Bundled Payment Summit
Bundled Payment Summit
Bundled Payment Summit
Bundled Payment Summit
Bundled Payment Summit
Bundled Payment Summit



Overview | Agenda | Continuing Education | Promotional Opportunities | Grantors & Exhibitors
Administration | Speaking Proposals | Webcast Log In | Past Events | Contact Us | Home




Go to Agenda:
Preconference | Day 2

Agenda: Day I
Thursday, June 4, 2015
7:30 a.m. Registration Commences
OPENING PLENARY SESSION
8:00 a.m.

Welcome and Introductions

Francois de Brantes, MS, MBA
Executive Director, Health Care Incentives Improvement Institute (HCI3), Newtown, CT (Chair)

    Speaker Bio

    Francois de Brantes is the Executive Director for the Health Care Incentives Improvement Institute, which is a not-for-profit company that designs and implements innovative payment and plan design programs to motivate physicians, hospitals and consumer-patients to improve the quality and affordability of care. Previously, Mr. de Brantes was the Program Leader for various healthcare initiatives at GE Corporate Health Care Programs, responsible for developing the conceptual framework and the implementation of GE's Active Consumer strategy. Mr. de Brantes attended the University of Paris IX - Dauphine where he earned a MS in Economics and Finance, and he attended the Tuck School of Business Administration at Dartmouth College, where he graduated with an MBA.

    Mr. de Brantes has been published in peer-reviewed journals such as the New England Journal of Medicine and Health Affairs and is frequently quoted in national media including the New York Times. He has also published two books, the latest being The Incentive Cure: The Real Relief For Health Care.
    Presentation Material (Acrobat)
8:30 a.m.

Setting the Stage: From the Front Line

Managing the Flaws in BPCI
Deirdre Baggot, PhD, MBA, RN
Senior Vice President, The Camden Group; Expert Panel Reviewer, CMMI Bundled Payment for Care Improvement Initiative Models 2-4, El Segundo, CA

    Speaker Bio

    Senior Vice President and Practice Leader for Bundled Payments, The Camden Group and a nationally recognized expert and Keynote speaker in the area of bundled payments. Author of more than 20 papers on bundled payments, healthcare reform, and payment transformation and featured expert on National Public Radio's Morning Edition, All Things Considered and Planet Money. In 2012 Ms. Baggot was an appointed expert reviewer by Centers for Medicare & Medicaid Services ("CMS") for the BPCI for Models 2-4. Ms. Baggot also served as a former lead for CMS Acute Care Episode ("ACE") Bundled Payment Demonstration.

    Prior to joining The Camden Group spent ten years in academic healthcare at Northwestern Memorial Hospital and The University of Michigan Health System in key leadership roles.

    Ms. Baggot holds a Doctor of Philosophy, University of Colorado; Masters in Business Administration and Gregory LaVert Scholar, Loyola University Graduate School of Business; Bachelor of Science in Nursing (summa cum laude), Southern Illinois University.
Optimizing Care for Bundled Payments
Jordan VanLare, MD
Engagement Manager, McKinsey & Company; Former Value-Based Purchasing Portfolio Lead, Centers for Medicare & Medicaid Services, New York, NY

    Speaker Bio

    Jordan is an Engagement Manager in McKinsey & Company's Mid-Atlantic Office and is part of the Health Systems & Services practice.

    He has over 10 years of experience in healthcare in both the public and private sector. Jordan recently led value-based purchasing efforts in the Center for Clinical Standards and Quality at the Centers for Medicare & Medicaid Services and was previously a program officer in the Office of the Secretary of the Department of Health and Human Services. As a nationally regarded expert in health systems, he has authored multiple peer-reviewed publications in and served as a peer reviewer for journals including New England Journal of Medicine, JAMA, Health Affairs, and JAMA Internal Medicine.
    Jordan completed his A.B. at Harvard University and his M.D. at Columbia University. He received post-graduate training in medicine at Yale University.
Fitting the Pieces in the Payment Reform Puzzle
Marc Berg, PhD, MD, MA
Principal, Healthcare Transformation, KPMG LLP US; Former Professor in Health Policy and Management, Erasmus University, Rotterdam, Washington, DC

    Speaker Bio

    Marc has been a pioneer for healthcare systems that produce high quality yet affordable care, with the methods he has developed now in use in over half of all Dutch hospitals. By applying business principles of operational excellence, he has helped public and private health providers improve value and reduce costs and waste.

    As senior partner of health consultancy Plexus, and previously as Professor in Health Policy and Management at Erasmus University in Rotterdam, Marc has developed practical measurements and benchmarking for quality, safety and operational performance and costs across a wide range of care settings.

    Among his many achievements are a multi-million Euro hospital quality improvement project, groundbreaking work on policy incentives and payment systems and studies for government, advisory bodies and insurance companies, where he has helped shape the Dutch insurance sector's approach to procurement. He drives innovation in care procurement strategies for health insurers and led the introduction of integrated care payment for chronic care into the healthcare system for the Dutch government.
Making it Work for Self Insured Employers
Cristie Upshaw Travis, MSHA
Chief Executive Officer, Memphis Business Group on Health, Memphis, TN

    Speaker Bio

    Cristie Upshaw Travis has been Chief Executive Officer of the Memphis Business Group on Health since 1994.

    She launched her career serving in health administrative and planning positions in Tupelo, Miss., and Tuscaloosa, Ala. She progressed to consulting with continuing care retirement communities, hospitals, and physicians with Ernst & Whinney in Memphis, Atlanta, Georgia, and Washington, D.C. She continued her rise in the health care arena as Vice President for a Washington, D.C.-based health care consulting firm.

