Donna Kinzer is focused on helping providers, payors, and other health care entities develop and implement new analytics, delivery approaches, payment models, and supporting infrastructure in response to transformational market shifts, changing customer demands, rapidly evolving patient centered technologies, and health care reform.

Currently assisting in the development of bundling and episode payment approaches to facilitate delivery reform, Ms. Kinzer is also developing strategic roadmaps for delivery system and infrastructure transformations. Ms. Kinzer is developing several alternative strategies for broad-based (statewide, all-payor, global budget) approaches to payment and delivery reform. She has worked with providers, regulators, payors, and software companies in the development of strategy roadmaps, regulatory strategies, utilization and cost benchmarking, potentially avoidable cost analysis, care delivery model changes, and new payment approaches. Payment model innovations have included the development of outpatient graduate medical education payment components for academic medical centers, comprehensive outpatient per visit payment approaches, and rationalized inpatient/outpatient payment levels for common procedures.

Ms. Kinzer’s 30-plus years in the health care field have included extensive experience with large health care data sets, including medical and pharmaceutical claims data, encounter data, cost reports, public and private benchmarks, market data, regulatory data sets, and other data sets. Her experience includes payment model development and evaluation for payors and providers, capitation and risk sharing models, medical education costs payment models, technology analysis, delivery structures, market analysis, premium, utilization and cost analysis in more than 50 markets, and bundled cost and payment analysis.

Ms. Kinzer also has experience with all payor/product models (including Medicare, Medicaid, commercial HMO, PPO, and indemnity), numerous provider/entity types hospitals, physicians, ambulatory surgery, pharmaceutical companies, and payment systems (Medicare Severity-Diagnosis Related Group, All Patient Refined DRG, ambulatory payment classifications, enhanced ambulatory patient groupings, ambulatory surgical center rates, resource-based relative value scale and other fee schedules, case rates, pharmacy and drug acquisition). She has worked extensively with all types of claims data including facility, professional, and drug claims.

Ms. Kinzer has served as an expert providing testimony in public hearings and quasi-judicial matters relative to health care reimbursement, cost, and policy issues. She has also served as an industry expert in litigation (civil and criminal) matters involving pharmaceutical companies, pharmacy benefit managers, managed care companies, and capitation disputes. Her experience includes corporate and regulatory matters involving complex transactions, organizational, and financial analysis including pre- and post-merger reviews of several health plans.

Education

• Towson University
  B.S., Business Administration-Accounting, 1976

Employment History

• Navigant Consulting, Inc.
  Managing Director
  2003 - 2010
• Andersen, LLP
  Partner
  1976 - 2002

Professional Affiliations

• Healthcare Financial Management Association
  
• Academy Health
  
• American Institute of Certified Pubic Accountants
  
• Johns Hopkins University, Health Finance
  Associate Professor (Past)

Community/Civic Activities

• Marjorie Cook Foundation
  Board Member