David Kennell, President, has over 30 years of experience in directing and managing projects involving designing/modifying payment systems, and advising on policies that impact healthcare financing and delivery. He has worked extensively with the TRICARE program, the military’s health insurance benefit, on the cost impacts on beneficiaries and the government of changes in program structure since 1985. For TRICARE, he helped design both its physician reimbursement system and its hospital payment system. He advises TRICARE on both the incentives in payment and operational issues involved with modifying provider payment systems. He also directs much of Kennell's work for CMS. For CMS he directed two major studies on the chronically critically ill populations and their use of Long Term Care Hospitals and is currently directing a study on primary care redesign. Before founding Kennell and Associates, he was a Senior Vice President of Lewin-VHI. During that time, he worked with analysts from the Brookings Institution to develop the Brookings-ICF Long Term Care Financing Model, a microsimulation model, and used it in a variety of long term care financing studies. He holds an M.P.P. from the Graduate School of Public Policy at the University of California at Berkeley.
Arnie Brooks, Senior Research Analyst, has more than 25 years of experience in health care economics, economic and cost-benefit evaluations, econometrics, and health care policy modeling. He has developed economic/actuarial cost estimates and IGCEs of TRICARE benefit changes. Many of these efforts have focused on new benefits, particularly preventive benefits. He has designed and maintained numerous cost and simulation models for DoD, including benefit cost simulation models, cost-effectiveness models, budgetary models, and actuarial models. He has also managed a number of projects using econometric models relating to copayments for preventive benefits, projection of the number of retirees who use the TRICARE system, and examining the relationship between bariatric surgery levels and complication rates. He has also analyzed the cost of numerous new program requirements resulting from legislative changes including the Comprehensive Autism Care Demonstration program and the Laboratory Developed Test Demonstration program. As a follow-up to these demonstrations, he has helped TRICARE to develop maximum allowable reimbursement rates for these programs. He has recently analyzed the potential costs to TRICARE of transgender services and cryopreservation. He has also assisted CMS in an analysis of the differences in Medicare payments, facility costs, and margins between patients in Medicare’s Long Term Care Hospital (LTCH) programs and long-term patients with similar conditions in acute care hospitals. He has also assisted CMS in the development of a Report to Congress regarding Medicare’s Long Term Care Hospital (LTCH) program. He holds an M.P.P. from the Graduate School of Public Policy at the University of California at Berkeley.
Marty Cohen, Ph.D., Vice President, has over 20 years of health care policy experience. He has managed wide-ranging projects for the Military Health System’s TRICARE program since 1992, including: modeling the cost impacts of benefit reforms proposals developed by DoD, Congressional committees, and independent commissions; analyzing strategic options for the future structure of TRICARE in support of DoD’s T4 Workgroup; estimating costs for new benefits and programs; evaluating the direct care system’s Patient-Centered Medical Home program; coordinating across MHS stakeholders to identify and resolve a wide range of TRICARE implementation issues; designing financial incentives for three generations of regional managed care contracts; analyzing legislative proposals; and specifying data system requirements. For CMS, Marty is directing an evaluation of how CMS provides data and data-related training to participants in health reform demonstrations and he co-led an evaluation of the clinical logic of two episode groupers under consideration for physician resource use reporting in Medicare. Marty also managed several projects to assist the U.S. Department of Veterans Affairs in implementing Medicare pricing for selected categories of purchased care claims. Marty holds a Ph.D. in Public Policy from George Mason University, an M.P.A. from Harvard’s Kennedy School of Government, and a B.A. from Harvard.
Wendy Funk, Vice President and Senior Health Services Researcher, has over 25 years consulting experience on a wide range of issues involving health services research, information systems, data quality, and data privacy rules and regulations. She works extensively with large medical claims and clinical data warehouses in both military and civilian settings. She was the project lead in developing TRICARE's data warehouse and expanded this repository to incorporate clinical data. She was the project director on a CMS contract to analyze data and produce statistics about chronic illness in the Medicare population. She regularly presents briefings at national and international conferences, local hospitals, and other venues. She also teaches courses in data quality, the use of information systems, performance measurement, the Privacy Act, and other topics. She holds an M.S. in Operations Research from the University of Kentucky.
