pay for performance healthcare conference
pay for performance healthcare conference
pay for performance healthcare conference
pay for performance healthcare conference
pay for performance healthcare conference
pay for performance healthcare conference



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




Go to Agenda:
Preconference / Day 1 | Day 3

Agenda: Pay for Performance Summit: Day II
Tuesday, March 3, 2015
7:00 a.m. Registration

MORNING PLENARY SESSION
8:00 a.m. Health Beyond Health Care: A Role for Care Delivery and Financing Systems?

There is a growing awareness of the limitations of the influence of health care delivery on the long term health of individuals and communities. Dr. George Isham will discuss the impact (and limits) of health care on individual and population health, and the emerging recognition of the importance of social determinants of health. Topics include how to think about a provider organization's relationship to these social determinants, community business models and organizational performance metrics, and incentives for improving health and their role in the overall health payment system.

George Isham, MD
Chief Health Officer and Plan Medical Director, Health Partners, Minneapolis, MN

    Speaker Bio

    Quote
    "We can substantially improve the health of communities and the care of patients through thoughtful and determined effort."

    Career
    As Senior Advisor, Dr. Isham is responsible for working with the senior management team of HealthPartners on health and quality of care improvement for patients, members and the community. Prior to his appointment as Senior Advisor in 2012, Dr. Isham served as HealthPartners' Medical Director and Chief Health Officer, a position he was appointed to in 1993. Dr. Isham is also Senior Fellow, HealthPartners Institute for Education and Research. As Senior Fellow, he is responsible for facilitating progress at the intersection of population health research and public policy.

    Prior to his current tenure at HealthPartners, Dr. Isham was medical director for MedCenters Health Plan in Minneapolis and executive director for University Health Care, Inc., in Madison, Wisconsin. His practice experience as a primary care physician included three years in the United States Navy, eight years at the Freeport Clinic in Freeport, Illinois, and three and one-half years as clinical assistant professor in Medicine at the University of Wisconsin.

    About HealthPartners
    Founded in 1957, the HealthPartners (www.healthpartners.com) family of healthcare companies serves more than one million medical and dental health plan members nationwide. It is the largest consumer-governed, nonprofit health care organization in the nation, providing care, coverage, research and education to improve the health of members, patients and the community.
    Presentation Material (Acrobat)

8:30 a.m.

State Innovation Models, Round 2

Alan Weil, Editor-in-Chief of Health Affairs, will moderate a panel of representatives from states that have received the State Innovation Model (SIM) Round 2 grants. In what is arguably the most creative and high-potential project sponsored by the Center for Medicare & Medicaid Innovation, the State Innovation Models Initiative provided nearly $300 million in the first round of funding to 25 states to design or test improvements to health care delivery and payment systems. The SIM projects offer an unprecedented opportunity to drive multi-payer change in ways that meet the diverse needs of states across the country.

Courtney Burke
Deputy Secretary for Health, Office of Governor Andrew M. Cuomo, Albany, NY
Greg Moody
Director, Governor's Office of Health Transformation, Columbus, OH

    Speaker Bio

    Ohio Governor John R. Kasich appointed Greg Moody to lead the Office of Health Transformation. OHT is responsible for engaging private sector partners to improve overall health system performance. Greg began his public service career as a budget associate for the U.S. House Budget Committee in Washington D.C. The Budget Chairman at the time, Rep. John Kasich, asked Greg to study the impact of Medicaid on federal spending - an assignment that set the course for his public policy career. Prior to joining the Kasich Administration, Greg was a senior consultant at Health Management Associates, and prior to that Interim Director of the Ohio Department of Job and Family Services, and Chief of Staff to the Dean at the Ohio State University College of Medicine.
    Presentation Material (Acrobat)
Dorothy Teeter
Director, Washington State Health Care Authority, Olympia, WA

    Speaker Bio

    Dorothy Teeter was appointed by Washington State Governor Jay Inslee in 2013 as Director of the state's Health Care Authority, which includes the state's two major health care purchasers ? the Medicaid program and state employee and retiree health benefits. Prior to that, she was a Senior Advisor in Policy and Programs at the Center for Medicare and Medicaid Innovation, Interim Director and Health Officer and Chief of Health Operations for Public Health in Seattle and King County. She also served earlier as a senior executive at Group Health Cooperative. Ms. Teeter holds a Master's degree in Health Services Administration from the School of Public Health at the University of Washington and is a Clinical Assistant Professor in the Department of Health Services at the University of Washington.
    Presentation Material (Acrobat)
Alan Weil, JD
Editor-in-Chief, Health Affairs, Washington, DC (Moderator)

    Speaker Bio

    Alan Weil became the Editor-in-Chief of Health Affairs on June 1, 2014. A multidisciplinary peer-reviewed journal dedicated to the serious exploration of domestic and international health policy and system change, Health Affairs is the nation's leading journal at the intersection of health, health care, and policy.

