Author: Jay Sultan

Jay Sultan is a preeminent thought leader in healthcare payment reform. He has extensive experience across healthcare enterprises and payment systems and a long track record using technology to catalyze breakthrough innovation. As a strategy consultant for Edifecs, Jay provides thought leadership and experience-based direction to foster innovation and disruption in the healthcare industry. He works closely with payer and provider leadership on healthcare policy and enabling technology. Jay helps shape Edifecs’ overarching business, technology, product architecture and new product go-to-market strategies. With more than 18 years of consulting and development experience in the payer and hospital settings, Jay helps define business requirements and is responsible for ensuring Edifecs technology is driving true healthcare reform. A nationally recognized expert in payment reform, Sultan began work on implementing episodes for payment over 15 years ago and has authored two patents in payment bundling. He has participated in both commercial and the Centers for Medicare and Medicaid Services (CMS) payment bundling programs – for both retrospective and prospective episodes, and is currently working on one of the largest episode of care programs in the industry. Jay has served and/or still serves as subject matter expert in payment bundles to the CMS, several states, various non-profits (such as IHA), and over 100 payer and provider organizations. He is regularly invited to speak at national industry conferences on payment reform, healthcare reform, and technology. Prior to joining Edifecs, Jay served as Associate Vice President, Chief Product Portfolio Architect and Expert in Value Based Reimbursement at TriZetto where he was responsible for enterprise product architecture, interaction of all products and the adoption of clinical analytics. While at Trizetto, he authored the industry’s first major piece of software to administer prospective payment bundles. Previously, as a principal of a consulting firm, Jay was the architect and principal author of two payment-bundling programs that were chosen by the CMS as Acute Care Episode demonstration project sites. As the chief operating officer of MedAlign, he developed a number of innovative payment reform programs, including episodic provider payment. Sultan received a master’s degree in international economics/policy from the University of Chicago and a bachelor’s degree in mathematics and political science from the University of Georgia.