    Cristie's main objective is to deliver the most promising strategies to Memphis employers to help them manage the cost and quality of their health benefit plans. To help meet this objective, she networks with, and is involved in, health care organizations and initiatives at a national level.
Douglas W. Emery, MS
Program Implementation Leader, Western Region, Health Care Incentives Improvement Institute (HCI3), Logan, UT (Moderator)

    Speaker Bio

    Doug Emery has been working in healthcare reform policy for nearly 25 years. Beginning in 1991, at the Institute of Political Economy, he and other colleagues began to work out a new microeconomic model for healthcare economics and episode of care purchasing. Since then, Mr. Emery has worked in the public sector (Public Employees Health Program of Utah), non-profit sector (eHealth Initiative) and the private sector as an executive and consultant (Oxford Health Plans, HealthSouth, HealthMarket, Medstat, Definity Health, etc.) He served as the Principal Investigator for the HRSA/OAT Connecting Communities for Better Health Cooperative Agreement, completed in May, 2007. Mr. Emery has published many articles and two books on moving towards episode of care, or Evidence-informed Case Rate purchasing. Currently, he serves as Program Implementation Leader, Western Region for HCI3 (Prometheus Payment and Bridges to Excellence). He is also Adjunct Professor, Jon Huntsman School of Business and Economics, Utah State University. From 1990 to 1998, Mr. Emery served in the Army National Guard in Fire Direction Control for self-propelled 8-inch howitzer battalions.
9:30 a.m.

Changing Payment in New York State

Jason Helgerson, MPP
State Medicaid Director, Deputy Commissioner, State of New York, Department of Health; Former Medicaid Director, State of Wisconsin, Wisconsin Department of Health and Family Services, Albany, NY

    Speaker Bio

    Jason Helgerson became New York's Medicaid Director on January 5, 2011. New York's Medicaid program provides vital health care services to over 5.3 million New Yorkers and has an annual budget in excess of $54 billion. Jason also serves as the Executive Director for New York's Medicaid Redesign Team. In this capacity he leads Governor Cuomo's effort to fundamentally reshape the state's Medicaid program in order to both lower costs and improve health care quality.

    Prior to New York, Jason was Wisconsin's Medicaid Director. In that capacity, he administered the state's nationally recognized BadgerCare Plus program for children and families (Wisconsin's Medicaid, and SCHIP); BadgerCare Plus Core Plan; SeniorCare (Pharmacy Plus Waiver); FoodShare (Supplemental Nutrition Assistance Program); and Wisconsin's Chronic Disease Program.

    Jason is also a Clinical Associate Professor at the State University of New York at Albany, School of Public Health.
    Presentation Material (Acrobat)
10:30 a.m. Break
11:00 a.m.

Innovator's Showcase

TriZetto
Tonia Burns
Assistant Vice President, NetworX Product Management, TriZetto Corporation, Chicago, IL

    Speaker Bio

    Tonia Burns is Associate Vice President-Product Management with TriZetto who is responsible for managing the advancement and delivery of the NetworX suite of products which includes NetworX Payment Bundling Administration, Pricer, Modeler and Modeler Analytics. In her 10 years at TriZetto, Tonia has led Product Design and Application Support teams focusing on solutions that help clients to reduce administrative expenses, optimize operational performance and implement new reimbursement models.

    Tonia's has more than 20 years of experience in the health care industry including leadership roles in claims and customer service operations as well as claim pricing product development.
    Presentation Material (Acrobat)
Providence Administrative Services
Diana Craft
President and Chief Executive Officer, Providence Administrative Services, San Antonio, TX

    Speaker Bio

    Diana Craft is President & Chief Executive Officer of Providence Administrative Services, Inc. located in San Antonio, Texas. Providence is the administrator of choice for more than 75% of BPCI Model 4 participants. They have been administering prospective bundles for over 6 years. Services include claims processing, data analytics, customized reporting for episode reconciliation, and gainshare program management and calculation.
    Presentation Material (Acrobat)
Wellbe
James Dias
CEO, Wellbe, Madison, WI

    Speaker Bio

    James Dias is the CEO of Wellbe. James believes technology, when creatively applied, can improve our life experiences. Intrigued by the amazing potential for internet and mobile technology to engage us all, James created a business model to reshape personal health management. He is the co-inventor of the Guided CarePath and leads Wellbe's innovations program to empower people and providers with new tools to improve health. James has launched several new businesses over his career including the Mediasite lecture recorder, the leading video learning appliance in companies and universities around the world.
    Presentation Material (Acrobat)
Medalogix
Shari Heath
Vice President of Product Management, Medalogix, Nashville, TN

    Speaker Bio

    As Medalogix's vice president of product management, Shari analyzes healthcare policy and provider operations to develop and execute product strategy road maps.

    Shari brings nearly 12 years of Healthcare IT experience, with a focus on product management & quality assurance, to the Medalogix team. Directly preceding her position with Medalogix, Shari was the vice president of product management at HomeCare Homebase, a home health and hospice electronic medical record provider.
    Presentation Material (Acrobat)
Stryker Performance Solutions
Paul Jawin, JD
Vice President - Alignment, Strategy and Reform, Stryker Performance Solutions, Chicago, IL

    Speaker Bio

    Paul brings more than 30 years of legal, business, financial and capital markets experience to his role in developing physician alignment and payment reform programs. A co-founder of Comprehensive Care Solutions--acquired by Stryker in 2012--he has helped physician organizations and health systems align and turn reform into opportunity by utilizing new payment and delivery structures, including Accountable Care Organizations (ACO) and bundled payments.

    Paul is a regular speaker at industry conferences and events, including the American Academy of Orthopaedic Surgeons Hospital-Physician Alignment Symposium. He co-founded and served as Senior Vice President and General Counsel of Secured Independence, Inc., and has held senior executive positions with public and private companies involved in real estate and senior housing. Paul has a Bachelor of Arts degree in History from Ithaca College, and practiced corporate, securities and real estate law in New York City for more than 10 years after graduating from Syracuse University School of Law with a Juris Doctor degree.
    Presentation Material (Acrobat)
Implant Partners
Steve Lamb
Lead Partner, Implant Partners, Arlington, TN

    Speaker Bio

    Steve joined Implant Partners in 2013 -- first to lead their sales and marketing initiatives, and now as lead partner for the entire group. He is passionate about changing healthcare and spearheads the group's efforts to align partners clinically, operationally and economically. Steve has a total of 23 years of experience in healthcare sales, marketing and commercial operations.

