Leaders accelerating the transformation of US healthcare by redefining payer-provider relationships.

Kevin is the Chief Executive Officer of Ridgeline Health Group.  Kevin is a nationally known managed care and population health expert.  He has led payer and provider business operations for healthcare systems such as Cleveland Clinic, Trinity Health, and Intermountain Health Care, as well as health plans such as Coventry Health Care and Centene. During the past 20 years, teams under Kevin’s leadership have achieved industry leading results through a wide variety of initiatives to drive organic growth, enhance top line revenue, improve medical expense management and reduce administrative costs. Kevin’s areas of focus include:

• Payer Contracting Strategy Development and Execution
• Value-Based and Risk-Based Contracting Strategy and Execution
• Contract Negotiation Strategy Development and Execution
• Strategic Pricing
• Health Plan Product Design and Development
• Network Development and Optimization
• Managed Care Organizations
• Population Health-Based Care Redesign
• Payer Business Development and Operations
• Medicare Advantage Organization and Product Development

Prior to Ridgeline Health Group, Kevin served as a Managing Director for BDC Advisors where he led the firm’s Payer Provider Innovation practice area.  Prior to that, Kevin served as Executive Director of Market & Network Services for the Cleveland Clinic. At the Clinic, Kevin held executive level accountability and signature authority for Cleveland Clinic’s top line revenue domestically and internationally.  He launched Cleveland Clinic’s first three health insurance initiatives with Oscar Health, Anthem and Humana, and developed a comprehensive strategic pricing and renegotiation strategy for the overall Clinic enterprise. 

Prior to the Cleveland Clinic, he served as Senior Vice President, Payer Strategy & Product Development of Trinity Health, where he led the contracting, product development and medical economics functions across the 22-state Trinity enterprise. Kevin was credited with increasing Trinity’s top line revenue by $1.1B over three years by renegotiating multi-year contracts with key payers and designing and launching numerous co-branded insurance products. Kevin also spent a year on a special assignment advising the Director of the Center for Medicare and Medicaid Innovation in developing alternative payment models for the Affordable Care Act. He honed his payer experience at Coventry Health Care where he served as Vice President, Provider Services, and held a similar role at Centene. 

Kevin publishes and speaks widely. He serves on a number of influential boards and national forums including the Health Care Transformation Task Force, and the National Business Group on Health. Kevin has a MHA from The Ohio State University and a BA from Brigham Young University.

Chris is a Partner with Ridgeline Health Group. He is a proven consulting leader and trusted advisor to senior healthcare executives with a focus on provider and payer healthcare markets. Chris has extensive experience in issues at the intersection of payers and providers as well as enterprise strategy. His areas of focus include: 

• Payer Contracting Strategy and Execution
• Contract Negotiation Strategy and Execution
• Value-Based and Risk-Based Contracting Strategy
• Strategic Pricing
• Payer-Provider Partnership Strategy and Development
• Managed Care Organizations
• Network Development and Optimization
• Enterprise Strategy 

Chris has consulted for organizations nationwide including academic health systems, community health systems, physician organizations, ambulatory providers, health plans and provider-sponsored health plans.  Chris publishes and speaks widely.

Prior to Ridgeline Health Group, Chris was a Principal with BDC Advisors where he focused his efforts in the Payer Provider Innovation and Enterprise Strategy practice areas.  He started his career with Guidehouse where he focused on driving operational improvements for provider organizations.

Chris received a Master of Business Administration at the Tuck School of Business at Dartmouth College, where he was named an Edward Tuck Scholar with Distinction. He graduated summa cum laude from Wake Forest University with Bachelor degrees in Finance and French.

Whitney Perlen is an Associate Partner with Ridgeline Health Group. She has built her career helping large health systems and provider groups navigate the everchanging healthcare landscape. Her areas of focus include: 

• Payer Contracting Strategy and Execution
• Contract Negotiation Strategy and Execution
• Value-Based and Risk-Based Contracting Strategy
• Strategic Pricing
• Managed Care Organizations
• Financial Feasibility Modeling and Analysis

Whitney has partnered with multiple organizations to develop and execute payer strategies including supporting contract negotiations and organizational redesign.  She has supported the development of multiple risk agreements and helped design a multi-segment payer-provider product strategy.  Her passions lie in working with her clients to create innovative payer-provider partnerships that align incentives, drive efficiencies and support improvements in patient care.  

