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
Speaking Proposals | Administration | Webcast Log In | Contact Us | Past Summits | Home




Go to Agenda:
Preconference / Day 1 | Day 2

Agenda: Pay for Performance Summit: Day III
Wednesday, March 26, 2014
7:30 a.m. Registration and Continental Breakfast in the Exhibit Hall

MORNING PLENARY SESSION
8:30 a.m.

Keynote Address: CMS Value Based Purchasing Update

Sean Cavanaugh
Deputy Director, Programs and Policy, Center for Medicare and Medicaid Innovation, Centers for Medicare and Medicaid Services (CMS), Baltimore, MD

    Speaker Bio

    Sean Cavanaugh is the Deputy Director, Programs and Policy, in the Center for Medicare and Medicaid Innovation at the Centers for Medicare and Medicaid Services (CMS). Previously, Mr. Cavanaugh was director of health care finance at the United Hospital Fund in New York City. He has also served in senior positions at Lutheran Healthcare (Brooklyn, NY), the New York City Mayor's Office of Health Insurance Access, and the Maryland Health Services Cost Review Commission. He started his career on Capitol Hill working for a member of the Ways and Means Health Subcommittee. He attended the University of Pennsylvania and the Johns Hopkins School of Hygiene and Public Health.
    Presentation Material (Acrobat)
9:00 a.m.

Keynote Panel: The Medicare SGR "Doc Fix" and Transition to Value Based Payment

Larry deGhetaldi, MD
Division President, Palo Alto Medical Foundation, Santa Cruz, CA

    Speaker Bio

    Larry deGhetaldi, M.D. is president of the Santa Cruz Division of the Palo Alto Medical Foundation (PAMF). Dr. deGhetaldi is a board-certified family medicine physician who has served a number of terms on the Santa Cruz Medical Clinic Executive Committee since joining the Clinic in 1985.

    The Santa Cruz Division of the Palo Alto Medical Foundation is the county's largest multispecialty physician organization with more than 140 physicians.

    Dr. deGhetaldi received his undergraduate degree at the University of California, Santa Cruz and his medical degree at the University of Southern California. He completed his postgraduate medical training internship at Stanford University and completed the Stanford University Family Practice Residency Program at San Jose Hospital. He is a graduate (Cohort I) of the California Health Care Foundation's Leadership Fellowship.
    Presentation Material (Acrobat)
Jack Lewin, MD
President and Chief Executive Officer, Cardiovascular Research Foundation; Chairman, National Coalition on Healthcare, New York, NY

    Speaker Bio

    Jack Lewin MD was appointed in 2013 as President and CEO of the Manhattan-based Cardiovascular Research Foundation (CRF), a very highly respected global enterprise focused on pre-clinical science, human clinical trials, and cutting-edge education in the interventional cardiology (IC) space. The "TCT" education brand is the world's largest provider of advanced IC education. From 2012 - 2013 he was Principal and Founder of Lewin and Associates LLC, a Washington DC health consulting firm focused on both the clinical and business aspects of health policy, including data-driven quality improvement, and delivery and payment system innovation. Serving on the boards of the eHealth Initiative, RHDI, and the National Coalition on Health Care, where he is currently Chairman, he assists physician, hospital, patient, and payer constituencies in navigating change during a time of tumultuous but opportunity-rich transition.

    Dr. Lewin had a remarkably innovative tenure as CEO of the American College of Cardiology (ACC) from 2006 through 2012. Prior to Coming to ACC, Lewin was CEO of the 35,000-member California Medical Association for eight years. Prior to that, he was Hawaii's Director of Health from 1986-1994. Before that, as a Commissioned Officer in the USPHS, Lewin was the founder and first Director of the Navajo Nation Department of Health, serving the needs of America's largest Indian tribe, straddling the three states of Arizona, New Mexico and Utah.