    Prior to joining Implant Partners, he held a number of progressively senior commercial positions with Merck & Co., Smith & Nephew, GTx, Medtronic Spine and Extra Ortho.
    Presentation Material (Acrobat)
HealthQX
Mark McAdoo, MBA
President and Chief Executive Officer, HealthQx; Former Director of Health Care, IBM Corporation, Philadelphia, PA

    Speaker Bio

    Mark is an entrepreneur with more than 25 years of experience building ventures, commercializing healthcare solutions and driving sales and client/partner relationships. Prior to launching HealthQx, he was the co-founder of IntelliSource Healthcare Solutions, which successfully exited through a sale to DST Health Solutions in 2011. Prior to founding IntelliSource Healthcare Solutions, he was the founder and CEO of Frontline Solutions, a venture capital-backed firm in the middle market workflow business. Prior to founding Frontline, he was the Director of Health Care for IBM Corporation. Mark has been active in the software venture capital market and is on the board of a number of emerging growth technology companies. Mark attended Drexel University, where he is currently on the Board of Drexel University's LeBow School of Business. He also holds an MBA degree from Columbia Business School.
    Presentation Material (Acrobat)
McKesson
Kristina Rollings
Assistant Vice President, Solution Design, McKesson Health Solutions, Atlanta, GA

    Speaker Bio

    Kristina Rollings has been with McKesson for 16 years in a variety of roles for various product lines. These roles have spanned implementation services, sales, and product management in the areas of clinical and financial solutions in acute care and ambulatory settings as well as financial payer solutions. Currently, Kristina is with the McKesson Health Solutions as an Associate Vice President, Solution Design for the Clinical Claims Management solutions. She has spent the last 4 years focused on payer automation for bundled payments for episodes of care. Kristina's current focus is on product and related market knowledge, planning, and execution for solutions that offer capabilities needed by Payers to efficiently operate in a mixed model environment during the transition to value based care.
    Presentation Material (Acrobat)
eviCore healthcare
Ken Van Cara
President, Bundled Payment and Post-Acute Care, eviCore healthcare; Former Senior Vice President of Medicaid Strategy, Magellan Health Services; Former National Vice President of Payment Integrity, UnitedHealth Group, Hartford, CT

    Speaker Bio

    Ken brings to the table an extensive healthcare quality and affordability background and a proven record of developing and managing clinical programs for the government sector. Prior to joining eviCore healthcare, Mr. Van Cara worked as the Senior Vice President of Medicaid Strategy at Magellan Health Services and as National Vice President of Payment Integrity at UnitedHealth Group. Mr. Van Cara also served as Vice President of Quality and Affordability, where he led the development of an oncology line of service and initiated development of rare diseases and gastroenterology lines. These programs served over 26 million Medicare Advantage and Commercial members and represented $6.2 billion in healthcare spend.
    Presentation Material (Acrobat)
Francois de Brantes, MS, MBA
Executive Director, Health Care Incentives Improvement Institute (HCI3), Newtown, CT (Moderator)

    Speaker Bio

    Francois de Brantes is the Executive Director for the Health Care Incentives Improvement Institute, which is a not-for-profit company that designs and implements innovative payment and plan design programs to motivate physicians, hospitals and consumer-patients to improve the quality and affordability of care. Previously, Mr. de Brantes was the Program Leader for various healthcare initiatives at GE Corporate Health Care Programs, responsible for developing the conceptual framework and the implementation of GE's Active Consumer strategy. Mr. de Brantes attended the University of Paris IX - Dauphine where he earned a MS in Economics and Finance, and he attended the Tuck School of Business Administration at Dartmouth College, where he graduated with an MBA.

    Mr. de Brantes has been published in peer-reviewed journals such as the New England Journal of Medicine and Health Affairs and is frequently quoted in national media including the New York Times. He has also published two books, the latest being The Incentive Cure: The Real Relief For Health Care.
12:00 p.m. Networking Luncheon

AFTERNOON TRACK SESSIONS
TRACK I: OPTIMIZING THE MEDICARE BPCI
1:00 p.m.

Overview and Introductions

Ray Herschman, MSc
President, xG Health; Former Senior Vice President of Enterprise Information Management, WellPoint, Indianapolis, IN (Moderator)

    Speaker Bio

    Ray is widely known for his experience leveraging IT and informatics to enable organizational change in healthcare.

    Ray was Senior Vice President of Enterprise Information Management at WellPoint and responsible for Enterprise Information Management strategies, business intelligence, and analytic capabilities roadmaps.

    Ray also served as Chief Operating Officer and Senior Vice President at WebMD Health Services and prior to that as Mercer Consulting's National Health and Group Benefits Practice Leader, specializing in consumerism and provider performance measurement.

    Ray received his BS in Chemistry, MS in Healthcare Fiscal Management and Accounting, University of Wisconsin.
1:30 p.m.

Managing the Shifting Roles

Brian Fuller, MBA
Director, Avalere Health; Former Vice President, Brooks Health System, Washington, DC

    Speaker Bio

    Mr. Fuller is a Director at Avalere Health, a comprehensive healthcare strategic advisory firm based in Washington, DC whose services are sought by premier organizations across the healthcare industry. He is a recognized thought leader in post-acute care and the impact and importance of post-acute care in new healthcare reform environments. Additionally, Mr. Fuller is a nationally recognized expert in bundled payments as one of only a few individuals in the US who has successfully submitted applications to CMS as a healthcare provider participant, consulted with hospitals and post-acute providers on bundled payment participation and was selected by CMS to serve as an expert panelist in application reviews for the Bundled Payments for Care Improvement initiative.