Geof Hileman, Vice President and Actuary, joined Kennell in 2010 and has over 15 years of both government and commercial experience. He is responsible for the oversight of actuarial projects with government clients, including the Defense Health Agency, the Centers for Medicare and Medicaid Services, and the Navy’s Bureau of Medicine and Surgery. This has included the development of a health-based risk adjustment model specifically tailored for the military beneficiary population. He has been deeply involved in the annual development of capitation rates for the Uniformed Services Family Health Plan since 1999. He has conducted multiple research studies related to risk adjustment on behalf of the Society of Actuaries. His specific areas of expertise are health-based risk adjustment, construction of actuarial models, and predictive modeling. Prior to joining Kennell, he was an actuarial director with BlueCross BlueShield of North Carolina and a consultant with Actuarial Research Corporation. He is a Fellow of the Society of Actuaries, a Member of the American Academy of Actuaries, and regularly presents at actuarial conferences and meetings. He holds an M.S. in Operations Research from the College of William and Mary.
Allison Russo, Dr.P.H., Research Director, has more than 15 years of health services research experience supporting federal government clients in the U.S. Department of Health and Human Services and the DoD. She specializes in the evaluation of healthcare quality improvement projects, performance measures, and policies affecting healthcare costs and utilization. She directs several analytic and research task orders under Kennell’s contracts with the Defense Health Agency and Navy Medicine, including the evaluation of access to appropriate care; potentially inappropriate healthcare utilization; the measurement of health outcomes, utilization and costs; and payment policy options that incentivize high quality care. For the Centers for Medicare & Medicaid Services (CMS), she directs the Systematic Review of CMMI Primary Care Initiatives project, which is synthesizing findings from multiple CMS primary care demonstrations in order to inform programmatic policy decisions by CMS on future advanced primary care approaches. Prior to joining Kennell, she was a Senior Research Leader at Truven Health Analytics supporting the Agency for Healthcare Research and Quality’s Healthcare Cost and Utilization Project (HCUP). She has authored numerous reports on a wide-range of healthcare utilization issues, including topics related to quality measurement, how hospital costs vary among different payer groups, and hospital and emergency room use among various patient populations. She regularly develops curriculum for and teaches numerous courses on the use of information systems to support healthcare decision-making, disease management programs, and health outcomes studies. She holds an M.P.H. in Epidemiology from the University of Alabama at Birmingham and a Dr. P.H. in Health Policy from the George Washington University.
W. Bart Smith, Senior Manager, has over 35 years of experience in healthcare financial management, strategy and resource allocation, the design and operation of complex healthcare organizations, healthcare policy analysis and program evaluation. He is a recognized expert in the operation and financing of the Department of Defense healthcare system. He has expertise in the development, financing, contracting, and implementation of large scale healthcare programs. He has prepared detailed business and costs analyses used to develop the cost impact of various initiatives related to TRICARE purchased care contracts, including the TRICARE Overseas Program. He identifies potential business risks and prepares recommendations related to the policy and procedures associated with the administrative performance of the delivery of healthcare. He formerly served as a Senior Health Program Analyst with the Office of the Assistant Secretary of Defense Health Affairs, where he developed managed care financing policy and implemented DoD managed care programs. Previous to that, he held military healthcare financial management positions including serving as a financial officer at military hospitals, major commands and medical research and development organizations. For his role in developing a joint DoD/HCFA Medicare marketing initiative in 1993, he received the Administrator’s Award, the highest award bestowed by the Administrator of the Health Care Financing Administration (HCFA). He holds a B.S. and M.A. from Middle Tennessee State University. He is a Fellow in the American College of Healthcare Executives and a Fellow of the Healthcare Financial Management Association, having served as President of the D.C. Metropolitan Chapter. He is also a Certified Government Financial Manager by the Association of Government Accountants.
Norma Bowling, Senior Analyst, has nearly two decades of experience as a military health data analyst. She is an experienced SAS programmer who routinely analyzes large health care data sets and performs detailed data extractions on a wide range of issues. She is an experienced Business Objects user and is an instructor for the M2 Analytics class. She helps maintain corporate documents on topics such as Data Quality, Case Management, Medical Management, and Financial Management. Prior to joining Kennell, she served as a Senior Health Data Analyst at SRA International, Inc. where she was an instructor for the Working Information Systems to Determine Optimal Management (WISDOM) course. She was also a subject matter expert with the Pharmacy Data Transaction System (PDTS) data and was the author for various sections in the M2 and MDR data dictionaries, as well as the M2 and MDR functional specifications. She holds an M.S. in Statistics from the University of Texas at San Antonio.
