David C. Lewis

David works with payers, providers, employee benefit consultants, and employer groups for private sector, state, and federal entities, including VHA. He has extensive experience evaluating and benchmarking provider reimbursement and contracting, and has developed and/or played a key role in multiple analytical tools, including:

• The Hospital Evaluation and Comparison System (HECS™), RBRVS for Hospitals™, and GlobalRVUs™, which are relative value based-systems for evaluating reimbursement and efficiency
• The Medicare Repricer
• Contract comparison and evaluation systems with emphasis on parity analysis
• Claims mapping and provider discount summarization processes used with most BlueCross BlueShield plans and many other payers
• Systems comparing average provider discounts by payer for employee benefit consultants to use with their clients

David has significant experience and proficiency in the following areas:

• Provider reimbursement benchmarking
• Provider contracting analytics and negotiation support
• Alternative payment methods
• Pricing and rate development
• Episode-based reporting
• ACO development
• Claims mapping and categorization
• Claims repricing
• Capitation development