What’s Next for Providers, Payers, and Policymakers

Gregory Poulsen

Senior Vice President

Intermountain Health

Greg Poulsen is Senior Vice President for Intermountain Healthcare. For 40 years Mr. Poulsen has variously had direct responsibility leading strategy development, research and planning, marketing, IT development, population health, and health policy for one of the most progressive and integrated health systems in the nation, and has been deeply immersed in all of Intermountain’s insurance, hospital and physician activities.

Mr. Poulsen is a Commissioner for the Medicare Payment Advisory Commission (MedPAC), which advises Congress on Medicare’s trillion-dollar payment issues. He has been a Board and Executive Committee member for the American Hospital Association; Chair of the AHA’s Mountain region; and chair of the Utah Hospital Association. He is a national guest scholar at the Stanford University School of Medicine and a guest lecturer at the Stanford Graduate School of Business. As a trustee for the American Board of Internal Medicine Foundation he was involved in the Foundation’s focus on advancing medical professionalism, including the influential Choosing Wisely initiative. He has been a consultant to the Swedish Health Ministry and has provided counsel on health policy development for several countries, including Great Britain, Canada, France, New Zealand, Australia, Norway, and Germany. As a commissioner for the Commonwealth Fund in Washington, DC he participated in the development of the policy papers and initiatives Bending the Curve, and Why Not the Best, which have helped shape the discussion on health policy in America for many years. He serves on the boards of many community organizations and is a board member and past chair of the Utah Foundation, a nonprofit public policy research organization. He serves as a policy lead for the World Economic Forum and serves on their international Value in Healthcare Committee. He has appeared frequently before Congressional committees and participates in many national and international health policy forums. He has authored and coauthored several health strategy and policy articles over many years including The Case for Capitation, published in the Harvard Business Review.

Mr. Poulsen holds a bachelor’s degree in biophysics and an MBA, both from Brigham Young University.

Based in Salt Lake City, Intermountain Healthcare includes 33 hospitals and associated delivery services in the Mountain West, a successful physician group practice with more than 3,500 practitioners, and a leading health insurer. Intermountain employs 60,000 dedicated caregivers.

• 3:30 - 4:30 PM, Mar 6, 2023 International Ballroom

  Bringing It All Together

Josh Trent

Principal

Leavitt Partners, an HMA Company

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Josh Trent is a principal based in Leavitt Partners’ Washington, D.C. office. Josh has more than a decade and a half of experience in the federal government—from the White House, to the U.S. Department of Health and Human Services, to the U.S. Senate and U.S. House on Capitol Hill.

In his role at Leavitt Partners, Josh develops and manages multi-sector alliances and advises clients throughout the health care sector on federal health care policy and strategy. He specializes in public insurance under Medicare, Medicaid, the Children’s Health Insurance Program, commercial health insurance, the 340B program, and the Affordable Care Act.

Prior to joining Leavitt Partners, Josh served as Chief Health Counsel for Chairman Greg Walden of the Committee on Energy and Commerce of the U.S. House of Representatives. In that role, Josh was the lead House staffer for the landmark legislation to combat the opioid crisis, The SUPPORT Act (P.L. 115-271). He also led the House’s work to reauthorize The Pandemic and All-Hazards Preparedness Act, which was eventually enacted the following year (P.L. 116-22).

Josh previously served under both Walden and Chairman Fred Upton as Deputy Chief Health Counsel. In this role, he played a key part in crafting the Medicaid, Medicare, and state Children’s Health Insurance Program (CHIP) provisions in the House’s Bipartisan Budget Act (P.L. 115-123), and he led the House’s work to enact the longest extension of the CHIP in the history of the program (P.L. 115-120). Previously, as Professional Staff under Chairman Upton, Josh assisted in the development and passage of the Comprehensive Addiction and Recovery Act (P.L. 114-198) and the sweeping law to advance the discovery, development, and delivery of cures and treatments, The 21st Century Cures Act (P.L.114-255).

Prior to working in the House, Josh served for five years as Health Policy Advisor for U.S. Senator Tom Coburn (R-OK). In that role, Josh was involved in the legislative process leading to the enactment of the Affordable Care Act.

Before coming to Capitol Hill, Josh spent six years in the administration of President George W. Bush, including three years as an executive recruiter in the Office of Presidential Personnel at the White House helping identify and recruit individuals for senior Administration roles. He also spent a year and a half as deputy director of the Office of Refugee Resettlement at the U.S. Department of Health and Human Services.

Josh received his bachelor of arts from Union University and received his master’s degree in international politics from the University of Bath in Bath, England.

• 3:30 - 4:30 PM, Mar 6, 2023 International Ballroom

  Bringing It All Together

Melinda Estep

Managing Director, Delivery System

Health Management Associates

Melinda Estep has been advising providers and healthcare leaders nationwide for more than 25 years, offering keen industry insights in the areas of strategic financial planning, mergers and acquisitions, and financial advisory services.

Melinda works closely with a variety of healthcare organizations to help them maximize resources, access needed capital, and develop solid financial strategies for navigating healthcare’s uncertain future.

Prior to joining HMA, she served as a hospital CFO and chief of business development providing strategic direction for optimal market and competitive positioning for several departments. She also led a five-year capital planning effort, ensured compliance and contracting validity, and led the revenue cycle team to improve the patient experience and increase revenue.

In addition, Melinda has provided short-term and long-term forecasting and scenario modeling for various project teams. She specializes in developing business cases with key stakeholders and identifying barriers and mitigations of risk.

Previously she served more than 10 years with Denver Health and Hospital in various executive positions including chief of business development, associate chief of operations for service lines, and associate CFO of financial and strategic planning.

Melinda earned a Master of Business Administration with a concentration in healthcare administration and a Bachelor of Science in finance, both from the University of Colorado, Boulder. She earned a Lean Management Systems Black Belt and was a fellow with America’s Essential Hospitals (NAPH) and the Healthcare Finance Management Association.

• 10:30 AM - 12:00 PM, Mar 6, 2023 State Room

  Getting to Value in Healthcare: How Value-Base Care, Population Health, Incentives Drive Quality

Mary Walter

Managing Director, Quality and Accreditation

Health Management Associates

Mary Walter is an accomplished executive leader with more than 30 years of experience in healthcare including extensive work in managed care insurance the past 25 years, quality and oversight of every aspect of health plan operations. She is deeply entrenched in the commercial, Medicare, Medicaid and Marketplace quality space that includes strategy and execution in quality compliance, interventions, population health, HEDIS, Stars, risk adjustment, value-based care and pay for performance, risk management, accreditation, delegation oversight, vendor management, geographical expansion and more.

Mary has worked managing state Medicaid relationships, both commercial and government business, meeting employer group, CMS and state quality regulations, including various accreditation requirements. In addition, she has led health plan quality operations and developed key partnerships to create and execute high quality programs and projects. She has partnered with multi-faceted provider groups including integrated delivery, fee-for-service, and capitated network models as well as accountable care organizations, management services organizations and independent practice associations to carry out upside/downside risk value-based care and pay for performance programs to improve the quality of customer care outcomes.

