Allen Miller

Allen Miller is the Principal and CEO of COPE Health Solutions. With over 25 years of experience providing health system and payor value-based payment strategy and transformation consulting services, Mr. Miller has led the planning and implementation of IDNs, IPAs, and ACOs throughout the U.S. More recently, he has been focused on facilitating and implementing long-term payor/provider partnerships that go beyond the typical capitation and global risk models. These innovative collaborations are focused on reducing total cost of care and improving the total premium and other revenue needed to fund profitability and ongoing infrastructure investment. Under Mr. Miller’s leadership, COPE Health Solutions and its subsidiary Analytics for Risk Contracting (ARC) LLC have become the preeminent go-to solutions companies for health systems and health plans committed to leadership roles in population health management for all lines of business

COPE Health Solutions complements its consulting services with the largest health care talent pipeline in the country, known as COPE Health Scholars providing a unique health care training experience to over 4500 students annually in over 20 hospital and ambulatory sites throughout California and Washington State. All participants receive a certificate from the UCLA School of Public Health. Select students are trained as care navigators, health coaches and complex care managers to support new roles being created as health system clients develop population health management capabilities and capacity.

A hallmark of COPE Health Solutions’ consulting services is engagement in transformative strategic planning, design and implementation work with large health systems, health plans and others to develop clinically integrated delivery networks, re-design financial incentives and to learn to leverage financial risk to improve quality and reduce costs. Mr. Miller and his team are consistently on the cutting edge of work to implement new health care policy, including federal demonstrations and state waivers across the country, by partnering with providers and payors to transform fragmented, acute care “un-systems” of delivery into coordinated systems of care focused on improving the health of populations, while enhancing efficiency and aligning financial incentives.

Select consulting engagements:

• Development of managed care and population health management strategy for a three hospital system in Los Angeles, impacting strategy for larger parent health system – transforming financial alignment and incentives from primarily fee for service to profitable dual institutional and professional risk contracts supported by physician alignment through development and implementation of an ambulatory strategy that includes numerous physician alignment vehicles, a new FQHC and various joint ventures
• Deployment of IPA development strategy, including development of IPA three/five-year financial pro-forma, cash flow, P&L; implementation of all governing bodies, physician contracting & network development, patient outreach & enrollment and execution of marketing & communication strategy; partnering with community organizations for targeted Exchange, Medicare and Medicaid enrollment
• Numerous engagements focused on due diligence and assessment of MSO partners, including facilitation of provider contracting and operational implementation and deployment of MSO services.
• Planning and launch of a new joint venture corporation in Upstate New York between two large health systems to manage a Medicaid population of 400,000 across 13 counties with a network of over 600 provider organizations – PMO, HIT, Strategy, Managed Care and Clinical Re-design support – exploring options for gain-share and longer term sub-capitated contacts with health plans through potential build or buy IPA strategy
• Development of one of the largest Delivery System Reform Improvement Regions in the state of Texas – and recognition as a statewide model – in partnership with JPS Health Care Network in Austin, Texas and providers including Texas Health Resources, HCA and Baylor across a nine county region
• Financial and HIT consulting for a large health system in New York City to develop a strategy for managing Medicaid through a sub-capitated arrangement with health plans
• PMO support, strategic planning, HIT and clinical redesign to support the development of an integrated delivery system via a new joint venture corporation owned by Seton Healthcare Family and the health district in Austin, Texas – significant actuarial and managed care strategy support for IPA-like business model providing coverage to 55,000 members
• Restructuring of a failing Medicaid and Exchange licensed health plan in Texas leading to long term sustainability and positioning for success under likely future state Medicaid policy scenarios
• Analysis of Medicaid ACO contractual relationships and facilitation of strategic visioning for long-term capabilities to manage the Medicaid and Exchange populations for a large health system in the Pacific Northwest
• Analysis, contract design and business planning for a county-wide population health management model across three hospitals, an IPA and a health plan in Northern California – including governance, ownership and capitalization considerations
• Numerous engagements for the provision of population health, utilization management and performance-based analytics for health plans, IPAs, medical groups and community clinics
• Numerous engagements for the provision of clinical workflow and care delivery redesign (e.g. implementation of eConsult, specialty care redesign and care coordination models) for primarily Medicaid/Medicare practices, community clinics and hospitals to optimize available resource, minimize avoidable referrals/ED utilization and improve physician satisfaction and patient experience/access
• Assessment of physician organizations for ACO readiness and performance, including data analysis, clinical integration and care coordination assessments, provider education/engagement; identification and mitigation of operational, clinical and business risks related to ACO and/or performance-based contracts
• Financial modeling and business agreements for shared-savings programs, including hospital, FQHC, community clinic and IPA partners for MSSP ACO
• Outsourced Strategic Planning and Business Development for a three hospital health system in Los Angeles – Strategic Planning, Business Development, Physician Alignment including IPA build or buy as part of overall managed care strategy development

A graduate of UCLA, both for his Bachelors of Science and his Masters of Public Health in Health Services, Mr. Miller also completed an intensive on International Business at Oxford University in England. Mr. Miller has served in numerous volunteer roles, which include: four years as an orthopedic consultant and trainer at Venice Family Clinic; a team member of the UCLA Medical Relief Team to Albania during the Kosovo War in 1998-99; and a member of a medical and dental relief group for the under-served in Tecate, Mexico. Mr. Miller also has extensive teaching and lecturing experience, most notably as a former faculty member teaching orthopedics for the American Academy of Family Physicians and the California Academy of Family Physicians.

Mr. Miller currently serves on the YMCA of Metropolitan Los Angeles Board of Directors and sits on the Advisory Boards for The Health Forum at UCLA, Health Career Connection, and the UCLA School of Public Health Department of Health Services.