Over the past three years, Top Health Alliance has convened a group of committed, unpaid board members to evaluate the impact of healthcare consultants operating outside the “Big 4.” Annually, we survey 50 specialized consulting firms, requesting each to nominate their most influential consultant. From these 50 nominations, 25 individuals are selected for interviews. During the interviews, each nominee responds to a set of predetermined questions and discusses their background and key strengths. Subsequently, four nominees are invited to present a case study on a specific topic to our board. The board then selects the best presentation, and the chosen consultant is awarded the title of “Small Firm Consultant of the Year”.