Accountable Care Organization Summit
Accountable Care Organization Summit
Accountable Care Organization Summit
Accountable Care Organization Summit
Accountable Care Organization Summit
Accountable Care Organization Summit



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Preconference | Day 2

SIXTH NATIONAL ACCOUNTABLE CARE ORGANIZATION (ACO) SUMMIT
AGENDA: DAY I
Thursday , June 18, 2015

8:30 a.m.

Welcome, Introductions and Overview

Elliott S. Fisher, MD, MPH
Director, Dartmouth Institute for Health Policy and Clinical Practice, John E Wennberg Distinguished Professor of Health Policy, Medicine and Community and Family Medicine, Geisel School of Medicine at Dartmouth, Co-Director, Dartmouth Atlas of Health Care, Lebanon, NH

    Speaker Bio

    Dr. Fisher is Director of the Dartmouth Institute for Health Policy and Clinical Practice and the John E Wennberg Distinguished Professor of Health Policy, Medicine and Community and Family Medicine at the Geisel School of Medicine at Dartmouth. He is also Co-Director of the Dartmouth Atlas of Health Care.

    His recent work has focused on developing and evaluating policy approaches to slowing the growth of health care spending while improving quality. He was one of the originators of the concept of "accountable care organizations" (ACOs) and worked with colleagues to carry out the research that led to their inclusion in the Affordable Care Act. His current research focuses on exploring the determinants of successful ACO formation and performance.
Mark McClellan, MD, PhD
Senior Fellow in Economic Studies and Director, Initiatives on Value and Innovation in Health Care, The Brookings Institution; Former CMS Administrator and FDA Commissioner, Washington, DC

    Speaker Bio

    A doctor and economist by training, he also has a highly distinguished record in public service and in academic research. Dr. McClellan is a former administrator of the Centers for Medicare & Medicaid Services (CMS) and former commissioner of the U.S. Food and Drug Administration (FDA), where he developed and implemented major reforms in health policy. These include the Medicare prescription drug benefit, the FDA' s Critical Path Initiative, and public-private initiatives to develop better information on the quality and cost of care. Dr. McClellan chairs the FDA' s Reagan-Udall Foundation, is co-chair of the Quality Alliance Steering Committee, sits on the National Quality Forum' s Board of Directors, is a member of the Institute of Medicine, and is a research associate at the National Bureau of Economic Research. He previously served as a member of the President' s Council of Economic Advisers and senior director for health care policy at the White House, and was an associate professor of economics and medicine at Stanford University.
    Presentation Material (Acrobat)
9:00 a.m.

Keynote Address/Discussion: Centers for Medicare and Medicaid Services Perspective on Payment Reform

Patrick H. Conway, MD, MSc
Deputy Administrator for Innovation and Quality, Chief Medical Officer, Director, Center for Medicare and Medicaid Innovation and Director, Office of Clinical Standards and Quality, Center for Medicare and Medicaid Services, US Department of Health and Human Services, Baltimore, MD

    Speaker Bio

    Patrick Conway, MD, MSc, is Chief Medical Officer for the Centers for Medicare & Medicaid Services (CMS), Director of the Center for Clinical Standards and Quality, and the Director of the Center for Medicare and Medicaid Innovation.

    Previously, he was Director of Hospital Medicine and an Associate Professor at Cincinnati Children' s Hospital. He was also AVP Outcomes Performance, responsible for leading measurement, including the electronic health record measures, and facilitating improvement of health outcomes across the health care system. Previously, he was Chief Medical Officer at the Department of Health and Human Services (HHS) in the Office of the Assistant Secretary for Planning and Evaluation. In 2007-08, he was a White House Fellow assigned to the Office of Secretary in HHS and the Director of the Agency for Healthcare Research and Quality.
    Presentation Material (Acrobat)
9:30 a.m.

Keynote Panel #1: Aligning Goals on Payment Reform

  • Keynote #1 Panel Brief
  • John Bertko, FSA, MAAA
    Chief Actuary, Covered California; Former Director, Office of Special Initiatives and Pricing, Center for Consumer Information and Insurance Oversight (CCIIO), Centers for Medicare and Medicaid Services, Sacramento, CA

      Speaker Bio

      John Bertko is currently an independent actuarial consultant working as the Chief Actuary with Covered California (California' s Insurance Marketplace) and was the Director of Special Initiatives and Pricing in the Center for Consumer Information and Insurance Oversight at the Centers for Medicare and Medicaid Services (CMS), retiring from this position as of January 31, 2014. He served as a senior actuarial advisor on various private insurance initiatives, including risk adjustment, insurance programs and insurance oversight activities. He served on the Massachusetts Connector Board from October 2014 to March 2015. He formerly was a Senior Fellow at the LMI Center for Health Reform, Adjunct Staff at RAND, a Visiting Scholar at the Brookings Institution, a Visiting Scholar at the Center for Health Policy at Stanford and the retired Chief Actuary of Humana Inc., where he managed the corporate actuarial group and directed work by actuarial staff for Humana' s major business units, including developing Part D, Medicare Advantage and consumer-driven health care products. He has extensive experience with risk adjustment and has served in several public policy advisory roles. He served on the panel of health advisors for the Congressional Budget Office and completed a 6-year term on the Medicare Payment Advisory Commission (MedPAC). He served the American Academy of Actuaries as a board member from 1994 to 1996 and as vice president for the health practice council from 1995 to 1996. He is a Fellow of the Society of Actuaries and a Member of the American Academy of Actuaries. He has a B.S. in mathematics from Case Western Reserve University.
    Carmella Bocchino
    Executive Vice President, Clinical Affairs, America's Health Insurance Plans (AHIP), Washington, DC

      Speaker Bio

      Carmella Bocchino, R.N., M.B.A., is a leading authority in identifying strategies that promote greater organization in the health care delivery system and advance innovative payment models that drive quality and value. As executive vice president at America's Health Insurance Plans (AHIP), Ms. Bocchino works with the executives of member organizations to develop patient-centered programs and tools, foster private-public partnerships and advance an interconnected highly functioning health care system.