Prior to Ridgeline Health Group, Whitney was a Manager at BDC Advisors where her work focused in the Payer Provider Innovation practice area.

Whitney received a Master in Public Health with a focus in Healthcare Management & Health Policy and Law from the Boston University School of Public Health. She is a Bachelor of Arts graduate of the University of Virginia College of Arts and Sciences.

Scott Boswell is a Senior Consultant with Ridgeline Health Group. He is focused on transforming the healthcare experience by partnering with organizations to develop long-term strategies that improve the payer-provider relationship.

Prior to Ridgeline Health Group, Scott was a Senior Consultant at Deloitte delivering audit and assurance services. During his time at Deloitte, he supported both public and private organizations in performing annual audits, developing valuation models, and advising on major transactions. During his time at Deloitte, he gained experience in:

• Financial modelling and analytics
• Organizational transformation
• Strategic deal structuring

Additionally, he supported the managing partners of the Deloitte Chicago office as a member of the management advisory council.

Scott received a Master of Science in accounting with an emphasis in financial transaction services from Wake Forest University. He earned a Bachelor of Science in accounting from Brigham Young University. Additionally, Scott is a Certified Public Accountant.

Giovanni Chiarella is a Senior Consultant at Ridgeline Health Group. He is focused on partnering with healthcare organizations in enhancing the payer-provider relationship through innovative strategies and solutions.

Previously, Giovanni was a Consultant at Deloitte Consulting within their Life Sciences & Health Care practice. During his time at Deloitte, he focused primarily on mergers and acquisitions support and organizational strategy development for health systems, payers, pharma, and private equity companies. Specifically, he supported organizations across the deal lifecycle, from commercial/operational due diligence to = integration planning. He also gained experience in the following areas:

• Growth strategy
• Strategic operational transformation
• Competitive market landscape analysis
• Financial analysis
• Go-to-market strategy

Prior to joining Deloitte, Giovanni received a Master of Health Administration from Columbia University, and he earned his Bachelor of Arts in Psychology from Dartmouth College.

Henrique Piedade is a Senior Consultant with Ridgeline Health Group. He is focused on assisting healthcare organizations across the country in effectively navigating the payer-provider ecosystem through innovative strategies and solutions.

Prior to Ridgeline Health Group, Henrique was a Senior Consultant at Deloitte delivering strategy consulting projects in the telecommunications industry. During his time at Deloitte, he supported organizations through transformative projects and gained expertise in:

• Market Analysis
• Pricing Strategy
• Growth Strategy
• Strategic Operational Transformation
• Financial Analysis
• Business Case Analysis
• Go-to-market Strategy

Henrique received a Master’s in Telecommunications Engineering from the Technical University of Lisbon, Portugal. He earned a Bachelor of Electrical and Computer Engineering from the Technical University of Lisbon, Portugal. Additionally, Henrique is certified in Project Management by the Project Management Institute.

Joseph Lu is a Consultant with Ridgeline Health Group. His focus lies in driving healthcare innovation and improving quality of care through strategies that leverage and enhance the payer-provider relationship.

During his graduate school coursework, Joseph had the opportunity to collaborate with major health systems to consult on strategy operations improvement and support a large medical device firm assess health policy and reimbursement changes. Specifically, he gained experience in:

• Health policy analysis
• Primary and secondary research
• Competitive market analysis
• Strategic operational transformation

Joseph received a Master’s in Public Health with a focus in Healthcare Management from the Boston University School of Public Health, as well as a Bachelor of Science in Cell and Molecular Biology from Eastern Michigan University.

Courtney Thompson is a Consultant with Ridgeline Health Group. She is interested in helping providers and payers develop strategies that drive healthcare transformation and improve the quality of care for patients.

