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Tom Kornfield

Senior Consultant

Tom Kornfield provides analytical support and strategic advice for clients on Medicare Advantage risk adjustment and payment, and on Part D issues. He has over 20 years of public and private sector experience in Medicare Advantage and Part D payment policy.

Prior to joining Avalere, Tom served as a vice president of Medicare policy at America’s Health Insurance Plans (AHIP). During his tenure at AHIP, he led risk adjustment policy discussions with plan members and external stakeholders. Additionally, he oversaw research and analyses about the impacts of Medicare Advantage (MA) payment and risk adjustment policies. He also helped to lead work looking at the distribution of rebates among Part D plans and contributed to analyses of the impacts of restructuring the Part D benefit.

Tom also spent 10 years working at the Centers for Medicare & Medicaid Services (CMS), where he held a variety of positions focused on MA and Part D payment policy. Specifically, Tom analyzed MA bids and payments and changes in MA payment rates, and he created a policy to allow for 5-star MA plans to market and enroll year-round.

He has also worked for Coventry Health Care, the Alliance of Community Health Plans, and the Senate Finance Committee. Tom holds a graduate degree from the University of Michigan’s School of Public Policy. His undergraduate degree is from Hamilton College.