Emerging Population Health Management Strategies in Our New Era of Health Care
October 27th and 28th, 2020
Presented virtually by PHA, your national trade association dedicated to Population Health Management, the 2020 Innovation Summit & Capitol Caucus gathered key leadership from across the health care industry and leading health policy analysts for two days of leading educational and informative content. The inspiring keynotes, provocative panels, and the innovation showcase presented pop health’s powerful path forward for success in improving health outcomes and driving affordability, while presenting participants with capabilities to strengthen and grow their business.
The 2020 live and virtual Summit program centered on: emerging high-value population health innovations in care delivery and management, planning for post-election policy scenarios, a renewed approach to social determinants of health, and capital and investment analysis. View all of the presentations on-demand!
2020 Innovation Summit Agenda:
10:00am – Welcome To The New Era of Health Care
Jaan Sidorov, MD: CEO & President, PA Clinical Network and President, Population Health Alliance
Welcome to PHA’s 2020 Innovation Summit and Capitol Caucus. PHA President Jaan Sidorov, MD will open with an introduction of our esteemed lineup of speakers and the Summit’s 4 key topic areas: emerging high-value population health innovations in care delivery and management, planning for post-election policy scenarios, a renewed approach to social determinants of health, and capital and investment analysis.
10:15am – Opening Keynote: Informed Decision Making in our New Era of Health Care – Equipping Population Health Managers for Success
Kyu Rhee, MD, MPP: Vice President and Chief Health Officer, IBM Corporation and IBM Watson Health
At a time of tremendous upheaval in the delivery of health care, there have never been more powerful and sophisticated tools available to help practitioners thrive in population health management. When data, technology, and expertise are built to work cohesively we can reinvent health care delivery to offer control to consumers, align incentives to optimize outcomes and spend, meet the consumer where they are, and act more collaboratively to better serve our populations & communities. Worldwide, regular citizens, front line health care workers, and lab-scientists have stepped up in a global emergency effort to flatten the COVID-19 curve. But mental illness, chronic disease, and health inequities are in a similar state of emergency and should be treated with urgency and global unity. In this welcome keynote address, Dr. Rhee will present the promising opportunities forced by 2020 changes and look ahead to what future care will look like for hospitals, systems, employers, and the Chief Health Officer.
11:00am – Population-Based Primary Care: How Village MD’s Innovative Partnerships Create State of the Art Care Delivery and a Refreshing Consumer Experience
A population-based approach to primary care has never been more important as six of ten Americans today live with at least one chronic condition requiring multiple daily medications. Village MD clinical data show that an integrated pharmacy and primary care approach is key to increasing medication adherence and improved patient outcomes. When combined with convenient access and a care delivery process that consistently earns high customer satisfaction, Village MD is innovating primary care delivery for the unique needs in our new era of population health management.
11:45am – Post-Election Health Care Policy Scenarios
Begin your 2021 strategic planning by preparing for various policy scenarios that could be at play given the potential election outcomes. Instead of predicting the winners and losers, this panel will prepare you for likely policy shifts under several different Congressional and Executive election outcomes. Congresswoman Allyson Y Schwartz and Sara Singleton bring a unique perspective rooted in deep relationships with the key policy decision-makers on both sides of the aisle.
1:00pm – Behavioral Health – An Essential Role in Population Health Management
Ron Manderscheid, PhD: Executive Director, National Association of County Behavioral Health and Developmental Disability Directors
Introduced and facilitated by:
Chip Terhune: SVP & General Manager, Government Accounts & Programs, Medecision
Perhaps more than ever before, an innovative, focused, ambitious behavioral health plan will help shift your population health management strategy from a house of cards to look more like a fortress. In this keynote presentation, Dr. Manderscheid will look ahead at the long-term impacts of COVID-19 on behavioral health and explore some of the promising actions that health care practitioners, plans, employers, and policy decision-makers should consider for curbing the damage and begin improving behavioral health outcomes.
1:45pm – A Renewed Approach to Social Determinants of Health
Lori Fresina: Vice President and Executive Director of Voices for Healthy Kids, American Heart Association
Sara Singleton: Principal, Leavitt Partners and advisor to NASDOH
Yvonne Heredia, PhD: Manager of Case Management, Neighborhood Health Plan of Rhode Island
For years we have known and understood that the Social Determinants of Health (SDoH) are highly correlated with higher costs, poorer personal and vulnerable population outcomes, and less consumer satisfaction with health care. Whether through intervention pilots, deep community engagement, true grassroots advocacy, or shifting quality measures, population health is increasingly equipped with actionable levers to address poverty and other key social determinants through an evidence-based intervention or “treatment” process. Each representing a unique experience with community engagement, these panelists’ insights will help practitioners formulate their SDoH action plans.
3:00pm – Academic Analytics and Business Analytics: Creating Credibility in Both
Data management, interoperability, predictive analytics, and artificial intelligence have been touted for years as the most powerful lever available for successful population health management. Yet the understanding of analytical output as it relates to management and policy decision making is still in its very nascent stages. In this panel, Dr. Alan Spiro and Mayur Yermaneni will describe the recent acceleration and forced changes of recent months, and how these will impact your population health management strategy in 2021 and beyond.
4:00pm – Closing Panel – Growing and Promising Investments in the Health Care Services Industry in Tumultuous Times
Tom Scully, JD: General Partner, Welsh, Carson, Anderson & Stowe and Former CMS Administrator
Lance Wilkes: VP, Sr. Equity Analyst, Sanford C. Bernstein
Rose Maljanian: CEO, HealthCAWS, Chairman Emeritus, Population Health Alliance, and Business Advisor, WaveEdge Capital (Host & Moderator)
Introduced by:
Keith Taylor: Senior Director, Business Development, PA Clinical Network
Presented through vantage points from Investment Banking, Private Equity and Venture Capital, this panel will conclude day 1 of the Summit by discussing the roles and perspectives of investors in health care services. Emphasis will include digital care and telehealth, primary care and retail, behavioral health, senior health and home care.