As a graduate public health student, Courtney had the opportunity to partner with multiple healthcare organizations to drive strategic management and innovation. Specifically, she gained experience in:

• Competitive market analysis
• Primary and secondary research
• Pricing strategy
• Strategic operational transformation

Courtney received a Master's in Public Health with a concentration in Healthcare Management from the Boston University School of Public Health. She earned a Bachelor of Science in Biological Sciences with a minor in Psychology from North Carolina State University.

Frank is a Senior Advisor with Ridgeline Health Group.  Frank is a senior healthcare executive and consultant with over 25 years of successful managed care and health plan leadership experience. He was Regional Vice President of Marketing and Sales for Coventry Healthcare for 15 years. During this time, Frank developed and executed successful market strategies, which increased Coventry’s self-insured managed care membership from 25,000 to over 300,000 in Missouri, Illinois, and Indiana. Prior to Coventry, he served as Director of Sales and Marketing for Healthsource (Cigna). His specific areas of focus include:

• Health Plan Strategy
• Health Plan Operations
• Payer Contracting Strategy and Execution
• Contract Negotiation Strategy and Execution
• Value-Based and Risk-Based Contracting Strategy
• Health Plans Mergers and Integration
• Medicare Advantage Organization and Product Development 
• State Regulatory Compliance and Monitoring 
• Consumer and Customer Service Planning

Frank is also the CEO and Managing Partner of ALINICO Holdings, where he has full profit and loss responsibility for a portfolio of investments. Prior to founding ALINICO in 2019, he was Market President of CVS Aetna’s “Heartland Health Plan”. His multi-state region included Aetna’s insurance business in Southern Illinois, Iowa, Missouri, Colorado, Nebraska, Kansas, North Dakota, and South Dakota. The plan covered more than 960,000 commercial, Medicare, and specialty members and generated $4B in annual revenue. He has substantial merger and acquisition experience and was responsible for facilitating the post-acquisition integration of Coventry Healthcare and Aetna, including migrating all lines of business, clinical networks and operating systems. 

Frank serves on the Signature Healthcare Foundation Board and was previously a board member on the Regional Business Council, Midwest Health Initiative, Center for Hearing and Speech, and the Leukemia & Lymphoma Society. He graduated from Illinois State University and received an MBA from Indiana Wesleyan University.

Amanda is a Senior Advisor with Ridgeline Health Group and brings over 15 years of experience partnering with providers and payers.  Amanda helps organizations create analytic platforms that drive population health management, clinical interventions, and risk share programs across numerous provider entities.  Bringing both clinicians and executives to the table, Amanda promotes a data-driven organizational culture that supports population health, reduces health care costs and improves quality in health care access and utilization. Amanda’s areas of focus include:

• Population Health Management 
• Clinical Interventions
• Value-Based and Risk-Based Contracting Strategy
• Data & Analytics
• Cost Reduction

Recently, Amanda served as Senior Vice President of Business Intelligence at Commonwealth Care Alliance, where she led the alignment of enterprise-wide analytics and data governance. Prior to joining Commonwealth Care Alliance, Amanda served as the Chief Analytics Officer for Neighborhood Health Plan of Rhode Island.  She has also held multiple roles at Blue Cross Blue Shield of Rhode Island, Trinity Health, and Blue Cross Blue Shield of Michigan, where she focused on provider and network innovation, population health analytics and value-based contracting strategy.

Amanda holds a Master’s in Public Health from Saint Louis University and is a PhD candidate in Health Services Research at the Boston University School of Public Health.  Her research centers on policies and interventions to reduce disparities in health care access among dual-eligible Medicare-Medicaid beneficiaries.