    For the previous decade he was the executive director of the National Academy for State Health Policy (NASHP). Previously, he directed the Urban Institute's Assessing the New Federalism project, held a cabinet position as executive director of the Colorado Department of Health Care Policy and Financing, and was assistant general counsel in the Massachusetts Department of Medical Security.

    He earned his bachelor's degree from the University of California at Berkeley, a master's degree from Harvard's Kennedy School of Government, and a J.D. from Harvard Law School.
10:00 a.m.
Refreshment Break in Exhibit Hall

MINI-SUMMITS
(Choose one Mini Summit only)
Mini-Summit IV: Patient-Reported Outcome Measures: What Will It Take To Realize The Promise?
10:30 a.m.
There is widespread agreement that patient-reported outcome measures (PROMs) represent an important -- even essential -- direction for performance measurement. At the intersection of an outcomes focus with emphasis on patient-centered care, PROMs have received increasing attention in recent years and significant progress has been made on developing the measures and moving them into practice. Yet, major challenges remain. This session features a physician who cares for patients and conducts research, and has created a free and open source Collaborative Health Outcomes Information Registry that features PROMs; a national leader in quality measurement who has spearheaded public reporting of PROMs in Minnesota; and a health plan executive who is working toward incorporating PROMs into performance standards for contracted provider networks.
Jim Chase, MHA
President, Minnesota Community Measurement, Minneapolis, MN

    Speaker Bio

    Jim is the President of MN Community Measurement, a non-profit organization whose mission is to improve the health of the community by publicly reporting information on health care quality. Community Measurement reports 76 measures on chronic and preventive care, procedural specialist care, hospital care, health information technology, patient experience, and cost. Community Measurement reports results on over 670 physician practice sites in Minnesota and surrounding communities. Jim is the Past Chair of the Network of Regional Healthcare Improvement, a group of leading regional health initiatives working to improve the quality and value of health in their communities. Jim also serves on the boards of the Institute of Clinical Systems Improvement, National Quality Forum and Apple Tree Dental.
    Presentation Material (Acrobat)
Sean Mackey, MD, PhD
Redlich Professor and Professor, by Courtesy, of Neurology; Chief, Division of Pain Medicine, Stanford University, Stanford, CA

Presentation Material (Acrobat)
Marcus Thygeson, MD, MPH
Senior Vice President and Chief Health Officer, Blue Shield of California, San Francisco, CA

    Speaker Bio

    As chief health officer, Marcus Thygeson leads the Blue Shield of California (BSC) Healthcare Services team in support of our mission to ensure all Californians have access to high-quality affordable health care. Dr. Thygeson received his bachelor of science summa cum laude from the University of California at Davis, an M.D. from Harvard Medical School, and an M.P.H. from the University of Minnesota. He received his medical training at Virginia Mason Hospital, where he was chief medical resident, and at the University of California San Francisco. Dr. Thygeson is Board-Certified in Internal Medicine and Gastroenterology.
    Presentation Material (Acrobat)
Jill Yegian, PhD
Interim Chief Executive Officer and Senior Vice President, Programs and Policy, Integrated Healthcare Association, Oakland, CA (Moderator)

    Speaker Bio

    Jill Yegian, Ph.D. serves as Interim CEO and Senior Vice President for Programs and Policy at the Integrated Healthcare Association, a multi-stakeholder leadership group focused on improving the quality, affordability, and transparency of health care in California through performance measurement and payment innovation. Prior to joining IHA, she co-directed the American Institutes for Research's Health Policy and Research Group, a team of over 70 health services research professionals. At AIR, she led work related to cost and quality information, health insurance exchanges, and implementation of payment reform. Prior to joining AIR, Dr. Yegian spent 13 years with the California HealthCare Foundation, where she worked to improve the State's financing and delivery systems for health care. At CHCF, she led the foundation's efforts to increase coverage among California's uninsured, and served as its first director of research and evaluation.

    Dr. Yegian has published widely in peer-reviewed journals, authored a book, and presents to research, policy, and industry audiences regularly. She received a bachelor's degree in human biology from Stanford University and a Ph.D. in health services and policy analysis from the University of California at Berkeley.
12:00 p.m.
Lunch in Exhibit Hall

Mini-Summit V: Innovative Payment in Cancer Care
10:30 a.m.
Increasingly, health plans and delivery systems are seeking alternatives to fee-for-service payment that can help manage escalating oncology expenditures while providing excellent, patient-centered care. Wellpoint Health Networks, UnitedHealthcare, and Hill Physicians Medical Group have all created innovative payment programs designed to promote evidence-based oncology care and align incentives. At this session, speakers from each organization will share insights from the design and implementation of their initiatives, demonstrating diverse approaches to redesigning oncology programs to address cancer care within the context of effective population management.
David Joyner, MBA
Chief Operating Officer, Hill Physicians Medical Group; Chair, Integrated Healthcare Association, San Ramon, CA

Presentation Material (Acrobat)
Jennifer Malin, MD, PhD
Medical Director for Oncology and Care Management, WellPoint, Los Angeles, CA

Presentation Material (Acrobat)
Lee Newcomer, MD, MHA
Senior Vice President, Oncology, Genetics and Women's Health, UnitedHealthcare, Minneapolis, MN

    Speaker Bio

    Lee N. Newcomer, MD is the Senior Vice President at UnitedHealthcare for Oncology, Genetics and Women's Health.