      A registered professional nurse and former hospital administrator, Ms. Bocchino's clinical and public policy expertise has been widely recognized by national and state lawmakers, policymakers, patient advocacy groups, employers, and throughout the health care community.
    Robert S. Galvin, MD, MBA
    Chief Executive Officer, Equity Healthcare; Operating Partner, Blackstone; Chair, Catalyst for Payment Reform, New York, NY

      Speaker Bio

      Dr. Robert Galvin is the Chief Executive Officer of Equity Healthcare (EH), which oversees the management of health care for firms owned by private equity companies. Before joining Blackstone, Dr. Galvin was Executive Director of Health Services and Chief Medical Officer for General Electric (GE) for fifteen years.

      Dr. Galvin is a nationally recognized leader in the areas of market-based health policy and financing, quality measurement and payment reform. He was a co-founder of the Leapfrog Group, founder of Bridges to Excellence/PROMETHEUS and Catalyzing Payment Reform (CPR).

      Dr. Galvin sits on the Institute of Medicine' s Board on Health Care Services. He is also on the Boards of the National Quality Forum and CPR. Dr. Galvin is Professor Adjunct of Medicine and Health Policy at Yale.
    Robert C. Sehring
    Chief Executive Officer - Central Region, OSF Healthcare System, Peoria, IL

      Speaker Bio

      In this position, he oversees services at four OSF hospitals: Peoria-based OSF Saint Francis Medical Center, Galesburg, Ill.-based OSF St. Mary Medical Center, Monmouth, Ill.-based OSF Holy Family Medical Center and Kewanee, Ill.-based OSF Saint Luke Medical Center. He also coordinates the strategic direction of OSFHCS' various operating units throughout the Central Region. Finally, in addition to his responsibilities for the Central Region, Mr. Sehring oversees OSFHCS' Accountable Care and Managed Care departments.

      Among various outside industry organizations, Mr. Sehring serves on the Health Care Transformation Task Force, which is a consortium of healthcare organizations and professionals committed to moving a significant portion of healthcare toward value-based payment arrangements by 2020.

      Mr. Sehring is stepping into this role from his prior role as chief of ministry services officer with OSF, in which he led the organization's value-based care agreements and participation in the Pioneer program.
    Mark McClellan, MD, PhD
    Senior Fellow in Economic Studies and Director, Initiatives on Value and Innovation in Health Care, The Brookings Institution; Former CMS Administrator and FDA Commissioner, Washington, DC (Moderator)

      Speaker Bio

      A doctor and economist by training, he also has a highly distinguished record in public service and in academic research. Dr. McClellan is a former administrator of the Centers for Medicare & Medicaid Services (CMS) and former commissioner of the U.S. Food and Drug Administration (FDA), where he developed and implemented major reforms in health policy. These include the Medicare prescription drug benefit, the FDA' s Critical Path Initiative, and public-private initiatives to develop better information on the quality and cost of care. Dr. McClellan chairs the FDA' s Reagan-Udall Foundation, is co-chair of the Quality Alliance Steering Committee, sits on the National Quality Forum' s Board of Directors, is a member of the Institute of Medicine, and is a research associate at the National Bureau of Economic Research. He previously served as a member of the President' s Council of Economic Advisers and senior director for health care policy at the White House, and was an associate professor of economics and medicine at Stanford University.
    10:30 a.m. Break
    11:00 a.m.

    Keynote Panel #2: Future Directions for Transforming Health Care Delivery through ACOs

  • Keynote #2 Panel Brief
  • Andrew Dreyfus
    President and Chief Executive Officer, Blue Cross Blue Shield of Massachusetts, Boston, MA

      Speaker Bio

      Andrew Dreyfus is President and Chief Executive Officer at Blue Cross Blue Shield of Massachusetts.

      Previously, Andrew served as BCBSMA's Executive Vice President, where he led the company's development of the Alternative Quality Contract, one of the largest payment reform initiatives in the nation.

      Andrew served as the first President of the Blue Cross Blue Shield of Massachusetts Foundation, which launched the "Roadmap to Coverage," that contributed to the passage of the state's 2006 Health Reform Law.

