Roles and Responsibilities

The U.S. Healthcare Efficiency Index® (USHEI) independent Advisory Council represents all facets of the healthcare industry. The role of the Council is to guide the USHEI efforts to create a national reference for raising awareness and monitoring the progress of the healthcare industry toward business efficiency.

US Healthcare Index Advisory Council Roster
Advisory Council Member Organization
Matthew Albright Centers for Medicare & Medicaid Services
Patrick Baier, D. Phil. National Opinion Research Center
Bryan Bearden WellPoint, Inc.
Jay Eisenstock Aetna
Chris Kent UnitedHealth Group
Reid Kiser CAQH
Thomas L. Meyers America's Health Insurance Plans
Stanley Nachimson Nachimson Advisors, LLC
Andrew L. Naugle Milliman
Richard Nelli Streamline Health
John L. Phelan, Ph.D. Milliman
Jane Sarasohn-Kahn THINK-Health
Fritz Scheuren, Ph.D. National Opinion Research Center/Human Rights Data Analysis Group
Erik C. Swanson Premier, Inc.
Robert M. Tennant Medical Group Management Association

US Healthcare Index Partners and Contributors

 


US Healthcare Index Advisory Council Biographies

Matthew Albright
Centers for Medicare & Medicaid Services

Matthew Albright is the lead health insurance analyst in the Administrative Simplification Group of the Office of E-Health Standards and Services (OESS) at the Centers for Medicare & Medicaid Services. He is an OESS liaison to the Advisory Council.

Albright leads the team that drafts regulations for the Administrative Simplification provisions of the Affordable Care Act. Since July, 2011 the team has published the Eligibility and Claim Status Operating Rule IFC, the Health Care EFT Standard IFC, the HPID proposed and final rules, and the EFT & ERA Operating Rule IFC. Before CMS, Albright worked as a Rules and Policy Specialist for Washington State Health Care Authority where he analyzed the impact of health care legislation and drafted regulations (Washington Administrative Code) on health care eligibility. Albright is adjunct faculty at St. Martin's University where he teaches ethics and philosophy. Albright earned a master's degree in divinity with an emphasis on bioethics from Harvard University.

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Patrick Baier, D. Phil.
National Opinion Research Center

Dr. Patrick Baier is a mathematician, statistician and cryptographer. He often works with fellow USHEI Advisory Council member Dr. Fritz Scheuren at the National Opinion Research Center to carry out statistical analyses, reviewing policies and procedures surrounding HIPAA compliance, and implementing tools for de-identification that meet HIPAA requirements.

Dr. Baier is a recognized authority on the HIPAA privacy rule, having been invited to present a published paper on the topic at the American Statistical Association (ASA) Joint Statistical Meeting. He has co-authored papers on various topics in applied cryptography with the computer security group at George Mason University. He has applied this cryptographic experience to the review of protocols and source code, has designed a number of encryption and de-identification tools from scratch and has assisted as a cryptographer and software engineer in the implementation of such tools. He holds a D. Phil. in mathematics.

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Jay Eisenstock
Aetna

Jay Eisenstock heads provider eSolutions at Aetna. He is responsible for the innovation and deployment of administrative, clinical and financial interactions between Aetna and the provider community. In previous roles at Aetna, Eisenstock led the company's efforts to achieve HIPAA compliance for electronic transactions.

Prior to joining Aetna, Eisenstock was vice president of the web development and business intelligence line of business for a technology consulting firm. He also held various leadership and technical positions with Electronic Data Systems Corporation (EDS). He is the current chair of the CAQH Committee on Operating Rules for Information Exchange (CORE) Joint Certification/Enforcement and Testing Subgroup, He serves the Workgroup for Electronic Data Interchange (WEDI) as a director, and the Electronic Health Network Accreditation Commission (EHNAC) as a commissioner. He was selected by the Certification Commission for Healthcare Information Technology (CCHIT) to participate in its Health Information Exchange Work Group. Eisenstock was honored with the Workgroup for Electronic Data Interchange (WEDI) Leadership in Technology award and was a finalist for Aetna's highest employee recognition award. He was also recognized as one of 11 top executives and thought leaders in the healthcare IT industry by eMids Technologies and Healthcare Payer News. Eisenstock earned a master's degree in business administration from the University of Massachusetts.

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Chris Kent
UnitedHealthcare

Chris Kent is Vice President of Provider and Automation Solutions within UnitedHealthcare. He is responsible for building and driving usage of provider self-service tools (web portals and EDI) to decrease administrative costs and improve the ease of doing business with UnitedHealthcare. His team also is focused on building automation to reduce manual work leveraging cost-effective and flexible tools.