    His career with UnitedHealth Group started in 1991 in the role of Chief Medical Officer focusing his work in the development of performance measures and incentives for the improvement of clinical care. In 2006 was appointed to lead the early initiative of combining clinical, financial and administrative incentives for improved and affordable cancer care; as of this day, his experience and results in this field have made Dr. Newcomer a well-known speaker and frequently guest in national and international conferences. His articles and studies have been featured in multiple publications.

    Prior to United Dr. Newcomer was the Medical Director for Cigna Healthcare, in Kansas City and is a founding member of Vivius, a consumer directed venture that allowed consumers to create their own personalized health plans. He is a board certified medical oncologist and practiced medical oncology for nine years in Tulsa and Minneapolis.
    Presentation Material (Acrobat)
Roger Tiao, PharmD
Clinical Pharmacy Coordinator, Hill Physicians Medical Group, San Ramon, CA
Ann Woo, PharmD
Clinical and Technical Advisor, Integrated Healthcare Association, Oakland, CA (Moderator)

    Speaker Bio

    Ann Woo is a Clinical and Technical Advisor for the Performance Measurement programs. Her responsibilities include supporting the day-to-day operations of the California Pay for Performance Program. She also supports the development of new measurement programs.

    Prior to joining IHA, Ann was the Director of Clinical Support at Hill Physicians Medical Group, a large Independent Physician Association. While at Hill Physicians, she integrated clinical quality measurements into the primary care physician incentive program and focused the organization's attention on clinical variation in specialty areas. Most recently, she implemented a Case Rate program for selected oncology practices in the network.
12:00 p.m.
Lunch in Exhibit Hall

Mini-Summit VI: Identifying Positive Deviance in Cost and Quality: Most Valuable Providers
10:30 a.m.
We know there is excellence in the U.S. healthcare system, as some physicians and hospitals are delivering higher quality care at a lower cost. Stanford University's Clinical Excellence Research Center (CERC) has conducted a quantitative, data-driven scan, leveraging a commercial claims database containing over 40 million covered lives and robust, validated measures to assess both quality and cost. They have identified and characterized providers that are delivering exceptional value -- higher quality at significantly less cost -- to their patients. Dr. Arnold Milstein and his team from Stanford will share insights into how high-performing primary care practices, specialists and community hospitals have defined a path toward better, more affordable healthcare.
Jim Frankfort, MD
Chief Medical Officer and Vice President, Clinical Informatics, IMS Health, San Francisco, CA

    Speaker Bio

    Jim Frankfort brings broad and varied experiences in Healthcare to his current position with IMS Health, including practicing medicine, advanced training in Quality/Process Improvement, deep Medical Informatics and IT experience, as well as Patient Safety program development expertise.

    Since 2007, he has served as the chief medical officer and been responsible for clinical informatics as a part of IMS Health solutions offered to healthcare payers and providers worldwide.

    Jim has practiced medicine for nearly 12 years as a private practice physician in pulmonary disease and critical care. During that time he also served as Physician?Information Services Liaison for Columbia Bay Area Healthcare and Good Samaritan Health System.

    Jim holds a B. A. degree from Lake Forest College, Illinois, and an M.D. degree from SUNY Downstate Medical Center, Brooklyn, New York.
Arnold Milstein, MD, MPH
Professor of Medicine and Director of the Clinical Excellence Research Center, Stanford University, Stanford, CA

    Speaker Bio

    Dr. Milstein is a Professor of Medicine and directs Stanford's Clinical Excellence Research Center. The Center designs and demonstrates in diverse locations scalable health care delivery innovations that provide more with less.

    Before joining Stanford's faculty, he created a national healthcare performance improvement firm that he expanded globally after its acquisition by Mercer. He subsequently co-founded three nationally influential public benefit initiatives, including the Leapfrog Group and was appointed as Congressional MedPAC Commissioner.

    He was elected to the Institute of Medicine (IOM) of the National Academy of Sciences and co-chaired its analysis of opportunities to safely slow national health spending growth.
Julia Murphy, MSc
American Idol in Medicine (AIM) Project Lead, Clinical Excellence Research Center, Stanford University, Stanford, CA
Melora Simon, MPH
American Idol in Medicine (AIM) Project Lead, Clinical Excellence Research Center, Stanford University, Stanford, CA