      Andrew is Chairman of the Board of the United Way, and serves on the boards of the Schwartz Center for Compassionate Healthcare, Jobs for Massachusetts, and the advisory boards of the Ariadne Labs and the BU School of Public Health.
    Thomas Malone, MD, MBA
    President and Chief Executive Officer, Summa Health System, Akron, OH

      Speaker Bio

      Dr. Thomas Malone was named President and CEO of Summa Health in January of 2015. Prior to his current appointment, he served as Summa' s Chief Operating Officer and President of Summa Akron City and Summa St. Thomas Hospitals. In his current role, Dr. Malone is responsible for leading Summa' s transformation from a hospital-based company to a patient-centered population health management organization that is strategically driven by a robust ACO named NewHealth Collaborative and is focused on providing integrated, coordinated and value-based care to the people of Northeast Ohio.
    Richard Merkin, MD
    President and Chief Executive Officer, Heritage Medical Systems, Del Rey, CA

      Speaker Bio

      Richard Merkin has been the CEO and founder of the Heritage Group since 1979. Under his stewardship, the Heritage Group has become the largest, physician­ owned and operated integrated delivery system in the United States with over 50 related healthcare companies. The Heritage Group encompasses numerous patent, venture capital, private equity, and insurance companies. Dr. Merkin serves on the Board of the California Institute of Technology and the Keck School of Medicine at the University of Southern California. He is the Co-founder of Fastercures. He has established the Richard Merkin Foundation for Stem Cell Research at the Broad Institute at Harvard and the Massachusetts Institute of Technology, the Richard Merkin Initiative at the Johns Hopkins Brain Sciences Institute, and the Richard Merkin Foundation for Neural Regeneration at UCLA.

      He is on the board of the California Nano Systems Institute and serves on many other boards that focus on science, healthcare and finance. Inspired by the x­Prize Foundation, Dr. Merkin launched the Heritage Health Prize, a $3 million global incentivized competition seekingto achieve a fundamental breakthrough in our ability to predict future hospitalization.
    Elliott S. Fisher, MD, MPH
    Director, Dartmouth Institute for Health Policy and Clinical Practice, John E Wennberg Distinguished Professor of Health Policy, Medicine and Community and Family Medicine, Geisel School of Medicine at Dartmouth, Co-Director, Dartmouth Atlas of Health Care, Lebanon, NH (Moderator)

      Speaker Bio

      Dr. Fisher is Director of the Dartmouth Institute for Health Policy and Clinical Practice and the John E Wennberg Distinguished Professor of Health Policy, Medicine and Community and Family Medicine at the Geisel School of Medicine at Dartmouth. He is also Co-Director of the Dartmouth Atlas of Health Care.

      His recent work has focused on developing and evaluating policy approaches to slowing the growth of health care spending while improving quality. He was one of the originators of the concept of "accountable care organizations" (ACOs) and worked with colleagues to carry out the research that led to their inclusion in the Affordable Care Act. His current research focuses on exploring the determinants of successful ACO formation and performance.
    12:00 p.m.

    The Next Frontier of Healthcare

    Michael Leavitt
    Founder and Chairman, Leavitt Partners; Former Governor of Utah; Former Secretary, US Department of Health and Human Services, Salt Lake City, UT

      Speaker Bio

      Michael O. Leavitt is the founder and chairman of Leavitt Partners, a health care intelligence business. In previous roles, Leavitt served as secretary of Health and Human Services (2005-2009), administrator of the Environmental Protection Agency (2003-2005) and three-time elected governor of Utah (1993-2003). While at EPA he oversaw the implementation of the most protective ground-level ozone standards in our nation' s history and signed the Clean Diesel Rule, a landmark rule to cleanup nonroad diesel fuel. His service at HHS included the implementation of the Medicare Part D Prescription Drug Program and the planning and preparation for a pandemic flu. Known as a seasoned expert in public policy, global health and health system reform, Leavitt is a sought after speaker and advisor to CEOs, governors, Members of Congress and political candidates. He and his wife Jackie have been married 37 years and lead a full live with five children and eleven grandchildren.
      Presentation Material (Acrobat)
    12:30 p.m. Networking Luncheon

    TRACKS GROUP I (Choose one of the following Tracks)
    TRACK 1: ALTERNATIVE APPROACHES TO MEANINGFUL QUALITY IMPROVEMENT AND MEASUREMENT
    ACO SUMMIT PANEL BRIEFS
    Below is the supplemental material for the Track 1 agenda.
    ACO Summit Panel Briefs (Acrobat)

    1:30 p.m.

    Keynote/Moderator:

    Thomas Valuck, MD, JD
    Partner, Discern Health; Former Senior Vice President for Strategic Partnerships, National Quality Forum; Former Senior Advisor and Medical Officer, Center for Medicare and Medicaid Services, Baltimore, MD

    Presentation Material (Acrobat)
    Panel:
    Michael G. Hunt, DO, FACOP, FAAP, MMI
    Chief Medical Officer and Chief Medical Information Officer, St. Vincent's Health Partners, Inc., Bridgeport, CT

      Speaker Bio

      Dr. Hunt, CPHO at St. Vincent's Health Partners, Inc. (SVHP), graduated from the University of Osteopathic Medicine and Health Sciences, Des Moines, IA, and completed his residency in Pediatrics at William Beaumont Army Medical Center, El Paso, TX. He completed his Masters in Medical Informatics at Northwestern University, and has academic appointments including assistant professor, Department of Pediatrics, Frank H. Netter MD School of Medicine At Quinnipiac University, Connecticut. He has led the clinical implementation of the EMR in ambulatory and inpatient environments, and developed chronic disease registries, clinical quality reporting, best practice standardization and managed transition to an ACO. SVHP is the first accredited healthcare organization recognized by URAC for clinical integration, and Dr. Hunt co-authored "Coordinating Care - Transforming the Delivery Process" Chapter in the Clinical Integration: Population Health and Accountable Care 3rd edition. SVHP continues to define medical management and medical services.
    Simone Karp, RPh
    Executive Vice President, Business Development, CECity.com, Inc., Homestead, PA

      Speaker Bio

      Ms. Karp, Co-Founded CECity 19 years ago and serves in the role of Chief Business Officer. Ms Karp has over 28 years of healthcare industry experience, with a focus on quality and performance assessment, measurement and improvement, continuous professional development, and healthcare consulting services for the pharmaceutical and biotechnology industries.

