Agenda Links: Preconference | Day II
DAY III
WEDNESDAY, JUNE 19, 2019
7:00 am
Registration Open; Networking Breakfast
JOINT ACO/BUNDLED/MACRA MORNING CLOSING PLENARY SESSION
8:00 am
Welcome and Introductions
Donald H. Crane, JD
President and Chief Executive Officer, America’s Physician Groups (APG), Los Angeles, CA (Co-chair)
President and Chief Executive Officer, America’s Physician Groups (APG), Los Angeles, CA (Co-chair)
Don Crane is the President and CEO of America’s Physician Groups, the nation’s leading professional association representing medical groups and independent practice associations practicing coordinated care. With offices in Los Angeles, Sacramento and Washington, America’s Physician Groups has become a leading voice for the value-based healthcare movement at the state and federal levels. America’s Physician Groups’ are at the forefront of national healthcare reform and represent the care model and payment methodologies adopted by federal legislation for the entire nation. Mr. Crane serves on the Board of Directors of the National Coalition on Health Care. In 2016, he received the prestigious Mathies Award for Vision and Excellence in Healthcare Leadership.
8:15 am
Value-based Care: The Paradox of Primary Care Leadership
Sean Cavanaugh
Chief Administrative Officer, Aledade, Former Deputy Administrator and Director, Center for Medicare, Centers for Medicare & Medicaid Services, Washington, DC
Chief Administrative Officer, Aledade, Former Deputy Administrator and Director, Center for Medicare, Centers for Medicare & Medicaid Services, Washington, DC
Sean Cavanaugh is the Chief Administrative and Performance Officer of Aledade, which partners with independent physicians to succeed in value-based payment models. He previously was the Deputy Administrator and Director of the Center for Medicare at the Centers for Medicare & Medicaid Services and Deputy Director at the Center for Medicare and Medicaid Innovation.
8:45 am
Value-based Payment, Technology, and the Future of Customer Service
Mark D. Smith, MD, MBA
Co-chair, Guiding Committee, Health Care Payment Learning and Action Network; Clinical Faculty, University of California, San Francisco; Attending Physician, Positive Health Program for AIDS Care, San Francisco General Hospital; Founding President and CEO, California Health Care Foundation, San Francisco, CA
Co-chair, Guiding Committee, Health Care Payment Learning and Action Network; Clinical Faculty, University of California, San Francisco; Attending Physician, Positive Health Program for AIDS Care, San Francisco General Hospital; Founding President and CEO, California Health Care Foundation, San Francisco, CA
Mark Smith is currently a Professor of Clinical Medicine at the University of California at San Francisco. From 2015-2019 he co-chaired the Guiding Committee of the Health Care Payment Learning and Action Network for the Center for Medicare and Medicaid Services. From 1996 through 2013 Dr. Smith was the Founding President and CEO of the California HealthCare Foundation. Dr. Smith helped build the Foundation into a recognized leader in delivery system innovation, public reporting of care quality, and applications of new technology in health care. Smith has published over 50 articles in peer-reviewed journals and 25 book chapters and monographs. A Board certified internist, he maintains an active clinical practice in HIV care at San Francisco General Hospital.
9:15 am
Global Value-based Healthcare Initiatives
Arnaud Bernaert, MBA
Head of Partner Development, Europe & North America, Head of Healthcare Industry, and Member, Executive Committee, World Economic Forum, Former Senior VP Strategy, Business Development and M&A, Philips Healthcare, Former European Regional Controller, Baxter Healthcare, Geneva, Switzerland
Head of Partner Development, Europe & North America, Head of Healthcare Industry, and Member, Executive Committee, World Economic Forum, Former Senior VP Strategy, Business Development and M&A, Philips Healthcare, Former European Regional Controller, Baxter Healthcare, Geneva, Switzerland
Arnaud Bernaert has dedicated his prolific career to strategy, partnerships, M&A and Healthcare policy matters. He has published extensively on those themes and received significant media coverage. He was a senior executive in multinational organizations such as Baxter and Philips Healthcare, then as the Global Head for Health and Healthcare Industries at the World Economic Forum. As a member of the Executive Committee of the World Economic Forum, Arnaud Bernaert has launched defining public private coalitions in fields as diverse as epidemics preparedness, vaccines and antibiotic innovation, value-based healthcare, precision medicine regulations, access to primary care, payment reforms, healthcare IT just to name a few. On such matters and many others, he also addressed as key note speaker, panelist, moderator or knowledge expert the participants of the most prestigious global healthcare gatherings in Davos, UNGA, Forbes conferences, World Health Assembly week, World Health summit and many other conferences.
