SUMMIT PRESENTATIONS
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Speaker presentations are password protected for 90 days from the start of the Summit. Registrants may log in by clicking here. For further information, email registration@hcconferences.com or call 800-503-7452.
Agenda Links: Preconference | Day 2
AGENDA: DAY I
THURSDAY, OCTOBER 12, 2017
7:00 am
Registration Opens in Exhibit Hall; Continental Breakfast
MORNING PLENARY SESSION
8:00 am
Welcome and Introduction: Overview of MACRA MIPS/APM Challenges and Opportunities
Donald H. Crane, JD
President and Chief Executive Officer, CAPG, Los Angeles, CA (Co-chair)
President and Chief Executive Officer, CAPG, Los Angeles, CA (Co-chair)
Don Crane is the President and CEO of CAPG, a national professional association composed of physician groups dedicated to coordinated, accountable care. These groups are in the forefront of national healthcare reform and represent the care model and payment methodologies adopted by federal legislation for the entire nation.
Mr. Crane joined CAPG in 2001 and has served as President and CEO since that time. During his tenure CAPG has expanded from being a division of a regional hospital trade association consisting of 40 member groups to a national professional association consisting of more than 250 physician organizations.
Mr. Crane serves on the Board of Directors of the National Coalition on Health Care. He is also the Editor-in-Chief of CAPG Health, a magazine that reports on business trends, legislation, and industry initiatives impacting coordinated care.
Mr. Crane joined CAPG in 2001 and has served as President and CEO since that time. During his tenure CAPG has expanded from being a division of a regional hospital trade association consisting of 40 member groups to a national professional association consisting of more than 250 physician organizations.
Mr. Crane serves on the Board of Directors of the National Coalition on Health Care. He is also the Editor-in-Chief of CAPG Health, a magazine that reports on business trends, legislation, and industry initiatives impacting coordinated care.
Barbara L. McAneny, MD
Board-Certified Medical Oncologist/Hematologist; Co-Founder and Managing Partner, New Mexico Oncology Hematology Consultants Ltd.; President-Elect, American Medical Association, Albuquerque, NM (Co-chair)
Board-Certified Medical Oncologist/Hematologist; Co-Founder and Managing Partner, New Mexico Oncology Hematology Consultants Ltd.; President-Elect, American Medical Association, Albuquerque, NM (Co-chair)
Dr. McAneny is CEO of New Mexico Oncology Hematology Consultants, LTD and the past President of the New Mexico Cancer Center Foundation. She has lived in Albuquerque since 1980.
Dr. McAneny is active in organized medicine and advocacy. She was the 1989 President of the Greater Albuquerque Medical Association and was President of the New Mexico Medical Society in 2000. She served a four-year term on the Practicing Physicians Advisory Council for the Centers for Medicare and Medicaid Services, on the AMA Council of Medical Service, and the American Society of Clinical Oncologists (ASCO) Board of Directors and their Clinical Practice committee. She is a member and Past-Chair of the Board of Trustees of the American Medical Association. In June of 2017, Dr. McAneny was elected by the AMA House of Delegates as President Elect of the AMA.
Dr. McAneny is active in organized medicine and advocacy. She was the 1989 President of the Greater Albuquerque Medical Association and was President of the New Mexico Medical Society in 2000. She served a four-year term on the Practicing Physicians Advisory Council for the Centers for Medicare and Medicaid Services, on the AMA Council of Medical Service, and the American Society of Clinical Oncologists (ASCO) Board of Directors and their Clinical Practice committee. She is a member and Past-Chair of the Board of Trustees of the American Medical Association. In June of 2017, Dr. McAneny was elected by the AMA House of Delegates as President Elect of the AMA.
Harold D. Miller
President and Chief Executive Officer, Center for Healthcare Quality and Payment Reform; Member, Physician-Focused Payment Model Technical Advisory Committee; Adjunct Professor, Carnegie Mellon University, Pittsburgh, PA (Co-chair)
President and Chief Executive Officer, Center for Healthcare Quality and Payment Reform; Member, Physician-Focused Payment Model Technical Advisory Committee; Adjunct Professor, Carnegie Mellon University, Pittsburgh, PA (Co-chair)
Harold Miller is the President and CEO of the Center for Healthcare Quality and Payment Reform (CHQPR) and serves as Adjunct Professor of Public Policy and Management at Carnegie Mellon University. He has twice given invited testimony to Congress on how to reform healthcare payment, and has worked to help design and implement payment and delivery system reforms. He is one of the eleven members of the federal Physician-Focused Payment Model Technical Advisory Committee that was created by Congress to advise the Secretary of Health and Human Services on the creation of alternative payment models. He has assisted numerous organizations in developing alternative payment models designed to support better care for patients at lower cost. Previously, Miller served as the President and CEO of the Network for Regional Healthcare Improvement (NRHI), as a member of the Board of Directors of the National Quality Forum, and served as the Strategic Initiatives Consultant to the Pittsburgh Regional Health Initiative (PRHI).
Kavita Patel, MD
Nonresident Senior Fellow Brookings Institution; Member, Physician-Focused Payment Model Technical Advisory Committee; Former Director of Policy, The White House; Former Senior Advisor, Senator Edward Kennedy, Washington, DC (Co-chair)
Nonresident Senior Fellow Brookings Institution; Member, Physician-Focused Payment Model Technical Advisory Committee; Former Director of Policy, The White House; Former Senior Advisor, Senator Edward Kennedy, Washington, DC (Co-chair)
Kavita Patel is the Associate Chief Medical Officer and Medicare Director at Johns Hopkins Medicine, Sibley Hospital. She is also a nonresident Senior Fellow at the Brookings Institution. Previously, she was a Fellow and Managing Director of Delivery System Reform and Clinical Transformation at the Engelberg Center for Health Care Reform in the Department of Economic Studies at the Brookings Institution. Dr. Patel also serves on the GAO Appointed Physician-Focused Payment Model Technical Advisory Committee (PTAC). Previously, she was Director of the health policy program at the New America Foundation and served in the Obama Administration as director of policy for the Office of Intergovernmental Affairs and Public Engagement in the White House. She also served as a policy analyst and trusted aide to Senator Edward Kennedy, was a health services researcher at UCLA and an Associate Scientist Research at the RAND Corporation.
9:00 am
Which Path to Follow: MIPS, CMS APMs or your own APM Model?
Donald H. Crane, JD
President and Chief Executive Officer, CAPG, Los Angeles, CA
President and Chief Executive Officer, CAPG, Los Angeles, CA
Don Crane is the President and CEO of CAPG, a national professional association composed of physician groups dedicated to coordinated, accountable care. These groups are in the forefront of national healthcare reform and represent the care model and payment methodologies adopted by federal legislation for the entire nation.
Mr. Crane joined CAPG in 2001 and has served as President and CEO since that time. During his tenure CAPG has expanded from being a division of a regional hospital trade association consisting of 40 member groups to a national professional association consisting of more than 250 physician organizations.
Mr. Crane serves on the Board of Directors of the National Coalition on Health Care. He is also the Editor-in-Chief of CAPG Health, a magazine that reports on business trends, legislation, and industry initiatives impacting coordinated care.
Mr. Crane joined CAPG in 2001 and has served as President and CEO since that time. During his tenure CAPG has expanded from being a division of a regional hospital trade association consisting of 40 member groups to a national professional association consisting of more than 250 physician organizations.
Mr. Crane serves on the Board of Directors of the National Coalition on Health Care. He is also the Editor-in-Chief of CAPG Health, a magazine that reports on business trends, legislation, and industry initiatives impacting coordinated care.
Shari M. Erickson, MPH
Vice President, Governmental Affairs and Medical Practice, American College of Physicians, Washington, DC
Vice President, Governmental Affairs and Medical Practice, American College of Physicians, Washington, DC
Shari M. Erickson serves as Vice President, Governmental Affairs and Medical Practice for the American College of Physicians (ACP). In this role, Ms. Erickson advocates for ACP positions with the Department of Health and Human Services, Centers for Medicare and Medicaid Services, and other federal agencies with responsibility for implementation of the Affordable Care Act and other federal health reform initiatives. She also directs the development of ACP policies and advocacy strategies in order to influence delivery system and payment reforms, as well as health insurance-related issues. Previously, Ms. Erickson worked as a Senior Associate in ACP’s Center for Practice Improvement and Innovation. Before coming to ACP, Ms. Erickson was a Senior Program Director with the National Quality Forum (NQF) in Washington, D.C. and she served as Senior Program Analyst at the National Committee for Quality Health Care and as a Program Officer at the Institute of Medicine of the National Academies.
Anne Phelps, MPP
US Health Care Regulatory Leader, Deloitte LLP; Former Executive Director, National Platform Committee; Former Special Assistant to the President for Domestic Policy (Health) (Bush), Washington, DC
US Health Care Regulatory Leader, Deloitte LLP; Former Executive Director, National Platform Committee; Former Special Assistant to the President for Domestic Policy (Health) (Bush), Washington, DC
A Principal with Deloitte & Touche LLP. Anne Phelps has more than twenty-four years of health care policy experience having worked in federal agencies, the US Senate, the White House and in consulting firms. She serves as a strategic business advisor to numerous health care stakeholders-including providers, health plans, employers, and life sciences companies-helping them navigate the complex health care regulatory environment and how it will impact their organizations.