Presentation Material (Acrobat)
12:00 p.m.
Lunch in Exhibit Hall


1:00 p.m. Win, Win, Win Approaches to Accountable Care: How Physicians, Hospitals, Patients, and Payers Can All Benefit from Healthcare Payment and Delivery Reform
The current fee-for-service system causes many patients to receive poor quality, uncoordinated care and it causes both purchasers and patients to pay far more than necessary for healthcare services. Harold Miller, a nationally recognized expert on payment and delivery reform, says that payers and policy-makers don't really understand the specific ways in which the fee-for-service system creates barriers to improvement, and that most current efforts at "payment reform," such as shared savings, value-based purchasing, and procedural bundles, do little to overcome the barriers and can actually make things worse. Miller will describe how condition-based payments and other innovative payment models can enable primary care providers, specialists, and hospitals to remain financially healthy while improving care for patients and reducing spending for purchasers -- a win-win-win. He will describe specific examples from primary care, cardiology, oncology, and other specialties, and he will show how to build successful ACOs from the bottom up, instead of the top down.
Harold Miller
President and Chief Executive Officer, Center for Healthcare Quality and Payment Reform, Pittsburgh, PA

    Speaker Bio

    Harold D. Miller is the President and CEO of the Network for Regional Healthcare Improvement (NRHI) and the Executive Director of the Center for Healthcare Quality and Payment Reform (CHQPR). Miller also serves as Adjunct Professor of Public Policy and Management at Carnegie Mellon University.

    NRHI is the national association of multi-stakeholder Regional Health Improvement Collaboratives. Miller organized the Network for Regional Healthcare Improvement's national Summits on Healthcare Payment Reform, and he is currently helping a number of states and regions in the U.S. to design and implement payment and delivery system reforms.

    Miller is a nationally-recognized expert on healthcare payment and delivery reform, and has given invited testimony to the U.S. Congress on how to reform healthcare payment. He has authored a number of papers and reports on health care payment and delivery reform, including "From Volume to Value: Better Ways to Pay for Healthcare," which appeared in the journal Health Affairs, the Center for Healthcare Quality and Payment Reform's reports How to Create Accountable Care Organizations and Transitions to Accountable Care, and the American Medical Association's report Pathways for Physician Success Under Healthcare Payment and Delivery Reforms.
    Presentation Material (Acrobat)
2:00 p.m.
Refreshment Break in Exhibit Hall

MINI SUMMITS
(Choose one Mini Summit only)
Mini-Summit VII: Managing High-Cost Therapies in an Accountable Care Environment
2:15 p.m.
Throughout the health care system, we see greater emphasis on "value-based payment" -- paying for care that produces the desired health outcomes rather than simply providing services. At the same time, specialty drugs and other therapies have emerged with sky-high price tags for treating patients with cancer, hepatitis C, and other conditions. Are these market dynamics compatible? Do the high prices of specialty drugs reflect their value, or the monopoly pricing of pharmaceutical manufacturers? This session features perspectives from a leading expert on assessing the evidence regarding the value of therapies, a major integrated delivery system that both pays for and provides care, and a representative of payers struggling to pay for high-cost therapies with constrained budgets.
Mark Gibson
Director, Center for Evidence-based Policy, OHSU, Portland, OR

Presentation Material (Acrobat)
Sharon Levine, MD
Associate Executive Medical Director, The Permanente Medical Group, Oakland, CA

    Speaker Bio

    Sharon Levine, MD, is an Associate Executive Director for The Permanente Medical Group of Northern California (TPMG, Inc.), and has held multiple leadership roles within the medical group and within Kaiser Permanente nationally.

    Dr. Levine serves on the Boards of Directors of the Public Health Institute of California, the California Association of Physician Groups (CAPG), The Reagan Udall Foundation, the Medical Board of California, Insure the Uninsured Project (ITUP), and the Board of Governors of the Patient Centered Outcomes Research Institute (PCORI). She is a member of the Committee on Evidence-Based Benefit Design of the National Business Group on Health.
    Presentation Material (Acrobat)
Steven D. Pearson, MD, MSc
President, Institute for Clinical and Economic Review (ICER), Boston, MA

Presentation Material (Acrobat)
Jill Yegian, PhD
Interim Chief Executive Officer and Senior Vice President, Programs and Policy, Integrated Healthcare Association, Oakland, CA (Moderator)

    Speaker Bio

    Jill Yegian, Ph.D. serves as Interim CEO and Senior Vice President for Programs and Policy at the Integrated Healthcare Association, a multi-stakeholder leadership group focused on improving the quality, affordability, and transparency of health care in California through performance measurement and payment innovation. Prior to joining IHA, she co-directed the American Institutes for Research's Health Policy and Research Group, a team of over 70 health services research professionals. At AIR, she led work related to cost and quality information, health insurance exchanges, and implementation of payment reform. Prior to joining AIR, Dr. Yegian spent 13 years with the California HealthCare Foundation, where she worked to improve the State's financing and delivery systems for health care. At CHCF, she led the foundation's efforts to increase coverage among California's uninsured, and served as its first director of research and evaluation.

