In The Loop – John Bertko

In this installment of In The Loop, ClosedLoop's thought leadership series, Carol McCall, Chief Health Analytics Officer, sits down with John Bertko to dive into risk adjustment, alternate payment models, and much more. John is currently Chief Actuary with Covered California and serves on the Panel for Health Advisors for the Congressional Budget Office. They discuss:

  • The evolution of risk adjustment and accountable care
  • How risk adjustment is central to value-based care and APMs
  • The importance of data and the ability to access and leverage it
  • How COVID-19 is affecting Medicare part A funding

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John Bertko is currently an independent actuarial consultant working as the Chief Actuary with Covered California (California’s Insurance Marketplace) and performs contract work for CMS on specific projects related to the ACA. John was previously the director for Special Initiatives and Pricing in the Center for Consumer information and Oversight at CMS. He was also formerly a Senior Fellow at the LMI Center for Health Reform, Adjunct Staff at RAND, a Visiting Scholar at the Brookings Institution, a Visiting Scholar at the Center for Health Policy at Stanford, and Chief Actuary of Humana Inc. He has served in several health policy roles, including a six-year term on the Medicare Payment Advisory Commission (MEDPAC).

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