Day 2: Showcasing Innovation
10:00am – Opening Keynote: The Role of Innovation in Investment Analysis
Ravi Sachdev: Partner, Clayton, Dubilier & Rice, LLC
Jaan Sidorov, MD: CEO & President, PA Clinical Network and President, Population Health Alliance (Discussion Moderator)
The national movement from volume to value has raised a requirement that effective innovation be at the front and center of any health care company’s strategy, across the spectrum of care delivery. In this opening keynote presentation of our second day of learning, Ravi Sachdev will present the role of innovation in the pursuit of success in value-based care arrangements. The audience will learn how private equity managers analyze a company’s innovation structure as well as hear about some of the developing opportunities for creativity and experimentation in our new era of health care.
10:45am – The Power of Machine Learning and Natural Language Processing to Unlock Utilization Review’s Full Potential
Ila Sarkar, PhD: Vice President of Analytics, eQHealth Solutions
Learn about integrated utilization management programs leveraging machine learning and natural language processing (NLP) to provide more efficient and consistent decision making while reducing review processing times, minimizing human errors, and providing elevated uniformity in review determinations. Machine learning algorithms use text mining to consume, understand, analyze, and manipulate text data for optimization of utilization review operations. Deploying these algorithms not only leads to consistent review outcomes but also enhances the usage of clinical resources more effectively and efficiently. Designing a utilization review initiative with the powers of machine learning and NLP includes an integrated team to evaluate utilization needs, ensuring medical appropriateness. Together, results includeprovider behavior molding and utilization patterns that deliver appropriate healthcare utilization without impacting quality outcomes. Innovative design and pioneering methods of utilization management programs inclusive of technological advances such as machine learning and NLP results in improvement of operational efficiencies and increased revenue by reducing turnaround times – while, most importantly, generating improved outcomes.
11:30am – Population Health Innovations Outside the United States
The global population health management (PHM) market is expected to reach 150 Billion by 2027, presenting tremendous opportunity for innovation in substantially different health care marketplaces and frameworks. In this presentation, hear from on-the-ground experts in Brazil and Japan as they present the current PHM challenges unique to their markets.
12:15pm – Gaps in Adopting Value-Based Care: The Post-Acute
Conundrum
Population Health teams continually struggle to broaden their value-based care footprint. We’ll show you how technology helps care managers track where their patients are after leaving the hospital, how they’ve improved communication with post-acute providers in real time, and how they have full insight into each patient’s condition. Understand the type of return you should see from your technology investment, and hear how one care manager leverages the technology to improve patient outcomes and save lives.
1:15pm – V-BID X: Better Coverage, Same Premiums and Deductibles
Mark Fendrick, MD: Director, University of Michigan Center for Value Based Insurance Design
Rebecca Zimmerman: Senior Advisor, Marketplace Plan Management Group, Center for Medicare and Medicaid Services
A V-BID X plan design reduces consumer cost-sharing for targeted high-value and increases cost-sharing on targeted service categories to offset the added costs resulting from the increased use of, and lower cost-sharing on, the selected high-value services. V-BID X presents a template to guide organizations interested in incorporating cost-neutral, value-based principles into plan benefit design. Applying targeted cost-sharing based on the clinical value – not price – of a service will allow consumers improved access to high-value care, reduced cost-related non-adherence and decreased exposure to harmful care. Payers enjoy the advantage of improved efficiency of their medical expenditures. These cost neutral designs are feasible, and there are a large number of plausible combinations of services or cost-sharing changes that could fit different needs and goals. The final 2021 Notice of Benefit and Payment Parameters rule provided broad support for the inclusion of V-BID principles in marketplace health plans.
2:15pm – Health Equity and the Opportunity to Improve Health Outcomes, Millions at a Time
Susan Kansagra, MD, MBA: Section Chief, NC Division of Public Health, Chronic Disease and Injury Section, North Carolina Department of Health and Human Services
As the COVID-19 pandemic has turned the health care industry upside down it has also cast a bright spotlight on our public health infrastructure, the population health management lever of the country. Coming off the heels of a five year slide in U.S. life expectancy, our ability to urgently adapt public health programming to match the lived experiences of our neighbors has never been more critical. Presented by Dr. Susan Kansagra, Section Chief of Chronic Disease and Injury for the North Carolina Division of Public Health, this session will present on public health framework for addressing chronic disease and how the continued widening of health disparities are calling for sincere, systemic change that address the root causes of inequities. Dr Kansagra previously served as Deputy Commissioner of the New York City Health Department as well as Assistant Vice President of Population Health for New York City’s public hospital system. She is the current President of the National Association of Chronic Disease Directors where she is leading a President’s Challenge to identify and combat racial inequities and structural racism in our work as health professionals.
3:15pm – Closing Panel – The Direct and Indirect Impact of COVID-19 on Health and Health Care Delivery
Ray Fabius, MD: President & Chief Medical Officer, HealthNEXT, Co-Chair of Program & Membership, PHA (Host & Moderator)
The impact of the pandemic on the entire population health continuum has been significant. In fact, one could argue that the indirect impacts on health and wellbeing are greater than the impacts being tracked at present by the CDC, Johns Hopkins and others. In this panel, experts in primary care, chronic care management, hospital and intensive care, as well as behavioral health, will elucidate the broader impact of SAR-2 on population health and provide guidance to mitigate these issues as we conclude two days of learning.
Mr. Desai started PatientPing in 2013 with one goal in mind: To connect providers everywhere to seamlessly coordinate patient care. Prior to founding PatientPing, Jay worked at the CMS Innovation Center (CMMI) where he helped develop ACOs, bundled payments, and other payment initiatives. Jay’s passion lies at the intersection of technology, policy, and community building. He has an MBA in healthcare management from Wharton and a BA from the University of Michigan. Jay feels lucky to love his work, but also loves running, all things music, and spending time with his family and friends.
