FORUM AGENDA

Wednesday, January 27, 2027

3:00 p.m. – 6:30 p.m.
Registration Open
5:00 p.m. – 6:30 p.m.
Welcome Reception

Thursday, January 28, 2027

7:30 a.m. – 6:00 p.m.
Registration Open
7:30 a.m. – 8:15 a.m.
Networking Breakfast
8:15 a.m. – 8:20 a.m.
Welcome Remarks
Speaker:

President & CEO
SIIA
Mike Ferguson serves as President & CEO of SIIA, providing executive management leadership as well as serving as a federal lobbyist. Mr. Ferguson has been with the association for more than 25 years.

He has significant expertise on self-insurance matters related to group health plans, workers' compensation programs, and captive insurance companies.

Prior to joining SIIA, he was a corporate communications specialist for Rockwell International at the company's world headquarters. Mr. Ferguson earned a bachelor's degree in political science from California State University, Long Beach.

8:20 a.m. – 9:30 a.m.
Transformative, YES or NO?!?

When the Hospital and Health Care Payer Price Transparency regulations were released back in 2019 and 2020 respectively, these new public disclosure requirements were heralded as transformative, game-changers, and ushering in a new era. Has any of that happened yet? If not, when might we see fundamental changes to the health care system? What does the Federal government need to do to make these original policy goals a reality? What can – and should – the private-sector do to effectuate these transformative and disruptive changes?

Moderator:

Legal & Policy Counsel
SIIA
Christopher E. Condeluci is Washington Counsel for the Self-Insurance Institute of America (SIIA). Chris previously served as Tax and Benefits Counsel to the U.S. Senate Finance Committee. During his time on the Finance Committee, Chris participated in the development of portions of the Patient Protection and Affordable Care Act, including the new health insurance Exchanges, the State insurance reforms, and the new taxes enacted under the law. He is one of the few senior Congressional staffers who actively participated in the health reform debate to join the private sector since the law's enactment, and as a result, he possesses a unique level of expertise on matters relating to tax law, ERISA, and the ACA.
Speakers:

Former Director of the Domestic Policy Council
Trump Administration 2016 to 2020
Andrew Bremberg is an attorney and political advisor who most recently served as the U.S. Permanent Representative to the Office of the United Nations and Other International Organizations in Geneva. He previously served as Assistant to the President and Director of the Domestic Policy Council under President Donald Trump. Bremberg began his career at the U.S. Department of Health and Human Services, where he served as Senior Advisor and Chief of Staff to the Assistant Secretary for Public Health during the George W. Bush Administration. He later worked as a department manager and health policy expert at MITRE, advising multiple federal agencies. Bremberg has also served as policy advisor and counsel to Senator Mitch McConnell and as policy director for Governor Scott Walker's 2016 presidential campaign and the GOP Platform Committee. Following the 2016 election, he led President-elect Trump's transition team for Health and Human Services and co-chaired the National Council for the American Worker. In 2019, he was confirmed by the U.S. Senate as Ambassador to the United Nations in Geneva, where he presented his credentials later that year.

Managing Director
Peterson Health Analytics
Cora Opsahl is the Managing Director of Peterson Health Analytics, a public-benefit company, created by Peterson Philanthropies to empower employers with independent, actionable data analysis of healthcare costs and quality. PHA combines price transparency data, employer claims data, and independent quality and safety ratings to enable employers to benchmark and reset their healthcare spending to deliver more affordable and higher-quality care for workers and their families.

Prior to joining PHA, Cora was the director of the 32BJ Health Fund, a self-insured Taft-Hartley benefit fund. While there, she prioritized a data-driven approach with a focus on reducing trend. During her 6 years, she oversaw over $240M in benefit savings from bold benefit design decisions, innovative RFPs, and implementing the largest direct healthcare contract of its kind with a health system.

She previously worked at Express Scripts, where she held a variety of roles, ranging from Medicare Part D to operations, strategy, and acquisitions. Opsahl earned an MBA from Saint Louis University.