Grace Emerson Terrell, MD, MMM, FACP, FACPE
Chief Executive Officer, Envision Genomics; Former President and Chief Executive Officer, Cornerstone Health Care; Member, Physician-Focused Payment Model Technical Advisory Committee, Huntsville, AL
Chief Executive Officer, Envision Genomics; Former President and Chief Executive Officer, Cornerstone Health Care; Member, Physician-Focused Payment Model Technical Advisory Committee, Huntsville, AL
Dr. Grace Terrell is CEO of Envision Genomics, helping clinicians diagnose rare disease through the integration of genomic data into clinical care. As a leader in health care delivery system reform, Dr. Terrell speaks to health systems, provider groups and professional organizations about the importance of improving population health through patient care model redesign, clinical and information integration, and value-based compensation.
In 2013, Dr. Terrell launched CHESS, a company dedicated to helping health systems and other medical groups make the transition to value-based medicine. For over 16 years, Dr. Terrell served as the President and CEO of Cornerstone Health Care.
Dr. Terrell currently serves on the U.S. Department of Health and Human Services’ Physician-Focused Payment Model Technical Advisory Committee, the Board of Directors of the American Medical Group Association, the American Medical Association’s Integrated Physician section, and the Oliver Wyman Health Innovation Center’s Leadership Alliance. She is also a practicing internist.
In 2013, Dr. Terrell launched CHESS, a company dedicated to helping health systems and other medical groups make the transition to value-based medicine. For over 16 years, Dr. Terrell served as the President and CEO of Cornerstone Health Care.
Dr. Terrell currently serves on the U.S. Department of Health and Human Services’ Physician-Focused Payment Model Technical Advisory Committee, the Board of Directors of the American Medical Group Association, the American Medical Association’s Integrated Physician section, and the Oliver Wyman Health Innovation Center’s Leadership Alliance. She is also a practicing internist.
Harold D. Miller
President and Chief Executive Officer, Center for Healthcare Quality and Payment Reform; Member, Physician-Focused Payment Model Technical Advisory Committee; Adjunct Professor, Carnegie Mellon University, Pittsburgh, PA (Moderator)
President and Chief Executive Officer, Center for Healthcare Quality and Payment Reform; Member, Physician-Focused Payment Model Technical Advisory Committee; Adjunct Professor, Carnegie Mellon University, Pittsburgh, PA (Moderator)
Harold Miller is the President and CEO of the Center for Healthcare Quality and Payment Reform (CHQPR) and serves as Adjunct Professor of Public Policy and Management at Carnegie Mellon University. He has twice given invited testimony to Congress on how to reform healthcare payment, and has worked to help design and implement payment and delivery system reforms. He is one of the eleven members of the federal Physician-Focused Payment Model Technical Advisory Committee that was created by Congress to advise the Secretary of Health and Human Services on the creation of alternative payment models. He has assisted numerous organizations in developing alternative payment models designed to support better care for patients at lower cost. Previously, Miller served as the President and CEO of the Network for Regional Healthcare Improvement (NRHI), as a member of the Board of Directors of the National Quality Forum, and served as the Strategic Initiatives Consultant to the Pittsburgh Regional Health Initiative (PRHI).
10:00 am
Break
10:30 am
Lessons Learned from Advanced APMs
ACOs: Medicare Shared Savings Program Tracks 2 and 3 and Next Generation
Kate de Lisle
Value Based Payment Research Lead, Accountable Care Learning Collaborative, Salt Lake City, UT
Kate de Lisle is the VBP Research Lead at Leavitt Partners, leading the firm’s team dedicated to tracking and understanding the accountable care movement. Building and managing relationships with ACO leadership across the U.S., Kate combines qualitative insights from frontline leaders with market- and state-level analyses to better understand the evolution of value-based care. Additionally, Kate directs the research efforts of the Accountable Care Learning Collaborative (ACLC), where she oversees the development of the Case Study Brief Program, a public library on care delivery transformation, among other initiatives. Before joining Leavitt Partners, Kate worked in the health care industry both clinically and administratively, including three years with the nationally-renowned health system, Intermountain Healthcare.
Comprehensive End-Stage Renal Disease Care Model
Edward R. Jones, MD
Medical Consultant to Chief Medical Officer, Medical Director, Fresenius Medical Care (FMC); Clinical Professor of Medicine, Temple University Hospital; Past Chairman, Kidney Care Partners; Former Counselor, Renal Physician Association, Philadelphia, PA
Edward R Jones, MD, FACP is currently Consultant to the Chief Medical Officer of Fresenius Medical Care. He works within Fresenius Integrated Renal Care with responsibilities for the Ed-Stage-Renal Disease Seamless Care Organization. In addition, he is managing partner of DVNNH, a nephrology practice which is one of six practices as an ESCO practice. He is past Chairman of Kidney Care Partners, and past Counselor to the Renal Physician Association
Comprehensive Primary Care Plus (CPC+) Model
Laura Sessums, MD
Director, Division of Advanced Primary Care, Center for Medicare and Medicaid Innovation; Former Chief, General Medicine Section, Walter Reed Army Medical Center, Baltimore, MD
Laura Sessums joined CMMI as the Director of the Division of Advanced Primary Care in 2013. At CMMI, she oversees the Comprehensive Primary Care Plus (CPC+) initiative, America’s largest multi-payer initiative to improve primary care. Until it ended in 2016, she ran the CPC initiative, an early CMMI multi-payer model to transform primary care payment and care delivery. Previously, she worked in academic medicine as a clinician-educator, mostly at Walter Reed Army Medical Center (as a civilian), where she served as the Chief of the General Medicine Section. She is a practicing general internist.
Oncology Care Model (two-sided risk)
Barbara L. McAneny, MD
Board-Certified Medical Oncologist/Hematologist; Co-Founder and Managing Partner, New Mexico Oncology Hematology Consultants Ltd.; President-Elect, American Medical Association, Albuquerque, NM
Dr. McAneny is CEO of New Mexico Oncology Hematology Consultants, LTD and the past President of the New Mexico Cancer Center Foundation. She has lived in Albuquerque since 1980.
Dr. McAneny is active in organized medicine and advocacy. She was the 1989 President of the Greater Albuquerque Medical Association and was President of the New Mexico Medical Society in 2000. She served a four-year term on the Practicing Physicians Advisory Council for the Centers for Medicare and Medicaid Services, on the AMA Council of Medical Service, and the American Society of Clinical Oncologists (ASCO) Board of Directors and their Clinical Practice committee. She is a member and Past-Chair of the Board of Trustees of the American Medical Association. In June of 2017, Dr. McAneny was elected by the AMA House of Delegates as President Elect of the AMA.
Dr. McAneny is active in organized medicine and advocacy. She was the 1989 President of the Greater Albuquerque Medical Association and was President of the New Mexico Medical Society in 2000. She served a four-year term on the Practicing Physicians Advisory Council for the Centers for Medicare and Medicaid Services, on the AMA Council of Medical Service, and the American Society of Clinical Oncologists (ASCO) Board of Directors and their Clinical Practice committee. She is a member and Past-Chair of the Board of Trustees of the American Medical Association. In June of 2017, Dr. McAneny was elected by the AMA House of Delegates as President Elect of the AMA.
Kavita Patel, MD
Nonresident Senior Fellow, Brookings Institution; Member, Physician-Focused Payment Model Technical Advisory Committee; Former Director of Policy, The White House; Former Senior Advisor, Senator Edward Kennedy, Washington, DC (Moderator)
Nonresident Senior Fellow, Brookings Institution; Member, Physician-Focused Payment Model Technical Advisory Committee; Former Director of Policy, The White House; Former Senior Advisor, Senator Edward Kennedy, Washington, DC (Moderator)
Kavita Patel is the Associate Chief Medical Officer and Medicare Director at Johns Hopkins Medicine, Sibley Hospital. She is also a nonresident Senior Fellow at the Brookings Institution. Previously, she was a Fellow and Managing Director of Delivery System Reform and Clinical Transformation at the Engelberg Center for Health Care Reform in the Department of Economic Studies at the Brookings Institution. Dr. Patel also serves on the GAO Appointed Physician-Focused Payment Model Technical Advisory Committee (PTAC). Previously, she was Director of the health policy program at the New America Foundation and served in the Obama Administration as director of policy for the Office of Intergovernmental Affairs and Public Engagement in the White House. She also served as a policy analyst and trusted aide to Senator Edward Kennedy, was a health services researcher at UCLA and an Associate Scientist Research at the RAND Corporation.
11:30 am
MACRA Implications for Health Plans and APMs Outside of Medicare: Participation Alternatives in Other Payer Advanced APMs
Peter Aran, MD
Medical Director, Population Health-Blue Cross Blue Shield, Blue Cross and Blue Shield of Oklahoma, Former Chief Medical Officer: Senior Vice President, Quality, Saint Francis Health System, Tulsa, OK
Medical Director, Population Health-Blue Cross Blue Shield, Blue Cross and Blue Shield of Oklahoma, Former Chief Medical Officer: Senior Vice President, Quality, Saint Francis Health System, Tulsa, OK
As medical director of population health, Dr. Aran coordinates value based care activities involving both internal and CMS related initiatives. The CMS programs include the Comprehensive Primary Care Initiative, Comprehensive Primary Care Plus, and the Oncology Care Model. He also works with the Beacon Communities and the Accountable Health Communities grants. He was a member of the Liver Transplantation team and an Assistant Professor of Medicine at the University of Chicago. While in private practice for 20 years in Tulsa he served in a number of leadership positions including being on the health system board of directors for 13 years and being the medical director of Disease Management. He later served as the system’s chief medical officer and senior vice president of quality. For the last two years he has been a medical director with Blue Cross Blue Shield of Oklahoma.
