Elise D. Smith, Senior Fellow, AHCA

If there’s a prevailing theme around the hours American Health Care Association senior fellow Elise Smith keeps, it’s that they are constant. 

AHCA President and CEO Mark Parkinson notes he and Smith “get caught up on Saturdays.” Jeffrey Kelman, M.D., the chief medical officer at the Centers for Medicare & Medicaid Services, notes he “could call her any time.”

“She’s dedicated and generous with her time. When members called, they would feel like they had come to the right place,” says John Barber, who served as the co-chairman of the AHCA Member Finance committee for five years. 

Smith’s accomplishments include, after studies at Barnard, Harvard and Columbia, arguing in front of now-Supreme Court Justice Anton Scalia (then on the U.S. Circuit Court of Appeals) in the 1980s. She became the first woman to head the Provider Reimbursement Board in 1986. 

Smith also isn’t a stranger to caregiving, having taken care of her aunt until she was 93. An only child, Smith lost both parents by her mid-30s. She  says her aunt, who was childless, was like a second mother. 

She’s also proud of a 50-year marriage to her husband, Bruce,  her children, Matt and Courtenay, and her grandchildren. When she was attending law school in the 1970s, both her son and daughter were young, and her husband “did a lot of the raising of the children.” He “was a saint,” she says. The couple today travels frequently, and patronizes theater productions, with “Henry IV” being a recent favorite.

They relocated to Washington, D.C., in the 1970s, after Bruce was hired at the Brookings Institution. As Smith moved through government work and law firms over her career, she began to learn more intricate details about reimbursement and policy. She began at AHCA in 1995 and worked with CMS officials on projects such as rolling out the Part D benefit in 2006.

“Elise was tireless in working with us as we reached out to facilities,” Kelman says. “She helped us make sure it worked. She’s warm, outgoing, and knowledgeable.” 

Another CMS official, Laurence D. Wilson, the director of the Chronic Care Policy Group, calls her “thoughtful and constructive.” 

Her relationship with John Barber, the chief financial officer at White Oak Management, echoes that. He notes Smith’s “endless amounts of dedication.”

“She had an unending desire to compete and win but she looked at our victories as victories for frail seniors,” Barber says.  

Both Parkinson and his predecessor, Bruce Yarwood, provided “enormous leadership,” Smith says. In 2011, shortly after Parkinson began as CEO, she was named senior vice president. 

“I really wanted to focus on the payment methodology,” Smith says. “I feel that I have a front row seat again.” 

Parkinson notes Smith is not only “very good at synthesizing,” but that he “is amazed by her ability to focus on issues for long periods of time.

“She’s an outstanding attorney, and really able to understand what people need to know,” he says.

Smith, who is 74, says she has “tried to be of assistance to an industry that has a necessary service. Anybody would be a fool not to plan for some sort of transition, but I’m going to fulfill my goal here to do what I have been asked to do, and to reach out more and more to groups that are interested in Medicare and Medicaid.”



Completes bachelor’s degree in economics at Barnard College; begins studying economics at Harvard University


Heads to Pakistan as a Fulbright Scholar


Completes degree at Columbia University School of Law


Attorney at Department of Health and Human Services, Health Care Financing and Human Development Services Division


Appointed chairwoman and member of Provider Reimbursement Review Board, HHS


Becomes deputy assistant secretary for health policy, Office of the Assistant Secretary of Planning and Evaluation, HHS


Joins AHCA as finance policy counsel


Becomes vice president of reimbursement and research at AHCA


Named senior vice president of Finance Policy & Legal Affairs Department, AHCA


Named AHCA senior fellow