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A strategic and innovative healthcare executive, Dr. Craig Thiele brings to HMA more than 25 years of clinical leadership experience in managed Medicaid and national commercial healthcare. He aligns payers, providers, consumers, community members, and regulators to develop and lead innovative initiatives focused on high-quality efficient care for highly-vulnerable citizens.
Prior to joining HMA, Dr. Thiele served for 10 years as the chief medical officer at CareSource, a multistate, multiproduct, nonprofit managed care plan, where he provided leadership and direction for the clinical, quality, and utilization/cost management functions of the company. He was instrumental in shifting business from a primarily Ohio-based Medicaid focus to a comprehensive, member-centric health and life services entity serving 1.7 million Medicaid, Medicare, and Marketplace members in multiple states.
Dr. Thiele created a value reimbursement contracting model now serving over 50 percent of membership and managed a $1.7 billion pharmacy department that generated $200 million in annual savings. He restructured clinical and reimbursement policy development supporting 11 lines of business, projecting $40 million in savings in 2017.
Dr. Thiele reduced opioids dispensed by CareSource healthcare providers by 30 percent and initiated a medication therapy management program that generated a 3-to-1 return on investment savings through improved adherence to chronic medications and reduced emergency room and inpatient admissions. He instituted primary care relationships in commercial retail settings, now serving over 7,000 members, and established relationships and operationalized clinical data sharing with Ohio’s two Health Information Exchanges. He created an integrated nurse advice line with a virtual telemedicine program for Medicaid and Marketplace products and implemented automated care management and pharmacy systems, reducing administrative structure and improving health plan and provider efficiency.
As national medical executive of clinical programs at Optum, a division of UnitedHealth Group, Dr. Thiele directed clinical program design and led medical directors in the support of utilization review and case management.
Dr. Thiele has nearly 15 years of clinical practice experience, serving as chair of the department of internal medicine at Premier Integrated Medical Specialists, hospitalist at South Dayton Acute Care Consultants, and in multiple medical director roles.
Dr. Thiele earned his MD from Wright State University Boonshoft School of Medicine and completed a residency in internal medicine. He earned his bachelor’s degree in chemistry from Miami University in Ohio. Dr. Thiele is certified through the American Board of Internal Medicine.