Chief Executive Officer
Innovu
As Chief Executive Officer of Innovu, Hugh O’Toole is changing advisor/consultant practice models from their siloed focus on Health & Welfare, Retirement and Property & Casualty, to a holistic Human Capital Risk Management model. He understands that the world of retirement services and benefits can be complicated and has dedicated his career to aligning the financial wellness of American employees with the positive impact their wellness has on the financial statement of their employers. With leading capabilities in data aggregation, data science/analytics and behavioral finance, the industry can have a much greater impact with the convergence of data and benefit disciplines versus a siloed view. In 2014, he founded Viability AG LLC, to address the relationship between financially well employees and the impact on the employer’s financial statement, through mitigating the future liability from healthcare, risk protection/management, productivity, and engagement of their employees. In 2015, Viability was purchased by MassMutual, and he joined the MassMutual team as a Senior Vice President. His first mission was to bring non-profit employers and their employees institutional investment product, versus the legacy insurance products historically sold to them. As a partner of Professional Pensions, Inc. they accomplished this mission, and the firm grew rapidly.

Co-Founder & Chief Product Officer
Handl Health
Ria Shah has a rich background in data analytics and actuarial modeling. At Handl Health, she spends much of her day thinking about data: how to parse and analyze terabytes of pricing files to ensure parity and quality; how to enrich poor data; and how to steer members to low-cost, high-quality care.

Prior to co-founding Handl Health, Ria worked as a strategy consultant for EY-Parthenon, specializing in developing data strategy for health systems and payors. At EY-Parthenon Berlin, she focused on using public and proprietary data to create value and outcomes-based contracts for public payors and big pharma.

Ria holds a degree in analytics and finance from the University of Pennsylvania Wharton School of Business.

9:30 a.m. – 9:45 a.m.
Networking Break
9:45 a.m. – 10:45 a.m.
Cracking Down on Plan Service Providers: Will It Result In Better Compliance With the TiC Requirements?

Currently, insurance carriers and third-parties that (1) build a medical provider network and (2) negotiate the rates for the providers in this network are producing TiC Machine-Readable Files (MRFs) that are inaccurate and incomplete. In most cases, a self-insured plan contracts with carriers and third-parties to access their provider network and negotiated rates, and often times, these carriers and third-parties also produce inaccurate and incomplete MRFs on behalf of the plan. If penalties were imposed on these carriers and third-parties that own the network and rates, would this increase compliance with TiC? Should the Department of Labor (DOL) have enforcement authority to crack down on these plan service providers?

Moderator:

Legal & Policy Counsel
SIIA
Christopher E. Condeluci is Washington Counsel for the Self-Insurance Institute of America (SIIA). Chris previously served as Tax and Benefits Counsel to the U.S. Senate Finance Committee. During his time on the Finance Committee, Chris participated in the development of portions of the Patient Protection and Affordable Care Act, including the new health insurance Exchanges, the State insurance reforms, and the new taxes enacted under the law. He is one of the few senior Congressional staffers who actively participated in the health reform debate to join the private sector since the law's enactment, and as a result, he possesses a unique level of expertise on matters relating to tax law, ERISA, and the ACA.
Speakers:

General Counsel
SBMA, LLC
Alden Bianchi serves as General Counsel of SBMA, LLC, a San Diego-based third-party administrator specializing in alternative funding arrangements for employer-sponsored group health plans. Prior to joining SBMA, Mr. Bianchi advised corporate, nonprofit, governmental, and individual clients on a broad range of executive compensation and employee benefits matters, including qualified and nonqualified retirement plans; equity and equity-based compensation arrangements; ERISA fiduciary and prohibited transaction issues; benefit-related aspects of mergers and acquisitions; and health and welfare plans. Mr. Bianchi represented the Romney administration in connection with the landmark 2006 Massachusetts health care reform legislation and testified before the Senate Finance Committee during the lead-up to the enactment of the Affordable Care Act. He is a past chair of the Bloomberg/BNA Pension & Benefit Publications Advisory Board. In 2023, Bloomberg Tax & Accounting awarded him the Leonard L. Silverstein Award for Distinguished Service in Federal Tax.

