After retiring from the Federal government in 2004, Steve has worked as a health care consultant focusing on quantitative analysis, policy analysis, strategic advising and product development for a diverse array of health care clients. With an appointment as a Visiting Scholar in Economic Studies at the Brookings Institution, Steve also worked at the Engelberg Center for Health Care Reform with Mark McClellan where, as part of the Brookings collaboration with The Dartmouth Institute headed by Elliott Fisher, he has focused on developing Accountable Care Organizations (ACOs). Steve's government service spans 30 years. As a Senior Advisor to the Administrator in 2004, Steve led implementation of the new Medicare drug benefit at the Centers for Medicare and Medicaid Services (CMS). From 1999 to 2004, Steve led the health staff at the Congressional Budget Office (CBO), serving as Assistant Director and Executive Associate Director. From 1976—1992, Steve worked at the White House Office of Management and Budget (OMB), serving for 7 years as Chief of the Health Financing Branch and for 2 years as a (career) Assistant Director. Between 1992 and 1998, Steve served as the Vice President for Marketing and for Government Programs at a publicly-traded HMO, Vice President for Strategic Planning at a large Medicaid HMO, directed managed care and other operations for a major academic health center, founded a venture-capital funded company, and consulted with a variety of health care clients.