    Previously, Brian worked for eight years and was the Vice President, Business Development and Planning for Brooks Health System, a not-for-profit integrated post-acute healthcare system that has been very active in bundled payments.
    Presentation Material (Acrobat)
Kelsey P. Mellard, MPA
Vice President, Partnership Marketing and Policy, naviHealth, Inc.; Executive Director, Post-Acute Care Center for Research (PACCR), Washington, DC

    Speaker Bio

    Kelsey P. Mellard is Vice President, Partnership Marketing and Policy, where she leads the policy agenda for Post-Acute Care Reform on behalf of naviHealth. She also led the implementation of the Bundled Payment for Care Improvement Initiative in partnership with the Center for Medicare and Medicaid Services. Kelsey also serves as an adjunct faculty member at Winona State University, in their College of Nursing and Health Services.

    Prior to joining naviHealth, Kelsey was Vice President of Policy for Health Services at UnitedHealth Group, working most closely with Optum. She served as Special Assistant the Director of the Center for Medicare and Medicaid Innovation (CMMI), where she helped establish CMMI along with serving on the Steering Committee for the Health Care Innovation Summit, resulting in the first ever public-private event of its kind. Kelsey attended Winona State University, where she received a Bachelor's of Science Degree in Community Health. She completed her Master's degree in Public Administration at the University of Kansas.
    Presentation Material (Acrobat)
Alan Pope, MD
Vice President of Medical Affairs and Chief Medical Officer, Our Lady of Lourdes; Founder of Delaware Valley Pulmonary Associates, LLC and Critical Care Associates of Delaware Valley, Camden, NJ

    Speaker Bio

    Alan Pope is the Chief Medical Officer for the Lourdes Health System, a member of the Trinity Health System. He has been a leader in the development of the Lourdes Health System's clinical integrated network and accountable care organization. His other responsibilities include the development and implementation of medical staff strategic planning and oversight, clinical programs, medical education, research, performance improvement and care management functions. He completed his training at the Harvard University Combined Pulmonary Program. Dr. Pope is a diplomate of the American Boards of Internal Medicine, Pulmonary, and Critical Care Medicine and the American Board of Sleep Medicine, and a faculty member of the Thomas Jefferson and Rowan Schools of Medicine.
    Presentation Material (Acrobat)
2:30 p.m.

Rethinking Post Acute Care in the Context of Bundled Payments

Kathleen Noorigian
Coordinator, Decision Support Systems, The Valley Hospital, Ridgewood, NJ

    Speaker Bio

    Kathleen has extensive hospital support experience and knowledge as she has been employed at The Valley Hospital in Ridgewood, New Jersey for over nine years. In addition, Kathleen has played a major role in the implementation and coordination of a post-acute care bundled payment program with The Valley. Prior to joining The Valley Hospital, Kathleen worked as a Budget and Reimbursement Analyst for Pascack Valley Hospital and as a Billing and Reimbursement Manager for Hospice of Morris County.
Stephan S. Rodgers
Chief Executive Officer, AccentCare; Former CEO Collaborative Care Business Unit, OptumHealth; Former Executive Vice President Product & Innovation, UnitedHealth Care, Dallas, TX

    Speaker Bio

    Stephan S. Rodgers is the CEO of AccentCare, a provider of post acute care with revenues of almost $500 million. With over 17,000 employees, AccentCare provides a wide range of services including home healthcare, hospice, medic al home care and personal care services to over 61,000 patients annually in over 110 locations.

    Before this assignment Mr. Rodgers worked for UnitedHealth Group for over 12 years in numerous senior leadership positions. Most recently he was the CEO of OptumHealth Collaborative Care which owns, manages, and provides administrative and technology services to physician practices.

    Mr. Rodgers holds a B.A. in Biochemistry from the University of California.
    Presentation Material (Acrobat)
Ken Van Cara
President, Bundled Payment and Post-Acute Care, eviCore healthcare; Former Senior Vice President of Medicaid Strategy, Magellan Health Services; Former National Vice President of Payment Integrity, UnitedHealth Group, Hartford, CT

    Speaker Bio

    Ken brings to the table an extensive healthcare quality and affordability background and a proven record of developing and managing clinical programs for the government sector. Prior to joining eviCore healthcare, Mr. Van Cara worked as the Senior Vice President of Medicaid Strategy at Magellan Health Services and as National Vice President of Payment Integrity at UnitedHealth Group. Mr. Van Cara also served as Vice President of Quality and Affordability, where he led the development of an oncology line of service and initiated development of rare diseases and gastroenterology lines. These programs served over 26 million Medicare Advantage and Commercial members and represented $6.2 billion in healthcare spend.
    Presentation Material (Acrobat)
3:30 p.m. Break
4:00 p.m.

Deploying Actionable Dashboards

Deirdre Baggot, PhD, MBA, RN
Senior Vice President, The Camden Group; Expert Panel Reviewer, CMMI Bundled Payment for Care Improvement Initiative Models 2-4, El Segundo, CA

    Speaker Bio

    Senior Vice President and Practice Leader for Bundled Payments, The Camden Group and a nationally recognized expert and Keynote speaker in the area of bundled payments. Author of more than 20 papers on bundled payments, healthcare reform, and payment transformation and featured expert on National Public Radio's Morning Edition, All Things Considered and Planet Money. In 2012 Ms. Baggot was an appointed expert reviewer by Centers for Medicare & Medicaid Services ("CMS") for the BPCI for Models 2-4. Ms. Baggot also served as a former lead for CMS Acute Care Episode ("ACE") Bundled Payment Demonstration.

    Prior to joining The Camden Group spent ten years in academic healthcare at Northwestern Memorial Hospital and The University of Michigan Health System in key leadership roles.