Before joining HMA, Mary founded and served as president of Healthcare & Integration Solutions, LLC. (HCIS), where she provided her expertise on quality measures including state Medicaid audits, Stars and HEDIS performance, patient safety, and quality compliance. She also supplied insight on strengthening fiscal operations in areas including marketing and sales, budgeting, product and market expansion, and key performance indicators.

Mary has also served as vice president of clinical quality of U.S. Medical with Cigna Medicare and has held several quality leadership roles with the top payers including Coventry, Aetna (now CVS Health), UnitedHealthcare, Anthem, Kaiser Permanente, and Molina Healthcare.

In those positions and experience, she led strategy, execution, and growth of the clinical quality teams, where she elevated population health management strategy and quality compliance oversight. Her leadership resulted in a CMS All Star nomination by passing the CMS audits for organization determinations, appeals and grievances, special needs plan model of care, and supported first-tier, downstream and related clinical entities. In addition, she supported her leadership team to fully pass HEDIS, risk management and NCQA audits with top scores year over year. She also received top regional and national awards for the TeenScreen Depression and Suicide Prevention Program at Kaiser Permanente.

Mary earned a Bachelor of Science degree in exercise physiology, and a minor in health at Iowa State University. In addition, she is a registered nurse, earning a three-year diploma, practical nursing degree at Iowa Methodist School of Nursing in Des Moines. She also holds a certification in process improvement/LEAN six sigma as an Improvement Advisor from KP National Process Improvement Institute.

She volunteers her time serving as a key board member for a non-profit organization that has a national footprint and volunteers in the community Food Share Program assisting families with food insecurities. Mary’s other passions include specialty cooking, entertaining, biking, hiking, raising an organic garden, landscaping, reading, and serving in her local church.

• 1:30 - 3:00 PM, Mar 6, 2023 Ambassador Room

  Moving the Needle on Medicare Stars Ratings

Mary Kay Rizzolo

CEO

Council on Quality and Leadership

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Dr. Rizzolo has served as President and CEO of the Council on Quality and Leadership (CQL) since 2016 and holds an appointment as an Adjunct Clinical Associate Professor at the University of Illinois at Chicago (UIC) since 2011. Other past experience includes Associate Director of the IL UCEDD (Institute on Disability and Human Development), Policy Director of the IL LEND Program, Director of Evaluation for the Family Support Research and Training Center, researcher at the Coleman Institute for Cognitive Disabilities (University of Colorado), and a Qualified Intellectual Disability Professional in NC.

Dr. Rizzolo contributed significantly for two decades to State of the States, a project of national significance that has collected and analyzed data on over 40 years of revenue, spending, and programmatic trends in the United States. She co-authored ten editions of State of the States and has authored or co-authored numerous peer-reviewed articles, reports, monographs, white papers, and issue briefs on her analyses of the project’s data as well as on voting, emerging technologies, family support, transportation, employment supports, quality of life, and personal outcomes.

Dr. Rizzolo has served on numerous national advisory committees, task forces, commissions, and boards of directors. A Fellow of AAIDD, Dr. Rizzolo has earned a bachelor’s degree in psychology from the University of North Carolina at Chapel Hill, a master’s degree in psychology from North Carolina Central University, and a doctorate in public health from UIC.

• 10:30 AM - 12:00 PM, Mar 6, 2023 Ambassador Room

  The Final Frontier: Bringing State Intellectual and Developmental Disability Service Systems into the Quality Conversation

Donna Martin

Senior Director for State Partnerships and Innovation,

ANCOR

Donna Martin brings leadership and longevity to her role as Senior Director for State Partnerships and Innovation with the American Network of Community Options and Resources (ANCOR). Prior to joining ANCOR, Donna served as the Executive Director for Community Provider Network of RI, the state-wide association for providers of services to people with intellectual and developmental disabilities.

Ms. Martin began her career working as a Direct Support Professional while in college. She went on to graduate from Providence College and also holds a master’s degree in Education from Rhode Island College. In the years since, she has held positions at all levels of service organizations in both community living and supported employment services, including program management, case management, senior administration and as the Executive Director for a provider agency serving people in Rhode Island and Massachusetts.

She began her work as the Director for Community Provider Network of Rhode Island in 2005 and during her tenure she led the provider community through challenging fiscal and regulatory times. She successfully cultivated relationships with legislators and state administrators that eventually led to the appropriation of funding increases for DSP wages and streamlined regulatory processes. She coordinated a formidable grassroots and lobbying campaign that has elevated the reputation of the association as one of the best organized advocacy entities within the state.

Donna left the state association to join the team at ANCOR in 2019 and has had the privilege of supporting their member state associations along with an array of special projects since then.

Donna is a life-long resident of Rhode Island and has a teenage son who has Autism. He is her greatest joy and has helped her understand the heart and soul of her professional life in a much deeper way. She brings her experience as a parent to her profession, and it has galvanized her advocacy and sensitivity to the needs of individual with disabilities and their families.

• 10:30 AM - 12:00 PM, Mar 6, 2023 Ambassador Room

  The Final Frontier: Bringing State Intellectual and Developmental Disability Service Systems into the Quality Conversation

Shane Spotts

Principal

Health Management Associates

With experience in Medicare and Medicaid financing and growth, as well as strategic partnerships and planning, Shane Spotts is a seasoned business development and healthcare consulting expert.

He rejoins HMA after serving with Anthem, Inc., in business development and alliance building roles. In these positions, he was responsible for developing, negotiating, and executing partnership agreements and unique business structures with health plans and provider groups.

In addition, Shane worked closely with stakeholders on agreement structures and financing as well as driving nationwide growth for the company’s Medicare and Medicaid products. He also maintained a 100 percent win rate across markets and served in an interim chief executive officer role.

While previously serving as a principal with HMA, he developed expertise in Medicaid and Intellectual/Development Disability (I/DD) financing and strategic planning. During that time, he also helped create the Indiana Integrated Healthcare Provider Association to develop a provider-led managed care model for long-term services and supports population and services.

Shane’s additional experience includes providing technical assistance to states, managing Medicaid waiver programs, applying for, and managing, grants and securing cost savings for programs.

He earned a Bachelor of Science degree in public policy and economics from Indiana University.

• 10:30 AM - 12:00 PM, Mar 6, 2023 Ambassador Room

  The Final Frontier: Bringing State Intellectual and Developmental Disability Service Systems into the Quality Conversation

Kathy Carmody

CEO

Institute on Public Policy for People with Disabilities

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30+ year career in I/DD field including organizational leadership; policy analysis and development; program design and implementation and strategic planning. Demonstrated success in program development, system design, professional development and fiscal responsibility for multi-dimensional organization. Personal strengths and attributes include exceptional written and inter-personal communication skills; data analysis, insight and presentation; curriculum design and training and broad knowledge and experience base in relevant I/DD topics including Medicaid Waiver funding and regulations; state and national best practice trends in employment, self-direction and service delivery; person-centered planning and practice and promotion of self-advocacy capacity among people with I/DD.

• 10:30 AM - 12:00 PM, Mar 6, 2023 Ambassador Room

  The Final Frontier: Bringing State Intellectual and Developmental Disability Service Systems into the Quality Conversation

Nazlim Hagmann, MD

Chief Medical Officer

Commonwealth Care Alliance

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Board certified psychiatrist, behavioral health executive with extensive experience in Public Psychiatry from provider as well as payer side. In depth knowledge in consultation, program development and implementation for improved quality and cost containment. Passionate to create thinking environments for high performing teams. Adamant believer in design thinking, person centered and person empowering care.

