410-542-4470, ext. 1
Payment reform offers huge potential to improve the health care system for both patients and providers. Our challenge is to design payment reform models that create the right incentives, are fair to providers, and are practical to implement.”
Guy D’Andrea founded Discern, LLC in 2004. As the firm’s Managing Partner, Guy is responsible for oversight of all of Discern’s client projects, which focus on reforms to health care payment and delivery that will improve the quality and value of the health care system. Discern’s clients include a range of public and private organizations, many of which are driving the agenda for change in health care. Working with clients such as the Leapfrog Group, the National Business Coalition on Health, the Hospital Quality Alliance, and others, Discern has been on the forefront of health system innovation.
Many of Guy’s projects focus on aligning economic incentives with better health system performance and outcomes. New payment models can support delivery systems changes, such as patient-centered medical homes (PCMH) and accountable care organizations (ACOs). Specific projects undertaken by Discern include designing hospital and physician pay-for-performance programs, assessing markets’ readiness for payment reform, and implementing shared savings payment models.
Before starting Discern, Guy spent seven years as a Vice President at URAC, where he was responsible for the development of URAC’s accreditation programs, including quality standards for PPOs, utilization management organizations, case management organizations, and consumer-directed health care. Prior to URAC, Guy spent five years working on managed care regulatory and policy issues with the American Association of Health Plans (now AHIP) and the Maryland Association of HMOs.
Guy received his undergraduate degree in philosophy from Cornell University. He earned dual Master of Business Administration degrees from Columbia University and the London Business School, where he graduated as the valedictorian of his program. He is a member of the American Association of Health Care Consultants, the American College of Healthcare Executives and the Mid-Atlantic Business Group on Health.
- “The Design and Application of Shared Savings Programs: Lessons from Early Adopters” Health Affairs, September 2012
- “COPD Pay-for-Performance White Paper and Technical Specifications” Developed for Boehringer Ingelheim
- “Sustaining The Medical Home: How Prometheus Payment Can Revitalize Primary Care.” Robert Wood Johnson Foundation, June 2009. (See especially pages 43-49).
- “Physicians Respond to Pay-for-Performance Incentives: Larger Incentives Yield Greater Participation.” American Journal of Managed Care, May 2009, pages 305-310.
- “Adding Value to PPO Services: A White Paper on Value-Based Benefit Design.” Developed for the American Association of Preferred Provider Organizations.
- “Model Predicts that HIT Stimulus Will Have Significant Impact.” Posted to Bridges to Excellence Web site, May 2009.
- “Should Health Care Come With a Warranty?” Health Affairs, June 2009.
- “Analyzing the Value of Accreditation: Application of Computer Decision Tools to a Complex Decision” Lippincotts Case Management” September – October 2006, pages 249 – 252.