Gaurav Lal | Executive Director | Innovative Solutions at Merck
Mr. Lal received a BS degree in biological sciences from Oklahoma State University and a MBA degree from Kellogg Graduate School of Management at Northwestern University. After beginning his career in the pharmaceutical industry with E.R. Squibb & Sons, he joined Merck in 1988 as a Professional Sales Representative in Texas. In his career, Gaurav has held positions of increasing responsibility in a broad range of business functions. His experience includes sales, sales training, field communications, sales management, managed markets, strategy & commercial model innovation In 2016, he moved into his current Executive Director, Innovative Solutions role responsible for expanding Merck’s capability to develop and incubate innovative programs and tools that address unmet needs of top customers, including integrated delivery systems, payers, retail chains and other influencers of health care decision-making that support Merck’s core franchises.
Anne Marie Polak | Senior Director | Leavitt Partners
Ms. Polak is a senior director based in Washington, D.C. In her role, she provides policy counsel and analysis to clients with matters involving regu-lations, legislation, and business implications. Anne Marie’s experience includes developing strategic messages and policy positions for Capitol Hill, administration, trade associations, and corporate audiences. Prior to joining Leavitt Partners, Anne Marie was a vice president for Faegre BD Consulting in the firm’s health and biosciences group. She also spent five years with the Podesta Group in Washington, D.C., while completing her law degree in the evenings at the George Mason University School of Law, graduating cum laude in 2010. Anne Marie also worked in the government and legal affairs office of Novo Nordisk in Washington, D.C., and as a congressional aide to Rep. Michael Ferguson of New Jersey.
Raymond J. Fabius, MD, CPE, FACPE
Co-Founder & President, HealthNEXT
Co-Chair, PHA Program and Membership Committee
Dr. Fabius has recently returned to his start up. HealthNEXT, a company dedicated to the development of organizational cultures of health — after serving as Chief Medical Officer of Truven Health Analytics (formerly the healthcare business of Thomson Reuters), the world’s leading source of intelligent information for business and professionals. In this capacity he is charged with developing and deepening relationships with customers, advising on product development, and providing counsel to the leadership on business strategy and medical issues. Formerly, Dr. Fabius served as strategic advisor to the President of Walgreens Health & Wellness Division. This organization will coordinate over 1,000 workplace health centers and 10,000 pharmacies, many with retail clinics, into a seamless primary care network across the country within the next five years. In the not too distant future, it will be possible to offer large employers medical and fitness services on-site as well as episodic illness care, health coaching and disease management monitoring at the employee’s nearest Walgreens pharmacy.
Dan Buettner | Founder | Blue Zones
Mr. Buettner is an explorer, National Geographic Fellow, award-winning journalist and producer, and a New York Timesbestselling author. He discovered the five places in the world—dubbed Blue Zones—where people live the longest, healthiest lives. His articles about these places in The New York Times Magazine and National Geographic are two of the most popular for both publications.
Buettner now works in partnership with municipal governments, large employers, and health insurance companies to implement Blue Zones Projects in communities, workplaces, and universities. Blue Zones Projects are well-being initiatives that apply lessons from the Blue Zones to entire communities by focusing on changes to the local environment, public policy, and social networks. The program has dramatically improved the health of more than 5 million Americans to date.
Mary Ann Cooney, RN, MSN, MPH | Chief | Association of State and Territorial Health Officials (ASTHO) Center for Population Health Strategies
Ms. Cooney provides strategic direction for the Centers three Pillars of Population Health – Clinical to Community Connections, Health Equity and the Social Determinants of Health, and Public Health Data Analytics and Informatics. Mary Ann previously worked for 14 years at the New Hampshire Department of Health and Human Services where she was Deputy Commissioner for the Department and Director of Public Health.
Mary Ann has served as adjunct faculty member for the Master of Public Health Program at the University of New Hampshire and recently re-ceived UNH’s 2016 Distinguished Alumni Award. She was School Health Director for the City of Manchester Public Health Department and President of the New Hampshire Public Health Association.
Tom Scully | General Partner | WelshCarson, Anderson & Stowe, Former CMS Administrator
Mr. Scully is a General Partner in the Healthcare Group, having joined WCAS in 2004. Before joining WCAS, he was the Administrator of the Centers for Medicare and Medicaid Services (CMS) for three years and the President and CEO of the Federation of American Hospitals for six years. He also served as the Deputy Assistant to the President and as the Associate Director of OMB under President GHW Bush from 1989 to 1993, and has practiced law at Alston and Bird; Patton Boggs; and Akin, Gump, Strauss Hauer and Feld. He is a Principal at the Lincoln Policy Group.
Don Wright, M.D., M.P.H. | Deputy Assistant Secretary for Health, Director | Office of Disease Prevention & Health Promotion
Dr. Don Wright has served as the Deputy Assistant Secretary for Health and Director of the Office of Disease Prevention and Health Promotion (ODPHP) since January 2012. In this capacity, he leads coordination and policy development for public health and prevention activities within the Office of the Assistant Secretary for Health, U.S. Department of Health and Human Services. He is also currently the acting Executive Director of the President’s Council on Fitness, Sports & Nutrition.
Jaan Sidorov, MD | President & CEO | The Care Centered Collaborative
Dr. Sidorov is a board-certified in general internal medicine physician with more than 25 years of experience in primary care, inpatient care, medical education and evidence-based practice. Jaan believes physician leadership throughout the continuum of care is the bedrock of value-based care delivery. He received his medical degree from Pennsylvania State University College of Medicine, and completed his internship and residency at the Dartmouth Hitchcock Medical Center in Hanover, New Hampshire. Jaan also served as a Chief Resident at Reading Hospital in Reading, Pennsylvania.
Andrey Ostrovsky, MD | President & CEO | Concerted Care Group; Former Chief Medical Officer, CMS
Dr. Ostrovsky is a practicing physician, social entrepreneur, and health policy expert who specializes in human-centered design, lean manage-ment, quality improvement, population health, and digital health. Dr. Ostrovsky was most recently the Chief Medical Officer for the Center for Medicaid and CHIP Services (CMCS), the nation’s largest insurer covering over 74 million people, annually.