Paul is a Senior Advisor with Ridgeline Health Group.  Paul brings over 20 years of healthcare industry experience in clinical and accountable care settings including hospitals, multi-specialty group practices, provider networks and regional healthcare delivery systems. He has specific expertise in:

• Accountable Care Organization, Development and Governance
• Business Model Development and Transformation
• Contract Negotiation Strategy and Execution
• Value-Based and Risk-Based Contract Strategy
• Strategic Pricing
• Informatics and Business Analytics
• Physician Network Design
• Care Management and Clinical Process Improvement
• Change Management and Consensus Building

Prior to consulting, Paul served as Chief of ACO Development (Michigan) and Senior Vice President Clinical Integration and ACO Development for Trinity Health, one of the largest multi-institutional Catholic healthcare delivery systems in the nation.  Trinity Health provides healthcare services to over 30 million people in 22 states. His experience at Trinity included ACO organization and development, the selection of health plan partners, population health, product design, and contract pricing and negotiation.  Paul serves on the governance boards of several Clinically Integrated Networks and Accountable Care Organizations.

Since the early 1990s, Paul has published and presented widely on population health and clinical integration.  He received his MD from Wayne State University School of Medicine and is a Diplomate in Internal Medicine, Pulmonary Medicine and Critical Care Medicine.

Lovell is a Senior Advisor with Ridgeline Health Group.  Lovell has over 20 years of progressive responsibility in managed care strategy, health plan product development and implementation for provider healthcare systems, government health plans and commercial health plans. A results-focused professional, Lovell has achieved a consistent record of market share growth and profitability with products he has designed and implemented by fostering cooperation and teamwork among sales and marketing, network development, product development, operations, and support functions. His areas of focus include:

• Contract Negotiation Strategy and Execution
• Network Development
• Managed Care Organization Performance Transformation
• Health Plan Product Design and Development
• Strategic Plan Development and Implementation
• Data Analytics

As Principal of Harmon Associates, an independent healthcare consultancy he founded in 2016, his recent engagements have included: executing network development (including hospital contracting) for a national health insurance carrier launching products in the Washington, DC market; completing network development (primary care and specialty physician contracting) for a multi-state health insurance carrier; creating a community-based brokerage agency serving multiple insurers across multiple states in the Mid-Atlantic region generating over $15M in annual premiums; and, organizing a private IPA/MSO on behalf of primary care and specialist physicians and negotiating contracts with health plans.

Prior to forming Harmon Associates, Lovell was Senior Vice President, Business Development, for Health Partners Plans, a managed care company, where he was responsible for the development of new ventures, products, sales, benefits and other strategic efforts as well as overseeing marketing, outreach, and corporate communications. Prior to Health Partners Plans, Lovell was Director of Government Sales for Health America (Coventry Health Care). Before that, he was Vice President of Marketing for Amerigroup and held executive marketing positions at Centene and UnitedHealthcare’s AmeriChoice. 

Lovell has an MBA and MS in Healthcare Finance from Temple University.

David McGuire is a Senior Advisor with Ridgeline Health Group.  Prior to this role, David served as Vice President for Payer Strategy and Contracting at Mass General Brigham and as a Senior Advisor to Mass General Brigham.  In the Vice President role, David was responsible for the development and execution of Mass General Brigham’s payer contracting strategy including the appropriate response to the market and health policy challenges facing the organization.  David’s areas of expertise include: 

• Payer Strategy Development and Execution
• Contract Negotiation Strategy and Execution
• Value-Based and Risk-Based Contracting Strategy
• Managed Care Organization Performance Transformation 
• Network Development
• Population Health Strategy
• Clinical Integration
• Insurance Product Development

David oversaw the negotiation and implementation of all managed care contracts with both commercial and government payers for Mass General Brigham.  Mass General Brigham has revenues of greater than $14B and a broad array of clinical assets including a physician network of 6,000 employed and affiliated physicians, two premier academic medical centers and a dozen acute and specialty care hospitals.  He held the Vice President position for ten years and before that served ten years in various managed care leadership positions with Mass General Brigham.  

Since 2018, as a Senior Advisor to Mass General Brigham, David has assisted in the integration of the Mass General Brigham Health Plan with the provider side of the organization and consulted on a variety of strategic projects and initiatives, in particular the areas of contract strategy and Medicare Advantage performance.