    Ms. Baggot holds a Doctor of Philosophy, University of Colorado; Masters in Business Administration and Gregory LaVert Scholar, Loyola University Graduate School of Business; Bachelor of Science in Nursing (summa cum laude), Southern Illinois University.
Mark I. Froimson, MD, MBA
Executive Vice President, Chief Clinical Officer, Trinity Health; Former President and CEO, Euclid Hospital, A Cleveland Clinic Hospital, Cleveland, OH

    Speaker Bio

    Dr. Mark Froimson is Executive Vice President and Chief Clinical Officer for Trinity Health. He formerly served as President and CEO of Euclid Hospital. He received a degree in Philosophy from Princeton University and his medical degree from Tulane University School of Medicine. He has also received his Masters in Business Administration from the Weatherhead School of Business at Case Western Reserve University. Dr. Froimson has been listed in the Best Doctors in America consistently since 2001. He is a member of numerous professional societies, the author of chapters, abstracts, review articles and is a nationally known speaker.
5:00 p.m. Adjournment and Networking Reception

TRACK II: SCALING STATE-WIDE BUNDLED PAYMENT INITIATIVES
1:00 p.m.

Overview and Introductions

Francois de Brantes, MS, MBA
Executive Director, Health Care Incentives Improvement Institute (HCI3), Newtown, CT (Co-chair)

    Speaker Bio

    Francois de Brantes is the Executive Director for the Health Care Incentives Improvement Institute, which is a not-for-profit company that designs and implements innovative payment and plan design programs to motivate physicians, hospitals and consumer-patients to improve the quality and affordability of care. Previously, Mr. de Brantes was the Program Leader for various healthcare initiatives at GE Corporate Health Care Programs, responsible for developing the conceptual framework and the implementation of GE's Active Consumer strategy. Mr. de Brantes attended the University of Paris IX - Dauphine where he earned a MS in Economics and Finance, and he attended the Tuck School of Business Administration at Dartmouth College, where he graduated with an MBA.

    Mr. de Brantes has been published in peer-reviewed journals such as the New England Journal of Medicine and Health Affairs and is frequently quoted in national media including the New York Times. He has also published two books, the latest being The Incentive Cure: The Real Relief For Health Care.
1:15 p.m.

A Framework for Fitting the Pieces

Marc Berg, PhD, MD, MA
Principal, Healthcare Transformation, KPMG LLP US; Former Professor in Health Policy and Management, Erasmus University, Rotterdam, Washington, DC

    Speaker Bio

    Marc has been a pioneer for healthcare systems that produce high quality yet affordable care, with the methods he has developed now in use in over half of all Dutch hospitals. By applying business principles of operational excellence, he has helped public and private health providers improve value and reduce costs and waste.

    As senior partner of health consultancy Plexus, and previously as Professor in Health Policy and Management at Erasmus University in Rotterdam, Marc has developed practical measurements and benchmarking for quality, safety and operational performance and costs across a wide range of care settings.

    Among his many achievements are a multi-million Euro hospital quality improvement project, groundbreaking work on policy incentives and payment systems and studies for government, advisory bodies and insurance companies, where he has helped shape the Dutch insurance sector's approach to procurement. He drives innovation in care procurement strategies for health insurers and led the introduction of integrated care payment for chronic care into the healthcare system for the Dutch government.
Jason Helgerson, MPP
State Medicaid Director, Deputy Commissioner, State of New York, Department of Health; Former Medicaid Director, State of Wisconsin , Wisconsin Department of Health and Family Services, Albany, NY

    Speaker Bio

    Jason Helgerson became New York's Medicaid Director on January 5, 2011. New York's Medicaid program provides vital health care services to over 5.3 million New Yorkers and has an annual budget in excess of $54 billion. Jason also serves as the Executive Director for New York's Medicaid Redesign Team. In this capacity he leads Governor Cuomo's effort to fundamentally reshape the state's Medicaid program in order to both lower costs and improve health care quality.

    Prior to New York, Jason was Wisconsin's Medicaid Director. In that capacity, he administered the state's nationally recognized BadgerCare Plus program for children and families (Wisconsin's Medicaid, and SCHIP); BadgerCare Plus Core Plan; SeniorCare (Pharmacy Plus Waiver); FoodShare (Supplemental Nutrition Assistance Program); and Wisconsin's Chronic Disease Program.

    Jason is also a Clinical Associate Professor at the State University of New York at Albany, School of Public Health.
2:15 p.m.

Update on the State of Ohio's Payment Reform Initiative

Robert Gladden
Vice President, Center for Analytics, CareSource Management Group, Dayton, OH

    Speaker Bio

    Bob is Vice President of the Center for Analytics at CareSource, a nonprofit Medicaid organization with almost 1.5 million members. He has served in a number of capacities for CareSource but currently leads the analytic efforts for the organization. Bob has 33 years of experience in the fields of health care analytics, predictive modeling health care administration, actuarial science, BI, data management, underwriting and finance with major consulting organizations, large hospital systems, management companies and payers. Bob holds an MA degree from Bowling Green State University in applied geography with a focus on quantitative methodologies.
    Presentation Material (Acrobat)
3:00 p.m. Break
3:15 p.m.

Update on the State of Tennessee's Payment Reform Initiative

Brooks Daverman, MPP
Director of Strategic Planning and Innovation, TennCare, Nashville, TN

    Speaker Bio

    Brooks Daverman is the Director of the Strategic Planning and Innovation Group at the Tennessee Division of Health Care Finance and Administration. His areas of expertise include implementing a statewide health care payment reform initiative, monitoring the federal health insurance exchange in Tennessee and managing state health insurance assistance programs.

    Mr. Daverman was previously an associate with Tennessee's Insurance Exchange Planning Initiative. Prior to that, Mr. Daverman was an Analyst with Tennessee's Division of Health Planning, where he was responsible for the creation of a database of all health insurance claims in Tennessee. Mr. Daverman has a Masters in Public Policy from Duke University, and was raised in Nashville.
    Presentation Material (Acrobat)
4:00 p.m.