Anshu Choudhri
Managing Director, Legislative and Regulatory Policy at Blue Cross Blue Shield Association, Washington, DC
Managing Director, Legislative and Regulatory Policy at Blue Cross Blue Shield Association, Washington, DC
Anshu has been with the Blue Cross Blue Shield Association for twelve years.In his current role in the Office of Policy and Representation, Anshu is responsible for advising BCBSA leadership on legislative and regulatory policy analysis, with an emphasis on various components of the Affordable Care Act, delivery system reform, MACRA, rising prescription drug costs, substance use disorder, healthcare quality, and network adequacy. Across these content areas, Anshu works with BCBS Plans to develop consensus opinion on proposed regulations and legislation and is responsible for the development of comment letters to various government agencies or responses to Congressional requests for information. Additionally, Anshu works closely with government agencies, Congressional staff and industry stakeholders in Washington to represent the BCBS Plan perspective and to develop partnerships for future collaboration.
Chip Howard
Senior Vice President, Partner Services, Remedy Partners, Former Vice President and Payment Innovations Leader, Humana Inc., Former Director, Accountable Care Organizations, WellPoint, Former Director, Financial Models, Alternative Reimbursement Programs, Florida Blue, Former Director, Provider Contracting Performance and Cost Analytics, Kaiser Permanente, Louisville, KY
Senior Vice President, Partner Services, Remedy Partners, Former Vice President and Payment Innovations Leader, Humana Inc., Former Director, Accountable Care Organizations, WellPoint, Former Director, Financial Models, Alternative Reimbursement Programs, Florida Blue, Former Director, Provider Contracting Performance and Cost Analytics, Kaiser Permanente, Louisville, KY
Chip Howard is Senior Vice President of Partner Services at Remedy Partners, the nation’s leading bundled payment company. He is responsible for leading Remedy’s field teams that work hand-in-hand with provider partners to ensure success under bundled payment arrangements. With Mr. Howard’s leadership, Remedy’s Partner Services teams enable provider partners to use its vast suite of tools, resources, and capabilities to improve outcomes and quality as well as promote cost-effectiveness.
Before joining Remedy, Mr. Howard served as Vice President and Payment Innovations Leader in the Provider Development Center of Excellence at Humana, Inc. where he was responsible for advancing its Accountable Care Continuum, including Humana’s primary care and bundled payment programs.
Before joining Remedy, Mr. Howard served as Vice President and Payment Innovations Leader in the Provider Development Center of Excellence at Humana, Inc. where he was responsible for advancing its Accountable Care Continuum, including Humana’s primary care and bundled payment programs.
Earl P. Steinberg, MD, MPP
Chief Executive Officer, xG Health; Former Vice President, Innovation and Dissemination, Geisinger Health System; Former Senior Vice President, Clinical Strategy, Quality and Outcomes, WellPoint, Inc., Columbia, MD
Chief Executive Officer, xG Health; Former Vice President, Innovation and Dissemination, Geisinger Health System; Former Senior Vice President, Clinical Strategy, Quality and Outcomes, WellPoint, Inc., Columbia, MD
Dr. Steinberg is a nationally known expert in evaluation and improvement of the quality and efficiency of health care. He currently serves as CEO of xG Health Solutions, a company formed by Geisinger Health System to help other health care delivery systems improve the quality and reduce the cost of the care they deliver. Prior to becoming CEO of xG Health Solutions, Dr. Steinberg served in several other leadership positions, including Executive Vice President of Innovation and Dissemination at the Geisinger Health System, Sr. VP for Clinical Strategy, Quality & Outcomes at WellPoint, Inc., CEO of Resolution Health Inc., Director of Quality Assessment and Improvement Systems at Covance, and Professor of Medicine and of Health Policy and Management at Johns Hopkins. Dr. Steinberg received his undergraduate, medical and public policy degrees at Harvard University and completed his residency training in internal medicine at Massachusetts General Hospital.
Dr. Steinberg has received numerous awards, including a Special Presidential Visionary Award from the National Kidney Foundation (2004) for his work as the scientific director of NKF’s landmark Kidney Disease Outcomes and Quality Initiative, which produced over 250 clinical practice guidelines for management of patients with end stage renal disease. He also is a Fellow of both the American College of Physicians and AcademyHealth and has published more than 125 articles in peer reviewed journals.
Dr. Steinberg has received numerous awards, including a Special Presidential Visionary Award from the National Kidney Foundation (2004) for his work as the scientific director of NKF’s landmark Kidney Disease Outcomes and Quality Initiative, which produced over 250 clinical practice guidelines for management of patients with end stage renal disease. He also is a Fellow of both the American College of Physicians and AcademyHealth and has published more than 125 articles in peer reviewed journals.
Howard Shapiro, PhD
Director of Public Policy, Alliance of Community Health Plans; Former Vice President for Public Policy, American College of Physicians, Washington, DC (Moderator)
Director of Public Policy, Alliance of Community Health Plans; Former Vice President for Public Policy, American College of Physicians, Washington, DC (Moderator)
Howard Shapiro serves as ACHP’s Director of Public Policy. His work covers policy development, analysis, regulatory and advocacy activities of the Alliance and ranges across federal health policy issues including Medicare, Medicaid, and the Affordable Care Act. He joined ACHP in 2008.
Dr. Shapiro has extensive health policy experience in Washington, D.C. as a senior manager of membership organizations, including the American College of Physicians (ACP), where he was Vice President for Public Policy. Immediately prior to joining ACHP, Dr. Shapiro was the first Executive Director of State Associations of Addiction Services. Dr. Shapiro has also done consulting work and research for the federal government, foundations, and non-profit organizations on issues that have included quality improvement, health coverage trends in the workforce, and access to health care. Earlier in his career he was Deputy Director of the Washington Office of the Governor of New Jersey and a Special Assistant to the U.S. Secretary of Health, Education, and Welfare.
Dr. Shapiro has extensive health policy experience in Washington, D.C. as a senior manager of membership organizations, including the American College of Physicians (ACP), where he was Vice President for Public Policy. Immediately prior to joining ACHP, Dr. Shapiro was the first Executive Director of State Associations of Addiction Services. Dr. Shapiro has also done consulting work and research for the federal government, foundations, and non-profit organizations on issues that have included quality improvement, health coverage trends in the workforce, and access to health care. Earlier in his career he was Deputy Director of the Washington Office of the Governor of New Jersey and a Special Assistant to the U.S. Secretary of Health, Education, and Welfare.
12:30 pm
Networking Luncheon and MACRA Technology Solutions Presentations
12:45 pm
MACRA Technology Solutions Session
Octavia Costea
MACRA Service Offering Leader, Cognizant, East Meadow, NY
MACRA Service Offering Leader, Cognizant, East Meadow, NY
Octavia Costea is the leader of the MACRA Service Offering at Cognizant. She has more than 12 years global experience in healthcare organizations, government, IT and business. Prior to Cogniznat, she founded and led a consulting company focused on patient-centered strategies in the nuclear medicine technology space.
Octavia holds an MBA from Babson College and JD from Romania. She is board certified in diagnostic testing and holds numerous other certifications in the healthcare and IT areas.
Octavia holds an MBA from Babson College and JD from Romania. She is board certified in diagnostic testing and holds numerous other certifications in the healthcare and IT areas.
Lindsey Bates
Market Director of Compliance, Philips, Alpharetta, GA
Market Director of Compliance, Philips, Alpharetta, GA
Christopher Cistuli
Vice President, Business Development, Darien, CT
Vice President, Business Development, Darien, CT
Sean Adetula
Senior Consultant, Provider Services, Signature Consulting Group, Windsor Mill, MD
Senior Consultant, Provider Services, Signature Consulting Group, Windsor Mill, MD
Brendan McAuley
Business Development, Healthcare Delivery Systems, New Jersey Innovation Institute, Newark, NJ
Business Development, Healthcare Delivery Systems, New Jersey Innovation Institute, Newark, NJ
Mr. McAuley began his career at the start of the dot com boom in the Silicon Valley of California where he was an executive search consultant building leadership teams for venture backed technology firms in the Bay Area. In 2001 he relocated to his native New York City and worked for EMR start up vendor, SRS Health. After 9 years growing the firm he then consulted for start-up companies in healthcare in fields of radiology, business intelligence, cost accounting, lean six sigma and project portfolio management. In 2016 Brendan joined NJII’s leadership team to manage business development and grow the Practice Transformation Network.
Matthew Fusan
Director, Solutions Consulting, SA Ignite, Chicago, IL
Director, Solutions Consulting, SA Ignite, Chicago, IL
Matthew Fusan is an experienced, senior leader with 15 years of experience in the health care industry in both the payer and provider markets. For the past three years Matthew has been focused on the transition from fee-for-service to value-based care, providing strategic consulting and developing solutions to help clients succeed with alternative payment models and population health management. Matthew’s primary focus has been on MACRA, the Quality Payment Program, and CMS Innovation Center models including ACOs, bundled payments, and comprehensive primary care models. Prior to Allscripts, Matthew held a variety of program management and delivery leadership positions at Blue Cross and Blue Shield of North Carolina and Highmark Blue Cross and Blue Shield.