    Dr. Yegian has published widely in peer-reviewed journals, authored a book, and presents to research, policy, and industry audiences regularly. She received a bachelor's degree in human biology from Stanford University and a Ph.D. in health services and policy analysis from the University of California at Berkeley.
3:45 p.m.
Refreshment Break in Exhibit Hall

Mini-Summit VIII: Lessons Learned in Implementing Bundled Payment in the Public and Private Sectors

2:15 p.m.
Early pilots and large scale implementation of bundled payment in the private and public sectors have generated hard won lessons. These range from practical operational challenges, such as how to automate bundled payments, to often-overlooked regulatory and insurance benefit design issues. During this session, representatives from organizations actively involved in these efforts will describe the challenges they encountered and solutions developed along the way. They will also explore the importance of using reliable data to drive key decisions in the implementation process and some of the broader social and cultural changes necessary to succeed.
Francois de Brantes, MBA
Executive Director, Health Care Incentives Improvement Institute, Newtown, CT

    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)
Jay Sultan
Strategy Consultant, Edifecs, Bellevue, WA

Presentation Material (Acrobat)
Tom Williams, DrPH
Vice President and General Manager, Accountable Care Operations and Strategy, Stanford Health Care; Former President and Chief Executive Officer, Integrated Healthcare Association, Oakland, CA

Presentation Material (Acrobat)
3:45 p.m.
Refreshment Break in Exhibit Hall

Mini-Summit IX: Transparency: Freeing the Data on Cost and Quality and Using it to Make Decisions
2:15 p.m.
Transparency is gaining traction, as entrepreneurs build decision-making tools for consumers and states create all-payer claims databases (APCDs). For all the appeal and momentum behind transparency, providing accurate, credible, relevant, and timely data to consumers and other audiences turns out to be complex and challenging. This session will provide a view from the front lines, with presentations from a leading APCD in the State of Colorado, an innovative journalism startup that uses reporting, crowdsourcing, big data and other tools to gather price information and provide it free of charge to consumers, and an academic initiative serving as a clearinghouse for information and analysis on issues related to market competition and price transparency.
Tracey Campbell
Vice President of Strategy & Business Development, All Payer Claims Database (APCD), Center for Improving Value in Health Care (CIVHC), Denver, CO

    Speaker Bio

    Ms. Campbell is a health care executive with over 25 years of health care IT experience. She has held positions at McKesson, Inteck, HealthTrio, and Numera, a telehealth care management solutions company. As APCD Director, Tracey is responsible for all aspects of the strategy, implementation, operation and sustainability of Colorado's APCD. She plays a key role in working with CIVHC's stakeholders including consumers, payers, businesses, providers and policy makers who will help move Colorado to better health, better care and lower costs. Tracey holds a Bachelor of Science in Journalism from the University of Kansas.
    Presentation Material (Acrobat)
Jaime King, JD, PhD
Professor of Law, UC Hastings College of the Law, San Francisco, CA

    Speaker Bio

    Jaime S. King is a Professor of Law at University of California, Hastings College of the Law, the Associate Director of the UCSF/UC Hastings Consortium on Science, Law and Health Policy, and the Executive Editor of The Source for Competitive Healthcare.

    Professor King's research examines some of the most complex challenges facing the U.S. healthcare system. She focuses on the drivers of healthcare costs, with a special interest in market consolidation and efforts to improve transparency in healthcare pricing. Professor King's scholarship also examines the balance between individual autonomy and state police power in medical decisions.
    Presentation Material (Acrobat)
Jeanne Pinder
Founder and Chief Executive Officer, ClearHealthCosts, Pelham, NY

    Speaker Bio

    Jeanne Pinder founded clearhealthcosts.com to bring transparency to the health care marketplace by telling people what stuff costs.

    She embraced web entrepreneurship after volunteering for a buyout from The New York Times. At The Times, she was an editor on the foreign desk, a reporter on the business desk, the deputy founding editor of the Circuits technology section and the work-life manager in the human resources department, among other posts.

    Before founding CHC, and before The Times, she worked at The Des Moines (Ia.) Register, The Grinnell (Ia.) Herald-Register and The Associated Press.

    In 2014, a partnership of clearhealthcosts, KQED public radio in San Francisco and KPCC/Southern California Public Radio in Los Angeles launched a groundbreaking project to crowdsource health care prices in a project the three partners call PriceCheck. Clearhealthcosts had conducted a previous similar pilot project with WNYC public radio in New York City.

    PriceCheck has brought the national spotlight to the partners, who have written about it for the Harvard Business Review/New England Journal of Medicine partnership, JAMA Internal Medicine, Health Affairs and the NPR Shots blog.
    Presentation Material (Acrobat)
Maribeth Shannon, MSHA
Director, Market and Policy Monitor Program, California HealthCare Foundation, Oakland, CA (Moderator)

    Speaker Bio

    Maribeth Shannon is director of the California HealthCare Foundation's Market and Policy Monitor program, which promotes greater transparency and accountability in California's health care system.

    Shannon's work involves the development of reliable information to assist decision-making for policymakers, providers, purchasers, and consumers of health care services. She focuses on increasing the availability and usefulness of health care data, reporting of market trends, advancing health care performance measurement and reporting, and increasing the availability and usefulness of information and tools for consumers.

