Derek S. Raynes is an attorney, healthcare executive, and business owner who has spent his career working alongside physicians. He most recently served as Director of Payment Reform at the OneCare Vermont ACO, where his work included oversight of the Comprehensive Payment Reform (CPR), Population Health Management (PHM), and total-cost-of-care risk programs.

Before OneCare, Raynes held healthcare leadership roles at UVM Medical Center and Shands at the University of Florida, with responsibility for managed care, payer contracting, revenue strategy, and payer relations. Raynes also spent ten years working alongside physicians representing injured patients. His experience is valuable because it is not limited to one lane. Raynes understands contracts, finance and accounting, operations, quality, liability, risk, and the realities of the Vermont healthcare landscape.

During his OneCare tenure, Raynes led the charge within the CPR program to pay independent primary care organizations a more equitable share of total healthcare spend. As a result, reimbursement to CPR practices climbed to 140% of the typical fee-for-service payments from government payers like Medicare and Medicaid. In his five years leading OneCare’s CPR and PHM programs, Raynes developed a keen understanding of Vermont clinicians and the realities shaping their decisions.

Personally, Raynes brings not only deep healthcare experience, but also the perspective of an owner-operator. In addition to his healthcare work, he is the owner of Alpine Options, a ski shop in Warren, Vermont. That experience gives him an even stronger appreciation for what it means to run a business, lead people, make decisions with incomplete information, and stay grounded in real-world operations. He lives in Williston, Vermont with his family. He enjoys skiing, golf, travel, reading, photography, the Los Angeles Dodgers and Kings, and spending time with his wife, two children, and their family dog.