Our Story
Evensun Health was founded by former health plan CFOs who saw a need for at-risk entities to have a partner whose incentives aligned with theirs. Evensun’s core philosophy and product offerings are built around the belief that successful health plans take control of their data and deploy the right tools to understand what the drivers of growth, profitability, and loss are within their population.
Our experience working with dozens of plans across multiple markets has shown us that the best way for health plans to take control of their destiny is to use and develop in-house capabilities that can understand the complexities of the ACA market. Evensun provides health plans, at risk entities, and others in the value chain of health care financing the tools to take control of your strategy and execution while providing you support and expertise along the way.
FOUNDER & PRINCIPAL CONSULTANT
Wesley Sanders
Evensun Health was founded in 2022 by Wesley Sanders, whose experience as the CFO of an ACA health plan led him to discover that companies large and small face similar challenges in achieving operational, financial, and strategic goals.
Wesley has spoken at various Health Plan Alliance and Society of Actuaries meetings on risk adjustment and ACA strategy and his expertise on ACA risk adjustment is frequently sought after.
Wesley’s educational background includes an MBA from Georgia Tech, a Master of Divinity from Emory University, and a Bachelor’s degree from Binghamton University.
Prior to his career in health plans, he was a United Methodist pastor. His first exposure to managed care began during seminary when he was appointed a member of the Board of Pension and Health Benefits for the North Georgia Conference of The United Methodist Church, which included serving on a task force to revise and update the health benefit plans in light of the ACA’s market reforms. He continues to serve his community as trustee and chair of finance at Mount Vernon United Methodist Church in Rocky Face, Georgia, where he lives with his wife and three children. He also serves as an adjunct professor at the Dalton State College, teaching courses in business ethics, philosophy, and logic.
Reach out to Wesley at wesley@evensun.health
PRINCIPAL CONSULTANT
JOE CALDWELL
Joe Caldwell has been working for provider owned health plans for the last 20 years and has been a CFO for the last 10. He’s worked in ACA, Medicare, Medicaid, DSNP, ASO, and CHP+ lines of business over the years with a focus on healthcare finance and operations to help organizations achieve sustainable success.
Through numerous insourcing projects over the years Joe has had claims, customer service, eligibility and billing, utilization management, contracting, pharmacy and case management under his purview as well as the more traditional finance centered departments of accounting, risk adjustment, analytics and medical economics. Bringing this skillset to Evensun aligns with the holistic mindset that the company takes towards aligning financial strategy with operational capabilities.
Reach out to Joe at joe@evensun.health
Particular areas of expertise:
ACA Risk Adjustment
ACA Enrollment and Billing
Individual Coverage Health Reimbursement Arrangements (ICHRAs)
EDGE Server Submission
EDI (837/835/834/270/271/276/277)
Statutory Accounting
Game Theory
Plan Design
1332 Waivers