Scaling Statewide Bundled Payment Initiatives

Aditya (Adi) Kumar, MBA
Principal, McKinsey & Company; Former Deputy Assistant, US Vice President; Former Director of Special Projects, The White House, Washington, DC

    Speaker Bio

    Adi Kumar is an Associate Partner in McKinsey's Washington, DC, office. He has helped clients in the private and public sector design healthcare operating systems, particularly in the area of value-based payment models, and has advised clients on the operational change efforts needed to enact these models. His work in these areas has spanned strategy, operations, pricing, and technology enablement. Adi leads McKinsey's Episode Based Payment Service Line and is also a leader of McKinsey Healthcare Analytics Group, specifically leading McKinsey's Healthcare Analytics team dedicated to episode based payments. Amongst other things, Adi has led a project across five payors to design common episode- and population-based payment models and implementation tools. He has also assessed the financial impact of various value-based payment strategies for different books of business across a state, and led provider clinical teams in the design of value-based payment strategies across multiple lines of specialty care.

    Adi joined McKinsey as a business analyst in 2003 after graduating from Georgetown University with a BA degree in economics and government. He left the firm in 2005 to study for an MBA at Stanford University, which he earned in 2007. He became deputy CFO for Obama for America that year, was part of the presidential transition team in 2008 and 2009. He then served in the White House from 2009 to 2012, where he oversaw the implementation of the $800B American Recovery and Reinvestment Act, also known as the 2009 Stimulus Bill, as well as served as an advisor to the Vice President and the White House Chief of Staff. He then rejoined the firm in his current position.
5:00 p.m. Adjournment and Networking Reception

TRACK III: MAKING IT WORK FOR EMPLOYERS AND PROVIDERS
1:00 p.m.

Overview and Introductions

Douglas W. Emery, MS
Program Implementation Leader, Western Region, Health Care Incentives Improvement Institute (HCI3), Logan, UT (Moderator)

    Speaker Bio

    Doug Emery has been working in healthcare reform policy for nearly 25 years. Beginning in 1991, at the Institute of Political Economy, he and other colleagues began to work out a new microeconomic model for healthcare economics and episode of care purchasing. Since then, Mr. Emery has worked in the public sector (Public Employees Health Program of Utah), non-profit sector (eHealth Initiative) and the private sector as an executive and consultant (Oxford Health Plans, HealthSouth, HealthMarket, Medstat, Definity Health, etc.) He served as the Principal Investigator for the HRSA/OAT Connecting Communities for Better Health Cooperative Agreement, completed in May, 2007. Mr. Emery has published many articles and two books on moving towards episode of care, or Evidence-informed Case Rate purchasing. Currently, he serves as Program Implementation Leader, Western Region for HCI3 (Prometheus Payment and Bridges to Excellence). He is also Adjunct Professor, Jon Huntsman School of Business and Economics, Utah State University. From 1990 to 1998, Mr. Emery served in the Army National Guard in Fire Direction Control for self-propelled 8-inch howitzer battalions.
1:10 p.m.

Solving the Tyranny of the Small "n"

Renee H. McLaughlin, MD, FACS
Senior Medical Director, CIGNA, Chattanooga, TN

    Speaker Bio

    Dr. Renee Mclaughlin is a senior medical director and the market medical executive for Cigna's Mid-South market. In this role she shares responsibility for managing the total medical cost for 800,000 CIGNA customers and serves as the senior medical liaison for CIGNA's provider partners and clients. She is the clinical director for CIGNA's performance improvement initiatives in the mid-South and is a member of Cigna's corporate team responsible for the design and implementation of Cigna's value-based solutions to improve quality, affordability, and patient satisfaction. She has extensive experience in the development, implementation, and operation of successful population health management and bundled payment partnerships. She speaks regularly at both regional and national forums on value-based health care delivery. Dr. McLaughlin also plays a leadership role in Cigna's LGBT diversity organization and supports Cigna's clients on transgender issues. She earned a BS at Adrian College, MS at Wayne State University, and completed her graduate and post-graduate medical and surgical training at the University of Pittsburgh, graduating with honors. She served as a Major in the United States Army during the first Gulf war.
Cristie Upshaw Travis, MSHA
Chief Executive Officer, Memphis Business Group on Health, Memphis, TN

    Speaker Bio

    Cristie Upshaw Travis has been Chief Executive Officer of the Memphis Business Group on Health since 1994.

    She launched her career serving in health administrative and planning positions in Tupelo, Miss., and Tuscaloosa, Ala. She progressed to consulting with continuing care retirement communities, hospitals, and physicians with Ernst & Whinney in Memphis, Atlanta, Georgia, and Washington, D.C. She continued her rise in the health care arena as Vice President for a Washington, D.C.-based health care consulting firm.

    Cristie's main objective is to deliver the most promising strategies to Memphis employers to help them manage the cost and quality of their health benefit plans. To help meet this objective, she networks with, and is involved in, health care organizations and initiatives at a national level.
    Presentation Material (Acrobat)
2:00 p.m.

Tying Benefits to Bundles

Mark Xistris, MAcc
Vice President Business Development and Provider Relations, The Alliance; Treasurer and Founding Board Member, Wisconsin Health Information Organization, Madison, WI

    Speaker Bio

    Mark Xistris joined The Alliance in 1997 and currently serves as Vice President, Business Development & Provider Relations. His main responsibilities include oversight of the provider network, pay-for-performance programs, quality/cost measurement initiatives, and business development for the cooperative.

    In addition to his work at The Alliance, Mark is a founding Board Member of the Wisconsin health Information Organization (WHIO), Wisconsin's voluntary APCD, where he serves on the Executive Committee, chairs WHIO's Data Mart Quality and Value Committees, and is the Treasurer Elect.