      During her career, Ms. Karp has pioneered efforts to improve the quality of patient care through the development of cloud and registry based technology solutions that align quality and performance improvement, continuous professional development and value based payment.

      Prior to CECity, Ms. Karp worked in the Pharmaceutical and Biotechnology industries for Lederle Laboratories and Amgen, Inc. And Co-Founded a healthcare consulting company, Integrated Healthcare Associates.

      Ms Karp is an Oncology Pharmacist and holds a BS degree in Pharmacy from the University of Pittsburgh.
    Kevin Larsen, MD, FACP
    Medical Director, Meaningful Use, Office of the National Coordinator of Health IT; Associate Professor of Internal Medicine, University of Minnesota; Former Chief Medical Informatics Officer, Hennepin County Medical Center, Washington, DC

      Speaker Bio

      Kevin L. Larsen, MD is Medical Director of Meaningful Use at the Office of the National Coordinator for Health IT. He leads ONCs work on quality policy, measurement and improvement, including clinical decision support and registries. He serves on a number of HHS and national groups coordinating measure policy and measure sets. Prior to working for the federal government he was Chief Medical Informatics Officer and Associate Medical Director at Hennepin County Medical Center in Minneapolis, Minnesota. He is also an Associate Professor of Medicine at the University of Minnesota. His research includes health care financing for people living in poverty, computer systems to support clinical decision making, and health literacy. In Minneapolis he was also the Medical Director for the Center for Urban Health, a hospital, community collaboration to eliminate health disparities.
    Lewis G. Sandy, MD, FACP
    Senior Vice President, Clinical Advancement, UnitedHealth Group; Senior Fellow, School of Public Health, Department of Health Policy and Management, University of Minnesota, Minnetonka, MN

      Speaker Bio

      Lewis G. Sandy, M.D., is Executive Vice President, Clinical Advancement, UnitedHealth Group (a Fortune 25 diversified health and well-being company dedicated to helping people live healthier lives). At UnitedHealth Group he focuses on clinical innovation, payment/delivery reforms to modernize our health care system, and physician collaboration. He also is a Principal in the UnitedHealth Center for Health Reform and Modernization, with a focus on payment/delivery innovation and policy. From 2003 to 2007, he was EVP and Chief Medical Officer of UnitedHealthcare, UnitedHealth Group' s largest business focusing on the employer/individual health benefits market. From 1997 to 2003, he was EVP of The Robert Wood Johnson Foundation. At RWJF, he was responsible for the Foundation's program development and management, strategic planning and administrative operations. Prior to this, Dr. Sandy was a program VP of the Foundation, focusing on the Foundation's workforce, health policy, and chronic care initiatives. An internist and former health center medical director at the Harvard Community Health Plan in Boston, Massachusetts, Dr. Sandy received his B.S. and M.D. degrees from the University of Michigan and an M.B.A. degree from Stanford University. A former RWJF Clinical Scholar and Clinical Fellow in Medicine at the University of California, San Francisco, Dr. Sandy served his internship and residency at the Beth Israel Hospital in Boston. He is a Senior Fellow of the University of Minnesota School of Public Health, Department of Health Policy and Management.
    3:00 p.m. Break

    TRACK 2: COMMERCIAL ACO INNOVATION AND GROWTH
    ACO SUMMIT PANEL BRIEFS
    Below is the supplemental material for the Track 2 agenda.
    ACO Summit Panel Briefs (Acrobat)

    1:30 p.m.

    Keynote/Moderator:

    David B. Muhlestein, PhD, JD
    Senior Director of Research and Development, Leavitt Partners, LLC, Salt Lake City, UT

      Speaker Bio

      David Muhlestein is Senior Director of Research and Development at Leavitt Partners. He directs the study of accountable care organizations through the LP Center for Accountable Care Intelligence and leads the firm's quantitative evaluation of health care markets. He is an expert in using policy analysis, predictive modeling and applied analytics to understand the evolving health care landscape and his insights have been quoted by publications such as The Wall Street Journal, The Seattle Times and Modern Healthcare. He completed his PhD and JD at The Ohio State University and his undergraduate at Brigham Young University.
      Presentation Material (Acrobat)
    Panel:
    D. Keith Fernandez, MD
    President & Physician-in-Chief, Memorial Hermann Physician Network; Chief Medical Officer, Memorial Hermann ACO, Houston, TX

      Speaker Bio

      Dr. Keith Fernandez is President and Physician-in-Chief of MHMD, the Memorial Hermann Physician Network, and Chief Medical Officer of the Memorial Herman Accountable Care Organization (MHACO) in Houston, Texas. Dr. Fernandez has been a member of MHMD for 22 years and served as Director and Chairman of the Board immediately prior to his current role. He chairs the Clinical Programs Committee, with over 40 specialty and subspecialty committees that provide governance for quality, safety and cost efficiency for MHMD and Memorial Hermann Health System (MHHS).