    Dr. Lewin received his B.A. in Biological Sciences from the University of California, Irvine, and his M.D. from the University of Southern California.
    Presentation Material (Acrobat)
William MacBain, MPS
Senior Vice President, Gorman Health Group, Washington, DC

    Speaker Bio

    Bill has more than 35 years of experience as a senior health plan executive and strategic consultant.

    Bill's engagements focus on strategic and financial planning. He provides guidance to health plans in the development and execution of profitable business models, drawing on 20 years of on-the-ground experience in operations and finance.

    Bill has held senior executive positions in finance and operations in several provider-owned health plans. He was a member of the Medicare Payment Advisory Commission (MedPAC) and the Prospective Payment Assessment Commission (ProPAC), and was president of the Managed Care Association of Pennsylvania. Bill also served as a board member of the American Association of Health Plans and the Group Health Association of America, predecessors of today's America's Health Insurance Plans (AHIP).

    Bill earned his BA and Master of Healthcare Administration degrees from Cornell University.
    Presentation Material (Acrobat)
10:00 a.m. Refreshment Break in the Exhibit Hall

CLOSING MINI-SUMMITS
(Choose one Mini Summit only)
Mini-Summit V: Reaching for the Medicare Stars
10:15 a.m.
Health plan performance on Medicare Star ratings is linked to significant financial incentives. Success in achieving a five star rating is contingent on both health plan and provider performance. This session will explain the ratings systems and share plan and provider strategies for successful performance.

William MacBain, MPS
Senior Vice President, Gorman Health Group, Washington, DC

    Speaker Bio

    Bill has more than 35 years of experience as a senior health plan executive and strategic consultant.

    Bill's engagements focus on strategic and financial planning. He provides guidance to health plans in the development and execution of profitable business models, drawing on 20 years of on-the-ground experience in operations and finance.

    Bill has held senior executive positions in finance and operations in several provider-owned health plans. He was a member of the Medicare Payment Advisory Commission (MedPAC) and the Prospective Payment Assessment Commission (ProPAC), and was president of the Managed Care Association of Pennsylvania. Bill also served as a board member of the American Association of Health Plans and the Group Health Association of America, predecessors of today's America's Health Insurance Plans (AHIP).

    Bill earned his BA and Master of Healthcare Administration degrees from Cornell University.
    Presentation Material (Acrobat)
Kelly Miller
Project Analyst, Integrated Healthcare Association, Oakland, CA

    Speaker Bio

    Kelly Miller is a Project Analyst at the Integrated Healthcare Association, where she supports the Value Based Pay for Performance program, as well as IHA's other performance measurement activities, including Medicare and Medicaid measurement, and HEDIS reporting by geography.
    Presentation Material (Acrobat)
Karen Sugano
Vice President, Network Management, SCAN Health Plan, Long Beach, CA

    Speaker Bio

    Karen Sugano joined SCAN in 2006 and is now Vice President and General Manager for SCAN in Northern California, responsible for the health plan's overall performance in the region. Ms. Sugano also remains head of Network Management for the health plan's service areas in Northern and Southern California and in Arizona. In this role she is accountable for developing and implementing provider network strategies in support of SCAN's growth and expansion objectives, including network strategic initiatives such as 5 Star.

    Her 20 years of healthcare experience includes leadership positions at top medical groups in Southern California. Her managed care responsibilities have included financial audit and recovery, claims, public policy, provider service and contracting.
    Presentation Material (Acrobat)
Jennifer Pereur, MBA
Director, Government Programs, Hill Physicians Medical Group, San Ramon, CA (Moderator)

    Speaker Bio

    Jennifer Pereur is the Director, Government Programs at Hill Physicians Medical Group.

    Healthcare professional with experience in medicare risk adjustment, network management, physician profiling, compensation strategies, and health care analytics. Specialties: network management, profiling, cost containment, performance based payments

    Prior to her position at Hill Physicians Medical Group, she was the Director, Payer Services at MedeAnalytics Inc.; Sr. Manager, Payer Services at MedeAnalytics Inc.; Manager, Product Management at MedeAnalytics; Manager, Network Management at Hill Physicians Medical Group and Project Analyst at Vivra Specialty Partners.

