We work with our health plan clients to maximize their understanding of complex reimbursement mechanisms, design and implement provider contracting arrangements, improve internal analytic and reporting capabilities, and generally mitigate risks present in the ever-changing health insurance market. We additionally support State agencies in the administration of public insurance programs with a focus on the review and development of actuarially sound capitation rates, risk-assessment methodologies, alternate payment mechanisms, and general program design. This experience has created a unique perspective that allows us to most effectively strategize, develop, and implement cohesive solutions that consider the goals of our clients as well as their industry partners.
ACAP Preferred Vendor
EHC is proud to partner with the Association for Community Affiliated Health Plans (ACAP), a national trade association which represents not-for-profit Safety Net Health Plans serving more than twenty million enrollees – nearly half of all individuals enrolled in Medicaid managed care. EHC was selected to participate in ACAP’s Preferred Vendor program based on recommendations from existing health plan members and approval from ACAP’s Board. We hope to help ACAP and its member plans achieve its vision to improve the health and well-being of lower-income and vulnerable populations and the communities in which they live.
Kyle founded Edrington Health Consulting in 2014 and is responsible for the design, development, and communication of client engagements. Kyle has experience working with State agencies, health plans, and provider stakeholders across 15 states. Past experience includes the development of actuarially sound capitation rates and the design and implementation of new programs for Medicaid and Managed Long Term Care populations. Additionally, Kyle works closely with health plans to provide a valuable resource to enhance analytic and reporting capabilities while also bridging the gap between the Executive, Finance, Management, and Analytic departments within the plan.
Joe is a Senior Actuarial Consultant at Edrington Health Consulting who joined the team in 2019 and is pursuing his Associate of the Society of Actuaries designation. He has experience developing analyses and consulting for both Medicaid state agencies and Medicaid managed health plans across multiple states. Making an impact on the quality of life with respect to those in need is something Joe is passionate about. His experience includes in-depth budget and financial analyses for States and health plans, IBNP forecasting, development of actuarially sound capitation rates, assisting with 1115 and 1915(b) waiver development, and assessing impacts of population and/or service changes.
A credentialed and experienced, actuary, Chris Dickerson has expertise in Medicaid managed care, risk adjustment, and capitation rate development as well as rate development for long-term services and supports, physical and behavioral health. Before joining HMA, he was a senior consultant with Optumas where he developed complex Excel models for actuarial topics including rate adequacy, risk adjustment, program changes, trend development, and Incurred but not reported (IBNR) reserving.
Cassie joined the EHC Team as a Senior Consultant in 2020. She has worked on a wide variety of Medicaid Managed Care projects, including setting actuarially sound capitation rates and assisting with the development of tools to evaluate health plan efficiency. Cassie thoroughly enjoys being involved in all phases of a project – starting with detailed data manipulation and ending with communication of complex analytics to clients. Cassie is excited to use her experience consulting State Medicaid agencies coupled with innovative analytics to assist health plans in better understanding the underlying risk of their members.
Ricky joined Edrington Health Consulting in 2016. His expertise is manipulating complex data sets with recent experience reviewing and repricing encounter data and manipulating Medicaid 820/834 and Medicare MMR data. Ricky is also responsible for the development of EHC’s IBNP model and works with multiple partners each month to develop reasonable reserves. Ricky has also developed and maintained EHC's forecast model being used to assist our partners in developing reasonable and appropriate budgets.
Paul joined EHC in 2020 as a consulting actuary. He is an Associate of the Society of Actuaries and has experience primarily in the health sector. With a background in mathematics and a passion for programming, actuarial work became the perfect avenue to combine these skillsets. Utilizing his keen attention to detail and ability to communicate complex ideas, Paul is responsible for Medicaid reserving projects, peer review, and other actuarial analyses. He is also utilizing his M.S. degree in Statistics and teaching experience to lead actuarial exam courses.
Daniel is an Actuarial Consultant who joined the Edrington Health Consulting team in 2022. He joins HMA after serving with UnitedHealth Group and Blue Cross Blue Shield of Arizona. His actuarial background covers IBNP reserving, forecasting products, corporate budgeting, rate pricing, and submitting rate filings. He is a local Arizonan, born and raised. He earned a Bachelor of Science in Mathematics from Arizona State University and has passed several actuarial exams.
Joe joined Edrington Health Consulting in 2019 to support ongoing data processing and analytics and to enhance our ability to understand this information and tell its story. Prior to joining EHC, Joe was (and still moonlights as) a university-level mathematics instructor having done graduate studies in mathematical physics and related software at ASU. This background has enabled him to provide a fresh perspective on both how we approach and communicate our analytics. As an Actuarial Analyst, Joe is responsible for raw data processing, model development and peer review.
Michelle is an analyst at Edrington Health Consulting who joined the team in 2022 with a background in state Medicaid managed care capitation rate development. Prior to joining the EHC team, she worked on projects spanning traditional actuarial pricing analyses, data monitoring and validations, as well as state legislative reporting focused on improving both access to health care services and quality of care for medical assistance beneficiaries. Michelle is pursuing her Associate of the Society of Actuaries and strives to continue to grow her actuarial and consulting skill set to support clients and their pursuit to provide health care to our country’s most vulnerable population.
Matt is an analyst at Edrington Health Consulting who joined the team in 2020 and is pursuing his Associate of the Society of Actuaries designation. His experience is in small group self-funded stop loss programs and includes IBNP forecasting, experience monitoring and analysis, and renewal pricing. Prior to starting his actuarial career, Matthew was a university-level mathematics instructor at Clemson University.
Keeley recently joined the team as an Analyst at Edrington Health Consulting. She’ll be utilizing her background in client and project management to support the team in balancing timeliness, thoroughness, and accuracy of each account. Keeley has experience in the governmental sector, providing recommended contributions for Illinois Pension Funds and other post-employment benefits.
McKenna is EHC's Office Manager and joined the team in 2019 after receiving her degree in Business Administration and Management from the University of Wyoming. She is responsible for project and staff management and ensuring that our team is successful in delivering work that exceeds expectations and meets timelines. McKenna also oversees the daily functions within the office and manages client contracts.
We look forward to hearing from you.
Call us today at: 602-899-7800
Email: [email protected]
7975 N. Hayden Road, Suite C-370
Scottsdale, AZ 85258