Denee Choice, MD | Vice President and Medical Director Physical Medicine | American Specialty Health
Dr. Choice is vice president and medical director for physical medicine services at American Specialty Health (ASH). Dr. Choice oversees the Rehabilitation Services Clinical Quality Evaluation program and leads the content development, training and clinical quality processes for ASH’s musculoskeletal health and pain management products.
Previously, she served as a Medical Director of Pain Management in the VA System where she led the development and implementation of multi-specialty clinics and treatment teams, complementary and alternative medicine services, and co-authored opioid safety guidelines, with the focus of reducing reliance on opioids for chronic pain.
Mary Jane Osmick, MD
Vice President & Medical Director Medical Services Department,
American Specialty Health
Chair, PHA Quality and Research SDH Task Force
Dr. Osmick is Vice President and Medical Director for the medical services department at American Specialty Health (ASH), one of the nation’s leading providers of specialty health services. As a physician executive with extensive internal medicine clinical expertise, Dr. Osmick provides medical management, quality oversight, clinical review and product development support across ASH product lines, including specialty health care, population health, and fitness and exercise services.
Helene Forte | Vice President, Public Plans Emerging Markets | Tufts Health Plan
Ms. Forte is responsible for leading Tufts Health Public Plans expansion efforts. Prior to her current position, she was vice president of care management for all Public Plans members.
Prior to joining Tufts Health Plan in 2014, Helene held positions in clinical program support and engagement strategy, care advocacy and medical management for Aetna, a national health plan. She also has served as vice president of medical operations at APS Healthcare Inc., a health management organization servicing commercial, Medicaid and state employee members, while serving consecutively as manager of health programs and manager of case management for Tufts Health Plan. She began her career as a staff nurse — and has taught classes in nursing at Mount Wachusett Community College and Montachusett Vocational School.
Elise Bowman | Director of Strategic Initiatives | Health Leads
As Director of Strategic Initiatives, Ms. Bowman oversees new social needs intervention initiatives among our clinical partners — including program design, resource database build-outs, and integration of Health Leads’ signature technology, Reach. Elise brings 10 years of direct service experience to her role, having previously served as a Health Leads program manager, a case manager for adults struggling with mental illness and homelessness, and in developing parent engagement initiatives in public education settings.
Elise has a passion for helping client-facing staff find sustainable, workable solutions to integrate social needs efforts into their daily work — and loves the opportunity to bring her experience and expertise to bear on the systemic change that comes from spreading social needs programs.
J. David Johnson | Vice President & Senior Consultant | Sage Consulting
Mr. Johnson leads the Sage Consulting’s work for a number of public sector, corporate, non-profit and multi-employer clients. David brings particular expertise in evidence-based workplace wellness programs and leveraging Behavioral Economics principles in Human Resources Management. He is also an Adjunct Professor in the Department of Psychology at Towson University.
David has over 29 years of experience in Health Care and Human Resources. He is a frequent national and regional speaker on workplace wellness and behavior change strategies. David has published multiple articles on employee benefits issues and has been quoted in US News & World Report, the Washington Business Journal, the Baltimore Business Journal, and Employee Benefits News. He holds an MBA in Health Care Management from Johns Hopkins University and a BS in Public Health from the University of North Carolina at Chapel Hill.
Sandeep Wadhwa, MD, MBA | Senior Vice President | Solera Health
Dr. Wadhwa is a leader in building population health programs for vulnerable populations. He serves as the senior vice president of market innovation and is the chief health officer for Solera Health where he is focused on scaling the Diabetes Prevention Program as well as health-related, social support interventions. Previously, Sandeep held population health leadership positions with 3M and McKesson. He also served as the State Medicaid Director for Colorado under its former Governor. While there, he oversaw a $4 billion program and led the effort to implement an accountable care collaborative. Sandeep also serves on the board of Reinvestment Fund, a $1 billion non-profit, financial institute devoted to revitalizing low-income neighborhoods. Sandeep continues to see patients at the Seniors Clinic at the University of Colorado Hospital where he serves as associate clinical professor in the division of Geriatric Medicine.
Anil Jain, MD | VP & Chief Health Informatics Officer | IBM Watson Health
Focused on the intersection of information technology, informatics, clinical medicine and innovation, Dr. Jain is VP and Chief Health Informatics Officer at IBM Watson Health. He was Co-Founder, Senior VP and Chief Medical Officer of Explorys, Inc. formed in 2009 based on innovations that he developed while at the Cleveland Clinic. In April 2015, Explorys was acquired by IBM as an integral component of the newly formed Watson Health business unit. In 2017, he was appointed by Congress to the Federal Health IT Advisory Committee established by the 21st Century Cures Act.
Rose Maljanian
PHA Board Chair
Chairman and CEO, HealthCAWS, Inc.
Ms. Maljanian is an accomplished senior executive with more than 25 years of experience in the health care industry. Rose’s leadership experience
spans corporate managed care, specialty population health management, delivery systems and public health settings and include product strategy,
design and development, M&A; operations and fiscal management; and quality improvement/outcomes research.
Rose, founder of HealthCAWS, Inc. serves as Chairman and CEO of HealthCAWS, Inc., a privately held corporation focused on improving health and making health care more affordable by aligning accountability models and supports for success. As President, Strategic Health Equations, LLC, her initiatives included sourcing and diligence for venture and private equity firms; and for existing companies, product portfolio development and strategic planning. Prior, Rose served as SVP Product Innovation at Magellan and VP Clinical Interventions at Humana and as chief executive for the Institute for Outcomes Research and Evaluation at Hartford Hospital. She holds a Bachelor of Science in nursing, was critical care certified and holds an MBA from Rensselaer Polytechnic Institute.