• 1:30 - 3:00 PM, Mar 6, 2023 Cuvee Room

  Developing a Behavioral Health Quality Strategy

Jami Snyder

Former Director

formerly with Arizona Health Care Cost Containment System

As the Chief Executive Officer for JSN Strategies LLC, Jami Snyder offers consultative services to states, payers, providers and vendors serving Medicaid and the Children’s Health Insurance Program. Prior to establishing JSN Strategies, from January 2019 through January 2023, Ms. Snyder served as a cabinet member under Governor Doug Ducey and as the director of Arizona’s Medicaid program, offering healthcare coverage to 2.5 million Arizona residents at an annual cost of $20 billion. With more than 20 years of public and private sector experience in the health and human services industries, Ms. Snyder’s areas of expertise include regulatory oversight, policymaking, and leadership development. Ms. Snyder also served as Medicaid director for the state of Texas. She is the immediate past president of the board for the National Association of Medicaid Directors, an organization she has been an active member of since 2016. Ms. Snyder is a 2013 Flinn-Brown Civic Leadership Academy Fellow and holds a master’s degree in political science from Arizona State University as well as a bachelor’s degree in political science from Gustavus Adolphus College in St. Peter, Minnesota.

• 1:30 - 3:00 PM, Mar 6, 2023 State Room

  Practical Approaches to Addressing Equity and Social Determinants of Health

Gina Lasky

Managing Director, Behavioral Health

Health Management Associates

Gina Lasky is a licensed psychologist with expertise in public sector behavioral health system design and programming including integration of behavioral health and primary care. She evaluates organizational readiness for integration and guides development and implementation of new models of collaborative care for delivery systems, county health systems, community behavioral health centers, and state corrections agencies.

She has examined state policy and administrative barriers to integrated care and has published work on leadership and team development in integrated care with the Center for Integrated Health Solutions and the American Psychiatric Association. She is co-editor of Integrated Care: A Guide to Effective Implementation for the American Psychiatric Association.

Gina has provided direct clinical care for numerous non-profit organizations, a public hospital, and a state hospital where she specialized in serious mental illness and working with individuals who were aggressive towards themselves and others. Gina has had leadership responsibility for an acute treatment unit, a detox program, crisis services, outpatient mental health clinics, and substance use treatment programs in community behavioral health. She has been responsible for clinical program development, quality improvement, and directly supervised clinical managers and therapists.

Gina is skilled in the culture change required to advance system transformation, such as integration. Her specialties include strategic planning, leadership models, team development and change management. Gina also works in partnership with HMA Community Strategies on building multi-sector and community-based solutions to promote integration at the system level and to engage organizations addressing the social determinants of health. She has experience in community organizing, group facilitation and partnership development.

Gina earned her doctorate in counseling psychology from the University of Denver and a master’s degree in public leadership with a specialization in multi-sector management from George Washington University. Gina is the past President of the College of Behavioral Health Leadership.

Gina lives in the mountains in Colorado and is an avid hiker and wildlife photographer.

• 1:30 - 3:00 PM, Mar 6, 2023 Cuvee Room

  Developing a Behavioral Health Quality Strategy

Robin Preston

Regional Vice President

Health Management Associates

Robin Preston is dedicated to improving access to healthcare for low-income populations. She has been working in the policy and operations spaces of healthcare for more than 30 years. During her career, she worked in the private sector and in managed care organizations, including comprehensive health and behavioral health. She worked as a public servant with the Centers for Medicare & Medicaid Services (CMS).

Before joining HMA, Ms. Preston served as associate partner for the Policy and Program Management practice within the IBM Watson Health’s Federal Consulting practice. She served as a subject matter expert on contracts covering value-based payment; Medicaid; managed care, including encounter data; home and community-based services; and substance use disorder treatment and access.

Ms. Preston spent more than eight years in increasingly senior roles with CMS where she was instrumental in the implementation of the Affordable Care Act at the federal level. She led implementation in 21 states that used managed care as a delivery system and led teams that oversaw Medicaid expansion in several states as well.

Her work with CMS included coordinating federal Medicaid response to crises, including natural disasters, Zika healthcare emergency, and the Flint, Michigan, water crisis. She managed regional offices and stakeholder relations and served as liaison to several associations and boards.

Prior to her career with CMS, Ms. Preston worked for a Medicaid managed care plan and had the opportunity to implement the DC Healthcare Alliance program for uninsured adults in the District of Columbia. She coordinated the opening of The Bridge Homeless Shelter in Dallas, Texas, with onsite behavioral health services, implemented pay for performance provider incentives for better patient outcomes, and helped plan enrollees navigate the healthcare system.

Ms. Preston earned a bachelor’s degree from the University of Maryland.

• 10:30 AM - 12:00 PM, Mar 6, 2023 Cuvee Room

  Medicaid Core Sets and the Growing Emphasis on Accountability

Amy Bassano

Managing Director, Medicare

Health Management Associates

A senior executive and nationally recognized health policy expert, Amy Bassano has more than 20 years of experience developing organizational vision and strategic plans, designing, and implementing payment systems, and driving change in the healthcare delivery system.

She joins HMA as managing director of Medicare services after serving as the deputy director for the Center for Medicare and Medicaid Innovation (CMMI) at the Centers for Medicare & Medicaid Services (CMS).

As senior executive at the CMMI, she oversaw the development and implementation of value-based purchasing models for both Medicare and Medicaid including accountable care organizations, bundled payment programs, and specialty initiatives in oncology, kidney care, prescription drugs, state-based models and dual eligibles. Additionally, she collaborated with states, health plans, purchasers, and international organizations to lead the national and international movement to value in healthcare.

In her more than 15 years at CMS, she served in various Medicare leadership roles including as director of the Hospital and Ambulatory Policy Group. In that role she developed and implemented hospital, physician, Part B prescription drugs, clinical laboratory, and other acute care payment policies, oversaw regulatory and sub-regulatory requirements for these providers and suppliers. She also led implementation of multiple major pieces of legislation including the Affordable Care Act for the payment systems in the policy group. She previously served as director of the divisions of Practitioner Services and Ambulatory Services and in the Office of Management and Budget.

Amy earned a Master of Policy Studies from John Hopkins University and a bachelor’s degree in history from Tufts University.

• 8:00 - 8:45 AM, Mar 6, 2023 International Ballroom

  Keynote Address

Meggan Schilkie

Vice President, Strategic Focus Areas

Health Management Associates

Meggan Christman Schilkie has a track record of success in healthcare innovation, program development, financing, policy and strategy with an emphasis on behavioral and public health.

Prior to joining HMA, Meggan served as Chief Program Officer for Mental Health at the New York City Department of Health and Mental Hygiene where she oversaw a $200 million portfolio of services including care coordination, crisis services, vocational and rehabilitative programs, housing, and peer support. During her tenure she increased efficiency, tapped into new revenue streams and secured millions of dollars in federal, state, city and private funding to drive innovation, pilot new ideas and expand effective programs including a Healthcare Innovations Grant from the Centers for Medicare and Medicaid Innovation (CMMI) to develop a revolutionary new continuum of services for people experiencing psychiatric crisis.