      Dr. Fernandez attended Florida State University and received his bachelor' s degree from University of South Florida. He received his doctorate of medicine in 1981 from the Uniformed Services University of the Health Sciences Ebert School of Medicine in Bethesda, Maryland. Dr. Fernandez completed his residency in Internal Medicine at David Grant Medical Center (affiliated with University of California at Davis) and his fellowship in Gastroenterology at Wilford Hall USAF Medical Center. He is currently an adjunct Clinical Professor of Medicine at The University of Texas Health Science Center at Houston. He is board-certified in Internal Medicine, Gastroenterology and Hepatology. He continues in part time, private practice as a gastroenterologist.
    Dana Gilbert
    Chief Operating Officer, Advocate Physician Partners, Chicago, IL

      Speaker Bio

      Dana Gilbert has served as Chief Operating Officer for Advocate Physician Partners since April 2013, overseeing APP field operations, physician engagement, medical services, clinical integration and clinical innovation.

      Gilbert previously held the role of Vice President of Clinical Innovation at APP, leading initiatives to support value based agreements and Advocate' s population health strategy. He joined APP in 2000 as a PHO Director, having spent 15 years prior at Advocate Illinois Masonic Medical Center.

      Gilbert earned his bachelor' s degree from the Massachusetts Institute of Technology (MIT) and master' s degree in management (healthcare/finance) from the Sloan School of Management at MIT.
    H. Scott Sarran, MD, MM
    Divisional Senior Vice President and Chief Medical Officer, Government Programs, Health Care Service Corporation, Former Chief Medical Officer, Blue Cross Blue Shield of Illinois, Chicago, IL

      Speaker Bio

      H. Scott Sarran, M.D., is Divisional Senior Vice President and Chief Medical Officer, Government Programs, Health Care Service Corporation (HCSC). He is responsible for network strategy and oversight (including ACOs), medical management and quality for HCSC' s government programs in all five (IL, TX, NM, OK, MT) states. Dr. Sarran joined HCSC in 2008 as Chief Medical Officer for Blue Cross Blue Shield of Illinois.
    Charles E. Saunders, MD
    Chief Executive Officer, Healthagen, an Aetna company; Former Executive in Residence, Warburg Pincus; Former Chief Medical Officer, Healtheon/WebMD, San Francisco, CA

      Speaker Bio

      Charles E. Saunders, M.D., joined Aetna on Jan. 31, 2011, as CEO of Healthagen, (formerly, Emerging Businesses). In this role, he is responsible for leading the strategic diversification of Aetna' s products, services and global opportunities. Dr. Saunders is a physician and an accomplished business executive with expertise in health care services, information technology and business process operations.

      Dr. Saunders came to Aetna from Warburg Pincus, one of the world' s largest and oldest private equity firms, where he served as an executive in residence. In that capacity, he provided strategic leadership in assessing and pursuing growth opportunities in health care services and health care IT.
    3:00 p.m. Break

    TRACK 3: VARIATION AND FINANCIAL PERFORMANCE METRICS
    ACO SUMMIT PANEL BRIEFS
    Below is the supplemental material for the Track 3 agenda.
    ACO Summit Panel Briefs (Acrobat)

    1:30 p.m.

    Keynote/Moderator:

    Greger J. Vigen, MBA, FSA, MAAA
    Independent Consulting Actuary; Co-Author, Measurement of Healthcare Quality and Efficiency: Resources for Healthcare, Professionals and Opportunities During Transformation: Moving To Health Care 2.0, Los Angeles, CA

      Speaker Bio

      Mr. Vigen is a health actuary and MBA. Before going independent, Greger worked through Mercer for major employers including CalPERS and was on the board of directors for a major IPA. He now works with major California medical groups, ACOs, and others. He is on the Health Council for the Society of Actuaries, chairs the Society' s Payment Model workgroup, and co-chairs the comparable workgroup for the Learning Network.

      Greger co-authored major papers for the Society on measurement and Health Care 2.0". His Masters comes from UCLA after undergraduate degree at the University of Southern California.
    Panel:
    Steven J. Bernstein, MD, MPH
    Associate Dean for Clinical Affairs, Professor, Department of Internal Medicine, Research Scientist, Department of Health Management and Policy, Director of Quality, University of Michigan Medical Group, University of Michigan, Ann Arbor, MI

      Speaker Bio

      Steven J. Bernstein earned his MD from the University of Rochester, completed his residency at the University of Pittsburgh, and received his MPH from UCLA. He is a Professor of Medicine and Associate Dean for Clinical Affairs at the University of Michigan (UM) where he directs Quality and Population Health for the UM Medical Group. He is responsible for measuring and improving ambulatory quality and working with pay-for-performance programs such as the Medicare Shared Saving Program. He is also an attending physician at the Ann Arbor VA Medical Center and a Research Scientist at the Center for Clinical Management Research.
    Angela Carmichael, MBA, RHIA, CDIP, CCS, CCS-P
    AHIMA-Approved ICD-10 CM/PCS Trainer, Health Information Management; Director, J.A. Thomas & Associates/Nuance Communications, Inc., Atlanta, GA