    Prior to joining CHCF, she served as assistant vice president for clinical services development for the University of California. She has also been executive director for an alliance of hospitals and medical groups in the San Francisco area, benefits manager for a major retail company, and in various management positions at Blue Cross of California.

    Shannon received a bachelor's degree in communications and industrial engineering from Northwestern University and a master's degree in health administration from the University of Colorado.
3:45 p.m.
Refreshment Break in Exhibit Hall

CONCURRENT SESSIONS
(Choose one Concurrent Session from each group.)
4:00 p.m.
CONCURRENT SESSIONS - GROUP 1

Session 1.1: Choosing Wisely: Unleashing Professionalism

An initiative of the ABIM Foundation, Choosing Wisely is working to spark conversations between providers and patients to ensure the right care is delivered at the right time. Participating organizations have created lists of "Things Providers and Patients Should Question" which include evidence-based recommendations that should be discussed to help make wise decisions about the most appropriate care based on a patients' individual situation. This session will cover the underpinnings of Choosing Wisely, how and why it's attracting multiple parties, and how it is being implemented by delivery systems and consumer groups.
Daniel Wolfson, MHSA
Executive Vice President and Chief Operating Officer, ABIM Foundation, Philadelphia, PA

    Speaker Bio

    Mr. Wolfson is Executive Vice President and COO of the ABIM Foundation, a not-for-profit foundation focused on advancing medical professionalism and physician leadership to improve the health care system. Mr. Wolfson has been instrumental in leading the Choosing Wisely® campaign (www.choosingwisely.org), a multi-year effort engaging more than 60 medical specialty societies to promote conversations between physicians and patients about utilizing the most appropriate tests and treatments and avoiding care that may be unnecessary and could cause harm.

    Previously, Mr. Wolfson served for nearly two decades as the founding president and CEO of the Alliance of Community Health Plans (formerly The HMO Group), the nation's leading association of not-for-profit and provider-sponsored health plans. During his tenure, Mr. Wolfson earned national recognition for spearheading the development of the Health Plan Employer Data and Information Set (HEDIS™).

    Before serving at the Alliance of Community Health Plans, Mr. Wolfson was the Director of Planning and Research at the Fallon Community Health Plan. During that time, he led the product development team that launched the nation's first Medicare risk contract with the Health Care Financing Administration.

Session 1.2: A Delivery System's Experience with a Very Large P4P Compensation Model

Fairview Health Services, a nonprofit delivery system in Minnesota with 44 primary care clinics, began reforming primary care provider (PCP) compensation in 2011. Its new model based 40% of PCPs' compensation on quality performance on five metrics, assessed at the clinic level. This session will begin with an introduction from Fairview Medical Group's VP of Quality and Innovation, describing the impetus for the model and its goals, followed by a discussion of key findings from the professor who led an evaluation of the model.
Jessica Greene, PhD, MPH
Professor, George Washington University, Washington, DC

    Speaker Bio

    Jessica Greene is a Professor in the George Washington University School of Nursing, where she also serves as the Associate Dean for Research. Dr. Greene is a health services researcher who evaluates health policies and strategies intended to improve health care quality. One key area of her focus is examining the impact of financial incentives on health care providers and on patients. Her research has been published widely, including in Health Affairs and the Journal of General Internal Medicine. She holds a PhD from New York University and an MPH from Columbia University.
Val Overton, DNP
Vice President, Quality and Innovation, Fairview Medical Group, St. Paul, MN

Presentation Material (Acrobat)

Session 1.3: Patient Engagement in Accountable Care Organizations

Colin LeClair
Executive Director, ACO Programs, Monarch HealthCare, Irvine, CA

    Speaker Bio

    Mr. LeClair is the Executive Director of Accountable Care at OptumHealth. Mr. LeClair is responsible for Monarch's Pioneer Model ACO, Monarch's Brookings-Dartmouth ACO, PrimeCare's Medicare Shared Savings Program, and other Commercial ACO ventures.

    Mr. LeClair was previously a Senior Strategy Consultant in the U.S. Healthcare Services Practice at L.E.K. Consulting, where he provided strategic counsel and real-world insight to L.E.K.'s healthcare clients, including healthcare payers, providers and distributors.

    Prior to joining L.E.K. Consulting, Mr. LeClair spent nearly a decade in a variety of executive leadership roles at Fortune 500 Medicare Advantage health plans.