Meggan played a leadership role in Medicaid reform implementation in New York City, including overseeing the conversion of targeted case management services for people with serious mental illness into Health Home Care Coordination services. She also provided education and training for managed care companies planning the integration of behavioral health services into newly developed integrated health and behavioral health managed care products.

During her tenure, Meggan managed the quality improvement of contracted behavioral health and social services as well as an expansion of thousands of units of supportive housing for individuals and families with mental health and substance use issues. She represented mental health system interests in a range of city and state task forces charged with improving criminal justice, law enforcement, and homeless services.

Meggan previously served in a variety of roles managing intergovernmental and legislative affairs around mental hygiene for New York City. She served as senior advisor to the Executive Deputy Commissioner for Mental Hygiene responsible for the oversight of the NYC service systems for individuals with developmental disabilities, substance use and mental illness as well as early intervention for children. She served as a policy advocate for the Coalition of Behavioral Health Agencies a non-profit trade organization representing over 100 community behavioral health providers, where she worked to increase funding for individuals suffering the psychological effects of 9/11 as well as to advocate for system improvements for mental health providers.

Meggan has a bachelor’s degree from Fordham University and a master’s degree in business administration from Columbia University.

In her spare time, Meggan considers herself an amateur chef and foodie – two hobbies she shares with her husband in Astoria, New York.

• 8:45 - 10:00 AM, Mar 6, 2023 International Ballroom

  Plenary Session

Kelsey Stevens

Principal

Wakely Consulting Group, an HMA Company

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Kelsey Stevens, FSA, MAAA, MBA, is a Principal at Wakely Consulting Group, an HMA Company. She joined the firm in 2012 and has more than 15 years of experience as a health actuary. She is a senior healthcare actuary and serves health plans, providers, and government agencies on both commercial and government programs. She also supports several ACOs participating in CMS and CMMI programs.

Kelsey supports several payer and provider clients in managing their overall value based care portfolio. Her work for these clients includes projections, historical performance evaluation, and strategic support such as contract term evaluation, downstream shared savings and shared loss distribution, attribution analysis, etc. Her current engagements include strategic support and pro forma modeling for the development of advanced alternative payment models. Generally, her experience lies in pricing, preparing regulatory rate filings and attestations of actuarial soundness, product design, trend analyses, financial reporting, and forecasting.

Kelsey is a Fellow of the Society of Actuaries and a member of the American Academy of Actuaries. She graduated from Florida State University with a Bachelor of Science in Actuarial Science and Statistics and a Master of Business Administration. Kelsey is a frequent speaker at industry meetings and was elected by her peers to serve a three-year term on the Health Section leadership council for the Society of Actuaries. She also served as the co-chair of the Value Based Care strategic initiative for the Society of Actuaries.

• 10:30 AM - 12:00 PM, Mar 6, 2023 State Room

  Getting to Value in Healthcare: How Value-Base Care, Population Health, Incentives Drive Quality

Justin Ley

CEO

Reema Health

Justin Ley began his career in the healthcare industry as a product manager, designer and ultimately Entrepreneur in Residence at UnitedHealth Group, one of the largest health plans in the United States. Since then, he has been embedded in Minneapolis' thriving health technology startup community as both a founder and a key leader. As Vice President of Product Development for Revel (now lcario), a behavioral science-based digital health company, Justin helped craft and implement a strategy that grew the organization exponentially in its first five years, eventually becoming the leader within its niche.
In 2019 Justin founded Reema Health, a Minneapolis health technology firm. Reema's breakthrough health platform uses proprietary technology and predictive data modeling to identify health plan members with the highest level of unmet social needs and connect them with Community Guides within their own neighborhoods. As CEO, Justin is responsible for the strategic direction of the organization and spearheads its relationships with clients and investors.
Justin holds a Master's in Business Administration from the University of St. Thomas - Opus College of Business and graduated from the University of Minnesota with a bachelor's degree in Political Science and Government.

• 1:30 - 3:00 PM, Mar 6, 2023 International Ballroom

  Quality Innovations: Healthcare Disrupters that Are Driving Improved Outcomes

Ryan Howells

Principal

Leavitt Partners, an HMA Company

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Ryan Howells is a Principal at Leavitt Partners based out of the Washington, D.C. office. Ryan has worked with the White House, Congress, HHS, and VHA on health care policy and interoperability issues. He currently helps lead the CARIN Alliance, a multi-sector, public-private alliance focused on giving consumers digital access to their health information. Ryan is a member of the CMS Medicaid Information Technology Architecture (MITA) Governance Board, Carequality Steering Committee, ONC’s FAST Identity Tiger Team, Technology Association of Georgia’s Digital Health Board, and the COVID-19 Health Care Coalition. He also serves as board observer for multiple health care companies. Before joining Leavitt Partners, Ryan was the General Manager for the government business unit of a private-exchange software vendor where he oversaw the implementation of software in three different state-based marketplaces. He managed a multi-million-dollar P&L, and was involved in the company’s IPO in late 2014. Earlier in his career, Ryan led the government operations division for iHealth Technologies (now Verscend Technologies) and served as an Account Executive for numerous regional and national health plans.

Ryan received his master’s in health administration from the University of Southern California, where he was a Dean’s Merit Scholar. He also holds a bachelor’s degree in English from Brigham Young University and is a Project Management Professional (PMP). He and his wife Alison live with their five children in Atlanta.

• 1:30 - 3:00 PM, Mar 6, 2023 International Ballroom

  Quality Innovations: Healthcare Disrupters that Are Driving Improved Outcomes

Lee Fleisher, MD

Director

Center for Clinical Standards and Quality, Centers for Medicare and Medicaid Services

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Lee A. Fleisher, MD, was named the Chief Medical Officer and Director of the Center for Clinical Standards and Quality for the Centers for Medicare and Medicaid Services in July 2020. In this capacity, he is responsible for executing all national clinical, quality, and safety standards for healthcare facilities and providers, as well as establishing coverage determinations for items and services that improve health outcomes for Medicare beneficiaries. He is also Professor Emeritus and Former Chair of Anesthesiology and Critical Care and Professor of Medicine at the University of Pennsylvania Perelman School of Medicine. From 2004 through July 2020, he was the Robert D. Dripps Professor and Chair of Anesthesiology and Critical Care and Professor of Medicine at the University of Pennsylvania.

Lee received his medical degree from the State University of New York at Stony Brook, from which he received the Distinguished Alumni Award in 2011. His research focuses on perioperative cardiovascular risk assessment and reduction, measurement of quality of care, decision making, implementation of cultural change and health policy. He has received numerous federal, industry and foundation grants related to these subjects and has published 175+ original articles, over 200 editorials, reviews and book chapters, and 9 books and collaborates with anthropologists, sociologists, as well as faculty from law, business and nursing.

He was Treasurer of the Board of Directors and Chair of the Finance Committee of the National Quality Forum. He was a member of the Care Transformation Forum (CTF) of the Health Care Payment Learning and Action Network (LAN) He is currently an Affiliated Faculty of the Quattrone Center for the Fair Administration of Justice and pursuing a Master in Law at the University of Pennsylvania Carey Law School. His is a Senior Fellow of the Leonard Davis Institute of Health Economics. In 2007, he was elected to membership of the National Academy of Medicine (formerly Institute of Medicine) of the National Academy of Sciences and served on Committees of the NAM.