      Speaker Bio

      Angela Carmichael is a Registered Health Information Administrator, a Clinical Documentation Improvement Practitioner and Certified Coding Specialist for both hospital and physician services including risk adjustment. She is an MBA with extensive experience in the health information management specializing in various payment methodologies, coding education, compliance and management. Her experience includes services provided in the hospital, physician office, consulting and insurance settings. She has expertise in technical writing, public speaking, testing and training development. In addition, Angela is an AHIMA approved ICD-10-CM/PCS Instructor and Ambassador.
    Derek DeLia, PhD
    Associate Research Professor, Center for State Health Policy, Rutgers University, New Brunswick, NJ

      Speaker Bio

      Derek DeLia is an Associate Research Professor at the Rutgers Center for State Health Policy. He also teaches Health Economics and Econometrics in the Rutgers Economics Department. His research focuses on the economics of hospitals and health centers; emergency care; shared savings arrangements; performance measurement in accountable care organizations (ACO' s); health insurance coverage; and healthcare delivery systems. He currently serves on the Agency for Healthcare Research and Quality Study Section on Health Systems & Value Research. He has provided expert commentary on healthcare issues for Public Television and Modern Healthcare magazine. He earned Ph.D. in Economics from Cornell University.
    Janice Singer, MA, MPH
    Vice President, Programs and Operation, Massachusetts Health Quality Partners; Former Director of Managed Care Programs, Massachusetts Medicaid Program, Watertown, MA

      Speaker Bio

      Janice Singer is Vice President of Programs for Massachusetts Health Quality Partners. She oversees clinical quality and patient experience comparative public reporting initiatives and pilot projects . She also directs MHQP' s Practice Pattern Variation Analysis program. Ms. Singer served as Director of Managed Care Programs for the Massachusetts Medicaid Program and as Senior Project Director for Brandies University's Health Policy Center. . Ms. Singer spent 11 years with Blue Cross and Blue Shield of Massachusetts, directing program development and strategic planning departments. She received a Master's in Public Health from Harvard University and a Master's in Sociology from Boston College.
    3:00 p.m. Break


    TRACKS GROUP II (Choose one of the following Tracks)
    TRACK 4: EMPLOYER-LED ACCOUNTABLE CARE INNOVATIONS
    ACO SUMMIT PANEL BRIEFS
    Below is the supplemental material for the Track 4 agenda.
    ACO Summit Panel Briefs (Acrobat)

    3:30 p.m.

    Keynote/Moderator:

    William E. Kramer, MBA
    Executive Director for National Health Policy, Pacific Business Group on Health, San Francisco, CA

      Speaker Bio

      Bill Kramer is Executive Director for National Health Policy at the Pacific Business Group on Health. Bill also serves as Project Director for the Consumer-Purchaser Alliance, and he is on the Board of the National Quality Forum and the NQF' s Measure Applications Partnership Coordinating Committee. Immediately prior to taking his position at PBGH, Bill led an independent consulting practice focusing on health reform, finance and business strategy. Prior to that, he was a senior executive with Kaiser Permanente for over 20 years. Bill has an MBA from the Stanford Graduate School of Business and a BA from Harvard.
    Panel:
    Joseph Gifford, MD
    Chief Executive, Accountable Care, Providence-Swedish Heath Alliance, Seattle, WA

      Speaker Bio

      Joseph M. Gifford, MD, serves as chief executive of the Providence-Swedish Health Alliance, the accountable care organization in Western Washington. He is responsible for the development of population health structures in Washington, and works in strategic partnership to support system-wide innovations in care management, population health contracting, and digital health capabilities. He is responsible for the Boeing Preferred Partnership program, the Medicare Shared Savings Program, and other accountable care contracts.

      Prior to joining Providence in 2012, Dr. Gifford served as executive medical director of Cambia, Inc., and as chief medical officer of Regence BlueShield of Washington. Previously, he worked in the information technology sector in product development for two software companies, including one he co-founded.

      Dr. Gifford practiced medicine as a board-certified emergency physician in Seattle. He earned his medical degree from the University of California at San Diego, his bachelor' s in English Literature from the University of California at Santa Cruz, with postgraduate studies in biochemistry at UC Berkeley, medical informatics at Stanford, and business at the University of Washington.
    Robert Ihrie
    Senior Vice President of Human Resources, Lowe's Corporation, Mooresville, NC

      Speaker Bio

      Robert (Bob) Ihrie was named senior vice president of compensation and benefits in 2014 and is responsible for compensation, benefits, relocation, central leave and disability management, human resources shared services and human resources communications.

      Bob previously served as senior vice president of human resources, responsible for the human resources generalists for Lowe's stores, distribution centers and customer support centers; senior vice president, responsible for employee rewards and services and as vice president of compensation and benefits.

