Zach Gaumer

Leader of strategy and business development and client relations for HMA across all lines of consulting business in Washington DC, Virginia, and Maryland. Includes consulting related to Medicare, Medicaid, marketplace plans, value-based care, commercial insurers, public health, addiction, justice involved health, and health IT and AI). Builder and leader of cross-functional teams of experts across HMA's various companies and departments. Strategic advisor to a range of clients on Medicare and Medicaid policy and reimbursement topics. Clients include foundations, associations, providers, payers, manufacturers, and state/federal governments. Areas of policy specialization include: hospitals, physicians, devices, ambulance, drugs, telehealth, plans, and state cost containment. Research includes the strategic design, implementation, and communication of analyses of complex policy questions. Quantitative work leveraging datasets such as Medicare claims and cost reports, MA encounter data, Medicaid claims, commercial claims, and other public health datasets. Qualitative analysis including interviews, focus groups, and surveys. Developer of strategic communications inducing white papers, slide decks, blog postings, media interviews and podcasts, Hill/Regulator meetings, presentations to boards and conferences, and journal articles. Testimony to federal commissions. Recent white papers and reports include: - Hospital ER Wait Time Delays in Maryland - Medicare Hospital Inpatient Device Intensive Payment Reform - Ambulance payment reform - 340B Duplicate Discounts: Policy Options - State Cost Growth Benchmarking: An evaluation of programs in 8 states - Modeling the Fiscal Impact of Obesity Drug Coverage on Medicaid Budgets - Medicare Trust Fund Solvency: Policy Options for Extending Part A

Manager of 20+ Washington DC-based consultants with broad subject matter expertise (Medicare, Medicaid, value-based care, commercial insurers, public health, addiction, justice involved health, and health IT and AI) and revenue of more than $10 million per year. Led strategic business development efforts, including thought leadership product development and event development in Washington DC, Virginia, and Maryland. Targeted clients in the commercial, state, federal, and county government space. Provided strategic consulting to a wide array of clients including providers, payers, foundations and trade associations.

Lead or contributed to reports and analyses related to Medicare reimbursement for hospital inpatient and outpatient services, telehealth services, ambulance services, emergency departments, ambulatory surgery centers, and other industries and systems. Modeled reimbursement systems to forecast payment and estimate the impact of policy changes. Conducted claims data analyses to assess industry trends. Managed administrative processes including hiring and external contracts.

Evaluated federal health care programs and studied health care industry trends and topics for the United States Congress. Subjects of analysis included: the first Accountable Care Organization payment demonstration project under the Centers for Medicare & Medicaid Services (CMS), Medicare reimbursement of specialty hospitals, the impact of legislative policies (BIPA) participating in the Medicare Advantage program (then the Medicare+Choice program), reimbursement for epinephrine under the Medicare ESRD program, and various hospital-related policy topics.

Childhood Asthma program: Studied the volume of hospital emergency department visits associated with pediatric asthma attacks, by the patient's residential zip code. Identified city-wide hot spots for pediatric asthma.

Activities: Private health insurance policy analysis for state legislation and regulatory issues Liaison to government agencies and community groups Web site design and marketing Policy topics: Mental health parity Massachusetts uncompensated care pool Community benefits requirements

Health Care and Justice research areas

Designed benefits and pension systems for Fortune 500 corporations.