• 8:00 - 8:45 AM, Mar 6, 2023 International Ballroom

  Keynote Address

Oxiris Barbot

CEO

United Hospital Fund

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OXIRIS BARBOT, MD, is president and CEO of United Hospital Fund (UHF). She is a nationally recognized physician, public health practitioner, and innovative leader at the intersection of public health, social justice, and health care delivery.
Dr. Barbot’s career has been defined by service, scholarship, and a commitment to community health equity. From 2018 until 2020, she served as Commissioner of Health and Mental Hygiene of the City of New York, leading the city’s successful response to the first wave of COVID-19. Her strategic decision-making, leadership of early action to address racial inequities, and clear and effective communication in both English and Spanish made a significant difference in public understanding, rapidly flattening the transmission curve and addressing the needs of the most vulnerable. As commissioner, she was also the driving force behind the city’s launch of a home visiting program for first-time families.
Previously she was first deputy commissioner at the New York City Department of Health and Mental Hygiene from 2014 until 2018, served as commissioner of the Baltimore City Health Department from 2010 until 2014, and was medical director of the New York City Department of Health and Mental Hygiene’s Office of School Health from 2003 until 2010. Before this, she was a community pediatrician at a federally qualified health center in Washington, D.C.
An independent, nonprofit organization, UHF works to build an effective and equitable health care system for every New Yorker by leveraging its public policy analysis to inform decision-makers, finding common ground among diverse stakeholders, and developing and supporting innovative programs that improve health and health care. Dr. Barbot became president in September 2022 and is the first woman to lead the organization since its founding in 1879.
An adjunct assistant professor at the Columbia University Mailman School of Public Health, Dr. Barbot was senior fellow for public health and social justice at The JPB Foundation from 2020 until 2022. She is a recipient of the Hispanic Health Leadership Award from the National Hispanic Medical Association and was named to the Crain’s New York Business “Notable Women in Health Care” list and City & State New York’s “Health Power 100” and “Nonprofit Power 100.” She currently serves on multiple national and local boards, including RIP Medical Debt, ChangeLab Solutions, and Phipps Neighborhoods. Previously she served on the boards of UHF and NYC Health and Hospitals. A prolific author of peer-reviewed articles and commentaries, she has been published in several academic journals, including The New England Journal of Medicine, Health Affairs, and The American Journal of Public Health, as well as lay publications such as The Washington Post and The New York Daily News.
Dr. Barbot received her undergraduate degree from Yale University, her medical degree from New Jersey Medical School, and completed her pediatric training at George Washington University - Children’s National Medical Center. She also holds an Honorary Doctorate of Science from The City University of New York, Lehman College.

• 8:45 - 10:00 AM, Mar 6, 2023 International Ballroom

  Plenary Session

Aneesh Chopra

President

CareJourney

Aneesh Chopra is the President of CareJourney, an open data membership service building a trusted, transparent rating system for physicians, networks, facilities and markets on the move to value. He served as the first U.S. Chief Technology Officer under President Obama (’09-’12) and in 2014, authored, “Innovative State: How New Technologies can Transform Government.” He serves on the Board of the Health Care Cost Institute, the New Jersey Innovation Institute, and earned his MPP from Harvard Kennedy School and BA from The Johns Hopkins University.

CareJourney uses population claims data to address use cases in network design and management, care model management, patient risk segmentation, spend and utilization trends, network integrity, low-value care, and provider, practice and facility (acute and post-acute)

• 8:45 - 10:00 AM, Mar 6, 2023 International Ballroom

  Plenary Session

Eric Schneider, MD

Executive Vice President

National Committee for Quality Assurance

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Eric Schneider, MD, M.Sc. leads NCQA’s measurement, research and contracting agenda as Executive Vice President of the Quality Measurement and Research Group. In this role, he helps drive NCQA’s efforts to create a more equitable health care system and to advance the move to digital quality measurement.
Dr. Schneider came to NCQA from The Commonwealth Fund, where he was Senior Vice President for Policy and Research and a member of its executive management team. He has a long history with NCQA, most recently as Co-Chair of its Committee on Performance Measurement. He served on that committee for more than 10 years, including nine as Co-Chair.
Prior to his tenure at The Commonwealth Fund, Dr. Schneider was principal researcher at the RAND Corporation and held the RAND Distinguished Chair in Health Care Quality. As the first director of Rand’s Boston office, Schneider built its highly regarded multidisciplinary team of health services researchers. As a professor at the T.H. Chan Harvard School of Public Health and Harvard Medical School Eric taught health policy and practiced primary care internal medicine for 25 years.
Widely regarded as one of the nation’s preeminent health services researchers, Dr. Schneider has authored more than 125 published peer-reviewed research investigations and dozens of other scientific or medical research publications, reviews, chapters, editorials, and more. His work has focused on four aspects of health care quality — performance measurement methods; evaluation of quality and safety measurement in public reporting and financial incentive programs; use of health care quality measures to assess racial, ethnic, and socioeconomic disparities in health care quality; and evaluation of innovative approaches in health insurance, organization and financing of health care, and the organization of health care delivery.
Dr. Schneider trained in health services research, public health and primary care general internal medicine. He holds a Bachelor of Science, cum laude, in biology from Columbia University and a Master of Science from the University of California, Berkeley. He earned his medical degree from the University of California, San Francisco. He is a member of the AcademyHealth Board of Directors and a fellow of both the American College of Physicians and the National Academy of Social Insurance.

• 8:45 - 10:00 AM, Mar 6, 2023 International Ballroom

  Plenary Session

• 1:30 - 3:00 PM, Mar 6, 2023 International Ballroom

  Quality Innovations: Healthcare Disrupters that Are Driving Improved Outcomes

Frank Opelka, MD

Medical Director

American College of Surgeons

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Dr Frank Opelka, MD FACS currently serves as the medical director for quality and health policy for the American College of Surgeons. He previously served as senior vice president of Louisiana State University (LSU) with oversight for two separate health science centers and ten safety net hospitals. During his time at LSU, Dr. Opelka was instrumental in architecting the privatization of the public hospital system into multiple non-profits which are now "owned" locally in each community across the State. Prior to his work at LSU, Dr. Opelka was the vice chair of surgery for finance at Beth Israel Deaconess Hospital in Boston Massachusetts and served as a visiting professor in the Harvard Faculty Medical Group. He has also served as President of the medical staff at the Ochsner Clinic where he played the key role in framing the merger of the hospital and the clinical faculty practice into one business enterprise.

Dr. Opelka has been instrumental in the American College of Surgeons public policies with regard to healthcare transformation, payment models, quality programs and value-based care.

Dr. Opelka is a published academic surgeon with several publications, book chapters and editorial positions in the field of Surgery. He currently holds an appointment as a Professor of Surgery at the George Washington School of Medicine.

