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Phil Shimer

Of Counsel

 


Phil joined TSG Consulting in 2010 following more than 35 years of governmental, intergovernmental and private sector work with an emphasis in managing and running large insurance-related entities. At TSG, he specializes in working with numerous clients on health care-related issues, especially in regard to the implementation of the West Virginia Health Insurance Marketplace. He also assists clients in increasing efficiencies and improving quality of care in health care delivery systems.

Prior to joining TSG Consulting, Phil served as a senior vice president and founding corporate officer of BrickStreet Mutual Insurance, a large, mono-line, multi-state workers' compensation insurance carrier. As the claims practice leader at BrickStreet, he was responsible for all aspects of the company's claims and medical management, as well as its small- and middle-market business.

Previous to BrickStreet, Phil served as deputy director of the Public Employees Insurance Agency, West Virginia's self-insured health plan for state employees. At PEIA, he helped to develop and implement multiple programs to improve members' health status, including a diabetes pilot, the "WV Portions" ad campaign and the Dean Ornish post-cardiac surgery program. He also worked on initiatives to reduce the agency's escalating prescription drug costs, including the establishment of a multi-state purchasing pool, generic substitution and academic counter-detailing.

Phil's other work in West Virginia included several positions with the Bureau for Medical Services, including acting commissioner, which made him responsible for day-to-day operations of the Medicaid program. As the bureau's deputy commissioner, he designed and secured federal approval for the state's first Medicaid managed care program, Mountain Health Trust. He also secured federal approval for the state's initial Children's Health Insurance Program (CHIP) and served as its director. Phil began his work in West Virginia state government as part of then-Gov. Jay Rockefeller's administration in 1977.

Between his initial work in West Virginia and his return to the state in 1995, Phil established cabinet-level representation in Washington, D.C., for the State of Hawaii and lobbied the federal government on behalf of the state's interests. He also established a Washington, D.C., office for the Western Governors Association and directed efforts on behalf of 21 western state governors for several years.

Phil has a bachelor's degree from Texas A&M University and a master's degree from California State University-Fullerton.