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Ipa Specialist, Expert Witness and Forensic Consultant.

President and CEO for United Healthcare in Chicago, Partner at Ernst & Young and Director of Managed Care consulting, CEO Summit Insurance, CEO CNA Health plans,

EXPERT ID: 11714

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Location:  US

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ADDITIONAL INFORMATION

 

Short Biography:

Jon, Co-Founder of Delphi of Florida, Inc. has a unique background as a managed care executive and consultant, who has achieved success in establishing ground-floor operations, helping large and medium-sized corporations experience profitable growth and administrating a large corporate entity. Jons perspective of the managed care and insurance industry is broad, in that, he has had the opportunity to work as a consultant with numerous HMOs, insurers, employers, health care providers and managed care entities in the area of health care cost containment strategy and implementation.

BUSINESS HISTORY

President, SUMMIT INSURANCE COMPANY - DAYTON, OHIO
December 1992 to May 1995

Jon assisted Upper Valley Medical Centers, a small hospital network of three hospitals, obtained an insurance license and begin a start-up PPO insurance operation. The insurance company has grown to over 10,000 policy holders in a county service area population of 90,000. Major achievements include medical hospital days per thousand under 200 (without the use of capitation or a PCP gatekeeper system), over 800 physicians under contract, excellent record of customer service and a 7% penetration of the market area. In addition, the results were achieved with local staff of which only one had prior HMO or insurance experience.

Partner, Director of Managed Care Consulting, ERNST & YOUNG - ILLINOIS
Oct. 1989 to Dec. 1992

Jon began the Actuarial, Benefits and Compensation practice (ABC) for Health & Welfare consulting for the region. The practice generates about $2.5 million in consulting annually and has a staff of 17 underwriters and actuaries. Personally sold majority of major clients including clients such as Wrigley, Associated Press and Koch Industries. Developed new approaches to Health & Welfare consulting which typically saved employers 3 to 15 percent of their benefit expenditures annually. The program has developed new relationships with over 100 employers clients in 18 months.

Prior to being asked to begin the ABC practice, Jon directed the Managed Care Consulting Group which consulted with numerous clients during a 4 year period. Jon directed all of the consulting services which included strategic planning, managed care product development, operational assessment, mergers and acquisitions and liquidations. Clients included over 60 HMOs (34 Acquisition projects), 40 hospitals, 12 Blue Cross Blue Shield plans, several large national insurers and numerous PPOs, Utilization Review Organizations and Medical Provider Organizations. Served as the national resource for the firm on managed care and as such, served on most of the firms managed care related task forces and was the main speaker for the firm to outside organizations. The Managed Care Group was the largest and most successful managed care consulting group in the country during this four year period of time.


President, Chief Executive Officer, SHARE HEALTH PLAN - ILLINOIS
Oct. 1982 to Oct. 1985

Jon founded Share Illinois that was funded by Share Health Plan of Minnesota in early 1983. It grew to $50 million in revenue by 1985 generating $2.4 million in pre-tax profit and $8.5 million in 1986 (sited by Health Market Survey as the most profitable HMO in the country on a PMPM basis in 1985). Share also was the first HMO in Chicago to have a HCFA Medicare capitated contract. It also had the largest number of provider locations (125) of any other HMO in the Chicago area in 1985. It was the first hospital-focused IPA in the country which fully captitated primary care physicians for all physician services and put the hospitals at risk for hospital services. Many of the provider agreements were exclusive relationships. This was a major achievement given the large number of HMOs that were organized during this same time period in the Chicago market. Share merged with United Health Care in 1985, but Share Illinois still represents a large portion of United's profits.


Executive Director, Chief Operating Officer INTERGROUP PREPAID HEALTH SERVICES, INC. - CNA INSURANCE CO.
June 1981 to Oct. 1982

Jon was the CEO of Intergroup (Illinois) which was the largest HMO in the State in 1982 with a business volume of $40 million and approximately 75,000 members. During the period Jon was CEO, the volume increased by 50% in 18 months and the number of employer clients grew from 500 to 650 companies. Utilization was decreased during this same period from 570 to 400 hospital days per thousand.

Prior to taking over Intergroup of Illinois, Jon started Intergroup (Indiana) which was a new HMO started in May of 1980. Jon developed the HMO and by May 1981 the staff had grown to 14 and the business volume was $3.5 million with 40 employer clients and 9,000 members. Intergroup was the first IPA type HMO in Indiana. Major achievements included selling the first HMO contracts in the Midwest for the steel industry including Bethlehem, US Steel and Inland as well as the first United Auto Workers and United Steel Workers accounts in Indiana.


 

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Utilization Review Ppos Hmos Mergers And Acquisitions Utilization Review
Mergers And Acquisitions Ppos Aso Agreements Erisa Ppos
Tpa Claims Claims Administation Erisa Health Claims
Claims Health Claims


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