Senior Vice President, Employee Benefits Consultant
Kapnick Insurance Group
Steve Miller has over 20 years of experience working as an employee benefits consultant with some of Michigan's most notable organizations. As a benefits consultant with Michigan-based Kapnick Insurance Group, Steve specializes in designing alternative health plans for large self-funded employers. He has a proven track record for developing programs and solutions that not only challenge, but completely re-imagine the status quo in healthcare.

Steve has significant experience designing, implementing, and consulting on solutions using advanced data analytics, including AI-based technologies with data aggregation. His broad perspectives working directly with employers, healthcare providers, and advanced technologies, places him in an ideal position to re-invent and continuously push the limits of sustainable healthcare models.


Associate Research Professor, Center on Health Insurance Reform
Georgetown University
Christine H. Monahan, J.D., is an associate research professor and faculty member at the Center on Health Insurance Reforms (CHIR) at Georgetown University’s McCourt School of Public Policy. At CHIR, Christine analyzes an array of issues related to health insurance and the U.S. health care system, produces actionable policy research, and provides technical assistance to policymakers and others seeking to advance evidence- based solutions that strengthen health coverage, increase affordability, and improve access to care. Her current focuses include hospital outpatient billing, corporatization in health care, and employer-sponsored insurance reforms, and she has a long history of working on consumer and patient protections.

Prior to joining the Georgetown faculty, Christine was Counsel for American Oversight, where she filed and litigated federal and state public record requests. She also previously worked as an Associate at the law firm Mehri and Skalet, PLLC, where she handled a diverse litigation caseload focused on insurance, health care, and consumer protection issues, and clerked for the Honorable Judith Rogers of the U.S. Court of Appeals for the D.C. Circuit.

Before attending law school, Christine spent several years working on passage and implementation of the Affordable Care Act at both the state and federal level, including as a Senior Health Policy Analyst at CHIR and a Health Policy Advisor at the National Partnership for Women & Families. During her prior tenure at CHIR, Christine wrote extensively on state implementation of health insurance marketplaces and other private insurance reforms.

Christine is a member of the D.C. Bar. She received her J.D. from Yale Law School and her undergraduate degree from Connecticut College.


Co-Founder & Chief Technology Officer
Serif Health
Matt leads engineering at Serif Health, bringing deep experience building clinical and data infrastructure. Prior to Serif, he led clinical software engineering at One Medical, where his team built core EHR capabilities including referrals, orders, and e-prescribing, achieving EPCS and SureScripts certification.

He has also held engineering leadership roles at Truepic, Dropbox, and Microsoft. Matt holds a BS in Computer Engineering from Northwestern University.

10:45 a.m. – 11:00 a.m.
Networking Break
11:00 a.m. – 12:00 p.m.
Navigating the New Era of Health Plan Strategy: Regulation, Data Transparency, & Actionable Innovation

Now that the Trump Administration has improved and strengthened the TiC regs and streamlined the MRF schema, how can plan sponsors use the pricing information to lower health care costs, re-negotiate provider contracts, and strengthen fiduciary oversight? Are there specific strategies and benchmarking that can be adopted to improve outcomes and help participants become better consumers of health care? Are there best practices for partnering with TPAs that can help plan sponsors satisfy their fiduciary obligations? How can AI be leveraged and are there practical AI use-cases in health plan evaluation?

Moderator:

Legal & Policy Counsel
SIIA
Christopher E. Condeluci is Washington Counsel for the Self-Insurance Institute of America (SIIA). Chris previously served as Tax and Benefits Counsel to the U.S. Senate Finance Committee. During his time on the Finance Committee, Chris participated in the development of portions of the Patient Protection and Affordable Care Act, including the new health insurance Exchanges, the State insurance reforms, and the new taxes enacted under the law. He is one of the few senior Congressional staffers who actively participated in the health reform debate to join the private sector since the law's enactment, and as a result, he possesses a unique level of expertise on matters relating to tax law, ERISA, and the ACA.
Speakers:

Chief Strategy Officer
Advanced Medical Strategies
David Cardelle, R.Ph., is AMS' Chief Strategy Officer. David joined AMS in June 2021 and is a Registered Pharmacist with an extensive 30+ year experience in the healthcare industry. Leveraging years of expertise and domain knowledge in the payment integrity (PI) industry, David worked with various health plans and companies to evaluate, advise, and improve PI outcomes.