• 1:30 - 3:00 PM, Mar 6, 2023 International Ballroom

  Quality Innovations: Healthcare Disrupters that Are Driving Improved Outcomes

Jake Schwartz

CEO

Brave Health

• linkedin

Jake grew up learning about healthcare from his father, an emergency medicine specialist. Jake co-founded General Assembly, a global organization devoted to helping people learn new technology skills and pursue work they love, and remains the CEO. Now, he brings his expertise in building mission-driven, tech-enabled businesses to Brave Health. Jake lives in New York and holds an MBA from Wharton and a BA from Yale.

• 1:30 - 3:00 PM, Mar 6, 2023 International Ballroom

  Quality Innovations: Healthcare Disrupters that Are Driving Improved Outcomes

Caroline Fichtenberg

Co-director

Social Interventions Research and Evaluation Network

• linkedin

Dr. Fichtenberg is one of the co-directors of the Social Interventions Research and Evaluation Network (SIREN) and Research Scientist in the Department of Family and Community Medicine at the University of California, San Francisco. In these roles, she leads efforts to conduct, catalyze, and disseminate high quality research on health sector strategies to reduce health inequities by addressing social determinants of health. She brings to these positions more than a decade of experience working to improve health and economic outcomes for America’s most vulnerable families, including seven years working on national efforts in Washington, DC. While Director of Research at the Children’s Defense Fund (CDF), she led the development of a report that identified nine federal policy changes that could reduce child poverty by 60 percent. As Director of Epidemiology and Planning at the Baltimore City Health Department, she oversaw the city’s first analysis of neighborhood health inequities that uncovered a 20-year gap in life expectancy between the richest and poorest neighborhoods of the city. Caroline also served as director of the Center for Public Health Policy at the American Public Health Association (APHA) and as Health Policy Advisor to Senator Harkin on the Senate Health, Education, Labor and Pensions committee, where she promoted health in all policies approaches to improve health outcomes and reduce health inequities. She earned her Ph.D. in Epidemiology from Johns Hopkins University, an M.S. degree in Biology from Yale University and an A.B. in Molecular Biology from Princeton University.

• 1:30 - 3:00 PM, Mar 6, 2023 State Room

  Practical Approaches to Addressing Equity and Social Determinants of Health

Keegan Warren, J.D., LL.M.

Senior Consultant

HMA

Keegan Warren-Clem brings a civil justice lens to bear on healthcare design and strategic planning and specializes in formalized and measurable approaches to social determinants of health and health equity.

Before joining HMA, she served as a senior managing attorney at Texas Legal Services Center and has more than a decade of experience developing, integrating, and evaluating medical-legal partnerships, which embed attorneys and paralegals within healthcare teams to mitigate unmet health-related social needs.

Through this national model, Keegan has worked collaboratively with healthcare providers serving patients through the lifespan to improve outcomes by bringing patient-centered legal and structural expertise into all aspects of the delivery of healthcare. She has also been a senior manager of targeted legal assistance programs for survivors of sexual assault, victims of crime, and veterans.

Keegan is adjunct professor and lecturer at The University of Texas' School of Law, McCombs School of Business, and School of Design and Creative Technologies where her courses focus on health justice, health law, and health policy.

Keegan is a 2020 National Academy of Medicine Emerging Leader in Health and Medicine Scholar and recently completed a forthcoming publication that proffers a practical epidemiological approach to legal interventions as a concrete means for increasing health equity for pregnant persons and new parents.

Keegan is a veteran of the Army National Guard and is also a member of the Order of St. Joan of Arc, the highest civilian award given by the Army Armor and Cavalry Associations.

Keegan can be reached at: kwarrenclem@healthmanagement.com

• 1:30 - 3:00 PM, Mar 6, 2023 State Room

  Practical Approaches to Addressing Equity and Social Determinants of Health

Caprice Knapp

Principal

Health Management Associates

A health economist and evaluator, Caprice Knapp has more than 20 years’ experience working on Medicaid and the Children’s Health Insurance Program (CHIP) in the private sector, state and federal policymaking, and academics.

In the private sector she was the federal policy director for Molina Healthcare, Inc. As an academic, she was an associate professor in the Department of Health Outcomes and Policy at the University of Florida (UF) conducting external quality review activities for Texas and Florida Medicaid and CHIP programs and maternal and child health research. In the policymaking arena, she worked in the Governor’s Office of State Planning and Budgeting in Colorado as well as the U.S. House of Representatives Energy and Commerce Committee as a Robert Wood Johnson Health Policy fellow. Most recently she was the North Dakota Medicaid Director from 2019 to 2022.

Caprice’s career has been focused on vulnerable populations, delivery system reform, and global health. Examples of her funded research topics include an assessment of Florida’s CHIP Reauthorization Grant; an evaluation of fertility-preservation decision making for adolescent girls with cancer; outcomes of concurrent models of pediatric palliative care; and an assessment of the quality, patient experiences, and costs of health and dental plans for children in Florida. Her global health projects also focus on maternal and child health and have been conducted in Africa, Asia, Europe, and South America.

At the University of Florida, Caprice earned a PhD in economics and completed postdoctoral training in health services research. She has authored more than 80 peer-reviewed publications, 60 government reports, and two books.

• 1:30 - 3:00 PM, Mar 6, 2023 State Room

  Practical Approaches to Addressing Equity and Social Determinants of Health

• 10:30 AM - 12:00 PM, Mar 6, 2023 Cuvee Room

  Medicaid Core Sets and the Growing Emphasis on Accountability

Rhonda Robinson Beale, MD

SVP, Chief Medical Officer, Mental Health Services

UnitedHealth Group

• linkedin

Dr. Rhonda Robinson Beale is a seasoned healthcare executive with over 30 years of experience
in health care systems, managed care and quality improvement in behavioral health and
medical care. She is the Deputy Chief Medical Officer for Mental Health Services within UHG.
Dr. Robinson Beale has served in the past as Senior Vice President, Chief Medical Officer for
Blue Cross of Idaho and for several other large national and local health care organizations,
such as Optum, PacifiCare, Cigna, Blue Cross Blue Shield of Michigan and Health Alliance Plan in
Michigan. She has been involved with many national organizations as a subject matter expert,
National Institute of Health, National Institute of Mental Health, Institute of Medicine, National
Quality Forum, American Psychiatric Association, American Psychological Association, American
Society of Addiction Medicine, NCQA and others.
Dr Robinson Beale has served on many national boards, engaged with key committees and
workgroups and has been significantly involved in influencing changes in the system. She was
on the IOM committee that created “Crossing the Quality Chasm and “To Err is Human.” Dr.
Robinson Beale has been involved in influencing local and national legislation particularly
around Parity and ACA issues. Her involvements led to her having the opportunity to testify
before the Senate’s Health, Education, Labor and Pension Committee (HELP) on the state of
behavioral health care.

• 1:30 - 3:00 PM, Mar 6, 2023 Cuvee Room

  Developing a Behavioral Health Quality Strategy

Claire Wang, MD, ScD

Associate Deputy Director

State of Delaware

Dr. Claire Wang is trained as a physician epidemiologist with a career that spans academia, federal and state governments, and the non-profit sector. She currently serves as the Associate Deputy Director in the Delaware State Department of Health and Social Services, Division of Substance Abuse and Mental Health. In this role, she is part of the Division’s executive team and oversees a portfolio including data analytics, program evaluation, and health information technology. She currently co-chairs the Data and Quality Subcommittee of Delaware’s Overdose System of Care. Prior to her current role, she was a tenured Associate Professor at Columbia University’s Mailman School of Public Health. She also served as Senior Program Advisor at the National Academy of Medicine and as a Robert Wood Johnson Health Policy fellow in the Obama administration.