Colorectal Cancer Screening: How Technology Can Increase Screening Rates
SPEAKER: Josh Sclar, MD, MPH
Chief Medical Officer, BioIQ
It’s 2018, which means the moment of truth has arrived for the National Colorectal Cancer Roundtable’s “80% by 2018” initiative for colorectal cancer screening. Needless to say, we’re not measuring up. And with the American Cancer Society lowering their recommendation of age that screening should start — from 50 to 45 — even more unscreened people may need this critical test. We discuss how technology, convenience and personalization can transform colorectal cancer screening rates and save more lives.
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Joshua Sclar, MD, MPH, is BioIQ’s Chief Medical Officer. Sclar is board certified in preventive medicine and public health and has over 15 years experience in healthcare. His career has spanned clinical practice, health services research and public health instruction in addition to building innovative, prevention-oriented healthcare delivery models for academia and business.
Prior to joining BioIQ, Sclar was the Chief Medical Officer at Ingenios Health Co., which developed one of the first purpose-built mobile technology platforms for health risk assessment. Sclar was a member of the steering committee that created the Johns Hopkins Sibley Innovation Hub and served as its first Lead Designer and Innovator in Residence. He has published research on a variety of topics in healthcare delivery while working at the FDA, Columbia University Medical Center, and the Johns Hopkins Center for Public Health and Human Rights. He has also been a full-time practicing physician at St. Luke’s Hospital in St. Louis, MO.
Sclar received his medical degree from the State University of New York and completed residency training at Johns Hopkins. He earned a master’s degree in public health as a BJC Healthcare Scholar at Washington University in St. Louis, and holds a bachelor’s degree from the University of Miami.
Successful Physician Engagement in the Value-Based World Webinar
SPEAKER: Gary Stelluti
Principal & Chief Strategist, HC Marketing
In this webinar, Gary Stelluti will outline what is becoming the Holy Grail of population health: physician engagement. Drawing on his experience in working with a number of high performing physician-led organizations, Mr. Stelluti will describe the successful elements of physician engagement. Using real world examples, this webinar will offer lessons learned that could be applied to other settings that are looking to engage physicians, drive value and achieve organizational success.
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Gary Stelluti has 20 years of experience in physician-specific marketing and communications, earning a reputation as a physician-engagement expert. Gary oversees client relations and the creation / implementation of market-specific physician engagement strategies. His experience includes working for large physician networks and IPA’s, single specialty practices and physician-owned companies throughout the United States.
Making Money on Population Health: The Transformational Imperative for Improving Health and Quality
Wednesday, November 7th, 2018
3 p.m. – 4 p.m. Eastern
SPEAKER: Gary L. Morel, MHA, FACHE CEO, FiveFifty Health
Gary Morel, MHA, FACHE, is the CEO of FiveFifty Health. Five percent of the population accounts for Fifty percent of all health care expenditures. FiveFifty has helped companies realize organizational managed care dreams for over 20 years. Morel pioneered the concept of provider-sponsored community health plans and was instrumental in the establishment, management, or rehabilitation of seven different fully insured health plans. Morel has served national health leadership and board roles in the fields of wellness, quality, policy, and business advocacy. Prior to forming FiveFifty, Morel was the visionary CEO of two teaching hospitals and a regional healthcare alliance. Morel has been an innovative transformational force in healthcare delivery and is now an advocate of aligning payer-provider incentives to practice value-based care and population health management.
Activating Physician Leadership in Population Health
SPEAKERS: William Faber, MD, MHCH
Managing Principal
Lumina Health Partners
Lucy Zielinski
Managing Partner
Lumina Health Partners
MODERATOR: Jaan Sidorov, MD
CEO & President
The Care Centered Collaborative
Population Health demands strong physician leaders. Many physicians are taking on executive and leadership roles as the industry shifts to value-based care. For example, physicians are leading by creating strategies and executing plans to transform care delivery, managing clinically integrated networks and ACOs, and facilitating various work groups. These new roles require a new skill set.
In this seminar, we will discuss practical techniques to activate physician leadership. A roadmap to leadership effectiveness will be shared, as well as the top 5 leadership competencies physicians must master.
Social Determinants of Health and Health Disparities
SPEAKER: Mary Jane Osmick, MD
Vice President and Medical Director
American Specialty Health
Join PHA’s next webinar detailing the recent release of the White Paper, examining the definition, impact, and potential interventions to reduce the effect of negative social determinants of health (SDH) on health status in the U.S. PHA’s Quality and Research Committee spearheaded this initiative to identify best practices and highlight areas where additional research is required to support organizations intervening in SDH.
The Population Health Alliance and its member organizations use best practices and recommendations in the White Paper to enhance and improve effective population health programs for employers, health plans, and other stakeholders. The White Paper is available as a benefit to members of the Population Health Alliance. Non-members may access an Executive Summary.
Driving Quality through Population Health Management Strategies: An Overview of the PHA Framework & NCQA Accreditation Standards
SPEAKER:
Rose Maljanian
Chairman & CEO
HealthCAWS, Inc.
Board Chair
Population Health Alliance
Rose Maljanian, Chairman & CEO, HealthCAWS, Inc., and PHA Board Chair will lead with a discussion on driving quality through application of PHA’s Population Health Management Framework across the care continuum and across market segments. Patricia Barrett, Vice President, Product Design and Support, NCQA will do a deep dive into the newly released NCQA Population Health Management accreditation standards and their implications for improving the value of PHM across the healthcare ecosystem.
Social Determinants of Health: Implications for Provider Value-Based Care Arrangements Webinar
SPEAKER:
Jaan Sidorov, MD
CEO and President
The Care Centered Collaborative
at The Pennsylvania Medical Society
Join PHA’s next webinar detailing the recent release of the White Paper, “Taking Action: Social Determinants of Health and Health Disparities,” examining the implications for provider value-based care arrangements.
The Population Health Alliance and its member organizations use best practices and recommendations in the White Paper to enhance and improve effective population health programs for employers, health plans, and other providers. The White Paper is available as a benefit to members of the Population Health Alliance.