David's keen business acumen for strategic planning, depth of industry knowledge, and impressive track record in developing innovative payment integrity solutions will continue to transform the payment integrity industry and affordability.

He has worked in various key roles as a Provider, working in retail and hospital pharmacies, as a Payer, working for a large BCBS plan as well as a regional HMO in Cambridge, MA, and as an outsourced Payment Integrity Partner, working with dozens of health plans across the U.S.

Most of David's career has been dedicated toward developing and managing new, innovative payment integrity solutions for the Payer industry. He pioneered the first outsource audit service for specialty injectable overpayments as well as developed and managed Hospital Bill Review, DRG Validation, Home Infusion, Renal Dialysis, DME, and Implant Audit and Recovery programs. Most recently, David helped to develop a unique transaction-based delivery model to help automate a variety of pre-submission payment accuracy solutions.

David has a BS in Pharmacy from the Massachusetts College of Pharmacy, Boston, MA.


Founder & Principal
Datavoce Consulting, LLC
Traci McGinnis is the founder of Datavoce Consulting, LLC and Chair of the SIIA Price Transparency Committee. She has nearly two decades of experience leading data and analytics work in healthcare technology. She helps benefits brokers, self-funded employers, and health tech companies turn claims, procurement, and operational data into insight leaders can act on. She also publishes data stories built on public datasets, covering topics such as prescription drug price transparency, employer GLP-1 coverage, and gaps in access to care. Traci holds a Master's in Healthcare Informatics and Analytics from Tufts University School of Medicine.

Co-Founder & Chief Executive Officer
Nara Health
Sidhartha (Sid) Sinha is the founder and CEO of Nara Health, an AI-native TPA. He has built and led product and implementation teams at multiple venture-backed health tech startups building data and AI products for top healthcare systems and insurers. Prior to that, Sid designed hospitals, clinics, and care delivery models across the US and Mexico at Vizient, a national healthcare analytics and services firm. He is an industrial engineer with a focus on complex systems design in healthcare.

Chief Legal Officer
Imagine360
Troy Sisum is the Chief Legal Officer at Imagine360, where he leads the company’s litigation strategy across the U.S., provides counsel on healthcare and ERISA matters, and partners with trade organizations on government relations. Troy is also the executive who oversees the company's HR function. Before joining Imagine360, Troy excelled as a trial attorney specializing in civil litigation involving prescription drugs, medical devices, and workers’ compensation subrogation cases. He is licensed to practice law in Pennsylvania, New Jersey, and multiple federal courts nationwide. Troy holds a bachelor’s degree from La Salle University and doctorate degree from Widener University Delaware Law School. Troy sits on the American Benefits Council Policy Board, Self-Insurance Institute of America (SIIA) Price Transparency Committee, and Montgomery School’s Board of Trustees.
12:00 p.m. – 1:00 p.m.
Forum Luncheon
1:00 p.m. – 2:00 p.m.
Compensation Disclosures & New PBM Transparency Requirements – Transformative or Too Confusing?

PBMs – as well as any other service plan provider – providing "pharmacy benefit management services" to a self-insured health plan must disclose specified compensation they receive to the plan's fiduciary. PBMs are also required to disclose to the plan fiduciary a whole host of information ranging from the receipt of rebates, price concessions, and spread compensation to the gross and net costs of the prescription drugs in the PBM's drug formulary. PBMs must also pass-through to the plan 100% of drug manufacturer rebates. Will this result in information overload for plan fiduciaries? Or, will this information give plan fiduciaries the power to lower the plan's health care spend?