Lauren Patrick
CEO and Founder, Healthmonix, Malvern, PA
CEO and Founder, Healthmonix, Malvern, PA
Lauren is the CEO of Healthmonix, specializing in innovative registry, improvement, and analytics tools. Lauren has been implementing gamechanging healthcare tools for over a decade, building on her background at Ernst & Young and Cap Gemini where she led large-scale IT implementation projects. Lauren is currently focused on building registries and associated analytics tools that identify strengths and weaknesses of healthcare organizations, while providing tools to further enhance better outcomes.
Phillip Spence
Sales Consultant, Healthmonix, Malvern, PA
Sales Consultant, Healthmonix, Malvern, PA
Phillip joined the Healthmonix team in 2016 as a Sales Consultant and currently works with some of Healthmonix’s largest clients and strategic partners. Phillip comes from a background in strategic relationships and development within non-profit organizations and is a proud graduate of the University of Florida, earning his degree in Economics.
George Newcomb
Director, Master of Health Care Delivery Science Program, Dartmouth College, Hanover, NH
Director, Master of Health Care Delivery Science Program, Dartmouth College, Hanover, NH
AFTERNOON MINI SUMMITS GROUP I: 2:00 pm – 3:00 pm
(Choose one Mini Summit only)
Mini Summit I: APM Models Supporting Specialty Medical Homes for Chronic Disease
2:00 pm
Welcome, Introductions, Discussions and Q&A
Janet Bull, MD, FAAHPM
Chief Medical Officer, Four Seasons Compassion for Life, Flat Rock, NC
Chief Medical Officer, Four Seasons Compassion for Life, Flat Rock, NC
Dr Janet Bull is Chief Medical Officer of Four Seasons Compassion for LIfe, and holds a consultant assistant professorship at Duke University Medical Center. She serves on the Steering Committee of Palliative Care Research Cooperative Group, and co-chairs the Global Palliative Care Quality Alliance. She is a senior medical advisor for Aspire Health. She is the Principal Investigator on a Center for Medicare and Medicaid Innovations Grant, on demonstrating the value of palliative care. She directs the research department at Four Seasons and has authored or coauthored several publications around quality in palliative care. She is the current President of the American Academy of Hospice and Palliative Care.
Lawrence Kosinski, MD, MBA, AGAF, FACG
Managing Partner, Illinois Gastroenterology Group; President, SonarMD, LLC; Community Private Practice Councillor, AGA Governing Board, Elgin, IL
Managing Partner, Illinois Gastroenterology Group; President, SonarMD, LLC; Community Private Practice Councillor, AGA Governing Board, Elgin, IL
Adam Weinstein, MD
Vice President Medical Affairs, DaVita Inc.; Nephrologist, Kidney Health Center of Maryland, Easton, MD
Vice President Medical Affairs, DaVita Inc.; Nephrologist, Kidney Health Center of Maryland, Easton, MD
Adam Weinstein lives on Maryland’s Upper Eastern Shore and is a co-founder of the Kidney Health Center of Maryland. He completed his training in internal medicine and nephrology at the University of Maryland School of Medicine and University of Maryland Medical Center.
He is currently a VP of Medical Affairs with Clinical IT Services at DaVita as well as a part-time clinical nephrologist in Maryland. He continues to serve as the AMA RUC advisor for the Renal Physicians Association (RPA) and chairs the RPA clinical data registry workgroup.
He is currently a VP of Medical Affairs with Clinical IT Services at DaVita as well as a part-time clinical nephrologist in Maryland. He continues to serve as the AMA RUC advisor for the Renal Physicians Association (RPA) and chairs the RPA clinical data registry workgroup.
Harold D. Miller
President and Chief Executive Officer, Center for Healthcare Quality and Payment Reform; Member, Physician-Focused Payment Model Technical Advisory Committee; Adjunct Professor, Carnegie Mellon University. Pittsburgh, PA (Moderator)
President and Chief Executive Officer, Center for Healthcare Quality and Payment Reform; Member, Physician-Focused Payment Model Technical Advisory Committee; Adjunct Professor, Carnegie Mellon University. Pittsburgh, PA (Moderator)
Harold Miller is the President and CEO of the Center for Healthcare Quality and Payment Reform (CHQPR) and serves as Adjunct Professor of Public Policy and Management at Carnegie Mellon University. He has twice given invited testimony to Congress on how to reform healthcare payment, and has worked to help design and implement payment and delivery system reforms. He is one of the eleven members of the federal Physician-Focused Payment Model Technical Advisory Committee that was created by Congress to advise the Secretary of Health and Human Services on the creation of alternative payment models. He has assisted numerous organizations in developing alternative payment models designed to support better care for patients at lower cost. Previously, Miller served as the President and CEO of the Network for Regional Healthcare Improvement (NRHI), as a member of the Board of Directors of the National Quality Forum, and served as the Strategic Initiatives Consultant to the Pittsburgh Regional Health Initiative (PRHI).
Mini Summit II: Episode-Based Cost Measure Development for the Quality Payment Program
2:00 pm
Welcome, Introductions, Discussions and Q&A
Theodore Long, MD, MHS
Senior Medical Officer, Quality Measurement and Value-Based Incentives Group, Centers for Medicare and Medicaid Services; Former Medical Director, Rhode Island State Department of Health, Baltimore, MD
Senior Medical Officer, Quality Measurement and Value-Based Incentives Group, Centers for Medicare and Medicaid Services; Former Medical Director, Rhode Island State Department of Health, Baltimore, MD
Theodore Long, MD, MHS is the Senior Medical Officer for the Quality Measurement and Value-Based Incentives Group at the Centers for Medicare and Medicaid Services (CMS) which covers federal programs including the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), the Hospital Readmission Reduction Program, and the Hospital Value-Based Purchasing Program.
Before coming to CMS, Dr. Long served as Medical Director for the Rhode Island State Department of Health.
He is also an Assistant Professor Adjunct at the Yale School of Medicine and an affiliate of the Harvard Medical School Center for Primary Care.
Before coming to CMS, Dr. Long served as Medical Director for the Rhode Island State Department of Health.
He is also an Assistant Professor Adjunct at the Yale School of Medicine and an affiliate of the Harvard Medical School Center for Primary Care.
Kavita Patel, MD
Nonresident Senior Fellow, Brookings Institution; Member, Physician-Focused Payment Model Technical Advisory Committee; Former Director of Policy, The White House; Former Senior Advisor, Senator Edward Kennedy, Washington, DC (Moderator)
Nonresident Senior Fellow, Brookings Institution; Member, Physician-Focused Payment Model Technical Advisory Committee; Former Director of Policy, The White House; Former Senior Advisor, Senator Edward Kennedy, Washington, DC (Moderator)
Kavita Patel is the Associate Chief Medical Officer and Medicare Director at Johns Hopkins Medicine, Sibley Hospital. She is also a nonresident Senior Fellow at the Brookings Institution. Previously, she was a Fellow and Managing Director of Delivery System Reform and Clinical Transformation at the Engelberg Center for Health Care Reform in the Department of Economic Studies at the Brookings Institution. Dr. Patel also serves on the GAO Appointed Physician-Focused Payment Model Technical Advisory Committee (PTAC). Previously, she was Director of the health policy program at the New America Foundation and served in the Obama Administration as director of policy for the Office of Intergovernmental Affairs and Public Engagement in the White House. She also served as a policy analyst and trusted aide to Senator Edward Kennedy, was a health services researcher at UCLA and an Associate Scientist Research at the RAND Corporation.
Mini Summit III: Lessons Learned from the Oncology Care Model
2:00 pm
Welcome, Introductions, Discussions and Q&A
Kerin Bess Adelson, MD
Assistant Professor of Medicine (Medical Oncology), Yale Cancer Center; Chief Quality Officer and Deputy Chief Medical Officer, Smilow Cancer Hospital at Yale-New Haven, New Haven, CT
Assistant Professor of Medicine (Medical Oncology), Yale Cancer Center; Chief Quality Officer and Deputy Chief Medical Officer, Smilow Cancer Hospital at Yale-New Haven, New Haven, CT
Kerin Adelson is an Associate Professor of Medicine (Medical Oncology) and Chief Quality Office at Yale Cancer Center and Smilow Cancer Hospital at Yale New Haven. She is actively involved in breast cancer clinical research and serves as an investigator on multiple clinical trials. In her role as Chief Quality Officer, Dr. Adelson is focused on improving care coordination for all patients treated in the Smilow Cancer Hospital Network, aligning care with national quality metrics, and developing models to enhance patient involvement in decisions about their cancer-care. Dr. Adelson sits on several national committees including the Southwest Oncology group Cancer Delivery Committee, the National Cancer Care Network Policy Committee and the American Society of Clinical Oncology Health Information Technology Committee.
Gabrielle B. Rocque, MD
Assistant Professor, Hematology and Oncology, School of Medicine, University of Alabama at Birmingham; Medical Director, Cancer Community Network, UAB Health System, Birmingham, AL
Assistant Professor, Hematology and Oncology, School of Medicine, University of Alabama at Birmingham; Medical Director, Cancer Community Network, UAB Health System, Birmingham, AL
Dr. Gabrielle Rocque is an Assistant Professor of Medicine in the Divisions of Hematology,Oncology and Gerontology, Geriatrics, & Palliative Care at the University of Alabama at Birmingham (UAB). She currently practices as a medical oncologist, specializing in the care of women with breast cancer.
