Tom Kornfield

by Rachad Davis

April 11, 2016

Vice President, Public Programs Policy, Federal Programs

Keynote Speaker Topics: Medicare

Tom Kornfield’s Biography

Mr. Kornfield is has 20 years of public and private sector experience in Medicare Advantage and Part D payment policy. He currently serves as Vice President of Medicare Policy at America’s Health Insurance Plans (AHIP), where he provides research and policy support to Medicare Advantage plans in the areas of risk adjustment, payment, and regulatory Medicare policy.  Previously he was a Vice President at Avalere Health, where he provided strategic advice to clients on the impacts of health reform, Medicare Advantage and Part D policy.  He spent 10 years at the Centers for Medicare and Medicaid Services (CMS) in a variety of roles tied to health plan payment and risk adjustment, including several years in a management role. In addition, he developed the idea to allow five-star Medicare health plans to market and enroll year round during his time at CMS.

He is an expert on Medicare risk adjustment and payment policy, having worked extensively with the risk adjustment model, developed impacts of changes to the model, and conducted training on both risk adjustment and Medicare Advantage payment for industry.  He has also presented on risk adjustment topics on webinars and at industry sponsored conferences. Furthermore, he led the development of the 2014 and 2015 annual Medicare Advantage and Prescription Drug Plan annual payment rate announcement. For this announcement, he coordinated efforts among several staff members and other components in CMS, developed bottom line impact analyses of the payment changes in the rate notice, and also contributed technical sections on the payment methodologies for Medicare Advantage associated with the Affordable Care Act.

Mr. Kornfield has a Master of Public Policy from the University of Michigan and a Bachelor of Arts from Hamilton College.