Prior to joining UnitedHealthcare, Kent was a Partner/Senior Consultant at a technology consulting firm and was responsible for developing new business and working with health care clients to more effectively leverage technology for new product development and process improvement. He also spent time as a Clinic Business Manager at MD Anderson Cancer Center (Houston, TX) responsible for all administrative functions (including interactions with insurance companies) for the Gastrointestinal/Endoscopy clinic. Kent holds a Master of Healthcare Administration degree from the Carlson School of Business at the University of Minnesota and Bachelor of Arts & Science degrees from Winona State University.

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Reid Kiser
CAQH

Reid Kiser is the director of research and measurement for CAQH. He led the transition of the U.S. Healthcare Efficiency Index from Emdeon to CAQH and will manage the evolution of the Index. He also guides other CAQH evaluation and measurement activities.

Before joining CAQH, Kiser held a series of progressively responsible roles at UnitedHealthcare, Inc., most recently serving as the national director of special projects and analytical reporting - quality management and performance. In that role, he focused on building quality improvement programs and analytical tools, specifically clinical performance measurement using evidence-based medicine and statistical data analysis. He developed enterprise-wide and segment-specific solutions for analysis and reporting to NCQA, including accreditation, CAHPS and HEDIS performance measurement. Before joining UnitedHealthcare, Inc., Kiser held senior positions at NCQA, where he led policy development and maintenance of CAHPS and HEDIS measure specifications. Reid also collaborated in the development and implementation of new metrics and products based on NCQA initiatives and priorities. He earned a master's degree in evaluative clinical sciences from Dartmouth College and Medical School.

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Thomas L. Meyers
America's Health Insurance Plans

Thomas L. Meyers is a Vice President with America's Health Insurance Plans (AHIP). AHIP is a national trade association representing member companies that provide health benefits to more than 200 million Americans. His industry experience provides insight and direction from a perspective developed as an executive in the group benefits business with a proven track record of successfully implementing business strategies focused on market expansion and bottom line growth. Process alignment, product development, product management, marketing, operations, and strategic and tactical planning have been key areas of focus.

Before joining AHIP, Tom held a variety of executive and management level positions at Travelers Insurance Company and Mutual of Omaha. He currently serves on the Workgroup for Electronic Data Interchange (WEDI) Board of Directors. Tom earned a bachelor's degree in finance from Siena College.

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Stanley Nachimson
Nachimson Advisors, LLC

Stanley Nachimson is principal of Nachimson Advisors, LLC, a health IT consulting firm dedicated to finding innovative uses for health information technology and to encouraging its adoption. Nachimson is focused on assisting healthcare providers and plans with ICD-10 implementation.

Nachimson is retired from the U.S. Department of Health and Human Services, where he served for more than 30 years in a variety of statistical, management, and health technology positions. While there, he developed HIPAA policy, regulations, and implementation planning and monitoring, beginning the CMS work on Personal Health Records, and serving as the CMS liaison with several industry organizations, including the Workgroup for Electronic Data Interchange (WEDI) and the Healthcare Information Technology Standards Panel (HITSP). He currently is the director of the North Carolina Healthcare Information and Communications Alliance, Inc. (NCHICA)-WEDI Timeline Initiative and serves QualEDIx Corporation as a member of its Board of Advisors. He earned a master's degree in applied statistics from George Washington University.

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Andrew L. Naugle
Milliman

Andrew L. Naugle is a principal in the Seattle office of Milliman, where his research focuses on analysis of administrative expenses for health plans. He maintains an extensive dataset of health plan operations benchmarks, which are used to evaluate the staffing, efficiency, productivity, and cost levels of health plans, insurance companies, and third-party administrators. He also has considerable experience with operational design and re-design for payers. His work was featured in the Institute of Medicine's Roundtable on Evidence-Based Medicine publication "The Healthcare Imperative: Lowering Costs and Improving Outcomes."

Naugle is a professional member of the Academy for Healthcare Management. He holds a master's degree in business administration with cum laude distinction from the University of Notre Dame.

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Richard Nelli
Streamline Health

Richard Nelli is the SVP & Chief Technology Officer for Streamline Health.

Prior to joining Streamline Health, Nelli served as chief technology officer for CareMedic Systems, where he led product management and information technology. Previously he was vice president of product management at Quovadx, where he guided the company's healthcare interoperability solutions strategy, and before that spent 10 years leading QuadraMed product development efforts. He has served in various product development and product management roles throughout his career, leading initiatives involving patient access, electronic data interchange, claims and remittance management, ePrescribing, health information exchange and medical banking. He holds a bachelor of business administration in management information systems with a minor in telecommunications engineering from the University of Mississippi.