Dr. Rocque’s research interests include improving the quality of healthcare delivery for cancer patients with an emphasis on shared decision-making, payment reform, and provision of supportive care services to patients. She served as Medical Director and focused on improving health and healthcare costs by implementing a lay navigator workforce to support cancer patients across from diagnosis through survivorship and end-of-life. She also received an American Cancer Society Mentored Research Scholar Grant to develop treatment plans aimed to enhance shared decision making for patients with metastatic breast cancer.
Dr. Rocque’s research interests include improving the quality of healthcare delivery for cancer patients with an emphasis on shared decision-making, payment reform, and provision of supportive care services to patients. She served as Medical Director and focused on improving health and healthcare costs by implementing a lay navigator workforce to support cancer patients across from diagnosis through survivorship and end-of-life. She also received an American Cancer Society Mentored Research Scholar Grant to develop treatment plans aimed to enhance shared decision making for patients with metastatic breast cancer.
Barbara L. McAneny, MD
Board-Certified Medical Oncologist/Hematologist; Co-Founder and Managing Partner, New Mexico Oncology Hematology Consultants Ltd.; President-Elect, American Medical Association, Albuquerque, NM (Moderator)
Board-Certified Medical Oncologist/Hematologist; Co-Founder and Managing Partner, New Mexico Oncology Hematology Consultants Ltd.; President-Elect, American Medical Association, Albuquerque, NM (Moderator)
Dr. McAneny is CEO of New Mexico Oncology Hematology Consultants, LTD and the past President of the New Mexico Cancer Center Foundation. She has lived in Albuquerque since 1980.
Dr. McAneny is active in organized medicine and advocacy. She was the 1989 President of the Greater Albuquerque Medical Association and was President of the New Mexico Medical Society in 2000. She served a four-year term on the Practicing Physicians Advisory Council for the Centers for Medicare and Medicaid Services, on the AMA Council of Medical Service, and the American Society of Clinical Oncologists (ASCO) Board of Directors and their Clinical Practice committee. She is a member and Past-Chair of the Board of Trustees of the American Medical Association. In June of 2017, Dr. McAneny was elected by the AMA House of Delegates as President Elect of the AMA.
Dr. McAneny is active in organized medicine and advocacy. She was the 1989 President of the Greater Albuquerque Medical Association and was President of the New Mexico Medical Society in 2000. She served a four-year term on the Practicing Physicians Advisory Council for the Centers for Medicare and Medicaid Services, on the AMA Council of Medical Service, and the American Society of Clinical Oncologists (ASCO) Board of Directors and their Clinical Practice committee. She is a member and Past-Chair of the Board of Trustees of the American Medical Association. In June of 2017, Dr. McAneny was elected by the AMA House of Delegates as President Elect of the AMA.
Mini Summit IV: No One Left Behind: Ensuring the Transition of Critical Access Hospitals to Value-Based Care
2:00 pm
Welcome, Introductions, Discussions and Q&A
Taylor Hittle
Health Policy Advisor, Congressman Markwayne Mullin; Former Senior Legislative Assistant, Congresswoman Mimi Walters; Former Legislative Assistant, Congressman John R. Carter; Former Staff Assistant, Congressman Michael Burgess, MD, Washington, DC
Health Policy Advisor, Congressman Markwayne Mullin; Former Senior Legislative Assistant, Congresswoman Mimi Walters; Former Legislative Assistant, Congressman John R. Carter; Former Staff Assistant, Congressman Michael Burgess, MD, Washington, DC
Brock Slabach, MPH
Senior Vice President, Member Services, National Rural Health Association; Former Administrator and Chief Executive Officer, Field Memorial Community Hospital, Washington, DC
Senior Vice President, Member Services, National Rural Health Association; Former Administrator and Chief Executive Officer, Field Memorial Community Hospital, Washington, DC
Brock joined NRHA in 2008. He has administrative responsibility for all areas of member services, including membership, communications and meetings/exhibitions. Brock was a rural hospital administrator for more than 21 years. He has been on the board of the National Rural Health Association and the regional policy board of the American Hospital Association, as well as many regional and state boards involving rural health. He earned a master of public health degree in health administration from the University of Oklahoma and a B.S. degree in biology from Oklahoma Baptist University. He is a fellow in the American College of Healthcare Executives.
Danielle Lloyd, MPH
Vice President of Policy and Advocacy, Premier Inc.; Former Senior Associate Director, American Hospital Association; Former Vice President, California Hospital Association, Washington, DC (Moderator)
Vice President of Policy and Advocacy, Premier Inc.; Former Senior Associate Director, American Hospital Association; Former Vice President, California Hospital Association, Washington, DC (Moderator)
Danielle Lloyd is the vice president for policy and advocacy as well as deputy director of the Washington, DC office of the Premier healthcare alliance. Danielle leads Premier’s policy analysis and development. Lloyd works with lawmakers, the White House, and other major stakeholders involved in healthcare policy and regulation. She also plays a leading role in Premier’s large-scale provider collaboratives by helping providers operationalize new federal policies and Premier’s non-profit research arm that seeks to share knowledge broadly across the country.
Prior to coming to Premier, Lloyd worked on an array of healthcare issues including Medicare and Medicaid payment, quality policies, and health information technology for the American Hospital Association, California Hospital Association, the U.S. House of Representatives Committee on Ways and Means and the Centers for Medicare & Medicaid Services. Danielle is an active volunteer for Sibley Memorial Hospital’s Patient & Family Advisory Council and Quality & Safety team.
Prior to coming to Premier, Lloyd worked on an array of healthcare issues including Medicare and Medicaid payment, quality policies, and health information technology for the American Hospital Association, California Hospital Association, the U.S. House of Representatives Committee on Ways and Means and the Centers for Medicare & Medicaid Services. Danielle is an active volunteer for Sibley Memorial Hospital’s Patient & Family Advisory Council and Quality & Safety team.
3:00 pm
Transition Break
AFTERNOON MINI SUMMITS GROUP II: 3:15 pm – 4:15 pm
(Choose one Mini Summit only)
Mini Summit V: Supporting Primary Care: Comprehensive Primary Care Plus (CPC+) and other Primary Care Models
3:15 pm
Welcome, Introductions, Discussions and Q&A
Karen Johnson, MHA
Vice President, Healthcare Insights and Partnerships, Blue Cross and Blue Shield of Kansas City, Kansas City, MO
Vice President, Healthcare Insights and Partnerships, Blue Cross and Blue Shield of Kansas City, Kansas City, MO
Karen Johnson is the Vice President, Healthcare Insights and Partnerships of Blue Cross and Blue Shield of Kansas City (Blue KC). Karen is responsible for delivering healthcare insights that inform healthcare strategies from both the employer and provider perspective. She is also responsible for the overall provider experience which includes relationship management as well as the operational services that support providers in Blue KC networks and programs.
Karen has worked in a variety of roles throughout the health insurance and health care industries for more than 30 years. She served as an internal consultant to Blue KC for six years and played an integral role in product development, marketing, and integrated health services. Previously, she worked as a benefits consultant, helping employers find new approaches to benefit design.
Karen has worked in a variety of roles throughout the health insurance and health care industries for more than 30 years. She served as an internal consultant to Blue KC for six years and played an integral role in product development, marketing, and integrated health services. Previously, she worked as a benefits consultant, helping employers find new approaches to benefit design.
R. Shawn Martin
Senior Vice President, Advocacy, Practice Advancement and Policy, American Academy of Family Physicians (AAFP), Washington, DC
Senior Vice President, Advocacy, Practice Advancement and Policy, American Academy of Family Physicians (AAFP), Washington, DC
Shawn Martin, senior vice president, advocacy, practice advancement and policy at the AAFP, is responsible for overseeing the AAFP Division of Government Relations and the Robert Graham Center for Policy Studies in Family Medicine and Primary Care in Washington, DC, as well as the Division of Practice Advancement.
Prior to joining AAFP, Martin served as director of government relations and health policy and director of socioeconomic affairs at the American Osteopathic Association, director of government relations and health policy, director of socioeconomic affairs and deputy director of government relations and director of congressional affairs.
Martin has served on multiple boards, including National Quality Assurance Coalition Patient Centered Medical Home Advisory Board, Agency for Healthcare Research and Quality Practice Transformation Advisory Board, Hospital and Facilities Accreditation Program Patient-Centered Medical Home Advisory Panel. He has served as chair of the Health Coalition on Liability and Access and is an active member of the Patient Centered Primary Care Collaborative.
Prior to joining AAFP, Martin served as director of government relations and health policy and director of socioeconomic affairs at the American Osteopathic Association, director of government relations and health policy, director of socioeconomic affairs and deputy director of government relations and director of congressional affairs.
Martin has served on multiple boards, including National Quality Assurance Coalition Patient Centered Medical Home Advisory Board, Agency for Healthcare Research and Quality Practice Transformation Advisory Board, Hospital and Facilities Accreditation Program Patient-Centered Medical Home Advisory Panel. He has served as chair of the Health Coalition on Liability and Access and is an active member of the Patient Centered Primary Care Collaborative.