    Mark earned a bachelor's degree in accountancy from Arizona State University (summa cum laude) and a master's of accountancy degree in health care fiscal management from the University of Wisconsin-Madison.
    Presentation Material (Acrobat)
2:50 p.m.

Legal Considerations for Employers, TPAs, and Providers

Robert G. Homchick, Esq.
Partner, Davis Wright Tremaine, Seattle, WA

    Speaker Bio

    Bob Homchick is a partner in Davis Wright Tremaine's national health care practice. As a health care transactional and regulatory lawyer, Bob counsels clients in areas such as physician self-referral (i.e., the federal Stark Law and its state law counterparts), regulatory compliance and fraud and abuse. Bob assists hospitals, physician organizations, ancillary services providers, and others in acquisitions, the formation and operation of joint ventures and in the development and implementation of new care delivery models, including accountable care organizations and other clinically integrated networks. His extensive experience includes defending providers in government audits, investigations, administrative proceedings and assisting providers with voluntary disclosures to federal and state enforcement agencies.
Chris Wilson, JD, MPH
Senior Manager, PYA, Knoxville, TN

    Speaker Bio

    Chris Wilson works with healthcare organizations to address strategic issues in an evolving market. He uses his unique combination of consulting and legal experience to design and implement clinical integration initiatives, public policy projects, mergers and acquisitions, and governance strategies. Chris also provides advisory services in the area of healthcare information technology and best practices in the delivery and measurement of evidence-based care for providers.
    Presentation Material (Acrobat)
3:40 p.m. Break
4:10 p.m.

Re-thinking Wellness Programs

Adam C. Solander, Esq.
Partner, Epstein Becker Green; Former Health Policy Counsel, ERISA Industry Committee, Washington, DC

    Speaker Bio

    Adam Solander is a Member of the Firm in the Health Care and Life Sciences practice, in the Washington, DC, office of Epstein Becker Green. Mr. Solander represents clients with respect to health regulatory compliance issues and health policy. He advises health care clients on issues concerning ERISA preemption, obligations of plan fiduciaries and breach of fiduciary duties, prohibited transactions, and denial of benefits. Mr. Solander also provides counsel on issues related to managed care laws and self-funded plans. He is a Certified CSF Practitioner, a designation given by the Health Information Trust Alliance (HITRUST), an organization that provides training to develop and maintain effective security programs for health care and life sciences companies.
    Presentation Material (Acrobat)
5:00 p.m. Adjournment and Networking Reception

TRACK IV: OPTIMIZING CARE FOR BUNDLED PAYMENTS
1:00 p.m.

Overview and Introductions

Amita Rastogi, MD, MHA, MS
Medical Director, Cost of Care Programs, Health Care Incentives Improvement Institute (HCI3), Chicago, IL (Co-moderator)

    Speaker Bio

    Dr. Amita Rastogi is the Chief Medical Officer at HCI3 and is the clinical architect behind Prometheus's evidence-informed case rates (ECRs). She works with clinicians to define the boundaries of an episode, works with statisticians to adequately risk-adjust ECRs, and interfaces with implementation leaders and medical directors to translate ECRs into bundled payments.

    Dr. Rastogi is a Mayo-trained cardiothoracic surgeon, with over 25 years of clinical and health services research experience. She received her Masters in Health Administration from the Martin School of Public Policy and Administration, University of Kentucky and her Masters in Health Studies (Biostatistics & Epidemiology) from the University of Chicago.
Jordan VanLare, MD
Engagement Manager, McKinsey & Company; Former Value-Based Purchasing Portfolio Lead Centers for Medicare & Medicaid Services, New York, NY (Co-moderator)

    Speaker Bio

    Jordan is an Engagement Manager in McKinsey & Company's Mid-Atlantic Office and is part of the Health Systems & Services practice.

    He has over 10 years of experience in healthcare in both the public and private sector. Jordan recently led value-based purchasing efforts in the Center for Clinical Standards and Quality at the Centers for Medicare & Medicaid Services and was previously a program officer in the Office of the Secretary of the Department of Health and Human Services. As a nationally regarded expert in health systems, he has authored multiple peer-reviewed publications in and served as a peer reviewer for journals including New England Journal of Medicine, JAMA, Health Affairs, and JAMA Internal Medicine.
    Jordan completed his A.B. at Harvard University and his M.D. at Columbia University. He received post-graduate training in medicine at Yale University.
1:30 p.m.

Innovations in Cancer Care

Andrew Pecora, MD, FACP, CPE
President and Chief Executive Officer, Regional Cancer Care Associates; Professor of Medicine University of Medicine and Dentistry of New Jersey, Hackensack, NJ

    Speaker Bio

    Dr. Andrew Louis Pecora in 1989 moved to Hackensack University Medical Center initially to serve as Director of the Adult Blood and Marrow Transplant Program. He was promoted in 2001 to serve as Chairman and Executive Administrative Director of the Cancer Center at Hackensack University Medical Center. In 2012 he was promoted to his current position of Vice President of Cancer Services and Chief Innovation Officer, Hackensack University Medical Center. Dr. Pecora also currently serves as President of Regional Cancer Care Associates. Dr Pecora was promoted to Professor of Medicine, UMDNJ-New Jersey Medical School, in 2004 and in 2013 to Professor of Oncology and Medicine, Georgetown University.

    Dr. Pecora co-founded and served as Chairmen and Chief Executive Officer of Progenitor Cell Therapy, L.L.C.; a company focused on facilitating the transfer of laboratory breakthrough to clinical application and practice in cell therapies. He also co-founded and served as Chairman of Amorcyte, Inc. a biotechnology company developing cell therapies for cardiovascular disease. Dr. Pecora founded COTA a healthcare software analytic company focused on enabling value based care delivery and serves as Executive Chairman. He served on the board of Cancer Genetics and is chairman of the board of Tetralogics, Inc., a company developing small molecules to treat cancer. He cofounded and currently serves as President of Regional Cancer Care Associates, an integrated cancer care delivery company with over 100 oncologists.