    Education: St. Mary's College of California; University of Iowa
12:00 p.m.
National P4P Summit Adjourns

Mini-Summit VI: Updates from Centers for Medicare and Medicaid Services (CMS) on Value Based Purchasing
10:15 a.m.
Health care transformation is a reality and will succeed, in part, based on CMS' ability to measure quality, align payment incentives with desired outcomes and across providers, and incent quality improvement that is based on evidence and uses health information technology. At this session, you will hear from senior CMS leaders about recent updates in this area and plans for the future.

David Sayen
Regional Administrator, Centers for Medicare and Medicaid Services (CMS) - Region IX, San Francisco, CA

    Speaker Bio

    David Sayen (pronounced "SIGN") is the Regional Administrator at the Centers for Medicare & Medicaid Services (CMS) San Francisco office. He brings more than 30 years of Federal experience in health and human services programs to the position. His accomplishments at HHS include work in Medicare health plans operations, financial management and program integrity, information technology, and public affairs. He earned his MBA in Health Administration from Temple University in Philadelphia.
Betsy L. Thompson, MD, DrPH
Chief Medical Officer, Centers for Medicare and Medicaid Services (CMS) - Region IX, San Francisco, CA

    Speaker Bio

    Dr. Thompson is the Chief Medical Officer for the Centers for Medicare and Medicaid Services (CMS) Regional Office in San Francisco and a Captain in the U.S. Public Health Service. Dr. Thompson serves as the chief CMS clinician for Region IX. Dr. Thompson has also served as Chief Medical Director for a rural non-profit health plan; a Medical Epidemiologist at the CDC; and a clinician for underserved populations. Dr. Thompson has participated on state, regional, and national committees focused on improving healthcare quality. She is board-certified in Internal Medicine and Preventive Medicine and holds a doctorate in Health Policy.
    Presentation Material (Acrobat)
12:00 p.m.
National P4P Summit Adjourns

Mini-Summit VII: The Future of Pay for Performance for Hospitals and Physicians: Next Generation Models in Public and Private Sectors
10:15 a.m.
There are intensive P4P efforts in the six states that received the first round of CMS State Innovation Model Testing awards. This session will review how they are using the funds to transform their states through value based initiatives and share sample models and early outcomes. Highlights include critical elements of this transformation including price/quality transparency, governance, contracting and execution strategies, and how to leverage lessons learned from first generation P4P models.

Deirdre Baggot, PhD (c), MBA
Vice President, The Camden Group, Los Angeles, CA

    Speaker Bio

    Ms. Baggot is a vice president at The Camden Group and a nationally recognized expert in the area of bundled payment. In 2012, Ms. Baggot was appointed by Centers for Medicare & Medicaid Services ("CMS") to be an expert reviewer for the Bundled Payments for Care Improvement Initiative ("BPCI") for Models 2 through 4.

    Prior to joining The Camden Group, Ms. Baggot served as the administrator of the cardiac and vascular institute at Exempla Saint Joseph in Denver, Colorado, where she played a key role in helping the hospital win the bid to be selected as an Acute Care Episode cardiovascular services pilot program - only one of four in the nation.

    Prior to joining Exempla Saint Joseph Hospital, Ms. Baggot worked for ten years in academic healthcare, first at Northwestern Memorial Hospital and later at The University of Michigan Health System in a number of key leadership roles.

    Currently, Ms. Baggot serves on the Board of the Colorado Organization of Nurse Leaders and is completing her Ph.D. at the University of Colorado, Denver, Colorado.
Kimberly Hartsfield
Senior Manager, The Camden Group, Little Rock, AR

    Speaker Bio

    Ms. Hartsfield is a senior manager with The Camden Group. She specializes in hospital operations with a focus on designing and implementing Medicare and commercial bundled payments. She has more than 22 years of experience in the healthcare industry and has frequently presented at national speaking engagements on a variety of topics including value-based payment models and provider cost and quality transparency as well as provider engagement.