Laura Sessums, MD
Director, Division of Advanced Primary Care, Center for Medicare and Medicaid Innovation; Former Chief, General Medicine Section, Walter Reed Army Medical Center, Baltimore, MD
Director, Division of Advanced Primary Care, Center for Medicare and Medicaid Innovation; Former Chief, General Medicine Section, Walter Reed Army Medical Center, Baltimore, MD
Laura Sessums joined CMMI as the Director of the Division of Advanced Primary Care in 2013. At CMMI, she oversees the Comprehensive Primary Care Plus (CPC+) initiative, America’s largest multi-payer initiative to improve primary care. Until it ended in 2016, she ran the CPC initiative, an early CMMI multi-payer model to transform primary care payment and care delivery. Previously, she worked in academic medicine as a clinician-educator, mostly at Walter Reed Army Medical Center (as a civilian), where she served as the Chief of the General Medicine Section. She is a practicing general internist.
Fahad Tahir, MBA
President and Chief Executive Officer, Saint Thomas Medical Partners; Former Vice President, Physician Enterprise, Providence Health System, Nashville, TN
President and Chief Executive Officer, Saint Thomas Medical Partners; Former Vice President, Physician Enterprise, Providence Health System, Nashville, TN
Fahad Tahir is Chief Executive Officer of Saint Thomas Medical Partners at Saint Thomas Health and a Fellow in the American College of Healthcare Executives. Fahad is also a Fellow of Washington DC’s Health Care Advisory Board. Fahad’s responsibilities for Saint Thomas Health include overseeing clinical, operational and financial performance of Saint Thomas Medical Partners, as well as physician network strategy, physician development and recruitment, and service line development.
Prior to joining Saint Thomas Health, Fahad served as Vice President of Physician Enterprise and Community Health Network at Providence, a health system in Washington, D.C. He was also Executive Sponsor for the implementation of a Health Information Exchange (HIE), an integrated EMR system that brings together the health records of multiple physician group practices, clinics, hospitals and health centers. Prior, held roles physician practice development, acquisitions and practice management at Columbia St. Mary’s Health System in Milwaukee, WI.
Prior to joining Saint Thomas Health, Fahad served as Vice President of Physician Enterprise and Community Health Network at Providence, a health system in Washington, D.C. He was also Executive Sponsor for the implementation of a Health Information Exchange (HIE), an integrated EMR system that brings together the health records of multiple physician group practices, clinics, hospitals and health centers. Prior, held roles physician practice development, acquisitions and practice management at Columbia St. Mary’s Health System in Milwaukee, WI.
Edith Coakley Stowe, MPA
Senior Manager, Manatt Health; Former Team Lead, Comprehensive Primary Care (CPC) Initiative, Center for Medicare and Medicaid Innovation, Centers for Medicare and Medicaid Services, Washington, DC (Moderator)
Senior Manager, Manatt Health; Former Team Lead, Comprehensive Primary Care (CPC) Initiative, Center for Medicare and Medicaid Innovation, Centers for Medicare and Medicaid Services, Washington, DC (Moderator)
Edith Coakley Stowe is a senior manager with Manatt Health, an interdisciplinary policy and business advisory practice of Manatt. Edith guides health systems in designing, developing and implementing innovative delivery models to improve the management and provision of healthcare. She focuses on providing project management leadership, clinical process design, quantitative analysis and health reform strategic consulting.
Prior to Manatt, Edith served as a Health Insurance Specialist at the Center for Medicare and Medicaid Innovation (CMMI) within the Centers for Medicare and Medicaid Services (CMS). Before CMS, Edith was a special assistant at the Office of the State Superintendent of Education for the District of Columbia Government. She started her career as a Barrister at Outer Temple Chambers in London, UK and later served as an associate for the Judge David Bazelon Center for Mental Health Law in Washington, D.C.
Prior to Manatt, Edith served as a Health Insurance Specialist at the Center for Medicare and Medicaid Innovation (CMMI) within the Centers for Medicare and Medicaid Services (CMS). Before CMS, Edith was a special assistant at the Office of the State Superintendent of Education for the District of Columbia Government. She started her career as a Barrister at Outer Temple Chambers in London, UK and later served as an associate for the Judge David Bazelon Center for Mental Health Law in Washington, D.C.
Mini Summit VI: Lessons Learned from the First Round of Alternative Payment Model (APM) Proposals Reviewed by the Physician-Focused Payment Model Technical Advisory Committee (PTAC)
3:15 pm
Welcome, Introductions, Discussions and Q&A
Regarding Project Sonar
Lawrence Kosinski, MD, MBA, AGAF, FACG
Managing Partner, Illinois Gastroenterology Group; President, SonarMD, LLC; Community Private Practice Councillor, AGA Governing Board, Elgin, IL
Regarding ACS-Brandeis Advanced APM
Christopher P. Tompkins, PhD
Director, Institute on Healthcare Systems, Associate Professor, Heller School for Social Policy and Management, Brandeis University, Waltham, MA
Christopher Tompkins led the research team that pioneered development of the Medicare shared savings payment model, and the blueprint for the Physician Group Practice demonstration, which became the basis for today’s Accountable Care Organizations (ACOs). He led the design of Medicare Hospital Value-Based Purchasing (HVBP). He directed the development of the Episode Grouper for Medicare (EGM). He is leading support for design innovation and empirical modeling of policy options for CMS regarding the Merit-Based Incentive Payment System (MIPS). He co-developed a new APM with the American College of Surgeons, which evaluates team-based care in an episode framework.
Mini Summit VII: The Evolving Role of BPCI in MACRA
3:15 pm
Welcome, Introductions, Discussions and Q&A
Nick Bluhm, MA, JD
Director, Strategy and Government Policy, Remedy Partners; Litigation Attorney/Health Insurance Specialist, US Department of Health and Human Services, New York, NY
Director, Strategy and Government Policy, Remedy Partners; Litigation Attorney/Health Insurance Specialist, US Department of Health and Human Services, New York, NY
Danielle Lloyd, MPH
Vice President of Policy and Advocacy, Premier Inc.; Former Senior Associate Director, American Hospital Association; Former Vice President, California Hospital Association, Washington, DC
Vice President of Policy and Advocacy, Premier Inc.; Former Senior Associate Director, American Hospital Association; Former Vice President, California Hospital Association, Washington, DC
Danielle Lloyd is the vice president for policy and advocacy as well as deputy director of the Washington, DC office of the Premier healthcare alliance. Danielle leads Premier’s policy analysis and development. Lloyd works with lawmakers, the White House, and other major stakeholders involved in healthcare policy and regulation. She also plays a leading role in Premier’s large-scale provider collaboratives by helping providers operationalize new federal policies and Premier’s non-profit research arm that seeks to share knowledge broadly across the country.
Prior to coming to Premier, Lloyd worked on an array of healthcare issues including Medicare and Medicaid payment, quality policies, and health information technology for the American Hospital Association, California Hospital Association, the U.S. House of Representatives Committee on Ways and Means and the Centers for Medicare & Medicaid Services. Danielle is an active volunteer for Sibley Memorial Hospital’s Patient & Family Advisory Council and Quality & Safety team.
Prior to coming to Premier, Lloyd worked on an array of healthcare issues including Medicare and Medicaid payment, quality policies, and health information technology for the American Hospital Association, California Hospital Association, the U.S. House of Representatives Committee on Ways and Means and the Centers for Medicare & Medicaid Services. Danielle is an active volunteer for Sibley Memorial Hospital’s Patient & Family Advisory Council and Quality & Safety team.
Erin Smith, JD
Director, Public Policy, Cardinal Health; Former Director, Division of Technical Model Support and Lead Bundled Payments for Care Improvement (BPCI) Initiative, CMMI, Center for Medicare and Medicaid Services, Washington, DC
Director, Public Policy, Cardinal Health; Former Director, Division of Technical Model Support and Lead Bundled Payments for Care Improvement (BPCI) Initiative, CMMI, Center for Medicare and Medicaid Services, Washington, DC
Erin Smith is Director of Public Policy at Cardinal Health where she serves as the lead policy expert for public payment policy and value-based care models for the Federal Government Relations group. Previously, she led the policy arm for naviHealth, a Cardinal Health company, in which she focused on bundled payments, care transitions, and post-acute care. Prior to Cardinal Health, Erin worked at CMS in the Center for Medicare and Medicaid Innovation, leading the team that implements the Bundled Payments for Care Improvement Initiative. Erin also brings experience from her time with the World Health Organization in Geneva, Switzerland and Avalere Health.
Grace Emerson Terrell, MD, MMM, FACP, FACPE
Chief Executive Officer, Envision Genomics; Former President and Chief Executive Officer, Cornerstone Health Care; Member, Physician-Focused Payment Model Technical Advisory Committee, Huntsville, AL
Chief Executive Officer, Envision Genomics; Former President and Chief Executive Officer, Cornerstone Health Care; Member, Physician-Focused Payment Model Technical Advisory Committee, Huntsville, AL
Dr. Grace Terrell is CEO of Envision Genomics, helping clinicians diagnose rare disease through the integration of genomic data into clinical care. As a leader in health care delivery system reform, Dr. Terrell speaks to health systems, provider groups and professional organizations about the importance of improving population health through patient care model redesign, clinical and information integration, and value-based compensation.
In 2013, Dr. Terrell launched CHESS, a company dedicated to helping health systems and other medical groups make the transition to value-based medicine. For over 16 years, Dr. Terrell served as the President and CEO of Cornerstone Health Care.