Healthcare’s Shifting Risk: The Implications for Physicians
SPEAKER:
Daniel Brooks
Senior Vice President
HealthEC
In this webinar, Daniel Brooks, Senior Vice President, HealthEC will review the rise of value-based purchasing and how the market has responded with consolidation and the entry of new players. He will focus on the transition from “IDN” (integrated delivery systems) to “RBE” (risk-bearing entities) and how that has prompted the arrival of alternative arrangements for providers, such as clinically integrated networks (CINs). Dan will provide insights on how providers can pursue success in this new market, how they will need to consider the pros and cons of “sponsorship alternatives” and carefully consider payer outreach strategies.
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Mr. Brooks currently serves as Senior Vice President at HealthEC, an international physician enablement and Population Health Platform provider. Dan has a long career serving the provider community, including as Vice President, Business Development at a multi-hospital health system, 20+ years healthcare management consulting, as Chief Strategy Officer at a Practice Management supplier, and as Executive Director of Medicare and Commercial ACOs.
Employer Interest in Population Health Improvement: Opportunities (and Challenges) for Providers
SPEAKER: Neil Goldfarb President and CEO
Greater Philadelphia Business Coalition on Health
Mr. Neil Goldfarb is President and CEO of the Greater Philadelphia Business Coalition on Health, an employer-led non-profit organization established in 2012 with the mission of developing best practices for maintaining a healthy workforce, and ensuring that when healthcare is needed it is safe, high-quality, accessible and affordable. Mr. Goldfarb brings over 30 years of healthcare research and management experience to his Coalition leadership position.
As Associate Dean for Research in the Jefferson School of Population Health, he was responsible for developing and carrying out the School’s research agenda, focused on healthcare quality and value, and economic evaluation of healthcare technologies. Concurrently, Mr. Goldfarb served as Director of Ambulatory Care Performance Improvement for the Jefferson faculty practice plan. His previous positions include Executive Director of a quality improvement consulting and data collection firm, and Vice President of Health Services for the Philadelphia region’s first Medicaid managed care plan.
Mr. Goldfarb has authored over 60 articles in the peer-reviewed literature, focused on his interests in health and disease management, quality measurement and improvement, care for the underserved, and health economics and outcomes research. He has served as adjunct faculty for the Jefferson College of Pharmacy and University of the Sciences. Mr. Goldfarb is Chair of the Board of Governors of the National Alliance of Healthcare Purchaser Coalitions (National Alliance), and founding co-Director of the National Alliance College for Value-based Purchasing of Health Benefits.
Orthopedic Medicine and Excellence in Episodes of Care: The Rothman Institute’s Journey
SPEAKER: Chris Vannello
Director of Quality
Rothman Institute
Chris Vannello is the Director of Quality at Rothman Institute in Philadelphia Pennsylvania. The Rothman Institute is one of the largest orthopedic practices in the country. Chris oversees all quality improvement initiatives internally, locally and nationally for the practice. She is responsible for the episode of care management as it relates to alternative payment models, monitoring of outcomes, the patient navigation process, MIPS and establishing and sustaining orthopedic centers of excellence with hospital partners. Chris sits on the Quality committee for the National Orthopedic Spine Alliance and is the co-leader for a national outcomes benchmarking group.
Before working at Rothman Institute Chris was a Director of Quality at Main Line Health Systems, Riddle Hospital in Media, Philadelphia. She was responsible for the overall hospital quality improvement initiatives including the stroke, chest pain and hip and knee replacement programs and certifications. She began her career as a nurse at Bryn Mawr Hospital in Bryn Mawr, Pennsylvania.
Activating Physician Leadership in Population Health
SPEAKERS: William Faber, MD, MHCH
Managing Principal
Lumina Health Partners
Lucy Zielinski
Managing Partner
Lumina Health Partners
Moderator: Jaan Sidorov, MD
CEO & President
The Care Centered Collaborative
Population Health demands strong physician leaders. Many physicians are taking on executive and leadership roles as the industry shifts to value-based care. For example, physicians are leading by creating strategies and executing plans to transform care delivery, managing clinically integrated networks and ACOs, and facilitating various work groups. These new roles require a new skillset.
In this seminar, we will discuss practical techniques to activate physician leadership. A roadmap to leadership effectiveness will be shared, as well as the top 5 leadership competencies physicians must master.
Population Health Management (PHM) for the Practicing Provider
SPEAKER: Rose Maljanian
Chairman & CEO
HealthCAWS, Inc.
Board Chair
Population Health Alliance
Rose Maljanian, Chairman & CEO, HealthCAWS, Inc., and PHA Board Chair will lead a discussion on driving quality through application of PHA’s Population Health Management Framework across the care continuum and across market segments. Patricia Barrett, Vice President, Product Design and Support, NCQA will do a deep dive into the newly released NCQA Population Health Management accreditation standards and their implications for improving the value of PHM across the healthcare ecosystem.
The Provider Engagement in Population Health: Organized Medicine as a Catalyst
SPEAKER:
Jaan Sidorov, MD
CEO and President
The Care Centered Collaborative
at The Pennsylvania Medical Society
Jaan Sidorov, MD, CEO of the Care Centered Collaborative, will provide an update on the role that state medical societies can play in organizing networks of physicians to adopt population health in the pursuit of value-based health insurance contracts. As the Triple Aim expands to include the 4th Aim of improving the work life of health care clinicians, stakeholders in population health are interested in leveraging independent community-based based physician as an additional resource. This webinar will describe several “lessons learned” in this emerging area of health care, and how local medical societies can potentially partner with other organizations in arrangements that further expand the population health market.