    Prior to The Camden Group, Ms. Hartsfield was the director of enterprise business intelligence -medical informatics for Arkansas Blue Cross and Blue Shield. There she was responsible for the implementation of Arkansas Health Care Payment Improvement Initiatives ("ACHPII"), a multi-payer statewide bundled payment initiative, including the development of reporting, methodology, and provider engagement. She also worked on the development and implementation of Accountable Care Organization ("ACOs") arrangements with facilities and provider groups throughout Arkansas and served as a healthcare consultant in both the employer and provider markets.

    Ms. Hartsfield earned her master's degree in public administration and her bachelor's degree from the University of Arkansas, Little Rock.
Frederick Isasi, JD, MPH
Director, Health Division, National Governors Association, Center for Best Practices, Washington, DC

    Speaker Bio

    Frederick Isasi, JD, MPH serves as the Health Division Director with the National Governors Association Center for Best Practices (NGA Center). In that role, he oversees the entire Health Division portfolio, including work related to: health care service delivery and payment reform, Medicaid reform and cost containment, state employee and retiree health benefits, maternal and child health, public health, prescription drug abuse prevention, and health insurance coverage issues such as insurance market reforms and health insurance exchange planning and operations. Previously, he served as the Vice President of Health Policy at The Advisory Board Company, where he founded the health policy division focused on surfacing insights related to transforming the quality and efficiency of healthcare with a particular focus on risk-based payments, accountable care, population health, patient engagement, and payment bundling. Frederick also served for five years as the Senior Legislative Counsel for Healthcare to U.S. Senator Jeff Bingaman, working on both the Finance Committee and Health Education Labor and Pension (HELP) Committee. He also worked extensively on the Affordable Care Act including the development of new health insurance exchanges and insurance market reforms.

    Frederick graduated with a JD from Duke University Law School and received a Masters in Public Health from the University of North Carolina at Chapel Hill with honors. Frederick also has published research on the adherence of HIV positive patients to anti-retroviral treatments and has extensive biomedical research experience.
Valinda Rutledge
President and Chief Executive Officer, Rutledge Health Care Consulting; Former Director of Patient Care Model Group, CMMI, Greenville, SC

    Speaker Bio

    Valinda Rutledge worked as a Senior Advisor and Group Director for the Patient Care Models Group within the Centers of Medicare and Medicaid Innovation (CMMI) where she led the development and roll out of the Bundled Payment for Care Improvement Initiative, Strong Start perinatal care and other National programs. She also served on the Governance Committee that selected the grants for the one billion dollar Health Care Innovation Challenge Grants.

    Before joining the CMS, Rutledge served as the Chief Executive Officer of CaroMont Health in Gastonia, North Carolina where she led the development of the 210 day bundled knee payment arrangement between CaroMont Health and North Carolina's largest health insurer, Blue Cross and Blue Shield of North Carolina. This initiative was designed to provide value based care leading to enhanced care coordination.

    Prior to CaroMont Health, Rutledge was Chief Executive Officer of Bon Secours Saint Francis Health System in Greenville, South Carolina. She was also Senior Vice President of the Bon Secours Health System with responsibility for system-wide physician alignment strategies, as well as market leader for both Kentucky and South Carolina.

    She recently received the 2013 Becker's Healthcare Leadership Award, which is given to the top 30 individuals in the nation who demonstrates leadership and impact to the industry on a national level.

    She is currently the President/CEO of Rutledge Health Care Consulting; a firm that focuses on assisting health systems and start-up companies transform their business models. She is frequently sought as a national speaker and consultant in the area of payment/clinical innovation.
Dorothy Teeter, MHA
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)
12:00 p.m.
National P4P Summit Adjourns

Mini-Summit VIII: Changing Payment and Changing Care for Medically Complex Patients
10:15 a.m.
Controlling health care costs depends on finding affordable ways to provide extra support to medically complex patients to avoid unnecessary utilization of health care services. This session features innovative programs around the country and their experiences re-designing care and payment for patients living with multiple chronic conditions, and at risk for hospitalization.

