About Us

Founded in 1986 and headquartered in Boston, Massachusetts, PCG helps public sector health, education, and human services organizations make measurable improvements to their performance and processes.

PCG’s Health Policy News Blog is written by some of PCG Health’s most knowledgeable and experienced health policy subject matter experts. With this blog, they aim to distill the latest federal and state health policy news into relevant and digestible reading.

Meet the Contributors

Health Policy News Team

James Waldinger

Mr. Waldinger, an Associate Manager at PCG, is an experienced Medicaid policy and reimbursement professional who focuses on healthcare operations, mental health and substance abuse policy and integration, and health care reform and its impact on Medicaid programs and providers. As the former Chief Financial Officer and Budget Director for the Massachusetts Medicaid Program, MassHealth, and CFO for the Massachusetts Behavioral Health Partnership (MBHP), Mr. Waldinger was responsible for understanding the fiscal impacts of all programmatic and policy changes, including the building, updating, and tracking of all provider reimbursement calculations, policies, and impacts. At MassHealth, Mr. Waldinger led all financial efforts related to multiple successful State Plan Amendments (SPAs) and 1115 Waiver submissions, including Massachusetts’ landmark health care reform waiver in 2005-6. At MBHP, Mr. Waldinger led efforts to implement a sophisticated inpatient psych hospital pay-for-performance initiative. Mr. Waldinger’s current role at PCG includes heavy involvement in claims processing and Medicaid reimbursement policy transformation. His experience speaks to multiple behavioral health engagements, from provider strategic planning, to statewide behavioral health services assessments, to the development of reimbursement methodologies that incentivize integration of community-based services. Mr. Waldinger’s in-depth understanding of provider costs, cost reporting, cost modeling, and cost settlement experience, provides clients with a unique understanding of the behavioral health system and potential impacts of policy changes.

Lisa Kaplan Howe

Lisa Kaplan Howe (J.D.) is a Senior Advisor who has spent her career working in health law and policy. At PCG, she focuses on statutory and regulatory analysis and strategic advising, particularly related to health care policy. Lisa has provided subject matter expertise to support state health care reform efforts, including policy development and regulatory support for health insurance Marketplaces and state insurance plan management efforts, Medicaid expansion and Medicaid Waivers (including DSRIP Waivers) and State Innovation Waivers. Lisa led PCG’s work with the New Hampshire Insurance Department relative the state’s Section 1115 Medicaid Waiver to provide coverage to newly-eligible adults through the Marketplace and continues to support the states’ Marketplace plan management work. In those roles, Lisa has served as the chief advisor and policy expert related to Medicaid and private insurance law to the New Hampshire Insurance Department, helping to identify, analyze and lead strategic consideration of federal opportunities and requirements. Lisa is also part of the team helping to design Colorado’s Delivery System Reform Incentive Payment (DSRIP) program. Ms. Kaplan Howe also provides broad policy and regulatory support to PCG’s other health care clients across the country, analyzing policy and regulatory developments, providing strategic advice relative to regulatory questions, and drafting policy briefs and position papers. Lisa is a managing editor of PCG’s monthly health practice area newsletter, Health Policy News. Prior to joining PCG, Lisa served as Policy Director at New Hampshire Voices for Health, where she led legislative and regulatory analysis, strategic planning, and implementation of the organization’s policy agenda. Her work included drafting bills, amendments, testimony, and communications and testifying at hearings. Lisa also held the positions of Private Market Policy Manager and Consumer Health Policy Coordinator at Health Care for All of Massachusetts. While there, she managed private insurance market policy work and was a member of the organization’s internal health reform team. Lisa also practiced law in the Ropes & Gray health care department, advising health care provider and insurer clients.

Lisa Lee

Associate Manager / Health Ms. Lee has been with PCG for 1 year and helps lead the Health Innovation, Policy and Information Technology Center of Excellence, specializing in Medicaid, CHIP, and ACA policy. Project accomplishments include the creation of Mississippi’s 1115 Waiver Application designed to assist Medicaid members with workforce training opportunities. Prior to joining PCG, Ms. Lee worked in a variety of roles, including Commissioner for the Kentucky Department for Medicaid Services. In addition, Ms. Lee served as Director of the Kentucky Children’s Health Insurance Program (KCHIP) for approximately 15 years. Ms. Lee graduated Summa Cum Laude with a Bachelor’s Degree in English from Kentucky State University.

Margot Thistle

Margot Thistle, Esq. is a managing editor of Health Policy News who has spent much of her career working directly on Affordable Care Act policy and implementation, including having lead plan management operational and policy planning for Vermont Health Connect, a state-based exchange. During her time at PCG, Ms. Thistle has worked extensively with state insurance departments and state agencies on health policy, market stabilization, and regulatory compliance matters. Ms. Thistle provides broad policy and regulatory support to PCG’s other health care clients across the country, analyzing policy and regulatory developments, providing strategic advice relative to regulatory questions, and drafting policy briefs and position papers. Ms. Thistle still has her admission ticket to the signing of Chapter 58 of the Acts of 2006, the historical Massachusetts health reform bill that preceded the ACA.

Thomas Entrikin

Mr. Entrikin has 45 years of experience with the Medicaid and Medicare programs. From 1981 to 1992, he was a Medicaid policy specialist with the US Health Care Financing Administration (HCFA), now the Centers for Medicare & Medicaid Services (CMS), providing technical assistance to states on Medicaid eligibility, coverage, and reimbursement; provider certification and enrollment; program integrity; recovery of third party liabilities; Medicaid Management Information System (MMIS) performance specifications and operations; interagency agreements; contracts with managed care organizations; health standards and certification requirements; and Medicaid waiver programs. Since coming to PCG in 1992, Mr. Entrikin has assisted in the design, development and implementation of revenue projects for school-based health services; hospital-based and municipal projects for pregnant women, infants, and children; state services offered through youth services, child welfare, mental health, substance abuse, developmental disabilities, and public health agencies; and reimbursement systems for hospitals, long term care facilities, and home and community-based services waiver programs. He has made presentations on home and community-based services waiver programs at national conferences sponsored by the Robert Wood Johnson Foundation as well as presentations on Medicare/Medicaid claiming and waiver options at the National Association of Reimbursement Officers and the National Association of State Human Services Finance Officers.
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