Moderator:

Legal & Policy Counsel
SIIA
Christopher E. Condeluci is Washington Counsel for the Self-Insurance Institute of America (SIIA). Chris previously served as Tax and Benefits Counsel to the U.S. Senate Finance Committee. During his time on the Finance Committee, Chris participated in the development of portions of the Patient Protection and Affordable Care Act, including the new health insurance Exchanges, the State insurance reforms, and the new taxes enacted under the law. He is one of the few senior Congressional staffers who actively participated in the health reform debate to join the private sector since the law's enactment, and as a result, he possesses a unique level of expertise on matters relating to tax law, ERISA, and the ACA.
Speakers:

Senior Vice President, Global Government Affairs, Policy, and Health Economics and Outcomes Research (HEOR)
Fresenius Kabi Biopharmaceuticals
Bio coming soon.

Senior Counsel
Foley & Lardner LLP
Hannah Demsien is a member of the Employee Benefits and Executive Compensation Practice Group, as well as the Insurance Practice Group. Her practice is primarily centered around addressing critical issues affecting group health and welfare benefit plans, health insurers, and the array of service providers in this industry, including third-party administrators. Hannah is a seasoned advisor on a multitude of legal matters, including the intricacies of the Affordable Care Act (ACA), the Consolidated Appropriations Act, 2021 (CAA), the No Surprises Act, the Mental Health Parity and Addiction Equity Act, HIPAA, COBRA, ERISA, Section 125 cafeteria plans, flexible benefit plans, wellness programs, health reimbursement accounts, health savings accounts, MEWAs, association health plans, third-party administrator, and pharmacy benefit manager regulations, among other critical health benefit issues.

Hannah is also part of the firm's Health Care & Life Sciences Sector, where she operates within the Payor-Provider Convergence Area of Focus. Here, she provides invaluable counsel to clients on matters pertaining to health plan compliance, plan design, ongoing plan administration, and the regulatory licensing of service providers and insurers. Hannah's experience extends beyond the confines of traditional legal advisory, as she adeptly navigates the complex landscape of employee benefits and insurance regulatory matters that often arise in merger and acquisition transactions.


Chief Clinical Officer
1Benecare
Bio coming soon.

Principal
Groom Law Group
Amber assists employers, plan sponsors, and health insurance companies on a wide range of health care and ERISA matters, including health benefit planning and design, day-to-day plan administration, and new benefit and product launches.

Immediately prior to joining Groom, Amber served as a high-ranking official at the Employee Benefits Security Administration (“EBSA”) of the U.S. Department of Labor (“DOL”). Most recently, as the Director of the Office of Health Plan Standards and Compliance Assistance (“OHPSCA”), Amber was DOL’s principal advisor on health care policy issues related to ERISA. She was also the agency lead on developing regulations, sub-regulatory guidance, interpretations, and opinions and coordinating external and internal compliance assistance, education, and training materials under part 7 of ERISA, the Affordable Care Act (“ACA”), the No Surprises Act, the Mental Health Parity and Addiction Equity Act (“MHPAEA”), the Health Insurance Portability and Accountability Act (“HIPAA“), and COBRA, among other health care laws. She regularly represented EBSA and DOL in meetings with senior administration officials and members of Congress.

While at EBSA, Amber was responsible for coordinating EBSA’s and DOL’s health care regulatory agenda and related interpretive issues with her counterparts at the U.S. Departments of Health and Human Services (“HHS”) and Treasury, the Internal Revenue Service (“IRS”), and various offices within the Executive Office of the President. In this role, she worked closely with a wide variety of external stakeholders, including employers and other plan sponsors, health insurance companies, third party administrators and other service providers, trade associations, consumer organizations, provider organizations, NAIC, and state agencies. Amber also frequently provided technical assistance to states on health care matters, as well as other Federal agencies, such as the Equal Employment Opportunity Commission (“EEOC”). In addition to her role in OHPSCA, Amber completed a detail in the Office of Enforcement in EBSA, where she helped oversee the agency’s health enforcement program and strategy.

Given her former high-ranking position at DOL, Amber is uniquely positioned to help clients anticipate regulatory and legislative developments and navigate government enforcement.

