OPEN MINDS Consultants & Advisors

Gene F. Rosetti
Senior Consultant, OPEN MINDS

Gene F. Rosetti, Senior Consultant, is an expert in health care financial systems with specializations in developing financial models, underwriting, and rate setting. Mr. Rosetti has evaluated and implemented alternative provider contracting and reimbursing strategies, including the development of fee schedules and capitation rate setting. His experience in provider reimbursement processes is with both the State of Pennsylvania and with BlueCross affiliated health plans. His experience with state government includes the evaluation of Medicaid managed care organizations' financial reports relating to capitation rates and HIV/AIDS adjusted rates, and capitation rate setting. Additionally, he analyzed federal and state policies on managed care reimbursement rates and made determinations on their impact.

Mr. Rosetti conducted rate setting for the Department of Public Welfare's mandatory managed care program (HealthChoices), and developed capitation rates for categories for the Behavioral Health Choices Program. Mr. Rosetti has analyzed state and national health cost trends to determine factors influencing growth in service costs for managed care programs, and compiled and analyzed data on MA recipients and service groups to determine trends in population, utilization, and unit costs. Mr. Rosetti holds a Master's in Economics and Statistics, and Marketing and Finance from the University of Scranton.