William MacBain, MPS

Bill has more than thirty years’ experience as a senior executive or strategic consultant to some of the nation’s most progressive health plans. 

In his role at Gorman Health Group, Bill’s client engagements include strategic planning, financial planning and feasibility analyses, due diligence reviews, and operational assessments. He provides guidance for health plans in developing and executing sustainably profitable business models, saving valuable resources with his operations experience and knowledge of CMS regulations.

Since the passage of health care reform in 2010, Bill’s work has focused on provider entities considering becoming Accountable Care Organizations (ACOs). This work has included developing business models, risk sharing arrangements, feasibility studies, model contracts and operational studies.

Most of Bill’s prior management experience has been in executive positions in health insurance finance and operations, primarily in provider-owned health plans.  Bill also has more than ten years of experience in management consulting, where his financial management and analysis, business planning and budgeting, contract negotiations, product design, and government affairs skills have become invaluable to GHG clients.

Prior to joining GHG, Bill served as CFO for a large regional health plan, chief operating officer for one of the largest rural-based health plans in the nation, and held senior finance and operations positions with several start-up health plans. He also contributed to federal and state health insurance policy as a member of two federal Medicare advisory commissions (MedPAC and ProPAC), and as president of the Managed Care Association of Pennsylvania. Bill has also served as a board member of the American Association of Health Plans and the Group Health Association of America, predecessors of today’s AHIP.  Bill also coauthored and published a series of successful HIPAA privacy rule policy templates.

Bill earned his BA and Master of Healthcare Administration degrees from Cornell University.