      Ihrie earned a bachelor's degree from Haverford College, a juris doctor degree from Temple University School of Law, and an MBA from Harvard Business School.
    Kristen Miranda
    Senior Vice President, Strategic Partnerships and Innovation, Blue Shield of California; Former Director, Provider/Plan Interface, WellPoint, Inc., Sacramento, CA

      Speaker Bio

      As Senior Vice President of Strategic Partnerships and Innovation, Kristen Miranda leads Blue Shield of California's statewide Accountable Care Organization (ACO) program. First implemented in 2010, the program has been described by Health Affairs as "one of the oldest and most successful ACOs in the country". Under Kristen' s leadership, Blue Shield' s pioneering work has shown impressive results and has attracted attention from a wide range of leading health care organizations, including the Institute of Medicine, Brookings Institution, AHIP and the National Health Service in the UK. Blue Shield is currently managing over 22 ACO partnerships statewide, and is rapidly expanding its program into new geographic regions and business segments.
      Presentation Material (Acrobat)
    5:00 p.m. Adjournment and Networking Reception

    TRACK 5: STATE INNOVATIONS IN ACCOUNTABLE CARE
    ACO SUMMIT PANEL BRIEFS
    Below is the supplemental material for the Track 5 agenda.
    ACO Summit Panel Briefs (Acrobat)

    3:30 p.m.

    Keynote/Moderator:

    Stephen Cha, MD
    Acting Director, State Innovations Group, Center for Medicare and Medicaid Innovation; Chief Medical Officer, Center on Medicaid and CHIP Services, Baltimore, MD

      Speaker Bio

      Dr. Cha is the acting group director for the State Innovations Group at the Center for Medicare and Medicaid Innovation. The State Innovations Group includes the State Innovations Model and the state all payor models. He is also the Chief Medical Officer for the Center on Medicaid and CHIP Services and promotes health transformation and modernization of the Medicaid and CHIP programs through delivery and payment reforms, and quality initiatives.

      Previously, he served as senior professional staff for the Committee on Energy and Commerce under Chairman Henry A. Waxman. During his tenure with Mr. Waxman he oversaw the drafting of multiple pieces of legislation, including sections of the Affordable Care Act, the American Recovery and Reinvestment Act, and the Food and Drug Administration Amendments Act of 2007.
    Panel:
    Robert F. Atlas, MBA
    President, EBG Advisors, Inc.; Medicaid Consultant, North Carolina DHHS, Washington, DC

      Speaker Bio

      Bob Atlas is President of EBG Advisors, Inc. He serves as an executive consultant on strategy, policy analysis, program development, and performance improvement for health care providers, payers, policymakers, investors, and others. Mr. Atlas has more than three decades of experience as an advisor to leaders in the health care industry and the public sector.

      Since 2013, Mr. Atlas has served as advisor on Medicaid reform to North Carolina' s Secretary of Health and Human Services. He facilitated the deliberations of a governor-appointed Medicaid Reform Advisory Group and coordinated the production of a March 2014 report to the General Assembly on proposed changes to the program, which emphasized provider-led accountable care models.

      After receiving an M.B.A. in Health Administration and Finance from The University of Chicago Booth School of Business, Mr. Atlas served as a commissioned officer in the U.S. Public Health Service. He worked in Medicare' s Health Standards and Quality Bureau and the Office of Health Maintenance Organizations.
    Marni Bussell, PMP
    State Innovation Model (SIM) Project Director, Iowa Medicaid Enterprise, Iowa Department of Human Services, Des Moines, IA

      Speaker Bio

      Marni Bussell joined Iowa Medicaid Enterprise in 2010 and is currently the Project Director for the State Innovation Model (SIM) grant for the Medicaid office and leads health home, HIT, and ACO initiatives. She has over fourteen years of experience in health information technology, working on both state and national level projects. She earned her Project Management Professional certification in 2009.
    Iyah Romm
    Policy Director for System Performance and Strategic Investment, Massachusetts Health Policy Commission; Former Director of Policy, Health Planning and Strategic Development, Massachusetts Department of Public Health, Somerville, MA

      Speaker Bio

      Iyah Romm leads the Care Delivery Innovation and Investment group at the Health Policy Commission in efforts to accelerate health system transformation. His particular focus is on developing policy and leveraging investments to increase appropriate community-based hospital use, improve efficiency, and promote effective allocation of health care resources. Prior to joining the HPC, Mr. Romm served as Special Advisor to the Commissioner of the Department of Public Health (DPH). Mr. Romm' s responsibilities included strategic and organizational planning, policy development, and oversight of the Department' s policy response to the recent nationwide fungal meningitis outbreak.
    Matt Salo
    Executive Director, National Association of Medicaid Directors (NAMD), Washington, DC

      Speaker Bio

      Matt Salo was named Executive Director of the National Association of Medicaid Directors (NAMD) in February 2011. The newly formed association represents all 56 of the nation' s state and territorial Medicaid Directors, and provides them with a strong unified voice in national discussions as well as a locus for technical assistance and best practices.

      Matt formerly spent 12 years at the National Governors Association, where he worked on the Governors' health care and human services reform agendas, and spent the 5 years prior to that as a health policy analyst working for the state Medicaid Directors as part of the American Public Human Services Association.

      Matt also spent two years as a substitute teacher in the public school system in Alexandria, VA, and holds a BA in Eastern Religious Studies from the University of Virginia.
    5:00 p.m. Adjournment and Networking Reception

    TRACK 6: STRATEGIES FOR MANAGING VULNERABLE POPULATIONS
    ACO SUMMIT PANEL BRIEFS
    Below is the supplemental material for the Track 6 agenda.
    ACO Summit Panel Briefs (Acrobat)

    3:30 p.m.