Before transitioning to managed care, David started his career working in the behavioral health sector as an administrator.  He holds a master’s degree in social work from Rutgers University and a BA from Georgetown University.

Dr. Modic is a Senior Advisor with Ridgeline Health Group. He most recently worked with Vanderbilt University Medical Center as Senior Vice President, Population Health and Professor of Radiology and Radiological Sciences. At Vanderbilt University Medical Center, Dr. Modic worked with the Population Health team to integrate clinical activities and to establish and enable evidence-based clinical standards across a diverse network of clinical settings. Dr. Modic’s area of expertise include:

• Population Health Management
• Clinical Transformation
• Clinical Practice Redesign
• Evidence-based Clinical Standards

Prior to joining Vanderbilt, Dr. Modic served as the Chief Clinical Transformation Officer at the Cleveland Clinic. In this role, he oversaw the areas of Quality and Safety, Patient Experience, Continuous Improvement, Distant Health (Telemedicine), the Cleveland Clinic ACO and Health Enabling Technology. As Chair of the first multidisciplinary Institute at the Cleveland Clinic, he was engaged in clinical practice redesign with a focus on disease lines and measurable outcomes.

During his time with the Cleveland Clinic, Dr. Modic also served as Chairman of the Division of Radiology and the Neurological Institute. He has served as a member of the Board of Trustees of the Cleveland Clinic Foundation, Society of Magnetic Resonance in Medicine and Board of Directors of the Society of Magnetic Resonance Imaging. He is a Fellow of the American College of Radiology and a recipient of the Gold Medal of the Society of Magnetic Resonance in Imaging.

Dr. Modic earned his bachelor’s degree from Xavier University and his medical degree from Case Western Reserve University (CWRU) School of Medicine. He completed a Diagnostic Radiology Residency and Neuroradiology fellowship at the Cleveland Clinic. Dr. Modic’s clinical practice and research interests have been focused on Neuro Imaging with a special interest in degenerative disease of the spine and its natural history.

Mike is a Senior Advisor with Ridgeline Health Group.  Mike focuses on issues of health plan / provider contract pricing and negotiation.  Mike’s areas of expertise include: 

• Payer Contracting Strategy and Execution
• Contract Negotiation Strategy and Execution
• Managed Care Organizations
• Network Development
• Project Management
• Business Development
• Strategic Planning and Execution

Prior to Ridgeline Health Group, Mike co-founded ATI Associates, a consulting firm providing assistance to health plans in the Medicaid, Medicare Advantage, and Commercial space with clients that include Anthem, Centene, Molina, Wellcare, Coventry and HCA.

Before launching ATI Associates in 2011, Mike spent several years in leadership roles with several Fortune 500 companies that specialize in healthcare solutions for members covered by Commercial, Medicare Advantage and Medicaid plans. Mike’s experience includes: developing a statewide Medicare and Medicaid network which quickly surpassed in size eight other established Medicaid networks in that state, negotiating significant hospital and PHO contracts throughout the Southeast and Mid-West, serving as lead contract negotiator on a Managed Care Team for a large multi-hospital system and assisting two Fortune 500 companies developing Statewide Duals and MA networks in the Southeast.

Mike’s prior population health experience includes the development of a 96-hospital network in three states, and consulting support for new healthcare plans and products. His early years in managed care included roles in operations, provider relations, network development, quality improvement and strategic planning.

Mike has a BS in International Law from the University of Oregon and served as a Captain in the U.S. Army from 1980 until 1991.

Sue Brown serves as Executive Administrator with Ridgeline Health Group and brings 20+ years of experience in administration and operations.  In her role, Sue is responsible for key operational and administrative functions for Ridgeline Health Group.  In addition, she provides Executive Assistant support to the CEO and Partners.  Known for her positivity, Sue is the line that connects the dots together to ensure continued success for the Ridgeline Health Group team.  

Prior to Ridgeline Health Group, Sue worked as an Executive Administrator for HC Wisdom and an Executive Assistant at Oliver Wyman, BDC Advisors and a Healthcare Venture Capital firm.