Tracy Comer, Senior Analyst, has over 10 years of experience in military healthcare, including 4 years as an Active Duty Officer in the Medical Service Corps. She has management experience at a health clinic and a regional medical headquarters where she focused on appointment call center operations, improving access to care, and the implementation of Patient Centered Medical Home (PCMH) across 11 military hospitals and clinics. She helped to develop strategic surgical metrics that the Army has used to monitor the performance of its Surgical Service Line. She has used her knowledge of Military Health System (MHS) data repositories in her analysis of provider supply and population care demand, ICD-10-CM/PCS coding updates, and analytic newsletters in support of Navy Medicine and the Defense Health Agency (DHA). She also volunteers as a Patient Representative at Sentara Northern Virginia Medical Center to maintain provider, nurse, and patient perspectives in a healthcare setting. She holds an M.H.A. from the University of North Carolina at Chapel Hill and is a Fellow of the American College of Healthcare Executives.
Lily Grimm, Senior Analyst, has over 25 years of experience in economic and health care research, specifically in data extraction/integration and survey research activities both in military and civilian health care fields. She is an experienced SAS programmer and survey expert with practical experience in survey design, statistical analysis, documentation and programming. She performs survey sample production monthly for several ongoing DHA surveys. She also performs analysis of detailed data extractions from large multi-million record data sets to support demonstration programs, data use agreements, and adhoc requests. In addition, she is responsible for developing various reference tables as well as drafting and maintaining the documentation for the MDR and M2. Prior to joining Kennell, she served as a Senior Health Data Analyst at SRA International, Inc. supporting the TMA and Army OTSG contracts. She has coauthored several publications on HMO trend, cost, and utilization issues. She holds an M.A. in Economics from Ohio University.
Doug Herbert, Senior Associate, has more than 20 years of experience in budget development and financial analysis for DHA. He specializes in the development of budgetary projections for TRICARE as well as the annual development of capitation rates for the Uniformed Services Family Health Plan (USFHP). Among multiple other initiatives, he has assisted in the development and implementation of TRICARE payment reform for sole community hospitals and hospital outpatient radiology departments. He also performs ad hoc data extractions from the MHS databases to inform budget related decisions as well as other Kennell research focusing on health care cost trends, post-acute care reimbursement, and health insurance policy. Prior to joining Kennell, he worked for the U.S. Navy on the Base Realignment and Closure (BRAC) initiative, and as a financial and budget analyst for DHA. He holds an M.P.A. from George Mason University.
Keith Hofmann, Senior Analyst, specializes in computer programming and analysis of health care data from large data sets. He performs ad hoc queries on the MHS Data Repository (MDR), in the MHS MART (M2), and in the VA Informatics and Computing Infrastructure (VINCI) environment for a wide range of work. He has worked on mental health studies including long-term mental health costs for deployed service members, tracking follow-up care for mental health referrals in both the MHS and the Veterans Health Administration (VHA), and studies on PTSD, substance use disorder and autism. He has also developed programs to measure or identify 30-day readmissions, ER utilization, hot spotters and other metrics. He has worked on clinical studies including building a model to predict the severity of Crohn's disease at initial diagnosis, and a study measuring the bleeding rates due to an anticoagulant drug given for various indications. He developed several processors that provide data in the MDR and works to monitor data quality in the MDR and M2. He moderates the MDR Users Group, provides MDR and SAS trainings, and training in MHS data through the WISDOM course. He has a B.S. in Physics and Chemistry from Tufts University.
Laura Hopkins, Senior Analyst, is an experienced SAS programmer who routinely analyzes large health care data sets and performs detailed data extractions on a wide range of issues. Past projects include data extractions to determine cancer prevalence among DoD beneficiaries, analysis of mental health costs and utilization, including specific analysis of active duty service members, the development of capitation rates for the Uniformed Services Family Health Plan, and ad hoc analyses of various proposed policy changes. She is also responsible for drafting functional specifications and developing software to implement corporate data processors. She frequently provides training to new MDR users that includes detailed SAS training. She helps maintain the existing corporate documents on topics such as Data Quality, Case Management, Medical Management, and Financial Management. Additionally, she advises the Privacy Board and DHA Privacy Officer on the health care data sensitivity levels of all research-related DSAs evaluated by DHA. For CMS, she performed analysis of chronic conditions using data from the Chronic Condition Warehouse, the development of statistics on cost and prevalence of chronic conditions, and the development of an Access Monitoring System. She holds an M.P.A. from New York University.