    Keynote/Moderator:

    Larry Atkins, PhD
    Executive Director, Long-Term Quality Alliance (LTQA); Former President, National Academy of Social Insurance, Washington, DC

      Speaker Bio

      Dr. Atkins is Executive Director of the Long-Term Quality Alliance and President of the National Academy of Social Insurance in Washington, DC. He was recently the Staff Director of the Federal Commission on Long-Term Care, which issued its final report in September 2013. Prior to that, he was Executive Director, U.S. Public Policy at the global pharmaceutical manufacturer Merck.

      Dr. Atkins is a veteran of more than 30 years of health and social policy analysis, policy development, and legislative representation at the local, state, and federal levels. Recent experience includes, Director, Public Policy at Schering-Plough Corporation; Founder and President of Health Policy Analysts, Inc.; Executive Director, Corporate Health Care Coalition.
    Panel:
    D. Clay Ackerly, MD, MSc
    Chief Clinical Officer, naviHealth, Inc.; Former Associate Medical Director, Population Health and Continuing Care, Partners HealthCare, Boston, MA

      Speaker Bio

      Dr. D. Clay Ackerly II, M.D., M.Sc. is Chief Clinical Officer of naviHealth, Inc., where he is responsible for clinical operations, care redesign, and clinical product development.

      He recently served as Associate Medical Director for Population Health and Continuing Care at Partners HealthCare, and as Assistant Chief Medical Officer for Non-Acute Services at the Massachusetts General Hospital (MGH), where he designed and implemented multiple care improvement efforts to reduce readmissions, improve care transitions, and increase patient access to intensive home-based services, as well as led regional and national collaborations to advance the quality of skilled nursing facility (SNF) and post-acute care.

      Prior to pursuing his medical training, Dr. Ackerly served in the private sector and the Federal Government, including at CMS, the Food and Drug Administration and the White House. Dr. Ackerly graduated from Harvard College with a degree in Health Policy; earned his medical degree as a Nanaline Duke Scholar at Duke University; and completed his Internal Medicine training at MGH. In addition, he holds a Masters degree in International Health Policy from the London School of Economics.
    Doug Pace
    Executive Director, Advancing Excellence in Long Term Care Collaborative; Former Executive Director, Long-Term Quality Alliance, Washington, DC

      Speaker Bio

      Doug Pace is the Executive Director of the Advancing Excellence in Long Term Care Collaborative (AELTCC). The AELTCC' s major initiative is the Advancing Excellence in America' s Nursing Home Campaign, a national campaign to improve the quality of life and quality of care for the country' s 1.5 million nursing home residents. Prior to AELTCC, Doug was the Executive Director of the Long-Term Quality Alliance (LTQA). Before joining the LTQA, Doug was the Director of the Long-Term Care Solution Campaign at Leading Age in Washington, DC. He returned back to Leading Age in March 2008 after 18 months as the Executive Director of the National Commission for Quality Long-Term Care. Before joining the Commission, Doug was the Vice-President for Culture Transformation and the Director of Assisted Living and Continuing Care with Leading Age. Prior to joining AAHSA in June of 2001, Doug was the President of the Tennessee Association of Homes and Services for the Aging (TNAHSA) in Nashville, TN. He is a licensed Nursing Home Administrator who ran a 210 bed multi level facility including a SNF, NF, a secured Alzheimer' s unit and assisted living before joining TNAHSA.
    Christine S. Ritchie, MD, MSPH
    Professor of Medicine, Harris Fishbon Distinguished Professor in Clinical Translational Research and Aging, Division of Geriatrics, Department of Medicine, University of California San Francisco (UCSF), San Francisco, CA

      Speaker Bio

      Christine Ritchie, MD, MSPH, is the Harris Fishbon Distinguished Professor in Clinical Translational Research and Aging at the University of California San Francisco. She is a board certified geriatrician and palliative care physician and medical director of Clinical Programs in the UCSF Office of Population Health. She is developing programs to optimize quality of life for those with chronic serious illness and multimorbidity. She co-leads a national Network of Home-based primary care and palliative care practices and is working to develop quality measures appropriate to the homebound population. She is President of the American Academy of Hospice and Palliative Medicine.
    Eliza (Pippa) Shulman, DO, MPH
    Senior Chief Innovation Engineer, Atrius Health, Boston, MA

      Speaker Bio

      Eliza "Pippa" Shulman, DO, MPH is the Senior Chief Innovation Engineer at the newly formed Atrius Health Innovation Center, charged with identifying, testing and implementing novel care delivery solutions for the largest independent multi-specialty medical group in the Northeast.

      Prior to being named to the Innovation Center Pippa was the Chief of Geriatrics and Palliative Care at Harvard Vanguard Medical Associates; tasked with leading improvement efforts in home care, extended care facilities, outpatient geriatrics and palliative care services.

      Dr Shulman is board certified in family medicine, preventive medicine, and hospice and palliative medicine. She is a graduate of the combined NH-Dartmouth Family Medicine Residency and the Dartmouth Hitchcock Leadership Preventive Medicine Residency, which is focused on developing physicians to lead change and improve systems of care.
      Presentation Material (Acrobat)
    5:00 p.m. Adjournment and Networking Reception


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    Preconference | Day 2




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