Dorrie Guest
Consulting Managing Director
Deloitte Consulting LLP
MODERATOR: Jaan Sidorov, MD
CEO and President
The Care Centered Collaborative at
The Pennsylvania Medical Society
and Population Health Alliance Provider Engagement Chair
As the healthcare system continues to rapidly evolve, physicians and hospitals are seeking approaches that help them better deliver affordable quality while simultaneously achieving their revenue objectives. In this webinar, speakers will present results from a recent study by the Deloitte Center for Health Solutions and discuss six readily achievable alignment strategies that they’ve uncovered in the course of interviews with health system executives across the United States. This webinar will focus on those strategies and how they can be deployed to meet providers’ preferences, leverage physician leadership, achieve actionable data insights, deploy financial incentives, maximize transparency and support optimal workflows.
John Haughton MD, MS
Chief Clinical Improvement Officer – Independent Health
Chief Innovation Officer – Chautauqua AMP (MSSP ACO)Dr. Haughton brings over 25 years of clinical experience and building and deploying population care workflow systems. He has an expertise in predictive modeling and is a member of the Population Health Alliance Board of Directors.
Description:
The discussion will include the following topic areas and use Independent Health and the Chautauqua AMP experience as examples of use in clinical care today:
Nicole Alexander-Scott, MD, MPH Director, Rhode Island Department of Health President, Association of State and Territorial Health Officials
Nicole Alexander-Scott has been the director of the Rhode Island Department of Health since May 2015. She brings to this position tremendous experience from her work as a specialist in infectious diseases for children and adults at hospitals in Rhode Island affiliated with Brown University and at the Rhode Island Department of Health. Her clinical and academic responsibilities were balanced with serving as a consultant medical director for the Office of HIV/AIDS, Viral Hepatitis, STDs, and TB in the Division of Infectious Diseases and Epidemiology at the Rhode Island Department of Health. Alexander-Scott is board certified in pediatrics, internal medicine, pediatric infectious diseases, and adult infectious diseases. She obtained a Master of Public Health degree from Brown University in 2011. She is also an assistant professor of pediatrics and medicine at the Warren Alpert Medical School of Brown University.
Originally from Brooklyn, New York, Alexander-Scott attended Cornell University, majoring in human development and family studies, and subsequently graduated from medical school in 2001 from SUNY Upstate Medical University at Syracuse. After completing a combined internal medicine-pediatrics residency at SUNY Stony Brook University Hospital in 2005, Alexander-Scott finished a four-year combined fellowship in adult and pediatric infectious diseases at Brown in 2009.
Presenter: Suzanne Mitchell, MD, MS
Founder, See Yourself Health LLC
Associate Professor, Family Medicine and Palliative Care
Boston Medical Center/ Boston University School of Medicine
A healthy lifestyle is an essential part of disease prevention, chronic disease management and population health. New technology solutions emerge each day designed to help people with lifestyle management. Yet few use scientific and evidence based strategies to make healthy lifestyle changes more achievable. This webinar will provide an overview of design, implementation and dissemination of the See Yourself Health platform – a novel educational platform targeting adults with chronic disease who are striving to make lifestyle changes. The program’s founder and lead scientific investigator, Dr. Suzanne Mitchell, will present early research findings and share how this novel approach is being used to help create communities of learning and change for patients with chronic disease.
Presenter: Ken Goldblum, MD
Chief Medical Officer
Tandigm Health
How can a network of high performing primary care practices work with an insurer to increase value for high risk populations? In this webinar, Tandigm’s Chief Medical Officer Ken Goldblum will describe this organization’s coordinated and regional approach to care southeast Pennsylvania that led to measurable increases in value.
Presenter: Dawn Tice RN, BSN, MBA
Division Vice President, Clinical Operations
Main Line Healthcare
Dawn Tice RN, BSN, MBA is the Division Vice President, Clinical Operations for Main Line Healthcare. Her presentation will examine how a regional health system successfully implemented a robust ambulatory quality strategy that included patient-centered practice transformation the implementation of centralized care management, and systemwide adoption of population management.
Presenter: Dr. Sanjay Seth
Chief Medical Informatics Officer, HealthEC
This webinar will review examples of how provider-led organizations have implemented population health management and value-based care solutions, lessons learned along the way, and how to leverage data for value-based contracting.
With over 30 years of clinical, administrative and consulting experience, Dr. Seth helps provider organizations transition to population health management, develop value-based care strategies, and engage in contract negotiations.
Dr. Seth has supported two physician groups in the formation of Accountable Care Organizations under the MSSP initiative, creating collaborative care coordination agreements and introducing technology and processes to manage ACO operations. He also established a payer supported Virtual Patient Centered Medical Home program for over 15,000 lives with care coordination and technology to comply with quality measures and utilization metrics.
Prior to joining HealthEC, he was a part of the turnaround team for Interfaith Medical Center, Newark Beth Israel Hospital Center at Orange and East Orange General Hospital, leading the implementation of complex hospital and physician clinical, financial, contractual and compensation relationships. Dr. Seth has also led numerous physician groups in their formation or re-structuring efforts including modification of billing systems, implementation of EMR’s and development of partnership agreements.
Creating true “value” for patients, practices and payers requires a commitment to quality, total cost of care and understanding your entire patient population. Practices serving pediatric patients have unique challenges in the move from fee for service to value based payments. Explore ways in which even small, independent practices can transform the care they deliver to create high value and remain financially viable in the changing healthcare landscape.
Rose Maljanian, PHA Board Chair, will lead with a discussion on driving quality through application of PHA’s Population Health Management Framework across the care continuum and across market segments. Patricia Barrett, Vice President, Product Design and Support, NCQA will do a deep dive into the NCQA Population Health Management accreditation standards and metrics.
Ms. Polak is a senior director based in Washington, D.C. In her role, she provides policy counsel and analysis to clients with matters involving regu-lations, legislation, and business implications. Anne Marie’s experience includes developing strategic messages and policy positions for Capitol Hill, administration, trade associations, and corporate audiences. Prior to joining Leavitt Partners, Anne Marie was a vice president for Faegre BD Consulting in the firm’s health and biosciences group. She also spent five years with the Podesta Group in Washington, D.C., while completing her law degree in the evenings at the George Mason University School of Law, graduating cum laude in 2010. Anne Marie also worked in the government and legal affairs office of Novo Nordisk in Washington, D.C., and as a congressional aide to Rep. Michael Ferguson of New Jersey.
