Electronic Health Reporter

Sean Creighton, a 15-year veteran of the Centers for Medicare & Medicaid Services (CMS), has joined Verisk Health as vice president for Risk Adjustment Solutions. Creighton will provide overall leadership and subject matter expertise on risk adjustment to Verisk Health, a leader in data-driven healthcare solutions. In this role, he will work closely with product development and delivery teams to enhance existing solutions and develop new world-class products that help Medicare Advantage and commercial plans ensure appropriate revenue and elevate performance. Verisk Health is a Verisk Analytics (Nasdaq:VRSK) business.

“As Medicare Advantage enrollment continues to grow and Health Insurance Marketplaces gain traction, health plans need more support than ever before to nimbly respond to an evolving marketplace,” said Nadine Hays, president of Verisk Health. “Sean’s extensive CMS experience and proven leadership will be tremendous assets to the Verisk Health team, helping us optimize our solutions so they continue to provide the best answers to our clients’ risk adjustment challenges.”

Before joining Verisk Health, Creighton was the deputy group director of the Payment Policy and Financial Management Group in the CMS Center for Consumer Information and Insurance Oversight. He also served as the director of the division of Payment Policy and Risk Adjustment in the Medicare Plan Payment Group in the Center for Medicare.

While at CMS, Creighton was responsible for payment policy and operations for both private marketplace and Medicare plans. Notable accomplishments include developing and implementing a system to make advance premium-tax credit and cost-sharing reduction subsidy payments to marketplace issuers under the Affordable Care Act; developing and implementing Parts C and D risk adjustment models; and serving as the sponsor and chief architect of the Medicare Encounter Data System.

Creighton holds a bachelor of arts degree in European studies from the University of Limerick and a master of science degree in sociology from the London School of Economics. He has won numerous awards for development and implementation of risk adjustment and payment models.

About Verisk Health
Verisk Health empowers a sustainable, value-based healthcare delivery and payment system with the data services, analytics, and advanced technologies that inform smarter business decisions and reduce risk. Our population health, revenue, payment, and quality solutions help health plans, providers, employers, and other risk-bearing entities improve the quality of healthcare delivery, contain costs, ensure appropriate revenue, and support compliance initiatives. Verisk Health is a Verisk Analytics (Nasdaq:VRSK) business. For more information, please visit veriskhealth.com.