Sarah Irie, Health Policy Analyst, performs qualitative research and assists with the development of economic/cost-benefit analyses and independent government cost estimates of TRICARE benefit changes for DHA. She conducts ad-hoc data extractions from the MDR using SAS and then analyzes the impacts of TRICARE benefit changes. She has also developed detailed literature reviews and analyzed administrative datasets for several research projects which utilize MHS data for econometric models, including those related to preventive services, new medical technologies, and healthcare quality improvement projects. She has helped with analysis of the cost of numerous new program requirements such as TRICARE’s comprehensive autism care and laboratory developed test demonstration programs. She is also a contributing writer of the Healthcare Analytics in Navy Medicine publication. These tasks complement her previous years of experience supporting NIH-funded, longitudinal health services intervention studies at a major public research university. She holds a B.A. in Psychology and International and Comparative Studies from the University of Michigan with additional training in Global Public Health and Environmental Studies.
Casey Kangas, Senior Analyst, is an expert in advanced SAS programming and SAS EBI technologies and has led numerous military health system (MHS) and Department of Veterans Affairs (VHA) data integration efforts. For the MHS, he developed SAS processors to load patient medical records and clinical data extracts containing appointment, medication, chemistry, and microbiology laboratory result information from the Clinical Data Repository into the MDR and M2. He also provides training in MHS data through MDR webinars and military dental data workshops. For the VHA, he performed data analytics for the VA Choice Act Assessments using the VINCI platform to develop CDW programs in SQL Server and SAS. The data analytics included detailed exploration and prediction of Veteran health care needs and VHA’s ability to effectively meet those needs, as well as physician staffing and productivity measurement, emergency department performance, and appointment scheduling. For Navy Medicine, he develops patient quality metrics for the joint VA/DoD Lovell Federal Health Care Center. These measures require a deep knowledge of both VA and DoD data systems that must be properly integrated for jointly treated patients to obtain a complete medical record. He is a certified Project Management Professional (PMP) and holds an M.B.A. from Mississippi State University.
John Montgomery, Ph.D., Senior Consultant, is an expert in TRICARE contract cost estimation with a strong background in healthcare administration and mathematical modeling. His primary consulting activities include cost analyses for TRICARE procurements and contract modifications, forecasting and analyses of healthcare and dental costs and workload for the Military Health System, and educational support for analytic methods. A retired Captain in the Navy Medical Service Corps and a past Director of the Office of CHAMPUS (the forerunner to the current TRICARE program), he has over 40 years of experience with the MHS. He holds a Ph.D. in Engineering Science (Operations Research) from the University of California, Berkeley, a Masters in Hospital Administration from the University of Minnesota, and a B.A. in Physics from Brigham Young University.
Ellen Macchiavello, Associate, has primary responsibility for maintaining the general ledger, preparing monthly invoices, preparing project tracking spreadsheets, calculating monthly cost projections, and preparing the incurred cost report. Her previous responsibilities included working as part of a team that maintained a desktop spreadsheet model for use by financial managers to forecast and analyze local costs for regional managed care support contracts and calculating bid price adjustments. She holds a B.S. in Business Administration from George Mason University.
Veronika Pav, Senior Analyst, conducts economic analyses using SAS and Business Objects. She also provides clients with extractions from the MHS Data Repository (MDR) using SAS and participates in a number of research projects that utilize MHS data. She has extensive experience in building cohort files, using clinical data, and calculating workload and costs. She leads a number of projects including building a centralized occupation health registry for one of the largest military hospitals tracking flu and other medical programs. She assists in regression, trend analysis, and forecasting. In collaboration with clinicians, she develops Bayesian models to predict outcomes of various diseases. She also works with data sources outside the Military Health System, particularly AHRQ’s Medical Expenditure Panel Survey and HCUP datasets. She develops and presents instructional materials for ad-hoc on-site training sessions at numerous Military Treatment Facilities and for web-based trainings. She is a WISDOM Business Objects Instructor and provides consultation to M2 users on MHS data sources and Business Objects functionality. She co-designed and teaches the M2 Data Analytics course as well as the MDR (SAS/UNIX) programming course. She is also a contributing writer of the Healthcare Analytics in Navy Medicine publication. She holds a Certificate in Forecasting Practice from the International Institute of Forecasters, a B.A. in Economics and French from Davidson College and an M.S. in Applied Economics from Johns Hopkins University.