2:00 p.m. – 2:15 p.m.
Networking Break
2:15 p.m. – 3:15 p.m.
Access to Health Claims Data, Contract Negotiations, & Fiduciary Litigation

SIIA and the employer-sponsored community have worked hard to convince Congress to improve and strengthen existing data-sharing requirements to make sure that plan sponsors can access their health plans' claims data. Now that Congress has answered the call, what should plan sponsors do? How can plan sponsors flip-the-script on contract negotiations with plan service providers to ensure that they have an unfettered right to access the plan's claims data, and also, audit claims to uncover mistaken, duplicate, and/or purposefully excessive claims payments? Should plan sponsors use the courts to effectuate Congress's efforts to empower plan sponsors to lower health care costs?

Moderator:

Legal & Policy Counsel
SIIA
Christopher E. Condeluci is Washington Counsel for the Self-Insurance Institute of America (SIIA). Chris previously served as Tax and Benefits Counsel to the U.S. Senate Finance Committee. During his time on the Finance Committee, Chris participated in the development of portions of the Patient Protection and Affordable Care Act, including the new health insurance Exchanges, the State insurance reforms, and the new taxes enacted under the law. He is one of the few senior Congressional staffers who actively participated in the health reform debate to join the private sector since the law's enactment, and as a result, he possesses a unique level of expertise on matters relating to tax law, ERISA, and the ACA.
Speakers:

Co-Founder & Chief Executive Officer
ClaimInformatics
Stephen Carrabba is the President and Co-Founder of ClaimInformatics. He provides hands-on management oversight of key aspects of the business including ensuring the business is run on a state-of-the-art, highly secure technology platform, hiring and retaining industry experts, fostering strategic partnerships, and developing a forward-looking vision and strategy.

With his training and inquisitive nature, Stephen researches the most up-to-date technologies and looks to drive the business toward early adoption whenever appropriate to improve efficiencies and establish a competitive edge. Stephen’s business success is inextricably linked with his ability to foster business relationships, earning the trust of clients and partners.

Prior to ClaimInformatics, Stephen founded several successful companies, including a nationally recognized cost reduction consultancy focused on taking the wasteful spending out of healthcare. With Stephen’s expertise in controlling expenses and maximizing profits, his clients benefit from technology-driven, personable service.

Stephen is a graduate of Babson College and is a member of several for-profits and non-profit boards. He was recognized by the Hartford Business Journal as a Forty under 40 Recipient because of his entrepreneurial accomplishments. Stephen lives in Connecticut with his wife and three children.


Partner
Varnum LLP
Herman is a trial and appellate attorney on Varnum's Litigation and Alternative Dispute Resolution team. He represents clients in complex disputes across the healthcare, construction, consumer protection, and constitutional law spaces, both in Michigan and nationally. His practice includes negotiating multimillion-dollar settlements for plaintiffs and achieving favorable resolutions and dismissals for clients on the defense side. Herman's litigation work includes representing companies and welfare benefit plans nationwide in ERISA hidden fee, claims overpayment, and plan mismanagement litigation and appeals. Federal judges have commended him for his "clear and cogent briefings" on complex ERISA legal issues and for "demonstrating efficiency, diligence, and competence" in prosecuting claims on behalf of plan sponsors and plans. His work in this area has led to national recognition as a trusted expert in ERISA hidden fee, claims overpayment, and plan mismanagement litigation, and he regularly presents at national conferences to corporate executives, benefits managers, and consultants of Fortune 500 companies on those topics. Most recently, Herman won a precedent-setting case in the United States Court of Appeals for the Sixth Circuit against Blue Cross Blue Shield of Michigan, establishing that its “Shared Savings Program” violated federal law. This case was featured in The American Lawyer’s “Litigator of the Week” column as a highlighted example of “impactful judiciary rulings,” as well as one of the “5 ERISA Decisions Attorneys Should Know” for 2025 in Law360. Herman also counsels commercial and residential contractors and owners in construction matters, advising them in transactional contexts as well as representing them in litigation. He has represented several owners in prosecuting novel claims against contractors for illegal kickback payments, defective workmanship, and hidden fees, and has also obtained summary dismissals and favorable settlements for contractors facing overcharge and defect claims. Over the last several years, Herman has assisted several municipalities, police officers, government officials, and businesses in constitutional litigation. He has obtained summary dismissals and judgments for clients defending against constitutional claims, while also securing favorable judgments and settlements for plaintiffs prosecuting constitutional claims ranging from free speech, excessive force, and failure-to-protect, to equal protection, takings, and due process.