Dr. Terrell currently serves on the U.S. Department of Health and Human Services’ Physician-Focused Payment Model Technical Advisory Committee, the Board of Directors of the American Medical Group Association, the American Medical Association’s Integrated Physician section, and the Oliver Wyman Health Innovation Center’s Leadership Alliance. She is also a practicing internist.
In 2013, Dr. Terrell launched CHESS, a company dedicated to helping health systems and other medical groups make the transition to value-based medicine. For over 16 years, Dr. Terrell served as the President and CEO of Cornerstone Health Care.
Dr. Terrell currently serves on the U.S. Department of Health and Human Services’ Physician-Focused Payment Model Technical Advisory Committee, the Board of Directors of the American Medical Group Association, the American Medical Association’s Integrated Physician section, and the Oliver Wyman Health Innovation Center’s Leadership Alliance. She is also a practicing internist.
Valinda Rutledge, MBA
Vice President, Public Payor Health Strategy, Care Coordination Institute, Greenville Health System; Former Group Director of Patient Care Model Group and BPCI Lead, Centers for Medicare and Medicaid Services, Greenville, SC (Moderator)
Vice President, Public Payor Health Strategy, Care Coordination Institute, Greenville Health System; Former Group Director of Patient Care Model Group and BPCI Lead, Centers for Medicare and Medicaid Services, Greenville, SC (Moderator)
Valinda Rutledge is the Vice President, Public Payor Health Strategy in the Care Coordination Institute at Greenville Health System, SC. She is responsible for identifying, analyzing, and supporting the implementation of opportunities related to government initiatives such as Bundled payments, Medicare advantage, Medicaid pilots, Dual Eligible, PCMH, and ACOs. She previously worked as a member of the leadership team (Senior Advisor and Group Director) at the Center for Medicare and Medicaid Services Innovation (CMMI). Before joining CMS, Ms. Rutledge served as the Chief Executive Officer of CaroMont Health. Ms. Rutledge received the 2013 Becker’s Healthcare Leadership Award, which is given to the top 30 individuals in the nation who demonstrate leadership and impact to the industry on a national level. She currently serves on several National Scientific Advisory Boards including NaviHealth and as a Subject Matter Expert for SG2.
Mini Summit VIII: How Patient-Centered Care is the Key to MACRA Success
3:15 pm
Welcome, Introductions, Discussions and Q&A
Robert McCleave, JD
Law Office of Robert W. McCleave, LLC, Rock Hill, SC
Law Office of Robert W. McCleave, LLC, Rock Hill, SC
Kashyap Patel, MD
Managing Partner and Chief Executive Officer, Carolina Blood and Cancer Care; President, South Carolina Oncology Society, Charlotte, NC
Managing Partner and Chief Executive Officer, Carolina Blood and Cancer Care; President, South Carolina Oncology Society, Charlotte, NC
Michael S. Barr, MD, MBA, MACP
Executive Vice President, NCQA; Former Senior Vice President, Division of Medical Practice, American College of Physicians; Chief Medical Officer, Baltimore Medical System, Inc., Washington, DC (Moderator)
Executive Vice President, NCQA; Former Senior Vice President, Division of Medical Practice, American College of Physicians; Chief Medical Officer, Baltimore Medical System, Inc., Washington, DC (Moderator)
Michael S. Barr is a board-certified internist and Executive Vice President for the Quality Measurement & Research Group at NCQA. His portfolio at NCQA includes performance measurement development, research, managing NCQA’s contracts and grants portfolio and contributing to strategic initiatives, public policy and educational programs. Prior to joining NCQA, Dr. Barr was Senior Vice President, Division of Medical Practice for the American College of Physicians, where he was responsible for promoting patient-centered care through the development of programs, services and quality improvement initiatives for internists and other health care professionals.
Dr. Barr’s previous experience includes Chief Medical Officer for Baltimore Medical System, Inc., and he practiced internal medicine full-time in the Division of General Internal Medicine at Vanderbilt University and held various administrative positions, including physician director, Medical Management Programs, for the Vanderbilt Medical Group. Dr. Barr was an active duty physician in the United States Air Force at Moody Air Force Base, Georgia.
Dr. Barr’s previous experience includes Chief Medical Officer for Baltimore Medical System, Inc., and he practiced internal medicine full-time in the Division of General Internal Medicine at Vanderbilt University and held various administrative positions, including physician director, Medical Management Programs, for the Vanderbilt Medical Group. Dr. Barr was an active duty physician in the United States Air Force at Moody Air Force Base, Georgia.
4:15 pm
Transition Break
MINI SUMMITS GROUP III 4:30 pm – 5:30 pm
(Choose one Mini Summit only)
Mini Summit IX: MACRA and Medicare Advantage Alternative Payment Models
4:30 pm
Welcome, Introductions, Discussions and Q&A
Anshu Choudhri
Managing Director, Legislative and Regulatory Policy at Blue Cross Blue Shield Association, Washington, DC
Managing Director, Legislative and Regulatory Policy at Blue Cross Blue Shield Association, Washington, DC
Anshu has been with the Blue Cross Blue Shield Association for twelve years.In his current role in the Office of Policy and Representation, Anshu is responsible for advising BCBSA leadership on legislative and regulatory policy analysis, with an emphasis on various components of the Affordable Care Act, delivery system reform, MACRA, rising prescription drug costs, substance use disorder, healthcare quality, and network adequacy. Across these content areas, Anshu works with BCBS Plans to develop consensus opinion on proposed regulations and legislation and is responsible for the development of comment letters to various government agencies or responses to Congressional requests for information. Additionally, Anshu works closely with government agencies, Congressional staff and industry stakeholders in Washington to represent the BCBS Plan perspective and to develop partnerships for future collaboration.
Edward Jhu, FSA, MAAA
Principal & Consulting Actuary, Milliman, Seattle, WA
Principal & Consulting Actuary, Milliman, Seattle, WA
Edward Jhu is a principal and consulting actuary specializing in healthcare consulting in the Seattle office of Milliman. He joined the firm in 1999. Ed’s expertise is in group healthcare, with an emphasis on government sponsored programs, (including Medicare and VHA) and health care payer/provider relations. His experience covers a broad spectrum, including providers, payers and purchasers. His consulting assignments have included evaluation and comparison of provider contracts, including development of the Hospital Evaluation and Comparison System (HECS) and Global RVUs, Medicare-based contract comparison tools. He also has experience in the development and review of alternative provider payment arrangements, supporting both providers and payers and the development of reasonable and customary charge models. In addition to his experience in healthcare, Ed also has extensive employee benefits experience with both Milliman and other consulting firms.
John O’Shea, MD
Senior Fellow, Center for Health Policy Studies, The Heritage Foundation; Former Senior Health Policy Advisor, Committee on Energy and Commerce, US House of Representatives, Washington, DC
Senior Fellow, Center for Health Policy Studies, The Heritage Foundation; Former Senior Health Policy Advisor, Committee on Energy and Commerce, US House of Representatives, Washington, DC
Mara McDermott, JD
Vice President, Federal Affairs, CAPG, Washington, DC (Moderator)
Vice President, Federal Affairs, CAPG, Washington, DC (Moderator)
Mara McDermott serves as the Vice President of Federal Affairs for CAPG, heading up the association’s federal legislative and regulatory activities in Washington, DC. Mara works on behalf of CAPG member organizations to advance policies that promote coordinated care. This role includes advocacy and education efforts with members of Congress and their staffs, the Administration, and other health policy stakeholders.
Prior to joining CAPG, Mara was Counsel in the health industry practice at Akin Gump Strauss Hauer & Feld. In this role, she focused on a variety of issues affecting health industry clients, with a particular emphasis on health policy and regulatory issues facing physician organizations, hospitals, pharmaceutical companies, and academic medical institutions.
Prior to joining CAPG, Mara was Counsel in the health industry practice at Akin Gump Strauss Hauer & Feld. In this role, she focused on a variety of issues affecting health industry clients, with a particular emphasis on health policy and regulatory issues facing physician organizations, hospitals, pharmaceutical companies, and academic medical institutions.
Mini Summit X: Bundled Payments and Other APMs for Surgical Care
4:30 pm
Welcome, Introductions, Discussions and Q&A
Stephen J. Lahey, MD
Professor and Chief, Division of Cardiothoracic Surgery, Vice Chair, Quality Improvement, Department of Surgery, University of Connecticut School of Medicine, UCONN Health, Farmington, CT
Professor and Chief, Division of Cardiothoracic Surgery, Vice Chair, Quality Improvement, Department of Surgery, University of Connecticut School of Medicine, UCONN Health, Farmington, CT
Dr. Lahey is Professor of Surgery, University of Connecticut School of Medicine and Chief of the Division of Cardiothoracic Surgery at the Pat and Jim Calhoun Cardiology Center at the University of Connecticut Health Center. Dr. Lahey is actively involved in national advisory panels through the American Medical Association, American College of Cardiology and the American Heart Association, which are rewriting national guidelines for cardiac surgery. He is also a member of the New York State Department of Health’s Cardiac Advisory Committee and Chairman of its subcommittee on Quality Assurance and past President of the New York Society for Thoracic Surgeons. He is also Vice Chair of the Society of Thoracic Surgeons Workforce on Coding and Reimbursement and Chair of the Society of Thoracic Surgeons Workforce on Health Policy, Reform and Advocacy.
