AGENDA: DAY III
FRIDAY, MAY 18, 2018
CLOSING PLENARY SESSION
8:00 am
Welcome and Introductions
Allyson Y. Schwartz
President and Chief Executive Officer, Better Medicare Alliance; Former Member (D/PA), US House of Representatives, Washington, DC (Chair)
President and Chief Executive Officer, Better Medicare Alliance; Former Member (D/PA), US House of Representatives, Washington, DC (Chair)
Allyson Y. Schwartz is President and CEO of the Better Medicare Alliance, a former member of the U.S. House of Representatives from Pennsylvania and a nationally recognized leader on health care issues. Having worked as a health service executive, Schwartz was elected to the Pennsylvania State Senate in 1990, serving 14 years until her election to Congress. In the state Senate, Schwartz was the driving force behind Pennsylvania’s CHIP program, which was a model for the federal CHIP program five years later. In Congress, Schwartz was appointed to the Ways and Means Committee and served as a senior member of the Budget Committee. Schwartz is a Distinguished Policy Fellow at the University of Pennsylvania’s Leonard Davis Institute of Health Economics, Visiting Fellow at the Penn Wharton Public Policy Initiative and Co-Chair of the Bipartisan Policy Center Health and Housing Task Force.
Jerry Penso, MD, MBA
President and Chief Executive Officer, AMGA; Former Medical Director, Continuum of Care, Sharp Rees-Stealy Medical Group, Washington, DC (Co-chair)
President and Chief Executive Officer, AMGA; Former Medical Director, Continuum of Care, Sharp Rees-Stealy Medical Group, Washington, DC (Co-chair)
Dr. Penso is president and chief executive officer at AMGA, a trade association that represents medical groups and other organized systems of care. Dr. Penso previously served as chief medical and quality officer for AMGA and president of AMGA Foundation.
Prior to joining AMGA, Dr. Penso served as medical director, continuum of care for Sharp Rees-Stealy Medical Group (SRSMG). In addition to his work at AMGA and SRSMG, Dr. Penso has served on the Integrated Healthcare Association Board of Directors, the California Cooperative Healthcare Reporting Initiative Executive Committee, and Board of Directors of the Behavioral Diabetes Institute, and chaired the Technical Quality Committee for California’s Pay for Performance program. He currently serves as chair of the Board of Directors of two AMGA subsidiaries, AMGA Analytics, and AMGA Consulting. Dr. Penso also serves on the board of the Pharmacy Quality Alliance.
Prior to joining AMGA, Dr. Penso served as medical director, continuum of care for Sharp Rees-Stealy Medical Group (SRSMG). In addition to his work at AMGA and SRSMG, Dr. Penso has served on the Integrated Healthcare Association Board of Directors, the California Cooperative Healthcare Reporting Initiative Executive Committee, and Board of Directors of the Behavioral Diabetes Institute, and chaired the Technical Quality Committee for California’s Pay for Performance program. He currently serves as chair of the Board of Directors of two AMGA subsidiaries, AMGA Analytics, and AMGA Consulting. Dr. Penso also serves on the board of the Pharmacy Quality Alliance.
8:15 am
Keynote Address
Mark E. Miller, PhD
Vice President, Health Care, Laura & John Arnold Foundation; Former Executive Director, MedPAC; Former Assistant Director, Health and Human Resources, CBO; Former Deputy Director of Health Plans, CMS; Former Health Financing Branch Chief, OMB, Washington, DC
Vice President, Health Care, Laura & John Arnold Foundation; Former Executive Director, MedPAC; Former Assistant Director, Health and Human Resources, CBO; Former Deputy Director of Health Plans, CMS; Former Health Financing Branch Chief, OMB, Washington, DC
Dr. Mark E. Miller is the Vice President of Health Care for the Laura and John Arnold Foundation. Mark leads the Foundation’s work to lower the cost and improve the value of health care. He joins the team with more than 30 years of experience developing and implementing health policy, including prior positions as the executive director of Medicare Payment Advisory Commission; assistant director of Health and Human Resources at the Congressional Budget Office; deputy director of health plans at the Centers for Medicare and Medicaid Services; health financing branch chief at the Office of Management and Budget; and senior research associate at the Urban Institute. Mark has extensive experience identifying emerging health care issues, developing policy solutions, working with policymakers, and engaging diverse stakeholders. He has been directly involved in the development of major health legislation such as the Balanced Budget Act; the Medicare Prescription Drug, Improvement, and Modernization Act; and the Affordable Care Act.
8:45 am
Delivery System Reform for Medicare Advantage
Robert Mirsky, MD, MMM
Vice President, Medical Operations and Chief Medical Officer, Medicare, Aetna, New York, NY
Vice President, Medical Operations and Chief Medical Officer, Medicare, Aetna, New York, NY
Bob Mirsky is Vice President Medical Operations and Chief Medical Officer for the Medicare organization. In this role, Dr. Mirsky drives operational excellence and best-in-class care management through our medical management, provider collaboration, network strategy, and medical economics disciplines.
Dr. Mirsky has extensive experience in quality improvement, medical management and accountable care across Commercial, Medicare and Medicaid lines of business. He held leadership roles at Tenet Health System of Florida, Blue Cross Blue Shield of Florida, Gateway Health Plan in Pittsburgh, Coventry Health Care, and North Shore-LIJ.
Dr. Mirsky has extensive experience in quality improvement, medical management and accountable care across Commercial, Medicare and Medicaid lines of business. He held leadership roles at Tenet Health System of Florida, Blue Cross Blue Shield of Florida, Gateway Health Plan in Pittsburgh, Coventry Health Care, and North Shore-LIJ.