Director, Policy & Payment Integrity
CERiS Health
Cereasa Horner is a healthcare professional with over 18 years of experience in payment integrity and revenue cycle management. She graduated with distinction from Capella University obtaining her Master’s in Healthcare Administration. Cereasa is currently the Director of Policy and Payment Integrity for CERIS.

She has a passion for developing healthcare policy and continues to spearhead the creation of new teams and payment integrity programs for CERIS. With constant changes in the healthcare landscape, Cereasa has been able to apply her extensive experience to move the conversation forward regarding healthcare policy and reimbursement between payers and providers.


Founder & Principal
Health Plan Legal Counsel
Julie Selesnick is a veteran attorney with 25 years of experience in litigation and health plan compliance. She advises plan sponsors, fiduciaries, and service providers on ERISA, the CAA, HIPAA, and mental health parity, helping clients manage risk, ensure compliance, and design legally sound, cost-effective health plans. Known for her strategic approach, Julie also supports contract negotiations, data access, and transparency initiatives.
3:15 p.m. – 3:30 p.m.
Networking Break
3:30 p.m. – 5:00 p.m.
Let's Change the World Through Price Transparency & Access to Health Claims Data

In the grand finale of the day, policy experts and industry leaders will give us their take on all of the content discussed in each of our Panel Discussions, and they will opine how the Federal government should and could change the law – and further explain how the private-sector can effectuate these legal changes – to change the world through price transparency and access to health claims data.

Moderators:

Legal & Policy Counsel
SIIA
Christopher E. Condeluci is Washington Counsel for the Self-Insurance Institute of America (SIIA). Chris previously served as Tax and Benefits Counsel to the U.S. Senate Finance Committee. During his time on the Finance Committee, Chris participated in the development of portions of the Patient Protection and Affordable Care Act, including the new health insurance Exchanges, the State insurance reforms, and the new taxes enacted under the law. He is one of the few senior Congressional staffers who actively participated in the health reform debate to join the private sector since the law's enactment, and as a result, he possesses a unique level of expertise on matters relating to tax law, ERISA, and the ACA.

Government Relations Manager
SIIA
Anthony currently serves as the Government Relations Manager for the Self-Insurance Institute of America (SIIA) where he assists in advocacy and political activities. His other roles include tracking state legislative and regulatory policy, as well as managing The Self-Insurance Political Action Committee (SIPAC). Anthony graduated from American University in 2020. His previous work experience includes working for Congresswoman Mikie Sherrill (NJ) and was most recently a legal clerk for the City Attorney of Elizabeth, New Jersey.
Speakers:

Executive Vice President, Risk Solutions
XO Health, Inc.
François leads XO Health's design and operational implementation of alternative payment models, and the ongoing performance of the network. Throughout his career he has led innovation and plan design for all aspects of advanced alternative payment models, from incentive design to contract structure to operational implementation. He actively supported the launch of the Leapfrog Group; created Bridges To Excellence; led the development and implementation of PROMETHEUS Payment; led the development and design of a value-based insurance design product; and applied that expertise to designing and implementing episodes of care and other advanced alternative payment programs for employers, providers, and health plans. He is also a senior partner at High Value Care Incentives Advisory Group. He previously led the commercial business line development of Signify Health's Episodes of Care Payment Division and was head of strategic initiatives for GE Corporate Healthcare for over a decade.

Chief of Staff and Head of Communications & Policy
Morgan Health
Brooke Thurston is Chief of Staff and Head of Communications and Policy for Morgan Health, a division of JPMorganChase focused on improving the quality, affordability and equity of health care in the United States. Morgan Health invests in health care companies that improve employer-sponsored health care. The group also supports the JPMorganChase Benefits Plan in evaluating new health care offerings for JPMorganChase employees, shares data-driven insights with the marketplace, and advocates for public policies that drive innovation in the employer market.