Dawn Sexton, Senior Analyst, performs data extractions on large MHS databases including the MDR and M2 in support of MTF improvement programs, TRICARE beneficiary and provider satisfaction surveys, and ad hoc requests. She uses Business Objects to create and maintain standardized reports for approximately 1,000 M2 users. The reports identify data quality issues, track financial trends, and facilitate patient-level monitoring for specific types of care such as ER and case management. She provides advanced-level direction to other MDR and M2 analysts on query building and guidelines for proper data interpretation. She is also an instructor for the Navy Medicine training course, Foundations in the Practice of Analytics, and the DHA training course, Data Quality Management Control. She has consulted for the MHS for over 15 years, including supporting the Defense Health Agency, the Air Force Surgeon General's Office and TRICARE Regional Office - North. She holds a certification in SAS and a B.S. in Zoology from the University of South Florida.
Christina D. Superina, Senior Associate, has over 10 years of consulting experience, mostly focusing on health reimbursement policy and analysis at Kennell. For the Defense Health Agency (DHA), she conducts claims data analyses to determine the policy and budgetary impacts of TRICARE benefit changes. She also works on several ongoing projects for DHA including one on mental health cost and utilization trends and one on Medicaid maternity and delivery reimbursement. She also has extensive experience focusing on post-acute care reimbursement for both DHA and CMS. For DHA, she analyzed long-term care hospital (LTCH) and inpatient rehabilitation hospital claims data to estimate the budgetary impacts of potential reimbursement changes. For CMS, she worked for five years on the Chronically Critically Ill (CCI) Population Payment Recommendation Project, where she analyzed LTCH and acute MedPAR claims data to identify the characteristics and costs of a critically ill population. She also contributed to the interim and final reports. Prior to joining Kennell, she was a Senior Consultant at IBM Global Business Services and held graduate level internships at the Blue Cross and Blue Shield Association and the Congressional Budget Office. She holds a B.S. from Bates College and an M.P.P. from the Georgetown McCourt School of Public Policy.
Spenser Steele, Actuarial Analyst, works on the development of capitation rates for the Uniformed Services Family Health Plan (USFHP), as well as the continuing development of a health-based risk adjustment model tailored for the military beneficiary population. He is a co-author of a recently-released research study from the Society of Actuaries comparing the statistical performance of commercial risk scoring models. Prior to joining Kennell in 2015, he performed and published research on bootstrapping clustered data using R. He holds a B.A. in Mathematics and Russian from Lawrence University.
Kathleen Timothy, Associate, has over a decade of experience supporting the Military Health System. She specializes in Privacy Act and HIPAA enforcement procedures, as well as the management of Data Sharing Agreements (DSA) for all Kennell contracts. For the Defense Health Agency, she advises the Privacy Board and DHA Privacy Officer on the health care data sensitivity levels of all research-related DSAs evaluated by DHA. In addition to her data protection expertise, she performs project management duties for a variety of projects. Prior to joining Kennell in 2008, she was the Senior Advisor to the Regional Director at TRICARE Regional Office – North and she worked as the Contract Program Analyst to the TMA Aurora Contracting Officer of the North Region Managed Care Support Contract. She holds a B.A. in International Relations from Saint Joseph's University.
Christina Witsberger, Senior Research Analyst, is a recognized expert in provider reimbursement policy and analysis, with over 25 years of experience in health services research, policy/economic analysis, statistics, and SAS programming. She is particularly knowledgeable about TRICARE and Medicare policies, and has worked extensively with many Medicare claims data, provider information, payment rate, and cost report data files. She has used them to analyze both inpatient and outpatient reimbursement issues for TRICARE. Chris functions as the main statistical and policy analyst on projects covering physician, clinical laboratory, ambulatory surgery, injectable drugs/vaccines, ambulance, birthing center, HOPD (OPPS) and inpatient psychiatric payment systems. She also manages the TRICARE rate construction and updating process for all of these payment systems, except for OPPS. She previously was a researcher at Lewin/VHI and a quantitative analyst at the RAND Corporation, where she worked on health policy, economic, and social science projects. She holds an M.P.H. in Biostatistics from UCLA.
Lisa Wright, Senior Research Analyst, has over 25 years of health care consulting experience. Her areas of expertise include: military health care, SAS programming, statistical analysis, and survey analysis. She analyzes and performs detailed data extractions from large multi-million record data sets to support demonstration programs, data use agreements, and adhoc requests, in support of DHA. She also provides ongoing data extractions and analysis support to assist in the negotiations of the regional managed care contracts. In addition, she supports the DHA Disease Management program and DHA Pharmacy Operations. Her experience also includes drafting functional specifications for MDR and M2. She holds a B.S. in Statistics from Virginia Tech and an M.S. in Operations Research from George Mason University.