Meet the “BPCI” A Team – Take Four!

Rina Vertes, FSA, MAAA, Senior Actuarial Consultant

Rina has almost 30 years of experience working with health insurance companies, providers, and other health care vendors. Until 2011, Rina was the Chief Actuary of BCBSMA, where she worked extensively on the implementation of and risk management response to MA health care reform. She was appointed to serve on the 2006 Special Commission to Study the Impact of the Merged Individual and Small Group Markets. She co-led the development and implementation of the Alternative Quality Contract, a provider payment model incorporating risk adjusted global payment and performance based incentives, considered a prototype for recent ACO models. Most recently, Rina was the CFO of Minuteman Health, the only member-governed health plan in MA, where she was part of the leadership team that successfully developed and launched the plans in MA and NH. Rina was appointed by Governor Charlie Baker to serve on the Board of the Massachusetts Health Connector, the state based health insurance exchange.

Currently, Rina is the President of Marjos Business Consulting, LLC. As a consultant, Rina provides actuarial and strategic expertise to clients so that they can manage risk and strategically respond to CMS and private sector payment reform initiatives including Bundled Payments, ACOs, and other value based relationships.   

Fran Cercek, MBA, Senior Financial Consultant

Fran has a strong background in healthcare data analysis and information systems—helping clients understand financial performance, identify trends, identify strengths and weaknesses, model new opportunities and assess payment reform impact. For the past five years, she has specialized in helping healthcare providers understand the financial impact of bundled payments, and developing analytics tools to support the ongoing management of these programs.

As Assistant Vice President of Finance for St. Anthony Hospitals, part of the 12-hospital Centura Health System in Denver Colorado, she was responsible for three acute facilities and multiple physician clinics—leading her team through the financial planning process for a 350-bed replacement hospital, a new 25-bed hospital and an Outpatient Mediplex. She also evaluated physician joint venture agreements, cardiac and orthopedic co-management arrangements, and has been responsible for all aspects of long range planning, revenue integrity, pricing, costing, and decision support databases for several large health systems in Ohio and Colorado. Fran has a Bachelor of Science degree in Finance from Wright State University and a Master of Business Administration degree in Management Information Systems from the University of Cincinnati.  

BACK