Before joining JPMorganChase, Brooke was Chief of Staff and Head of Communications at Haven, a joint venture backed by JPMorganChase, Amazon and Berkshire Hathaway. She also has experience working as an on-the-record spokesperson for a large health care system with a network of hospitals, physicians and outpatient facilities. Brooke started her career in Washington, D.C., working on Capitol Hill and then for VOX Global, a public affairs firm, where she worked on behalf of payers, providers and large non-profit health care organizations.

Brooke holds a Bachelor of Arts in Government from Colby College.


Founder and Chief Executive Officer
Randolph Pate Advisors
Randy brings over two decades of public and private sector healthcare policy and regulatory experience to his role at Randolph Pate Advisors. In his most recent position serving as Deputy Administrator of the Centers for Medicare & Medicaid Services (CMS) and Director of the Center for Consumer Information and Insurance Oversight (CCIIO), Randy led the turnaround of the Health Insurance Exchanges and was instrumental in several major health policy initiatives.

During his tenure at CCIIO, premiums for benchmark plans on HealthCare.gov dropped for the first time, decreasing for three straight years. Competition on the Exchanges also increased, as the percentage of counties with only one insurer offering coverage dropped from 52% in 2018 to just 9% in 2021. Randy also led the drafting of major regulations such as the 2017 Market Stabilization Rule and played a key role in shaping federal policy on the HHS Risk Adjustment Program, Section 1332 State Innovation Waivers, Transparency in Coverage (Price Transparency), and Individual Coverage Health Reimbursement Arrangements (ICHRAs). Finally, he also spearheaded the development of Enhanced Direct Enrollment (EDE), a new technology pathway that has already enrolled millions of consumers into individual market coverage.

Earlier in his career, Randy served in a number of roles on Capitol Hill in both the House and the Senate, including as Public Health Counsel for the House Energy and Commerce Committee and later as Health Counsel for Rep. Kevin Brady on the House Ways and Means Committee. Randy was also a Health Policy Fellow at the Heritage Foundation and served as a Senior Advisor at the Department of Health and Human Services during the George W. Bush Administration.

Working in the private sector, Randy helped launch the MITRE Corporation’s policy work with CMS, and for six years served as Vice President of Public Policy for Health Care Service Corporation (HCSC), the largest customer-owned health insurance company in the country.

Randy is a licensed attorney and holds bachelor’s and law degrees from the University of Alabama. He received his Master’s in Public Health from Johns Hopkins University.


Founder & Chief Executive Officer
Third Horizon 
David Smith is the Founder and Chief Executive Officer of Third Horizon, where he oversees the firm’s strategic direction, client engagement, business development, finance, and organizational operations. He also hosts The Cost of Care podcast, produced with Lemonada Media, which has surpassed 1.5 million downloads and ranks among the top health and wellness podcasts globally. Since founding Third Horizon in 2018, he has grown the organization to 25 full-time professionals while leading engagements spanning behavioral health transformation, payment innovation, and market analytics for government agencies, payers, providers, and community organizations nationwide.

David brings 16 years of experience in health care strategy, payment reform, coalition building, and systems transformation. His expertise includes health care economics, strategic planning, alternative payment model design, facilitation, and cross-sector collaboration.

Prior to founding Third Horizon, David spent eight years at Leavitt Partners, where he served as Chief Development Officer alongside former U.S. Health and Human Services Secretary Mike Leavitt. During his tenure, he organized and facilitated 11 cross-sector alliances focused on federal health policy reform, coordinated strategic planning initiatives for more than 30 organizations, and delivered over 100 national speaking engagements on health care transformation. He also served as an original convener of the Alliance for Addiction Payment Reform and co-created the Medicaid Transformation Project with former CMS Administrator Andy Slavitt, bringing together 27 health systems to advance payment and delivery reform initiatives.

David earned a Master of Statistics from the University of Utah and a Bachelor of Business Management from Utah Valley University.

5:00 p.m. – 6:00 p.m.
Closing Networking Reception

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