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John L. Phelan, Ph.D.
Milliman

Dr. John L. Phelan is a management and technology practice leader with Milliman. He specializes in strategy, implementation, operations improvement, transaction processing regulatory compliance and technology initiatives. He is responsible for the Milliman Security Management System (MS2), robust security administration software that supports state-of-the-art compliance, including HIPAA compliance.

Prior to joining Milliman, Dr. Phelan implemented and led a multi-state managed care organization encompassing provider networks, medical management, customer service and claims. He also has managed a national healthcare and workers' compensation network of more than 300,000 providers. Additionally, his prior experience includes an executive role at WellPoint/Blue Cross of California and at the Blue Cross and Blue Shield Association. He also has consulted with hospitals, physicians, health systems and government on managed care contracting, marketing, and product development; drafted and helped implement state health and mental health legislation; and started and managed several community psychiatric facilities. He holds a Ph.D. from the University of Chicago.

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Jane Sarasohn-Kahn
THINK-Health

Jane Sarasohn-Kahn is a health economist and management consultant who has worked with healthcare stakeholders for more than 20 years. She focuses at the nexus of healthcare and technology, deploying scenario, strategic and business planning; forecasting; and health policy analysis. She also writes the Health Populi blog.

Sarasohn-Kahn has assisted stakeholders in every segment of the healthcare industry throughout her career, including technology and medical device companies; educational institutions; pharmaceutical manufacturers and distributors; healthcare providers; payers and health plans; consumer products companies; non-profits; and financial services firms. She founded THINK-Health, a strategic health consultancy, after spending 10 years as a healthcare consultant with firms in the U.S. and Europe. She is a frequent collaborator with the California HealthCare Foundation (CHCF) and writes a column for iHealthBeat, an online publication of CHCF. She often speaks and writes on healthcare consumers, health economics, information technology and scenario planning in healthcare. She earned a master's degree in economics and MHSA in Health Planning from the University of Michigan.

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Fritz Scheuren, Ph.D.
National Opinion Research Center/Human Rights Data Analysis Group

Dr. Fritz Scheuren is a senior fellow and vice president at the National Opinion Research Center, a survey research arm at the University of Chicago. His work focuses on resolving complex issues related to sampling and to the analysis of data from government agencies and private sector institutions. He also is a statistical consultant for the Human Rights Data Analysis Group (HRDAG).c

Before joining NORC, Dr. Scheuren was a principal at Ernst and Young, LLP. Before that, he served as a senior fellow at the Urban Institute, where his work focused on welfare reform; led the Statistics of Income Division at the Internal Revenue Service, which supports tax policy research; and was chief mathematical statistician at the Social Security Administration Office of Economic Opportunity. Dr. Scheuren has received numerous awards and honors, including the American Statistical Society (ASA) Founders Award and the Shiskin Award for contributions to U.S. Economic Statistics. He was a finalist for the Senior Executive Association Executive Excellence Award. He is a fellow of ASA and of the American Association for the Advancement of Science (AAAS), and is an elected member of the International Statistical Institute. He holds a Ph.D. in statistics from The George Washington University.

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Erik C. Swanson
Premier, Inc.

Erik Swanson is responsible for corporate strategy and development at Premier, Inc., including management of the overall strategic planning process, oversight for enterprise strategic projects and support for external development of partnerships, investments and acquisitions. He works closely with the management team in an advisory capacity on multiple business issues including mergers and acquisitions, investment priorities, product development, operational improvement, and innovation.

Prior to joining Premier, Swanson held a similar position at WellPoint as its vice president of corporate strategy development. Before that, he was a partner in the strategy practice of Accenture, where he advised health plan clients on key business issues. He holds a master's degree in business administration from Emory University.

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Robert M. Tennant
Medical Group Management Association

Robert Tennant, is the Senior Policy Advisor with the Washington, DC-based Government Affairs Department of the Medical Group Management Association (MGMA). Mr. Tennant focuses on federal legislative and regulatory health information technology issues for MGMA including HIPAA, ICD-10, electronic health records, electronic prescribing, administrative simplification and other electronic health information technology issues. Mr. Tennant serves on numerous industry initiatives, including Vice-Chair of the Board of Directors of Workgroup for Electronic Data Interchange (WEDI) and was past Chair of the WEDI Strategic National Implementation Process (SNIP).

In addition, Mr. Tennant was co-chair of a multi-stakeholder ICD-10 coalition and serves on the HIMSS ICD-10 Workgroup, the Physicians EHR Coalition, Bipartisan Policy Center on Health IT, Markle Foundation Consumer Engagement Workgroup, Council for Affordable Quality Healthcare CORE initiative, National Uniform Claim Committee. He previously served on several workgroups for the Certification Commission for Healthcare Information Technology. Mr. Tennant was the recipient of the WEDI leadership in Technology and Distinguished Service awards. He received his master's degree in political science from the University of Western Ontario.

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