• 1:30 - 3:00 PM, Mar 6, 2023 Cuvee Room

  Developing a Behavioral Health Quality Strategy

Katharine Iskrant

President

Healthy People

• linkedin

Katharine is the President of Healthy People, an NCQA-licensed HEDIS audit firm and a CMS Data Validation firm. She is a member of NCQA’s Audit Methodology Panel and NCQA’s HEDIS Data Collection Advisory Panel. She is featured on a NCQA ECDS podcast. Katharine has been a Certified HEDIS® Compliance Auditor since 1998 and has directed more than two thousand HEDIS audits.
Previously, as CEO of the company Acumetrics, Katharine provided consultancy services to NCQA which helped their initial development and eventual launch of the NCQA Measure Certification Program.
Katharine is a frequent speaker at HEDIS conferences, including NCQA conferences. She received her BA from Columbia University and her MPH from UC Berkeley School of Public Health. She is a member of the National Association for Healthcare Quality and is published in the fields of healthcare and public health.

• 1:30 - 3:00 PM, Mar 6, 2023 Ambassador Room

  Moving the Needle on Medicare Stars Ratings

Vanita Pindolia, PharmD, MBA

Vice President, Stars Program

Emergent Holdings

• linkedin

Vanita Pindolia joined Emergent Holdings in 2021 as vice president of the Stars Program. She serves as a key member of the Emerging Markets executive management team and is responsible for developing, implementing and monitoring the enterprise strategy for Medicare Stars. She is also responsible for identifying industry-leading practices, strategies, partnerships and risk management processes and reporting that result in exceptional performance across all Stars dimensions.

Prior to coming to Emergent Holdings, she worked at Henry Ford Health System (HFHS) for 28 years, with the last 11 years spent as the vice president of Ambulatory Clinical Pharmacy Programs for HFHS and Health Alliance Plan, working with multiple System business unit executive teams across primary and specialist physicians, population health leaders, hospital quality teams, multiple health plan departments and non-HFHS physician groups, in a quasi-matrix environment to align payer goals with provider practices to achieve System goals.

Over the past 15 years, she has served on multiple national and local committees that have focused on numerous quality metrics, biosimilar work and payers and providers collaboration partnerships.

Vanita holds a Doctor of Pharmacy from the University of Michigan and a Master’s in Business Administration from Oakland University.

• 1:30 - 3:00 PM, Mar 6, 2023 Ambassador Room

  Moving the Needle on Medicare Stars Ratings

John Myers

VP of Health Quality & Stars

Humana

John Myers has been with Humana for 21 years and is currently the Vice President of Health Quality and Stars. Primary responsibilities include driving performance and improvement in Stars results for all 40+ Humana Inc contracts in collaboration with partners across the enterprise. Previously he served as Vice President of Membership & Plan Services, where he was responsible for enrollment, billing, and related services for Humana Medicare and Medicaid customers. John joined Humana from US Airways in 2002 and has held progressively responsible leadership roles focused on process improvement, quality, and operations in the Retail and Employer Group segments. John holds a degree in mathematics from Millsaps College and a Master's degree in Operations Research from Rensselaer Polytechnic Institute.

• 1:30 - 3:00 PM, Mar 6, 2023 Ambassador Room

  Moving the Needle on Medicare Stars Ratings

Kate Koplan, MD

COO & AMD Quality & Safety

Southeast Permanente Medical Group

• linkedin

For 20 plus years, Dr. Kate Koplan has brought strategic direction and solutions across the healthcare ecosystem. Her leadership and commitment to Kaiser Permanente’s mission, and to that of Harvard Vanguard/Atrius Health’s mission in Boston, MA prior to that, has measurably improved individuals’ lives and health, creating safer and more equitable care across the communities she served.
Dr. Koplan is a senior executive at Kaiser Permanente, a unique integrated care and coverage model providing high-quality, affordable health care to 12+ million members, with over 300,000 employees, 63,000 nurses, and 23,000 physicians. Dr. Koplan is a nationally recognized leader with a Quality Executive role and clinical practice in Kaiser Permanente Georgia, based in Atlanta, Georgia. She is a thought partner and expert in strategic and operational planning and implementation of practice-changing health care innovations. She is a highly sought-after authority on bringing value-based, human-centered care and innovations to the forefront of making health care better, more affordable, and more equitable and accessible. Some of her favorite and most recent accountabilities include: COVID-19 Emergency Operations Co-Commander, and the Physician Executive Sponsor for NCQA & Medicare Stars performance (only GA plan to accomplish most recent 4 years in a row of 5-Star performance); Effectiveness and Equity of Care; Risk, Safety Systems and Peer Review; Research and Academic Affairs; Performance Improvement; and Clinical Pharmacy Practice and Safety.
She holds a bachelor’s degree from Yale College, a Medical Doctorate from Emory University School of Medicine, and a Master of Public Health from the Emory University Rollins School of Public Health. She completed her Residency at the Harvard Medical School, Brigham and Women’s Hospital, and continuously practiced and remained Board-certified in Internal Medicine. She is also Board-Certified in Lifestyle Medicine.
As the daughter of two physicians, she is a committed community leader in her hometown of Atlanta. Dr. Koplan has served in the community – most recently on the Board of the United Way of Greater Atlanta and National Quality Forum’s National Equity Task Force. In her free time, you can most frequently find her walking the neighborhood, parks, and beltline trails around metro Atlanta with her Golden Retriever, or during the right season, find her at baseball games with her husband and her son, equally cheering for the Braves and the Red Sox.

• 1:30 - 3:00 PM, Mar 6, 2023 Ambassador Room

  Moving the Needle on Medicare Stars Ratings

Sandeep Wadhwa, MD

Global Chief Medical Officer

3M

• linkedin

Sandeep Wadhwa, MD, MBA Global Chief Medical Officer, 3M Health Information Systems
Dr. Sandeep Wadhwa is the Global Chief Medical Officer for 3M Health Information Systems, where he oversees development of payment and quality methodologies used by multiple countries and US payers and providers. He is a population health leader with a particular focus serving underserved populations. Sandeep served as the State Medicaid Director for Colorado during the Great Recession. He has had leadership positions with Solera Health, Noridian and McKesson and serves on the board of Reinvestment Fund, a $1B non-profit devoted to revitalizing low-income neighborhoods, and the Population Health Alliance. Sandeep volunteers at the Seniors Clinic at the University of Colorado Hospital. He earned his BA at Wesleyan, MD at Cornell and MBA at Wharton and is board-certified in internal medicine and geriatrics.