Dr. Fabius has recently returned to his start up. HealthNEXT, a company dedicated to the development of organizational cultures of health — after serving as Chief Medical Officer of Truven Health Analytics (formerly the healthcare business of Thomson Reuters), the world’s leading source of intelligent information for business and professionals. In this capacity he is charged with developing and deepening relationships with customers, advising on product development, and providing counsel to the leadership on business strategy and medical issues. Formerly, Dr. Fabius served as strategic advisor to the President of Walgreens Health & Wellness Division. This organization will coordinate over 1,000 workplace health centers and 10,000 pharmacies, many with retail clinics, into a seamless primary care network across the country within the next five years. In the not too distant future, it will be possible to offer large employers medical and fitness services on-site as well as episodic illness care, health coaching and disease management monitoring at the employee’s nearest Walgreens pharmacy.
Mr. Buettner is an explorer, National Geographic Fellow, award-winning journalist and producer, and a New York Timesbestselling author. He discovered the five places in the world—dubbed Blue Zones—where people live the longest, healthiest lives. His articles about these places in The New York Times Magazine and National Geographic are two of the most popular for both publications.
Ms. Cooney provides strategic direction for the Centers three Pillars of Population Health – Clinical to Community Connections, Health Equity and the Social Determinants of Health, and Public Health Data Analytics and Informatics. Mary Ann previously worked for 14 years at the New Hampshire Department of Health and Human Services where she was Deputy Commissioner for the Department and Director of Public Health.
Mr. Scully is a General Partner in the Healthcare Group, having joined WCAS in 2004. Before joining WCAS, he was the Administrator of the Centers for Medicare and Medicaid Services (CMS) for three years and the President and CEO of the Federation of American Hospitals for six years. He also served as the Deputy Assistant to the President and as the Associate Director of OMB under President GHW Bush from 1989 to 1993, and has practiced law at Alston and Bird; Patton Boggs; and Akin, Gump, Strauss Hauer and Feld. He is a Principal at the Lincoln Policy Group.
Dr. Don Wright has served as the Deputy Assistant Secretary for Health and Director of the Office of Disease Prevention and Health Promotion (ODPHP) since January 2012. In this capacity, he leads coordination and policy development for public health and prevention activities within the Office of the Assistant Secretary for Health, U.S. Department of Health and Human Services. He is also currently the acting Executive Director of the President’s Council on Fitness, Sports & Nutrition.
Dr. Sidorov is a board-certified in general internal medicine physician with more than 25 years of experience in primary care, inpatient care, medical education and evidence-based practice. Jaan believes physician leadership throughout the continuum of care is the bedrock of value-based care delivery. He received his medical degree from Pennsylvania State University College of Medicine, and completed his internship and residency at the Dartmouth Hitchcock Medical Center in Hanover, New Hampshire. Jaan also served as a Chief Resident at Reading Hospital in Reading, Pennsylvania.
Dr. Ostrovsky is a practicing physician, social entrepreneur, and health policy expert who specializes in human-centered design, lean manage-ment, quality improvement, population health, and digital health. Dr. Ostrovsky was most recently the Chief Medical Officer for the Center for Medicaid and CHIP Services (CMCS), the nation’s largest insurer covering over 74 million people, annually.
Dr. Choice is vice president and medical director for physical medicine services at American Specialty Health (ASH). Dr. Choice oversees the Rehabilitation Services Clinical Quality Evaluation program and leads the content development, training and clinical quality processes for ASH’s musculoskeletal health and pain management products.
Ms. Forte is responsible for leading Tufts Health Public Plans expansion efforts. Prior to her current position, she was vice president of care management for all Public Plans members.
As Director of Strategic Initiatives, Ms. Bowman oversees new social needs intervention initiatives among our clinical partners — including program design, resource database build-outs, and integration of Health Leads’ signature technology, Reach. Elise brings 10 years of direct service experience to her role, having previously served as a Health Leads program manager, a case manager for adults struggling with mental illness and homelessness, and in developing parent engagement initiatives in public education settings.
Mr. Johnson leads the Sage Consulting’s work for a number of public sector, corporate, non-profit and multi-employer clients. David brings particular expertise in evidence-based workplace wellness programs and leveraging Behavioral Economics principles in Human Resources Management. He is also an Adjunct Professor in the Department of Psychology at Towson University.
Dr. Wadhwa is a leader in building population health programs for vulnerable populations. He serves as the senior vice president of market innovation and is the chief health officer for Solera Health where he is focused on scaling the Diabetes Prevention Program as well as health-related, social support interventions. Previously, Sandeep held population health leadership positions with 3M and McKesson. He also served as the State Medicaid Director for Colorado under its former Governor. While there, he oversaw a $4 billion program and led the effort to implement an accountable care collaborative. Sandeep also serves on the board of Reinvestment Fund, a $1 billion non-profit, financial institute devoted to revitalizing low-income neighborhoods. Sandeep continues to see patients at the Seniors Clinic at the University of Colorado Hospital where he serves as associate clinical professor in the division of Geriatric Medicine.
Focused on the intersection of information technology, informatics, clinical medicine and innovation, Dr. Jain is VP and Chief Health Informatics Officer at IBM Watson Health. He was Co-Founder, Senior VP and Chief Medical Officer of Explorys, Inc. formed in 2009 based on innovations that he developed while at the Cleveland Clinic. In April 2015, Explorys was acquired by IBM as an integral component of the newly formed Watson Health business unit. In 2017, he was appointed by Congress to the Federal Health IT Advisory Committee established by the 21st Century Cures Act.
Ms. Maljanian is an accomplished senior executive with more than 25 years of experience in the health care industry. Rose’s leadership experience
John Haughton MD, MS