Andrew Smithson

Andrew Smithson

Co-Founder & CEO, TRYNYTY health:enablement
Value-Based Care Strategy · Financial Analytics · Managed Care Consulting

📍 Chicago, IL 📞 (502) 544-5278 ✉️ Andrew@trynytyhealth.com LinkedIn →
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Professional Experience
TRYNYTY health:enablement September 2024 – Present
Co-Founder & CEO
  • Developed a comprehensive business plan for a transformative managed care technology platform designed to reduce provider administrative burdens, enhance healthcare data integrity, and drive patient engagement to improve health outcomes.
  • Created a strategic roadmap for an initial product addressing critical gaps in existing VBC solutions, leveraging deep expertise in value-based care operations and designed for rapid scalability.
  • Authored pitch deck materials and led early-stage fundraising outreach to position TRYNYTY as a leader in innovative VBC technology solutions.
  • Built the MSSP ACO Explorer — a free, interactive platform covering 12 years of MSSP program data across 1,000+ ACOs, demonstrating the analytics capabilities of the TRYNYTY platform.
COPE Health Solutions April 2021 – August 2024
Director, Managed Care & Financial Analytics Consulting
  • Created integrated financial models for diverse clients including Provider Sponsored Health Plans (PSHPs), aligning strategies across geographies and lines of business to support client strategic goals.
  • Led the redesign and implementation of financial modeling tools, transitioning from legacy Excel systems to the ARC platform, enabling scalable and consistent analytics for provider and payor clients.
  • Negotiated a guaranteed $120M in additional revenue over five years for a VBC contract on behalf of a 30,000-member IPA.
  • Spearheaded thought leadership initiatives, including publishing an early analysis on CMS's proposed risk adjustment model changes (v24 to v28) that garnered significant industry attention and spurred industry-wide discussion.
  • Directed multiple simultaneous high-value client engagements including PSHP expansion strategies and VBC transformations.
Great Lakes Integrated Network — Vice President, Finance (Interim) · February 2022 – March 2023
  • Conducted a comprehensive readiness assessment and restructured the Management Services Organization (MSO) to support VBC arrangements, streamlining processes and enhancing operational efficiency.
  • Developed a 3-year strategic roadmap for payor contracting, including securing an ACO REACH product in a competitive application process.
  • Renegotiated key payor contracts and led financial turnaround efforts that converted an annual $2M loss into an $8M surplus.
  • Oversaw a comprehensive reorganization of the operation and led the Board of Directors Finance Subcommittee while managing multiple strategic initiatives simultaneously.
Athletico, LTD August 2020 – April 2021
Director, Managed Care
  • Strategized the shift to a concierge and value-based reimbursement model for physical therapy services, leveraging prior experience with bundled payments.
  • Conducted market assessments and financial modeling to support M&A and de novo expansion strategies, driving organizational growth.
University of Chicago Medical Center May 2018 – August 2020
Value-Based Payments Manager
  • Achieved incremental successes implementing value-based arrangements, particularly with the COPD bundled payment program, delivering measurable cost savings and improved patient outcomes.
  • Contributed to performance improvements across joint replacement bundles, oncology care, MSSP, and Medicare Advantage risk contracts.
  • Negotiated and managed value-based contracts with payers, aligning terms with system strategic objectives.
  • Developed KPIs, a predictive risk model, and reporting to enhance transparency and accountability across value-based programs.
Humana Inc. July 2010 – May 2018
Various Roles — 8 Years of Progressive Responsibility
Provider Engagement Manager — Chicago, IL · August 2016 – May 2018
  • Championed Humana's 'Provider Simplicity' initiative for the Illinois market, driving a 20% increase in risk adjustment and achieving a 4.5-star rating through strategic collaboration with internal teams and providers.
  • Co-managed a $2 billion P&L with the regional CFO, delivering $400 million in revenue growth.
  • Created a risk adjustment reporting package to optimize clinical documentation for providers including Advocate Healthcare, Oak Street Health, and ChenMed.
Network Contracting Finance Manager — Chicago, IL · March 2014 – August 2016
  • Modernized contracting finance processes, cutting monthly workloads by over 50% and enabling deeper insights into provider relations and performance.
Provider Analytics & Transparency Analyst — Louisville, KY · April 2012 – March 2014
  • Leveraged episodic groupers to optimize provider networks, generating cost savings through data-driven performance evaluations.
  • Advanced Humana's value-based care capabilities by developing analytics for 'Care Decision Insights', bundled payments, and narrow networks.
  • Created a tool to assist in mitigating $2 billion in potential sequestration payment liabilities across U.S. markets.
Customer Reporting Analyst — Louisville, KY · July 2010 – April 2012
  • Delivered custom reporting and analytics to support Humana's commercial and Medicare lines of business.
Areas of Expertise
Value-Based Care
VBC strategy, ACO operations, MSSP, ACO REACH, Medicare Advantage risk contracts, bundled payments
Financial Analytics
Financial modeling, P&L management, risk adjustment, Stars analytics, predictive cost modeling
Managed Care
Payor & provider contracting, network strategy, IPA management, MSO operations, PSHP development
Technology & Data
Healthcare data analytics, platform development, EMR optimization, population health reporting
Leadership
Executive consulting, Board engagement, cross-functional team leadership, strategic planning
Policy & Regulatory
CMS risk adjustment methodology, Medicare/Medicaid policy, regulatory compliance, rate analysis