9:45 am
The Challenges and Opportunities for Hospitals and Health Systems in Moving to Value-based Care
Lori Morgan, MBA
President and Chief Executive Officer, Huntington Hospital; President, Legacy Emanuel Medical Center, Pasadena, CA
President and Chief Executive Officer, Huntington Hospital; President, Legacy Emanuel Medical Center, Pasadena, CA
Dr. Lori Morgan was hired as Huntington Hospital’s CEO and president in 2017. Before joining Huntington, she was the president of Legacy Emanuel Medical Center in Portland, Oregon and the corporate vice president of Legacy Health. Prior to Legacy, she was the medical director of the Trauma Trust and a practicing trauma surgeon and intensivist in Tacoma, WA. Additionally, she served as the co-director of the Surgical ICU and a trauma surgeon at the University of Iowa Hospital and Clinics between 1997 and 2000.
10:15 am
Transition Break
10:30 am
Case Study of BlueCross BlueShield of North Carolina’s Value-based Payment Initiatives
James P. Sharp, MPH, JD
Director, Health Care Strategy and Transformation, BlueCross BlueShield of North Carolina; Former Policy and Strategy Advisor, Office of the Director, Center for Medicare and Medicaid Innovation, Washington, DC
Director, Health Care Strategy and Transformation, BlueCross BlueShield of North Carolina; Former Policy and Strategy Advisor, Office of the Director, Center for Medicare and Medicaid Innovation, Washington, DC
JP Sharp is the Director of Healthcare Strategy and Transformation at Blue Cross and Blue Shield of North Carolina where he leads the design of new payment models and strategic healthcare initiatives to transform care delivery, which includes the launch of the Blue Premier program. JP previously worked at the CMS Innovation Center, where he led the development of the Next Generation ACO Model, the Quality Payment Program under MACRA, and strategic planning in the Office of the Director.
11:00 am
How Medicare Advantage Related to Value-based Care
John Gorman
Founder and Former Executive Chairman, Gorman Health Group; Former Assistant to the Director, Office of Managed Care, HCFA, Former Press Secretary and Staff Director, US Representative John Conyers, Jr. (D-MI), Washington, DC
Founder and Former Executive Chairman, Gorman Health Group; Former Assistant to the Director, Office of Managed Care, HCFA, Former Press Secretary and Staff Director, US Representative John Conyers, Jr. (D-MI), Washington, DC
John Gorman is Founder & Former Executive Chairman at Gorman Health Group (GHG). In this role, he led the development of the industry’s leading consulting practice and several entrepreneurial ventures in government health programs. John’s work focused on Medicare, Medicaid, and Affordable Care Act strategy, governance, and turnaround of distressed health plans. Prior to founding the firm, John served as Assistant to the Director of Health Care Financing Administration’s Office of Managed Care, where he provided day-to-day management and served as the external liaison for the Medicare and Medicaid managed care programs. During the 1993 debate on national healthcare reform, John was chief lobbyist on healthcare financing issues for the National Association of Community Health Centers, an organization of federally-funded primary care clinics for the medically underserved. John’s career in Washington began as Press Secretary and Staff Director for U.S. Representative John Conyers, Jr. (D-MI), then Chairman of the Government Operations Committee.
11:30 am
Strategies to Integrate BPCIA, ACOs and APMs into a Unified Strategy to Deliver People-centered Care
Deirdre Baggot, PhD, MBA, RN
Healthcare Strategist and Payment Innovation Expert, Former Expert Reviewer, BPCI Program, Former Lead, CMS ACE Program, Washington, DC
Healthcare Strategist and Payment Innovation Expert, Former Expert Reviewer, BPCI Program, Former Lead, CMS ACE Program, Washington, DC
Deirdre Baggot is one of the healthcare industry’s most respected voices on the subject of bundled payments. The leader of ECG’s Bundled Payments practice, she has been invited to testify before Congress on the efficacy of bundled payments, was appointed expert reviewer by the Centers for Medicare & Medicaid Services for the Bundled Payments for Care Initiative, and has served as the lead for the Acute Care Episode Bundled Payment Demonstration. Deirdre also is an adviser for New York Medicaid bundled payment pilots.
