Rina Vertes, FSA, MAAA
President, Value-Based Care Solutions
Rina C. Vertes, FSA, MAAA has over 35 years of experience working with health insurance companies, providers, and other health care stakeholders to design and implement comprehensive alternative payment models that have been widely studied and adopted.
Rina has previously served as the Chief Actuary and Chief Underwriter of Blue Cross Blue Shield of Massachusetts where she led large teams that worked on the implementation of and risk management response to extensive Massachusetts health care reform initiatives. She was appointed to serve on the State’s Special Commission to Study the Impact of the Merged Individual and Small Group Markets. She co-led the development and implementation of the Alternative Quality Contract, a provider payment model incorporating risk adjusted global payment and performance-based incentives, widely considered a prototype for ACO models. She has also worked with multiple national payor organizations.
Since 2011, Rina was the President of Marjos Business Consulting, LLC. As a consultant, Rina provided actuarial and strategic expertise to clients so that they can manage risk and strategically respond to CMS and private sector payment reform initiatives including bundled payments, ACOs, and other advanced value-based relationships.
Rina is a Governor-appointed member of the Board of the Massachusetts Health Connector, the state-based health insurance exchange, and was appointed in 2020 to serve on the Merged Market Advisory Council. She continues to foster the pursuit of meaningful healthcare payment reform serving as the Chair of the Medicare Workgroup of the American Academy of Actuaries and a professor at Northeastern University.
Rina is a Member of the American Academy of Actuaries and a Fellow of the Society of Actuaries and received her undergraduate degree in Math and Actuarial Science from the University of Connecticut.