improvement
  • Physician and provider onboarding
  • Medical group best practice development
  • Physician/hospital alignment strategies

Rose received an undergraduate degree and a master’s degree in Health Services Management from Webster University in Kansas City, Missouri in addition to an R.N. from St. Luke’s School of Nursing, Kansas City, Missouri. She is also is a Fellow in the American College of Medical Practice Executives and holds a Green Belt in Lean Six Sigma.


Howard B. Graman, M.D., FACP

Howard B. Graman, MD, FACP, is a Vice President with AMGA Consulting Services. He has spent the majority of his career as a physician executive with extensive experience in clinical transformational change and leadership in large, multi-specialty physician practices. Prior to joining AMGA Consulting, he was CEO of PeaceHealth Medical Group with more than 900 providers and 100 practice locations in 3 states. Additional roles included Chair, Department of Primary Care and Regional Medicine, Carilion Clinic and medical director of Carilion Medical Group as well as Executive Director, Cleveland Clinic Florida, and Chair, Board of Directors, Cleveland Clinic Hospital (Weston, Florida).

Earlier in his career, practicing as a general internist, he was Professor of Medicine at University of Vermont and was a commissioned officer in the National Health Service Corps. He has been actively involved in governance at AMGA and was Chair of the Board in 2014. Dr Graman has been an invited speaker at national meetings as well as leadership retreats for many member organizations. He completed undergraduate studies at City University of New York, his medical degree at SUNY – Downstate, and a residency in internal medicine at the University of Michigan.

In his role as consultant with AMGA, Dr. Graman has played a pivotal role in engagements involving health system and medical group strategy, operations, governance, compensation and interim leadership.


Tom Holets, M.B.A., M.H.A., FACMPE

Tom Holets is a Vice President with AMGA Consulting and a seasoned healthcare executive with nearly 30 years of experience leading a variety of healthcare delivery and ancillary-related businesses. He has held the position of Chief Executive Officer, Chief Administrative Officer, and President of industry-leading delivery systems in the Upper Midwest and Southeastern United States.

Tom’s experiences have ranged from start-ups, to mergers and acquisitions, to business turnarounds, to market-leading organizational transformations. His accomplishments related to quality, efficiency, and leadership development in health care delivery have been recognized by national organizations such as the American Group Practice Association and the Medical Group Management Association.

In 2008 and 2009, his division of Allina Health System was granted the Acclaim Award for broad-scale improvements in healthcare delivery consistent with the Institute of Medicine guidelines. In 1996, under Tom’s leadership, Olmsted Medical Center was created by merging two free-standing non-profit delivery systems.  Recently, Tom has been the senior leader and architect of a number of alignment and integration efforts involving delivery systems, insurers, and hospital systems. Tom has a track record of progressive business growth, profitable operations, and industry-leading innovations.

Tom has served on a number of community and business boards during his professional career. These included the (Rochester, MN) Mayor’s Economic Development Committee, Urban Ventures, and the PGA’s 3M Championship. He has also been a member of national boards responsible for physician compensation and payor contracting issues.

Tom holds master’s degrees from the College of Medicine (Health Care Administration) at the University of Iowa and from the University of Minnesota (M.B.A.-Finance). He also holds an Advanced Management Certification from Wharton School at the University of Pennsylvania. Tom is a Paul Harris Fellow and a Fellow of the American College of Medical Practice Executives.


Will Holets, M.B.A., M.H.A.

Will Holets is Director with AMGA Consulting. His areas of expertise include strategic planning, operations, process improvement, and data analytics. Prior to joining AMGA’s consulting group, Will held various management and leadership positions across the healthcare field in settings ranging from academic medical centers to for-profit integrated delivery systems. He brings with him over four years of experience in healthcare planning, operations, and analytics. He has significant experience strategic planning, operational leadership and solution development/implementation.

Will received his M.B.A. from the Tippie College of Business (M.B.A.) and his M.H.A. from The College of Public Health at the University of Iowa. He holds a Bachelor’s of Science in management from the University of Denver.



Elizabeth Siemsen

Elizabeth Siemsen is a Director with AMGA Consulting. Liz brings more than 20 years of experience in healthcare with broad exposure to all elements of a healthcare system, including physician group practices. Most recently, she was a member of the senior leadership team of Mercy Hospital-Allina Health and led planning and performance improvement projects for the hospital and across the system. Liz began her healthcare career as a financial analyst in decision support before expanding into performance improvement, operations and leadership roles for Allina Health and HealthEast in the Minneapolis/St. Paul area.

Liz’s areas of expertise include strategic planning and deployment, performance improvement, data analytics, health system operations and leader development. She holds a bachelor’s degree in economics and business from Lafayette College and a master’s certificate in organizational leadership from St. Catherine University, in addition to completing Six Sigma green belt and LEAN training programs.


Kelsi O’Brien, M.H.S.A.

Kelsi O’Brien is a Director with AMGA Consulting Services. Her areas of expertise include compensation plan design, operations optimization and improvement, change management and provider utilization. Kelsi has been in health care consulting for over 6 years. Prior to consulting she held a Director level position with a major academic medical center.

Kelsi brings over 10 years of health care experience to the team. She has worked with provider organizations of various sizes and scope from across the country.  Her depth and breadth of expertise assures fresh perspective and insight whether it’s for assessment and planning or complete implementation.

Kelsi received her MHSA from the University of Kansas, School of Medicine. She also holds a bachelor’s degree in Health Information Management the University of Kansas, School of Allied Health.


Danielle DuBord

Danielle DuBord is a Staff Consultant with AMGA Consulting.  Since joining AMGA Consulting in 2015, her main area of expertise includes data analytics, survey development, and benchmarking. Danielle is responsible for conducting AMGA’s longest running survey, the Medical Group Compensation and Productivity survey, a standard in the industry from more than 30 years.

Prior to joining AMGA’s consulting group, Danielle developed her keen analytic skills as systems analyst and planner for national and international retail operations.  She brings with her 15+ years of experience in analytical problem-solving, operational planning/systems implementation, Lean and Six Sigma process, and customer service.  Danielle is a proven analytical thinker and holds a degree in psychology from Augsburg College.