Value-based care strategy from someone who has run it from both sides of the table.
I help payers, providers, ACOs, and health tech companies reduce the cost of care and win under value-based contracts. Twenty-plus years leading medical economics and network strategy at Aetna/CVS Health and Magellan Health, now working directly with organizations that need answers, not a slide deck.
CVS Health / Aetna • Magellan Health • Veterans healthcare • FACHE • PMP • Six Sigma Green Belt • U.S. Army veteran
$30M+
in growth delivered through value-based contracting strategy
$7M+
in cost-of-care savings identified through analytics and targeted interventions
20+ years
in medical economics, provider networks, and value-based contracting, on both the payer and provider side
Who I work with
Health plans and payers
Medical economics, trend identification, and value-based program design from someone who built and ran these functions inside a national plan. I help you launch new VBC programs, fix ones that have stalled, and put rigor behind cost-of-care and network strategy decisions.
Health systems, physician groups, and ACOs
You are being asked to take on more risk with less clarity about how the math works. I model your contracts, find where the medical spend is going, and help you negotiate and perform under MSSP and commercial value-based arrangements with a clear line of sight to the dollars.
Health tech and digital health companies
Payers buy differently than you think. I have sat on their side of the table and know what a contracting and medical economics team needs to see before they say yes. I help you build the economic case, structure the value-based deal, and avoid the mistakes that stall payer partnerships.
How I can help
Every engagement starts with a specific problem and ends with a decision you can act on. These are the six areas where I do my best work.
Value-based contract strategy and modeling
Design, model, and negotiate arrangements that pay off for you, from upside-only to full risk.
Financial modeling of proposed VBC terms, benchmarks, and risk corridors
Negotiation support and term-sheet review, payer side or provider side
Program design for new launches and turnarounds of stalled programs
Cost-of-care diagnostics
Find where the medical spend is actually going and what to do about it.
Trend decomposition by service category, population, and site of care
Identification and sizing of savings opportunities with intervention plans
Ongoing tracking so savings show up in the results, not just the deck
ACO and MSSP performance
Understand your benchmark, your risk, and the levers that move shared savings.
Benchmark and expenditure analysis under current MSSP rules
Attribution, quality, and risk-adjustment reviews
Readiness assessment for moving to higher-risk tracks
Network strategy and provider economics
Build networks that deliver on both access and cost.
Provider performance and cost-efficiency analysis
Network design and tiering for value-based products
Strategy for physical and behavioral health networks
Payer strategy for health tech and start-ups
Get to a signed payer contract faster, with terms you can deliver on.
Economic value story built the way payer analytics teams evaluate it
Contract structure options, from PMPM to outcomes-based
Preparation for medical economics and network due diligence
Behavioral health value-based care
Bring VBC discipline to the fastest-growing and least-standardized part of the cost curve.
Behavioral health cost and utilization analysis
Value-based arrangements for BH providers and integrated models
Alignment of behavioral and physical health incentives
Ways to work together
Most engagements fall into one of three shapes. If you are not sure which fits, start with a call and we will figure it out together.
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A set number of hours each month for strategy calls, review of policy and market-impact reports, and quick answers by email. For leaders who want an experienced second opinion on call.
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Month-to-month retained work with defined deliverables. I own a project from scoping through completion, or contribute to one your team is already running.
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Extended engagements of six months or more where I take ownership of a transformative initiative, from launching a value-based program to rebuilding a medical economics function.
Not sure where to start? Start with a conversation.
A 30-minute call is enough to tell you whether I can help and what it would look like. No pitch, no obligation. Send a note and I will reply within one business day.