    Mr. LeClair earned his B.S. in Business Administration from the Walter A. Haas School of Business at the University of California, Berkeley. He recently received the designation of Certified Health Insurance Executive (CHIE) by the America's Health Insurance Plans (AHIP) Executive Leadership Program and the Kellogg School of Management.
    Presentation Material (Acrobat)

Kim MacPherson, MPH, MBA
Co-Director, Berkeley Center for Health Technology; MPH Program Director, University of California at Berkeley School of Public Health and Haas School of Business, Berkeley, CA

    Speaker Bio

    Kimberly MacPherson, MBA, MPH is the Associate Director of Health Management at the Haas School of Business. She is also the Program Director and Lecturer in Health Policy and Management at the School of Public Health and Co-Director for the Berkeley Center for Health Technology (BCHT) with Dr. James Robinson. Ms. MacPherson brings over 20 years of health industry experience spanning leadership roles in operations, management consulting and strategic/business planning and product development. She is a member of the Board of Trustees for St. Francis Memorial Hospital in San Francisco. She earned her MBA MPH from U.C. Berkeley in 1994.
    Presentation Material (Acrobat)

Session 1.4: Engaging Multiple Stakeholders in the Implementation of a Maternity Bundled Payment in California Hospitals

Summarizing preliminary results from the RWJF Maternity Bundled Payment Pilot Project and discussions from a Maternity Stakeholder Summit (September 2014), this session dives into the challenges, successes, and resources required to successfully implement a maternity blended payment among commercial health plans and hospitals.

Elliott K. Main, MD
Director, California Maternal Quality Care Collaborative, Director, Maternal-Fetal Medicine California Pacific Medical Center, San Francisco, CA

Brynn Rubinstein, MPH
Senior Manager, Transforming Maternity Care, Pacific Business Group on Health, San Francisco, CA

    Speaker Bio

    Brynn Rubinstein serves the Senior Manager of the Transform Maternity Care program at the Pacific Business Group on Health.

    Previously, she worked at the Kaiser Permanente's Pediatric Developmental Disabilities Office; the Department of Health and Mental Hygiene in NY; and the Association of Maternal and Child Health Programs in DC.

    Her Masters' thesis examined evidence-based strategies for cesarean reduction and she presented her findings at APHA's 2012 Annual Conference. Brynn holds a MPH from the Mailman School of Public Health, Columbia University and a BA in History and Global Health from Northwestern University.
    Presentation Material (Acrobat)

Session 1.5: Advancing Primary Care Delivery: Practical, Proven, and Scalable Approaches

Primary care is central to effectively treating patients, yet the delivery system faces challenges in meeting growing demand, targeting capacity to where it is needed most, and providing high-quality care. A variety of proven and scalable building blocks can help bolster and better target primary care capacity. These include leveraging a diverse primary care workforce, assembling multi-disciplinary care teams, and utilizing health information technology. Increasingly, advanced service delivery models such as medical homes and accountable care organizations are leveraging these building blocks to provide patient-centered care. These approaches show promise, but achieving improvements in quality and reductions in costs rests in large part on adoption of value-based payment models.
Samuel W. Ho, MD
Executive Vice President and Chief Medical Officer, UnitedHealthcare; President, UnitedHealthcare Clinical Services, Cypress, CA

    Speaker Bio

    Dr. Sam Ho is currently Chief Medical Officer for UnitedHealthcare, UnitedHealth Grou'ps health benefits division, and, as President of Clinical Services, is responsible for the clinical advancement of 40 million members throughout the U.S., including enrollees in commercial, Medicare, Medicaid, and military health plans. He is the clinical executive specifically responsible for the execution of the quality improvement, medical management, care delivery transformation, performance measurement, transparency, and health care affordability programs throughout UnitedHealthcare and is also active in helping lead the value-based benefits and value-based provider payment programs.
    Presentation Material (Acrobat)
Simeon Schwartz, MD
Chief Executive Officer, WESTMED Practice Partners, Purchase, NY

    Speaker Bio

    Dr. Schwartz is founding President and CEO of WESTMED Medical Group and the CEO of WESTMED Practice Partners (WPP). The group has grown into a 285+ physician primary care focused multi-specialty group practice. He has been committed to improving both operational and clinical efficiency with a focus on quality. To accomplish this, Dr. Schwartz and WESTMED have been early adopters of healthcare IT and have worked with many IT vendors with process and system redesign to improve care. WESTMED Practice Partners, established in 2011, is a management services company that has evolved from the success of the WESTMED Medical Group. The mission of WPP is to provide comprehensive, turnkey solutions for advanced ambulatory care sites.

    Dr. Schwartz is a hematologist and oncologist. He received his undergraduate degree from the Massachusetts Institute of Technology and his medical degree from Yale University School of Medicine in New Haven. Dr. Schwartz then completed his internship and residency at The New York Hospital-Cornell Medical Center and a fellowship in hematology and medical oncology at Memorial Sloan Kettering Cancer Center.
    Presentation Material (Acrobat)
Mark Selna, MD
Chief Medical Officer for the Sutter Health Peninsula-Coastal Region ; Chief Accountable Care Officer for the Palo-Alto Medical Foundation (PAMF), Palo Alto, CA

    Speaker Bio

    Mark Selna, MD is Chief Medical Officer for the Sutter Health Peninsula-Coastal Region and the Chief Accountable Care Officer for the Palo-Alto Medical Foundation (PAMF). Dr. Selna's primary responsibility is to provide leadership and oversight for the design, implementation and alignment of "total-cost-of-care" population health management capabilities.

