Brian Fallon Email & Phone Number

Global, Us

Halleon Health Advisors is a consulting firm specializing in the design and implementation of hospital sponsored health plans known as a Collaborative Care Model. The design and implementation of these programs feature member engagement, provider risk (upside and downside) and market leading reimbursement methodologies.There are two divisions:Contracting & Analytics1 Facility and professional contracting, including bundle payment methodologies, market assessment, migration analysis, risk analysis, analysis for stop-loss markets.2, Sales and Marketing implementation strategies to promote the clinical care available through the Collaborative Care Model to local brokers, TPAs and employers. Halleon is TPA and broker agnostic.

Saint Louis, Mo, Us

: Responsible for hospital, physician and ancillary contracting in Illinois, Arkansas and the expansion states of Indiana, Ohio and Kentucky:  Accountable for regional cost of care initiatives consistent with Anthem pricing guidelines and trend targets. Designed, contracted and implemented Custom Network Configurations in strategic HealthLink markets of St. Louis, MO, Columbia MO, Belleville, IL, Springfield, IL, Chicago, IL Negotiated client specific arrangements for key HealthLink clients. Manage data analytic function for the HealthLink network – includes rate analysis for hospital physicians and ancillaries. Fee schedule development and maintenance.  Produce an annual pricing packet reflecting $4 billion in charge data to the insurance market entities that assume and manage risk. Accountable for maintaining an Illinois physician flat fee that generates $ 8 million in revenue. Designed and implemented a Payor strategy promoting strengths of the network. Evaluation include discount position by both member and provider 3 digit zip codes, case mix indexing, cost to charge ratio by facility and a risk band analysis evaluating varied levels of specific stop loss. Conduct reinsurance meetings with stop loss markets to demonstrate contract strength .Participated in sales and renewal presentations with sales and account management

St. Louis, Mo, Us

September 1992 – November 2000 BJC Health System, St. Louis, MODirector, Regional Managed Care Business DevelopmentResponsibilities Included: Hospital contractor for BJC facilities in St. Louis, Columbia, MO, Alton IL Participated in the management of two Physician Organizations (CHPG and Missouri Baptist PHO) securing global risk arrangements Designed and imolemented a clinical carve outs for diabetes, orthopedics and mental health Participated in the design and implementation of clinical programs such as a Work Comp product (OccuMed, OMNET) and Mental Health – Behavioral Health Partners.  Participated in the management of a Provider owned network Great Rivers PPO Network (GRN) as Chief Operating Officer Designed and implemented a fully insured health plan for GRN Contracted BJC rural affiliate providers into GRN for clinical steerage to Barnes-Jewish Hospital and St. Louis Children’s Hospital. Provided BJC rural affiliates with managed care consulting services which included: Employee benefit plan evaluation and analysis Managed Care Contracting IPA / PHO Development Capitation and carve out contracting