Peter Bacon Email & Phone Number

Waukesha, Wi

Executive in-charge of Population Health, Quality, Direct-to-Employer, Community Population Outreach, Managed Care Contracting, Provider Relations, Inpatient Care Managment, Hispnic Resource Center, Behavioral Health, and Occupational Medicine, Therapy, Lab Services, and Radiology. Responsibilities also include the administrator for ProHealth Solutions, which is an ACO with nearly 1,000 providers; and overall provider contracting for facility, independent and employed providers.I am also very active in Governance at ProHealth Care and in the community. These include past Board Chair at Waukesha County Business Alliance, Waukesha County Business Alliance Policy Board, Vice Chair at The Rehab Hospital of Wisconsin, Board Chair at La Casa Esperanza Foundation, Board Member at Empathia and Board Member at Moreland Surgery Center.I have been very fortunate to work with a great group of people helping ProHealth Care work in Waukesha County increasing quality scores while reducing costs. This collaboration of Independent physicians, employed physicians, and the health system is a very unique relationship and has really improved performance.I have really enjoyed working effectively with Waukesha County Business Leaders through the Waukesha County Business Alliance to further drive growth in the marketplace.

Madison, Wisconsin Area

Executive responsible for exporting Dean Health Plan’s core competencies to other markets through value-added service offerings and the development of joint venture partnerships with integrated health systems. Helps develop partnerships with these health systems to form Accountable Care Organization (ACO) and/or joint venture insurance collaborations to enable health systems to create their own provider sponsored health plan. Enables Dean Health Plan/SSM to generate new sources of revenue and improve long-term strategic positioning beyond its core business model offering of Insurance and care delivery services in south-central Wisconsin.The role includes the identification of alliance targets, obtains system wide consensus on targets, strategic development of the value proposition, relationship development, deal negotiation, program implementation and ongoing General Manager Responsibilities. The initial relationship was part of a start-up initiative for Dean Health Plan. The launch was a success and the program continues to make progress in spite of numerous issues resulting from changes in the new healthcare legislation. In the first thirteen months in existence, we have added over 15,000 lives. We continue to make improvements to our initial partnership and this will provide a strong foundation for future alliances.Our team has developed a robust set of tools to budget, manage, adjust and steer the business model to meet the alliance objectives. We have been very responsiveness to the needs of the partner and there is a strong level of trust between the organizations.

Greenwich, Ct

Executive in charge of business development for the largest telemedicine company. Worked effectively with this entrepreneurial organization to grow value to the shareholders. Prior to my departure, I was developing and driving strategies around retail, worksite clinics, and Teladoc Connect. All three programs were eventually installed and are part of the current product offering.

Milwaukee, Wi

Promoted to the new "rainmaker role" to focus on strategies to develop new businesses for Assurant Health. The role provided intense focus on strategies identifying and developing value propositions at targeted industries. The industries focused on included financial services, property and casualty, retail, and franchises. Property and Casualty. Identified and completed the opportunity with USAA. This relationship was projected to grow into a nine figure revenue producer. Two year process included identifying, targeting, and driving the deal to conclusion. The program was effectively implemented for a very demanding client.Banking. This was the first target and proved very successful as deals were competed with Citi, Bank of America and National City. Targeted approaches included mail, e-commerce, and advertising on card statements. The tests provided over $10,000,000 in revenue and helped develop direct mail marketing capabilities.Retail. Co-led the inaugural CEO Challenge team to develop a strategy of utilizing retail as a distribution channel. The deal with Walgreens was eventually completed.Franchisees. Completed deals with Penske and Tupperware to sell health insurance products into their franchisee and customer base. Global Client Management. Assurant Health's representative on the key strategic council at Assurant. Worked with some of Assurant's largest clients including Citi, Chase, HSBC, GE Money, and Cuna Mutual.Health Savings Account. Was responsible for the HSA operations. Also, helped organize the American Bankers Association HSA Council which remains the largest HSA lobbying group. Members included Wells Fargo, MasterCard, JPMorgan Chase, Bank of America, Visa, Fifth Third Bank, Optum, UMB, and WageWorks.

Milwaukee, Wi

Was promoted to the role of Vice President and the purchasing of provider network services for over $500,000,000 in annual claim spend. Added numerous other responsibilities over time.Pharmacy Services. Executive responsibility for Pharmacy. Made decision to develop a RFP early due to the changing PBM landscape. Managed the review and the recommendation to move to a new PBM. The change saved $64,000,000 over 4 years. Led the successful implementation and moved over 1,000,000 members with minimal disruption. Completely re-engineered our processes and integrated the vendor into our risk management capabilities. Direct provider negotiations. Identified and developed the concept of negotiating high cost claims directly with providers. Tested, obtained funding, and developed the lead for this opportunity. This area continued to grow and saved Assurant $18,000,000 annually.Student Health. General Manager for student health division. Developed the strategy to revamp the line. The annual sales were $25,000,000 and maintained ROE's.Horizon Health. Executive responsible for the P&L at Horizon Health, a PPO network in Las Vegas. Customers included MGM/Grand, Venetian, New York-New York, Silverton, and City of Las Vegas. Business provided annual profits in excess of $300,000.Identified an opportunity to purchase PHCS stock from Humana. Many obstacles had to be overcome and the eventual sale of purchased PHCS netted an additional $26,000,000 over the original stock purchase price.National Contracts. Hired new lead and developed integrated strategy for passive networks and ancillary arrangements. Numerous multi-million dollar savings initiatives were implemented.

Greater Milwaukee Area

Manager Provider Negotiations - Was promoted to lead the provider network department and provider negotiations for the State of Wisconsin.Successfully completed contract negotiations with large health systems and physician groups. Kept cost per unit rates below United Healthcare benchmarks.Worked closely with the operations personnel to streamline provider contracts in order to automate the claims process. This process was instrumental in making the Wisconsin operations the most efficient plan at UnitedHealthcare.Set-up the initial Medicare+Choice contracts for the health plan. Developed and installed per diem methodology that provided a competitive advantage.

Financial position that reviewed provider contract strategies and determined contract valuation. Fully developed skills needed to analyze and determine the cost expectations for the provider contracts. This included a thorough knowledge of capitation, risk sharing, and bonus incentives. Developed the medical expense budgets and was responsible for claim reserve schedules.

The first management program executive promoted to Assistant Store Manager-Operations and Personnel Manager.

Ms-Accounting, 1988

Activities and Societies: President of the Master's Student Association

Bba, Finance

High School Diploma