Win Whitcomb, MD, MHM
Chief Medical Officer, Remedy Partners; Assistant Professor of Medicine, University of Massachusetts Medical School; Co-Founder and Past President, Society of Hospital Medicine, Darien, CT
Chief Medical Officer, Remedy Partners; Assistant Professor of Medicine, University of Massachusetts Medical School; Co-Founder and Past President, Society of Hospital Medicine, Darien, CT
Win Whitcomb serves as Chief Medical Officer for Remedy Partners. He oversees all aspects of the clinical enterprise, and the intersection between clinical, technology, and business areas. Prior to joining Remedy, Dr. Whitcomb led the development and implementation of several bundled payment programs at Baystate Health in conjunction with its commercial health plan and the Center for Medicare and Medicaid Innovation.
Dr. Whitcomb has led the development of the hospitalist specialty since 1994, when he assumed leadership of the nation’s first 24/7 on-site hospitalist program. Dr. Whitcomb is co-founder and past president of the Society of Hospital Medicine. , He has been on the ground floor of a myriad of initiatives that form the foundation of the hospitalist movement, including working with the American Board of Internal Medicine to create board certification for hospitalists.
He also serves as Assistant Professor of Medicine at the University of Massachusetts Medical School.
Dr. Whitcomb has led the development of the hospitalist specialty since 1994, when he assumed leadership of the nation’s first 24/7 on-site hospitalist program. Dr. Whitcomb is co-founder and past president of the Society of Hospital Medicine. , He has been on the ground floor of a myriad of initiatives that form the foundation of the hospitalist movement, including working with the American Board of Internal Medicine to create board certification for hospitalists.
He also serves as Assistant Professor of Medicine at the University of Massachusetts Medical School.
Harold D. Miller
President and Chief Executive Officer, Center for Healthcare Quality and Payment Reform; Member, Physician-Focused Payment Model Technical Advisory Committee; Adjunct Professor, Carnegie Mellon University, Pittsburgh, PA (Moderator)
President and Chief Executive Officer, Center for Healthcare Quality and Payment Reform; Member, Physician-Focused Payment Model Technical Advisory Committee; Adjunct Professor, Carnegie Mellon University, Pittsburgh, PA (Moderator)
Harold Miller is the President and CEO of the Center for Healthcare Quality and Payment Reform (CHQPR) and serves as Adjunct Professor of Public Policy and Management at Carnegie Mellon University. He has twice given invited testimony to Congress on how to reform healthcare payment, and has worked to help design and implement payment and delivery system reforms. He is one of the eleven members of the federal Physician-Focused Payment Model Technical Advisory Committee that was created by Congress to advise the Secretary of Health and Human Services on the creation of alternative payment models. He has assisted numerous organizations in developing alternative payment models designed to support better care for patients at lower cost. Previously, Miller served as the President and CEO of the Network for Regional Healthcare Improvement (NRHI), as a member of the Board of Directors of the National Quality Forum, and served as the Strategic Initiatives Consultant to the Pittsburgh Regional Health Initiative (PRHI).
Mini Summit XI: What MACRA Means for Employers: Purchaser Priorities and Alignment with the Quality Payment Program
4:30 pm
Welcome, Introductions, Discussions and Q&A
Leah Binder
President and Chief Executive Officer of The Leapfrog Group, Washington, DC
President and Chief Executive Officer of The Leapfrog Group, Washington, DC
Leah Binder is President & CEO of The Leapfrog Group. She is a regular contributor to Forbes.com, the Huffington Post, and the Wall Street Journal expert forum. She was named on Becker’s list of the 50 most powerful people in healthcare in 2014, and cited by Modern Healthcare among the 100 most influential people and top 25 women in healthcare in 2013.
Under her leadership, The Leapfrog Group launched the Hospital Safety Score, which assigns letter grades assessing the safety of general hospitals across the country. She has also fostered groundbreaking innovations in the annual Leapfrog Hospital Survey, including partnerships to eliminate early elective deliveries, central line-associated bloodstream infections and safe use of health technology.
Under her leadership, The Leapfrog Group launched the Hospital Safety Score, which assigns letter grades assessing the safety of general hospitals across the country. She has also fostered groundbreaking innovations in the annual Leapfrog Hospital Survey, including partnerships to eliminate early elective deliveries, central line-associated bloodstream infections and safe use of health technology.
Linda Brady
ACO Portfolio Manager, Health Care Strategy and Policy, Boeing, Chicago, IL
ACO Portfolio Manager, Health Care Strategy and Policy, Boeing, Chicago, IL
Linda Brady is a member of the Health Care Strategy and Policy team at The Boeing Company. In her role, Linda manages the overall portfolio of Boeing’s Preferred Partnership (ACO) programs, from the initial contracting phase through implementation and sustainment. She has over 20 years of experience in the health care industry and is a Six Sigma Green Belt. Prior to Boeing, Linda was a consultant at two of the leading health benefits consulting firms where she advised large complex organizations on their health care benefits strategy, including direct contracting arrangements, TPA integration, ACO implementations and measurement.
Stephanie Glier, MPH
Senior Manager, National Health Policy, Pacific Business Group on Health; Former Program Analyst, US Department of Health and Human Services; Former Associate Policy Officer, Commonwealth Fund, San Francisco, CA
Senior Manager, National Health Policy, Pacific Business Group on Health; Former Program Analyst, US Department of Health and Human Services; Former Associate Policy Officer, Commonwealth Fund, San Francisco, CA
Stephanie Glier is Senior Manager for National Health Policy at the Pacific Business Group on Health. Stephanie leads the Consumer-Purchaser Alliance, a collaboration of leading consumer and purchaser groups working together toward a high-value health care system through performance measurement, value-based payment, and care redesign. Stephanie’s work includes building consensus among consumers and purchasers and advocating for consumer and purchaser interests in national policy related to improving the quality, patient experience, and affordability of the health care system.
Prior to joining PBGH, Stephanie served as a program analyst for the U.S. Department of Health and Human Services (HHS) in Washington, D.C., working to improve health care quality and outcomes. At HHS, Stephanie shaped the strategic direction of HHS quality measurement and public reporting initiatives. Previously, she served as Associate Policy Officer at the Commonwealth Fund where she worked to implement a national policy strategy for improving health system performance.
Prior to joining PBGH, Stephanie served as a program analyst for the U.S. Department of Health and Human Services (HHS) in Washington, D.C., working to improve health care quality and outcomes. At HHS, Stephanie shaped the strategic direction of HHS quality measurement and public reporting initiatives. Previously, she served as Associate Policy Officer at the Commonwealth Fund where she worked to implement a national policy strategy for improving health system performance.
Amy Tippett Stangler
Senior Director, Northeast Business Group on Health, New York, NY
Senior Director, Northeast Business Group on Health, New York, NY
Amy Tippett-Stangler is the Senior Director for Northeast Business Group on Health (NEBGH) and leads the New York State State Innovation Model (SIM) for Advanced Primary Care (APC). In this role, she holds overall accountability for the strategic initiative that brings together purchasers, payers, providers and government in order to create a new value based payment model designed to achieve the Triple Aim – improving health, enhancing quality and reducing costs for all New Yorkers. Ms. Stangler worked for Highmark Blue Cross Blue Shield and Oxford Health Plans, where she worked with the Medicare market and intensive care management programs. Previously, she also worked at Pitney Bowes, Yale New Haven Hospital and Mount Sinai Health System, where she implemented the strategy for physician solicitation, contracting and ongoing provider relations. In addition, Ms. Stangler has experience at a population health management company where she served as Vice President, Health Plan Market.
Mini Summit XII: Developing Alternative Payment Models to Align Specialty Physicians and Payers in Value-Based Care Delivery
4:30 pm
Welcome, Introductions, Discussions and Q&A
Christian Downs, JD, MHA
Executive Director, Association of Community Cancer Centers, Rockville, MD
Executive Director, Association of Community Cancer Centers, Rockville, MD
Lance Luria, MD, FACP
Chief Medical Officer, Mercy Care Management, Mercy Health, Springfield, MO
Chief Medical Officer, Mercy Care Management, Mercy Health, Springfield, MO
Paul Marchetti, MBA
Chief Growth Officer, New Century Health; Vice President, National Care Management Team, Healthagen LLC; Former Head, National Care Management, Aetna Inc.; Former Senior Vice President, Network and Medical Cost Management, UnitedHealth Group, Wellesley, MA
Chief Growth Officer, New Century Health; Vice President, National Care Management Team, Healthagen LLC; Former Head, National Care Management, Aetna Inc.; Former Senior Vice President, Network and Medical Cost Management, UnitedHealth Group, Wellesley, MA
Paul Marchetti is responsible for the national growth and adoption of NCH’s value-based specialty care solutions by risk-bearing provider groups, health plans and management services (MSOs). He brings more than 25 years of experience in leading service delivery transformation for health plans and health systems. Prior to joining NCH, Paul concluded more than a decade of national care and physician network leadership at Aetna, where his national care management responsibilities included P&L, product development and product sales for Aetna’s Commercial and Medicare clinical operations. During his tenure, Paul successfully led the integration of clinical operations and services after Aetna’s acquisition of Coventry Health Care. He was also responsible for the implementation of clinical programs supporting Aetna’s ACO and joint venture relationships. Before joining Aetna, he held senior executive network management roles at United Healthcare and Horizon Healthcare and management positions at Physicians Health Services and Saint Joseph’s Medical Center.
Mark L. Sobczak, MD
Clinical Director, Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA
Clinical Director, Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA
5:30 pm
Networking Reception