    Dr. Selna's prior positions include being the Sutter Health Vice President of Clinical Integration, the Associate Chief Innovation Officer for the Geisinger Health System, the Chief Operating Officer at HealthHelp, Inc., the Chief Medical Officer for various multi-state health plans and a clinician/administrator for the Colorado Permanente Medical Group (Kaiser).

    Dr. Selna earned his undergraduate degree at the University of California (Los Angeles) and his medical degree at the University of Virginia. He completed his residency in pediatrics at the University of Colorado.
    Presentation Material (Acrobat)

Session 1.6: Population Health Management - Creating a Clinically Integrated Network

To achieve high-value care, clinically integrated networks must synthesize and analyze data, manage cost through utilization, and transparently demonstrate quality. St. Vincent's Health will share how an organization can condense disparate data sources to create timely, accurate, and actionable information allowing the healthcare team to focus on individual patient needs while improving the population's health. This case study will demonstrate how patients are uniquely identified through multivariate risk analysis and how the network can effectively manage the patient and population through analytics to limit over-utilization and demonstrate high-quality care.

Michael Hunt, DO
Chief Medical Information Officer/Chief Medical Officer, St. Vincent's Health System, Bridgeport, CT

    Speaker Bio

    Dr. Hunt is Board Certified in Pediatrics. He completed his Masters in Medical Informatics at Northwestern University in 2012. He is an associate professor of informatics at St. Louis University. During his clinical experiences, he accepted challenging leadership positions and was promoted to Chief Medical Information Officer at Mercy, headquartered in St. Louis, Mo. He looks forward to remaining active in Connecticut.
    Presentation Material (Acrobat)

Thomas A. Raskauskas, MD, MMM, CHCQM
President & CEO, St. Vincent's Health Partners, Bridgeport, CT

    Speaker Bio

    Dr. Raskauskas is Board Certified in Obstetrics and Gynecology, and he is certified in Health Care and Quality Management by the American Board of Quality Assurance and Utilization Review Physicians. He completed his Masters in Medical Management from Carnegie Mellon in 2011. He has been involved with numerous research projects while teaching, and has served on multiple hospital committees.

Concurrent Session 1.7: Paying for Quality: How to Promote Optimal Use of Appropriate Therapies

As reimbursement shifts from pay for volume to pay for performance, there are provider incentives to limit use of costly resources. To counteract this incentive, a proper selection of quality measures and adequate financial compensation based upon meeting them can promote optimal use of diagnostic and therapeutic interventions. This session will review recent research and provide both policy and practical perspectives on this challenge. Implementing incentives to meet both clinical and financial goals is imperative for payers, providers, and patients.

Robert W. Dubois, MD, PhD
Chief Science Officer, National Pharmaceutical Council, Washington, DC (Moderator)

    Speaker Bio

    Robert W. Dubois, MD, PhD, joined the National Pharmaceutical Council in October 2010 as its Chief Science Officer. In this role, he oversees NPC's research on policy issues related to comparative effectiveness research, as well as on how health outcomes are valued.

    Dr. Dubois, who is board certified in internal medicine, brings more than 25 years of experience in health services research and comparative clinical effectiveness. He has co-founded and led various health care research organizations in developing quality research with practical application. Most recently, he was the chief medical officer at Cerner LifeSciences, where he focused on comparative effectiveness and the use of an electronic health records infrastructure to implement clinical change.

    Throughout his career, Dr. Dubois' primary interest has centered on defining "what works" in health care and finding ways for that evidence to inform health care decision making. He is a recognized expert in the areas of defining best practice, disease management and appropriateness of care. He has authored more than 100 peer-reviewed articles on comparative effectiveness, evidence-based medicine, the development of practice guidelines and determining the optimal use of high-cost medical services.

    Dr. Dubois received his AB from Harvard College, his MD from the Johns Hopkins School of Medicine and his PhD in Health Policy from the RAND Graduate School. He is a member of the Medicare Evidence Development and Coverage Advisory Committee, Steering Committee for the Electronic Data Methods Forum, and the Advisory Board of the Institute for Clinical and Economic Review.

Thomas Valuck, MD
Partner, Discern Health, Former Senior Vice President for Strategic Partnership, National Quality Forum, Baltimore, MD

    Speaker Bio

    Dr. Tom Valuck assists Discern's clients in the development of quality strategy and the use of quality measurement for innovative payment and delivery models aimed at improvement. Previously, Dr. Valuck was Senior Vice President for Strategic Partnerships at NQF, where he oversaw the NQF-convened partnerships--the Measure Applications Partnership (MAP) and the National Priorities Partnership (NPP)--as well as NQF's engagement with states and regional community alliances. Dr. Valuck also served as a Senior Advisor and Medical Officer at CMS, where he advised agency and HHS leadership regarding Medicare payment and quality of care, particularly value-based purchasing.
    Presentation Material (Acrobat)

Fiona Wilson, MD
Senior Vice President and Chief of Clinical Transformation, Brown and Toland Physicians, San Francisco, CA

5:00 p.m.

Day II Adjourns


Go to Agenda:
Preconference / Day 1 | Day 3




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




© Health Care Conference Administrators
Contact Webmaster