John McCarthyFounding PartnerColumbus, Ohio
John McCarthy has more than 25 years of health care consulting and government leadership experience. Before co-founding Speire, John served as CEO of Upshur Street Consulting. He also spent eight years as Medicaid director in Ohio and the District of Columbia. John helps clients navigate the rapidly changing healthcare markets in the public and private sectors at both the federal and state levels. He is a nationally-recognized expert in Medicaid reforms, value-based purchasing, delivery system design, system implementation and reimbursement policy.
In Ohio, John served as the director of the Ohio Department of Medicaid (ODM), Ohio’s first cabinet-level Medicaid agency. John implemented a series of innovative policy initiatives that modernized ODM by improving the quality of health services at a substantial value to Ohio’s taxpayers. He implemented a new managed care program that provided choice to 1.6 million managed care beneficiaries. He also implemented a pioneering, managed care program with the Centers for Medicare & Medicaid Services (CMS) for the integration and coordination of care for individuals enrolled in both Medicaid and Medicare. John’s modernization efforts also included the implementation of a new integrated eligibility system and the launch of the Medicaid Information Technology System (MITS), a sophisticated claims processing system to boost efficiency and communicate with providers.
In the District of Columbia, John served as policy director and then, Medicaid director. As Medicaid director, John was part of the executive team that transitioned and reorganized Medicaid to be the largest freestanding agency in the District. He developed and procured new managed care contracts, increased oversight of the managed care plans and created a pay-for-performance quality bonus. Prior to his government service, John spent 10 years at EP&P Consulting, serving as corporate manager. At EP&P, he led Medicaid transformation engagements for multiple states.
John also played a significant role nationally, serving as vice president of the National Association of Medicaid Directors. John serves on the board of Triad Behavioral Health and Experience Wellness Center and Savida Health. He also is an inaugural policy fellow for the United States of Care. John holds a master’s degree in public affairs from Indiana University’s School of Public and Environmental Affairs and a bachelor’s degree in chemistry from Indiana University.