    Dr. Pecora has been involved in numerous research projects in an effort in improve the outcomes of patients with cancer. His work includes leading the international effort to standardize CD34 enumeration and working to develop the production of stem cell products that are free of contaminating malignant cells using technologies including CD34 selection and ex vivo expansion.
Glenn Pomerantz, MD, JD
Chief Medical Officer and Vice President, Horizon Blue Cross Blue Shield of New Jersey; Former Regional Medical Director, Northeast Region, Aetna; Former National Medical Director, CIGNA, Newark, NJ

    Speaker Bio

    Dr. Glenn Pomerantz is Vice President and Chief Medical Officer with Horizon Blue Cross Blue Shield of New Jersey. He is responsible for medical management activities, including quality and care management, utilization management, medical review, appeals, medical policy and the clinical development of medical cost reduction initiatives, outliers management, and behavioral health policy.

    Prior to joining Horizon BCBSNJ, Dr. Pomerantz worked for more than 25 years in the clinical and health insurance fields. He most recently served as head of Regional Care Management for Aetna. He also spent seven years at Cigna HealthCare, he led teams in National Contracting and Medical Management.
    Presentation Material (Acrobat)
Tracy Spinks, BAA
Program Director Cancer Care Delivery, University of Texas MD Anderson Cancer Center, Houston, TX

    Speaker Bio

    Tracy Spinks is the Program Director, Cancer Care Delivery at MD Anderson Cancer Center in Houston. Tracy collaborates with external agencies and other cancer centers to improve the quality, value, and patient-centered ness of cancer care through oncology-focused healthcare policy, quality metrics, and alternative payment models. In 2012, she served as a consultant and scientific writer for the Institute of Medicine.

    Previously, Tracy provided financial, management, and litigation consulting services. She holds a Bachelor of Business Administration in Management Information Systems from the University of Houston and a Certificate of Public Health from The University of Texas School of Public Health.
    Presentation Material (Acrobat)
2:30 p.m.

Innovations in Obstetrics

Steve E. Calvin, MD
Medical Director of the Minnesota Birth Center; Developer, BirthBundle™, Minneapolis, MN

    Speaker Bio

    Steve Calvin is a physician who is board certified in OB/GYN and the subspecialty of Maternal-Fetal Medicine. He is a 1980 graduate of Washington University School of Medicine in St. Louis. He served in the National Health Service Corp and for the last 26 years he has been in practice in Minnesota where he serves as a Clinical Associate Professor in the Department of OB/GYN and also as Co-chair of the Program in Human Rights and Health in the School of Public Health at the University of Minnesota. He founded the Minnesota Birth Center with nurse midwife colleagues in 2012.
    Presentation Material (Acrobat)
Karen Love, MHA
Senior Vice President, Strategic Planning & Partnership, Community Health Choice; Former Executive Director, Harris County Healthcare Alliance, Houston, TX

    Speaker Bio

    Karen H. Love, MHA joined Community Health Choice, Inc. in 2012 as Senior Vice President for Strategic Planning and Partnerships. Previously, she served as the founding Executive Director of the Harris County Healthcare Alliance. Under her leadership, the group improved access to care for the area's estimated 1.5 million uninsured and medically underserved.

    Ms. Love's experience also includes roles with the Houston-Galveston Area Council, time as Chief Operating Officer of a management services organization, and managerial positions with Ochsner Medical Institutions.

    Ms. Love holds a bachelor's degree from the University of Texas, Austin, and a master's degree from Tulane University, New Orleans.
    Presentation Material (Acrobat)
3:30 p.m. Break
4:00 p.m.

Innovations in Cardiology

Hannah Alphs Jackson, MD
Program Director for Value-Based Delivery, Northwestern Memorial HealthCare, Chicago, IL

    Speaker Bio

    Dr. Alphs Jackson is Program Director for strategy, operations and program development of the Northwestern Medicine health system's value-based delivery portfolio. She has lead the implementation of multiple bundled payment and Center of Excellence partnerships with large, national employers across four service lines. She has facilitated Northwestern Medicine's application to the CMS Bundled Payment for Care Improvement initiative and is leading the implementation of this program at two hospitals across four medical and surgical episodes. In addition, Dr. Alphs Jackson has contributed to the design and implementation of the infrastructure to support a population health-based program for Northwestern Memorial HealthCare's employee group health plan, a payer-sponsored medical home model and a clinically integrated, post-acute preferred provider network.
Joseph Cacchione, MD
Chairman, Heart and Vascular Institute Strategic Operations, Cleveland Clinic, Former Chief Quality Officer, Saint Vincent Health System, Cleveland, OH

    Speaker Bio

    Joseph G. Cacchione, M.D., F.A.C.C., is an interventional cardiologist at the Cleveland Clinic; Robert and Suzanne Tomsich Department of Cardiovascular Medicine; Arnold and Sydell Miller Heart and Vascular Institute. In addition to his clinical responsibilities, Dr. Cacchione is the Chairman of Operations and Strategy, Cleveland Clinic Heart and Vascular Institute. As a leader in health care quality initiatives, he heads up Network Growth Strategy for the Cleveland Clinic Foundation. Previous to his tenure at the Cleveland Clinic, he was in a private practice for over nineteen years and served as executive vice president and chief quality officer at Saint Vincent Health System in Erie, PA.
    Presentation Material (Acrobat)
5:00 p.m. Adjournment and Networking Reception


Go to Agenda:
Preconference | Day 2




Overview | Agenda | Continuing Education | Promotional Opportunities | Grantors & Exhibitors
Administration | Speaking Proposals | Webcast Log In | Past Events | Contact Us | Home




© Health Care Conference Administrators
Contact Webmaster