James T. West
Senior Advisor

James West has over 25 years of experience in the Health Care industry, both on the Provider and the Payor sides. James has been a leader in Managed Care for the past 15 years as a nationally recognized leader in contract negotiations and network development for health systems and health plans. He had responsibility for negotiations valued at over a billion dollars (per payor) for various systems including WellStar Health System (11 hospitals) and Adena Health System (3 hospitals). James has contracted for numerous health plans, most of which were provider-owned (e.g., Alliant, Piedmont-Wellstar, and Promina). In addition to commercial negotiations, he has developed and negotiated Value Based Reimbursement contracts and methodologies for Medicare Advantage and Managed Medicaid, and he then transitioned this methodology into Commercial contracts for facilities and physicians.

As an expert in the development and implementation of Accountable Care Organizations and Clinically Integrated Networks, such as WellStar Health System and Neighborhood Health Plans, James has built the strategic case for the development of these for both health systems and insurance plans and has led implementation and operationalization. Through Adena Health System and Advanced Medical Pricing Systems, James developed bundled pricing for providers and contracted for bundled services on behalf of Employers and TPAs. James has advocated for and implemented direct contractual relationships between healthcare providers and large single and multi-site employers to integrate providers’ quality programs directly into the employers’ benefit designs to lower cost and improve quality.

James received a Master’s Degree in HealthCare Policy and Administration from Mercer University. He received a Juris Doctorate from Campbell University School of Law. He received a Bachelor of Arts Degree from Campbell University in Buies Creek, North Carolina.