PacificSource Health Plans
Type: Not-for-profit regional health plan HQ: Springfield, OR Members: Commercial, Medicare Advantage, Oregon Medicaid Employees: ~1,200 Revenue: ~$750M
Prior Relationship
None. Never contacted. Clean slate.
C-Suite
| Name | Title |
|---|---|
| John Espinola, MD | President & CEO (since April 2023; former Premera/Kinwell) |
| Shawn Akavan, MD | EVP & CMO (owns clinical guidelines, medical policy, UM) |
| Tracy-Ann Mussenden, RN | VP, Medical Management (joined Aug 2024; former Kaiser, Centene) |
| Peter Davidson | CFO |
What's Going On
- Financial pressure: AM Best placed ratings under review. $75M premium deficiency reserve booked for 2025 ($44M MA, $30M Medicaid). Holding company injected $25M capital.
- Dedicated UM investment: Hired Tracy-Ann Mussenden (VP Medical Management) specifically to tighten clinical oversight — career UM exec, 19 years at Kaiser/Centene/Meridian.
- Active UM tightening: New utilization reviews required for behavioral health members with 26+ therapy visits (2024).
- CEO is a physician executive from payer side (Premera) — clinical and financial tension sits at the top.
Who to Email
Shawn Akavan, MD — EVP & CMO. Owns clinical practice guidelines, medical policy, and UM efficiency. Under direct financial pressure to demonstrate medical management impact.