Alan Glaseroff, MD
Co-Director, Stanford Coordinated Care, Stanford, CA

    Speaker Bio

    Dr. Alan Glaseroff is Co-Director of Stanford Coordinated Care, a service for patients with complex chronic illness. Dr. Glaseroff, a member of the Innovation Brain Trust for the UniteHERE Health Trust, is a Clinical Advisor to the PBGH Intensive Outpatient Care Program CMMI Innovation Grant that began in July 2012, served on the NCQA Patient-Centered Medical Home Advisory Committee 2009-2010, the "Let's Get Healthy California" expert task force in 2012 - present, and the Executive Committee for the CA Advanced Primary Care Institute from 2013 to the present. Dr. Glaseroff was named the California Family Physician of the Year for 2009.

    Dr. Glaseroff's interests focus on the intersection of the meaning of patient-centered care, patient activation, and the key role of self-management within the context of chronic conditions.
    Presentation Material (Acrobat)
Tracy L. Johnson, PhD
Director, Health Care Reform Initiatives, Denver Health and Hospital Authority, Denver, CO

    Speaker Bio

    Dr. Tracy Johnson joined Denver Health and Hospital Authority (DHHA) in 2010 as Special Assistant to the CEO, responsible for assisting DHHA with the implementation of federal health care reform, especially in the areas of delivery system and payment reform. She is now serving as Director, Health Care Reform Initiatives and is co-PI, directing the evaluation of a $20 million CMS Health Care Innovation Award. Previously, she served as president of Health Policy Solutions, Inc., a Colorado-based consulting firm that specialized in health policy analysis, health services research and evaluation, including projects such as:
    • Providing technical assistance to two governor-appointed commissions on health care reform;
    • Advising the State of Colorado on health insurance exchanges and the Medicaid agency on issues related to cost, coverage, and quality;
    • Conducting the needs assessment for a multi-million dollar HIT initiative for CO safety net clinics;
    • Serving as survey director the CO Household Survey (2001) on health care access and coverage;
    • Briefing The Commonwealth Fund Commission on a High Performance Health System on Colorado's health care system and policy context;
    Dr. Johnson holds a Ph.D. in Health Policy and Management from the Johns Hopkins School of Hygiene and Public Health (1998) and an M.A. in Bioethics from the University of Virginia (1992).
    Presentation Material (Acrobat)
Robert D. Lerman, MD
Vice-President, Medical Director, Physician Integration, Dignity Health, CA

    Speaker Bio

    Robert Lerman, M.D. was born and raised in Los Angeles and completed his undergraduate degree in Biological Sciences at Stanford University. He earned his medical degree at Albany Medical College and completed training in internal medicine, cardiology, and clinical cardiac electrophysiology in Southern California, where he was in private practice for 18 years.

    Dr. Lerman joined Dignity Health in 2012 and provides the overall clinical direction and leadership of the Dignity Health clinical integration and population health programs. He also is on the leadership team for co-management, bundled payments initiatives and primary care re-design.
    Presentation Material (Acrobat)
Lisa Mangiante, MPP, MPH
Program Director, Pacific Business Group on Health, San Francisco, CA

    Speaker Bio

    Lisa Mangiante leads the Intensive Outpatient Care Program (IOCP) at the Pacific Business Group on Health, focusing on care redesign for patients with complex chronic illness. She has extensive experience in health policy, program development and management, as well as in strategies to improve care for and prevent avoidable hospital use by high-risk patients. Previously, Lisa served as Director of Global Market Access and Policy at Robert Bosch Health Care and has held additional management and analyst positions in the nonprofit sector. She holds master's degrees in public policy and public health from the University of California at Berkeley.
12:00 p.m.
National P4P Summit Adjourns

Go to Agenda:
Preconference / Day 1 | Day 2




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




© Health Care Conference Administrators
Contact Webmaster