• 10:30 AM - 12:00 PM, Mar 6, 2023 State Room

  Getting to Value in Healthcare: How Value-Base Care, Population Health, Incentives Drive Quality

Keshia Bigler

Director Informatics and Evaluation, Quality & Innovation Support

CareOregon

• linkedin

Keshia Bigler (She/Her) is the Director of Informatics and Evaluation at CareOregon. Prior to her current role, she served as the Population Health Portfolio Manager for Columbia Pacific CCO for three years. She has extensive experience in health research, systematic reviews and evidence based care, evaluation, quality improvement, population health, value based payment, Medicaid and Medicare, and health policy and advocacy. She has worked on projects to reduce cancer screening inequities, increase adoption and spread of HIT tools statewide, convened and led multidisciplinary taskforces aimed at improving integration and health outcomes within communities, and served as the co-chair for the Oregon Community Paramedicine and Mobile Integrated Health Coalition for 7 years. She has a strong passion for health equity and believes healthcare is a human right. Keshia received her MPH from OHSU with a focus in Primary Care and Health Disparities, a Graduate Certificate in Population Health Informatics from CUNY, and a Bachelor of Science in Community Health and Human Biology.

• 10:30 AM - 12:00 PM, Mar 6, 2023 State Room

  Getting to Value in Healthcare: How Value-Base Care, Population Health, Incentives Drive Quality

Connie Savor, MD

Chief Medical Officer

Denver Health

Connie Savor Price, MD is the Chief Medical Officer (CMO) at Denver Health and a Professor of Medicine in the Division of Infectious Diseases at the University of Colorado School of Medicine. Prior to becoming the CMO, she served as the Chief of Infectious Diseases and the Medical Director of Infection Control and Prevention at Denver Health for 13 years. Dr. Price is board-certified in internal medicine, infectious diseases, and medical microbiology. Her research and clinical interest focuses in healthcare epidemiology and methods to prevent and rapidly detect emerging and antimicrobial resistant infections. Dr. Price has a track record of successful federal funding as a Principal Investigator from the National Institutes of Health, the Department of Defense, and the Agency for Healthcare Research and Quality. She has published >75 manuscripts and delivered >175 lectures on the prevention of healthcare associated infectious diseases and related topics. She is active in the Infectious Diseases Society of America, served in an elected position on the Board of Directors of the Society of Healthcare Epidemiology of America, and as past chair of the American Society for Microbioloty section on Healthcare Epidemiology. Dr. Price was the physician representative on the inaugural Colorado Healthcare Associated Infections advisory committee for public reporting of healthcare associated infections for Colorado. She has recognized expertise in outbreak management and has served as a consultant to public health authorities around the world on control of emerging infections, specifically MERS and SARS, as well as Ebola preparedness.

• 10:30 AM - 12:00 PM, Mar 6, 2023 State Room

  Getting to Value in Healthcare: How Value-Base Care, Population Health, Incentives Drive Quality

Rose Kakoza, MD

Physician Executive

Complex and Community Primary Care, Christiana Care Health System

Rose Kakoza, MD, MPH is a board-certified primary care internist at ChristianaCare where she serves as Senior Clinical Network Director for Population Health. In that role she oversees the clinical strategy for the ChristianaCare Clinical Alliance, the health system’s clinically integrated network. She also serves as the Senior Medical Director for the health system’s Medicaid Accountable Care Organization (Delaware Medicaid Quality Partners) and Medicare Shared Savings Program ACO (eBrightHealth). With oversight over the clinical strategy across all value-based contracts for the network, Dr. Kakoza drives the design and scale of an effective models of care delivery and the development of innovative population health management programs and services to help drive value and cost savings. Dr. Kakoza also oversees CareVio, Population Health’s case management subsidiary organization supporting approximately 100,000 risk lives across value-based lines of business. Dr. Kakoza also serves as the physician executive over Complex Primary Care and Community Medicine, overseeing ChristianaCare’s primary care practices and programs that target underserved populations. She brings extensive experience to her roles, including expertise in population health, managing and improving care delivery in large health care systems with complex physician networks and community partnerships.

Dr. Kakoza is passionate about cultivating health equity and advocating for health policy that addresses structural barriers facing underserved populations. As a leader, Dr. Kakoza is dedicated to the growth and development of her teams, aligning employees to long-term strategic visions, and inspiring positive transformation.

Previously, Dr. Kakoza served as Assistant Medical Director for Medicaid at Mass General Brigham and as the Medical Director for the Medicaid ACO at the Brigham and Women’s Hospital. She is highly regarded for her primary and specialty care-based innovations, which focus on medically complex patients, social determinants of health and complex behavioral health management.

Dr. Kakoza holds an MPH from Harvard School of Public Health, an MD from Harvard Medical School and a BA in Sociology, cum laude, from Harvard College.

Dr. Kakoza lives with her husband and two children in Wilmington, DE. A believer in family as a foundation for health and success, Dr. Kakoza takes great pride in her role as “mom” alongside her other professional titles.

• 10:30 AM - 12:00 PM, Mar 6, 2023 State Room

  Getting to Value in Healthcare: How Value-Base Care, Population Health, Incentives Drive Quality

• 10:30 AM - 12:00 PM, Mar 6, 2023 Cuvee Room

  Medicaid Core Sets and the Growing Emphasis on Accountability

David Wedemeyer

Principal

Health Management Associates

David Wedemeyer is an established data expert and a seasoned consultant with expertise developing Healthcare Effectiveness Data and Information Set (HEDIS) and risk programs, process improvements, and software tools.

In the medical management field, he has experience with quality improvement and has provided subject matter expertise in building software tools to auto-code service and diagnosis codes for electronic medical records (EMR) systems. This included working with certified vendors and health plans. In addition, he has developed processes for standardized data pulls from electronic medical records databases and supplemental sources.

David has significant accreditation expertise, specifically National Committee for Quality Assurance (NCQA) Accreditation and has been a featured speaker on this topic at numerous conferences including the Medicare Advantage Congress conference. At HMA, he will assist clients with a wide range of NCQA needs while helping them navigate process improvement, risk adjustment, Medicare Stars programs, and requests for procurement of new state and federal programs.

He has prepared, audited, and submitted all requirements for NCQA Accreditation. With a focus on improvement and return on investment, he also developed HEDIS, Consumer Assessment of Healthcare Providers and Systems, and Health Outcomes Survey and Starts proactive programs to save organizations efforts and resources.

David has extensive experience writing responses to request for proposal (RFP) questions pertaining to all medical management areas for state and federal business including Medicaid and Medicare programs in California and Arizona.

Before joining HMA, David served as senior director of quality improvement with LA Care Health Plan where he directed and developed workgroups and quality projects focused for improvement in Model of Care and Medicare Stars programs, and oversaw all annual credentialing, quality review, and evaluations including HEDIS, NCQA, Medicare and Medicaid programs.

A former vice president of quality improvement with Care1st Health Plan, he developed Special Needs Plan (SNP) programs and the SNP model of care as well as the plan’s Medicare Risk Assessment and Adjustment process, consistently leading the plan to improvements in HEDIS rates and reaching High Performance Levels. He also developed a web portal for data exchange and group dashboards aimed at improving ratings and outcomes to streamline efforts. Under his leadership, the plan secured a commendable NCQA rating.

With a background in direct patient care, David began his career in nursing, serving as a registered nurse, nurse coordinator, urgent care staff nurse and staff development coordinator. He received a Bachelor of Science in Nursing degree from the University of Phoenix. He also completed certifications as an emergency medical technician and licensed vocational nurse.

• 1:30 - 3:00 PM, Mar 6, 2023 Ambassador Room

  Moving the Needle on Medicare Stars Ratings