Andrea Gelzer, MD, MS, FACP

AmeriHealth Caritas

Andrea Gelzer has served as senior vice president medical affairs and corporate chief medical officer for AmeriHealth Caritas, a Medicaid and Medicare managed care organization, for the past nine years.  Over that time period, the company has seen tremendous growth.  Directly managing a team of more than 550 associates, she has had responsibility for annual medical expenditures of $9B and has also successfully built and scaled up many corporate shared health care services functions, including medical/care management, clinical policy development, quality, informatics, and provider contracting.  She has deployed new approaches to alternative/value-based payment, as well as innovative population health management strategies to engage and improve health outcomes for vulnerable populations.  She previously served as chief medical officer for Boston Medical Center HealthNet Plan, the largest Medicaid and Commonwealth Care managed care organization in Massachusetts.  She also served in multiple roles, including senior vice president of clinical public affairs at Cigna Corporation, and for 12+ years worked in private practice in Internal Medicine.

A known industry leader, Dr. Gelzer is a pioneer in the development of provider organizations and health information exchanges.  She is skilled in leading diverse stakeholder groups and proving exceptional value. She currently serves on several influential industry committees including the National Committee for Quality Assurance (NCQA) Committee on Performance Measurement, the Health and Human Service (HHS) Health Care Payment and Learning Network (LAN) Care Transformation Forum (CTF), and the Core Quality Measures Collaborative (CQMC) Steering Committee. She is the Chairman of the Board of Directors of HSX, HealthShare Exchange, Philadelphia’s health information exchange and is also the Chairman of the board of its newly spun off, for-profit entity, HSX MarketStreet.  She is a member of the board of the Association of Community Affiliated Plans (ACAP), as well as the American Telemedicine Association (ATA).  She is the past-chair of the Chief Medical Officer Leadership Council at America’s Health Insurance Plans (AHIP).  She also previously served on the Agency for Healthcare Research and Quality (AHRQ) National Advisory Council.

Dr. Gelzer also recently served as a board member and a member of the audit committee of Cooper Atkins Corporation, a privately held multi-national company and developer of wireless health care temperature management solutions, until the company was sold to Emerson (EMR) in January 2018.  Dr. Gelzer earned her undergraduate degree from Tufts University and her doctor of medicine from St. George’s University. She received a master’s degree in preventive medicine/administrative medicine at the University of Wisconsin, Madison. She is a board certified by the American Board of Internal Medicine and by the American Board of Preventive Medicine in clinical informatics.