Joseph Egan
Director of Operations, Value-based Programs, Tenet Healthcare; Former Administrative Director, Michigan Pioneer ACO, Royal Oak, MI
Director of Operations, Value-based Programs, Tenet Healthcare; Former Administrative Director, Michigan Pioneer ACO, Royal Oak, MI
Joseph Egan has been with Tenet Healthcare Corporation for nearly a decade and is currently serving as the National Director of Value-Based Programs. Joseph is responsible for the strategic development, implementation, and business operations for Tenet’s value-based portfolio, including: Commercial Clinically Integrated Networks, Accountable Care Organizations, and Episodic Bundle Payment Programs.
Joshua M. Liao, MD, MSc, FACP
Associate Medical Director, Contracting and Value-based Care, Assistant Professor, University of Washington, Seattle, WA
Associate Medical Director, Contracting and Value-based Care, Assistant Professor, University of Washington, Seattle, WA
Dr. Liao is a board-certified internal medicine physician and the Associate Medical Director for Contracting and Value Based Care at UW Medicine, where he is also the Director of the UW Medicine Value and Systems Science Lab, a unit embedded within the health system and applies scholarship to drive change that impacts patients and populations. Dr. Liao’s expertise includes policy analysis related to value-based payment and care reforms, with scholarly work focusing on evaluating and testing the impact of value-based payment and delivery reforms on patients, physicians, and health care organizations. He is also an Associate Editor for Healthcare: The Journal of Delivery Science and Innovation. He was also a Clinical Fellow in Medicine at Harvard Medical School. He is an Adjunct Senior Fellow at the Leonard Davis Institute of Health Economics located at the University of Pennsylvania, where he received his training in health policy research.
Melanie Matthews, MA
CEO, NW Momentum Health Partners ACO; CEO, Physicians of Southwest Washington; Former VP Operations, Prestige Care, Olympia, WA
CEO, NW Momentum Health Partners ACO; CEO, Physicians of Southwest Washington; Former VP Operations, Prestige Care, Olympia, WA
Melanie Matthews is the dynamic, creative and innovative CEO at Physicians of Southwest Washington (PSW) bringing more than 20 years of operations, financial, human resources and product marketing experience in health care services for specialty populations. Since she joined the company in 2016, she has maintained the core principals in which PSW was founded on and expanded business lines to include MSO services including credentialing, coding and compliance and the implementation of CMMI innovation models such as the Next Generation ACO. Melanie’s extensive knowledge in post-acute care provides strategic focus in reducing overall cost of care as well as provider and beneficiary engagement. Prior to PSW, Melanie served for three years as Vice President of Operations for Prestige Care, Inc. Among her other accomplishments, Melanie serves as the chair of the Washington Health Care Association and was selected by the American Health Care Association as a “National Political Ambassador” in 2013.
Valinda Rutledge, MBA
Vice President of Federal Affairs, APG; VP Public Payor Health Strategy, Care Coordination Institute, Prisma Health; Former Group Director, Patient Care Model Group and BPCI Lead, Centers for Medicare and Medicaid Services, Washington, DC
Vice President of Federal Affairs, APG; VP Public Payor Health Strategy, Care Coordination Institute, Prisma Health; Former Group Director, Patient Care Model Group and BPCI Lead, Centers for Medicare and Medicaid Services, Washington, DC
Valinda Rutledge is currently the Vice President of Federal Affairs at America’s Physician Groups. She is responsible for analyzing and advocating for APG’s positions on government initiatives such as bundled payments, Medicare advantage, Medicaid pilots, Dual Eligible, PCMH, and ACOs.
Jay Sultan
Vice President, Healthcare Strategy, Cognizant, Watkinsville, GA (Moderator)
Vice President, Healthcare Strategy, Cognizant, Watkinsville, GA (Moderator)
Jay Sultan has been working on the intersection of payment reform policy and enabling technology for twenty years. He is a software executive that has been a pioneering voice on both the policy of payment reform and the reality of its execution at scale. He is now serves as the VP Healthcare Strategy at Cognizant, creating new solutions to enable value based care through engagement. Jay has previously authored two patents on payment bundling methods and has been engaged by payers, providers, and governments on the best ways to implement new VBR and VBID programs.
12:30 pm
Summit Adjournment
Agenda Links: Preconference | Day II