Patricia F. Jones, RN, MBA
Healthcare Management Consultant

Patty specializes in analysis, strategy development, and designing and improving management, operations, and performance for healthcare management operations. She has over 20 years of experience in delivery system and health insurance operations and has worked extensively with healthcare organizations involved in commercial, Medicare/Medicaid, and other government programs. This experience includes care management programs, network contracting and reimbursement, health and wellness programs, and information strategies.

Patty has led the process of analyzing data to determine care management opportunities and priorities, conducted assessments of operations and work processes, overseen the selection and implementation of information and analytical tools, and designed reporting and evaluation mechanisms. In addition to specific expertise in medical management and provider network contracting and management, she has extensive experience with data, decision support systems, performance benchmarking, and analytical tools. Patty has assisted clients in developing new and improving existing utilization management, case management, and quality and disease management programs. She has experience designing, implementing and evaluating medical home and accountable care models.

David P, Mirkin, MD
Principal, Physician Healthcare Management Consultant

David is a family practitioner with 25 years of experience in medical management. He serves as a senior consultant assisting clients in a variety of areas, including traditional utilization management, provider profiling, disease management, length-of-stay management for hospitals, return-on-investments evaluations for disease management and wellness programs, and clinical data analysis. David has significant international experience, having consulted to clients in the U.K., Europe, and Asia.

Prior to joining Milliman, he was corporate medical director and senior medical director for Medicare risk at FHP International.

David holds active medical licenses in California, Utah, and Pennsylvania.

Bruce S. Pyenson, FSA, MAAA
Principal, Consulting Actuary

Bruce’s practice focuses on helping clients succeed in healthcare. He consults to healthcare businesses, integrated delivery systems, employers, providers, advocacy groups, HMOs, and reinsurers on issues ranging from market strategies and capitation to healthcare reform. Although Bruce is an actuary, for most projects, he develops solutions that integrate the financial, clinical, and operational components required for financial success. In recent years, cutting-edge client projects have included an assessment of cancer screening, pandemic influenza, healthcare reform evaluations for advocacy groups, the restructuring of disease management vendor processes, and actuarial cost/benefit evaluations for pharmaceutical manufacturers.

Bruce is a member of C-Change, the cancer collaborative. He served on the board of the Health Project (Koop Awards) from 2002-2004. He also served on the National Advisory Committee of RW Johnson Foundation’s Rewarding Results Program.

Bruce is the editor and co-author of Managing Risk: A Leader’s Guide to Creating a Successful Managed Care Provider Organization (AHA Publishing, 1998) and Calculated Risk: A Provider’s Guide to Assessing and Controlling the Financial Risk of Managed Care (American Hospital Publishing, 1995). Bruce has also authored several Milliman research reports on topics such as obesity, hepatitis C, hospital outpatient trends, healthcare reform, and programs for the disabled elderly.

He is co-author of several scientific articles on hospice- and hospital-acquired infections, and is the co-author of Employee Benefits for Small Business (JK Lasser, Simon & Schuster, 1991, 1992). His contributions are part of the current Society of Actuaries exam syllabus.