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James P. Highland

Principal | PhD, MHSA

jhighland@berrydunn.com

Jim is a health economist and financial consultant with over 30 years of experience in healthcare helping nonprofit and public clients solve complex financial and decision support problems related to healthcare policy, insurance coverage, costs, and payment.

Jim advises state policy makers and executives in community healthcare organizations on financial strategy, access to coverage, benefit pricing, rate (premium) negotiation, provider payment and contracting, and developing systems to support analysis of population health data. He has done in-depth work on the costs of health coverage under Medicaid, Medicare, and commercial insurance, on population-based pricing for provider-sponsored MCOs and accountable care programs, on contract design for value-based payment and risk-sharing arrangements, and on transparency in commercial insurance markets.

Jim is a health economist and financial consultant with over 30 years of experience in healthcare helping nonprofit and public clients solve complex financial and decision support problems related to healthcare policy, insurance coverage, costs, and payment.

Jim advises state policy makers and executives in community healthcare organizations on financial strategy, access to coverage, benefit pricing, rate (premium) negotiation, provider payment and contracting, and developing systems to support analysis of population health data. He has done in-depth work on the costs of health coverage under Medicaid, Medicare, and commercial insurance, on population-based pricing for provider-sponsored MCOs and accountable care programs, on contract design for value-based payment and risk-sharing arrangements, and on transparency in commercial insurance markets.

Jim uses his expertise—in the policy issues and institutional details of the healthcare system, in economic incentives and their effect on system participants, and in the data available to analyze healthcare problems—and his seasoned judgment to advise leaders of health organizations on their options for the future. In addition to over 30 years of experience working with leaders in the field, he has taught aspiring health system leaders at the University of Pennsylvania’s Wharton School, the Sloan Program in Health Administration at Cornell University, and the University of Maine System’s Muskie School of Public Service.

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EDUCATION

BA, Economics, honors, Northwestern University

MHSA, Health Services Administration, University of Michigan

PhD, Applied Economics, The Wharton School, University of Pennsylvania

CERTIFICATIONS

  • PhD
  • MHSA

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