Carol is a physician with particular expertise in Medicare payment policy and alternative payment models; healthcare claims-based analytics in Medicare, commercial, and Medicaid markets; and value-based contracting. She consults to a wide range of clients, including healthcare providers, provider networks, organizations managing population health, employers, payers, pharmaceutical companies, device manufacturers, disease management vendors, and local and national healthcare organizations.
Prior to joining Milliman, Carol served as a senior executive at the Center for Medicare and Medicaid Services (CMS) in the Center for Medicare and Medicaid Innovation (CMMI). In that role, she provided clinical, analytical, operational, and strategic direction to teams throughout CMS. Her work focused on the design, implementation, and evaluation of tests of new payment and service delivery models under the Affordable Care Act. In previous positions at CMS, she directed fee-for-service payment policy under Medicare’s Physician Fee Schedule, Hospital Outpatient Prospective Payment System, and Ambulatory Surgical Center Payment System.
Prior to her work at CMS, Carol held several executive positions at the Health Resources and Services Administration, where she oversaw the development and implementation of federal programs preparing physicians to care for underserved populations. She has practiced as a general pediatrician and preventive medicine specialist for 25 years.