9:15 am
Keynote Address: Member of Congress
Peter Roskam, JD (R/IL)
U.S. Representative for the 6th District of Illinois; Ways & Means Health Subcommittee Chairman for the 115th Congress, Wheaton, IL
U.S. Representative for the 6th District of Illinois; Ways & Means Health Subcommittee Chairman for the 115th Congress, Wheaton, IL
U.S. Representative Peter J. Roskam is the Congressional representative for Illinois’ 6th district. He is currently in his sixth term of service.
Representative Roskam serves as the Ways & Means Health Subcommittee Chairman for the 115th Congress where he is leading a series of hearings and roundtable discussions addressing the opioid crisis and regulatory reform. He also sits on the Tax Policy Subcommittee and previously led the Oversight Subcommittee.
Representative Roskam was at the center of the investigation into the IRS after it was revealed the agency was targeting Americans for their personal, religious, and political beliefs and he championed efforts to overhaul the troubled agency’s civil asset forfeiture program and probed the relationship between the rising costs of college and the tax code.
Roskam is Chairman of the House Democracy Partnership, serves as a co-chair of the House Republican Israel Caucus, and serves on the Board of Directors for the National Endowment for Democracy.
Representative Roskam serves as the Ways & Means Health Subcommittee Chairman for the 115th Congress where he is leading a series of hearings and roundtable discussions addressing the opioid crisis and regulatory reform. He also sits on the Tax Policy Subcommittee and previously led the Oversight Subcommittee.
Representative Roskam was at the center of the investigation into the IRS after it was revealed the agency was targeting Americans for their personal, religious, and political beliefs and he championed efforts to overhaul the troubled agency’s civil asset forfeiture program and probed the relationship between the rising costs of college and the tax code.
Roskam is Chairman of the House Democracy Partnership, serves as a co-chair of the House Republican Israel Caucus, and serves on the Board of Directors for the National Endowment for Democracy.
9:30 am
Final MA Rate Notice
Lynn F. Dong, FSA, MAAA
Principal and Consulting Actuary, Milliman, Inc., Seattle, WA
Principal and Consulting Actuary, Milliman, Inc., Seattle, WA
Lynn Dong is Principal and Consulting Actuary with Milliman, Inc. and has over 20 years of healthcare actuarial experience and consults extensively with provider organizations and commercial and Medicare health plans. She has significant experience in evaluating risk-based contacts and alternative payment models for provider organizations. Lynn serves on Milliman’s Health Research Board and is deeply involved in the research and development of multiple components of Milliman’s Health Cost Guidelines.
Jane Galvin
Director, Regulatory Affairs, Blue Cross Blue Shield Association, Washington, DC
Director, Regulatory Affairs, Blue Cross Blue Shield Association, Washington, DC
Jane Galvin is the Managing Director, Regulatory Affairs, for the BlueCross and BlueShield Association in their Washington, D.C. Office of Policy and Representation.
Ms. Galvin’s responsibilities at BCBSA include working with Blue Plans on federal regulations and other health care issues that impact Plan businesses, working directly with critical government agencies, such as the US Departments of Labor, Health and Human Services, Treasury, and also the Centers for Medicare and Medicaid Services on federal regulatory issues and government programs such as Medicare Advantage, Part D, Medicare Secondary Payor issues etc.
Ms. Galvin has been with BCBSA since 1998. Prior to joining BCBSA she worked for Kaiser Permanente in their Mid-Atlantic Region and at other health care trade associations such as GHAA and the Health Insurance Association of America, as well as for a Member of Congress.
Ms. Galvin’s responsibilities at BCBSA include working with Blue Plans on federal regulations and other health care issues that impact Plan businesses, working directly with critical government agencies, such as the US Departments of Labor, Health and Human Services, Treasury, and also the Centers for Medicare and Medicaid Services on federal regulatory issues and government programs such as Medicare Advantage, Part D, Medicare Secondary Payor issues etc.
Ms. Galvin has been with BCBSA since 1998. Prior to joining BCBSA she worked for Kaiser Permanente in their Mid-Atlantic Region and at other health care trade associations such as GHAA and the Health Insurance Association of America, as well as for a Member of Congress.
David Introcaso, PhD
Senior Director for Regulatory and Public Policy, AMGA; Former Healthcare Policy Advisor, House Majority Leader Rep. Steny Hoyer, Washington, DC
Senior Director for Regulatory and Public Policy, AMGA; Former Healthcare Policy Advisor, House Majority Leader Rep. Steny Hoyer, Washington, DC
David Introcaso, is currently Senior Director of Regulatory and Public Policy at AMGA. David has been doing health care delivery and related research and policy work for over the twenty years in Washington, D.C. He moved to DC in the mid-1990s to work at DC General Hospital. He subsequently served as the Evaluation Officer at the Agency for Healthcare Research and Quality (AHRQ), as a Public Health Analyst in the DHHS Office of the Assistant Secretary for Planning and Evaluation (ASPE) and as Healthcare Policy Advisor for the House Majority Leader, Rep. Steny Hoyer. He has also worked as a consultant to numerous clients including the American Heart Association, the American Public Health Association, the Coalition to Transform Care, the National Association of ACOs, the National Hospice and Palliative Care Organization and United Health Group. David has taught as an adjunct professor at the University of Chicago, Georgetown and George Washington University.
Howard B. Shapiro, PhD
Director of Public Policy, Alliance of Community Health Plans; Former Executive Director, State Associations of Addiction Services, Washington, DC
Director of Public Policy, Alliance of Community Health Plans; Former Executive Director, State Associations of Addiction Services, Washington, DC
Howard Shapiro is Director of Public Policy for the Alliance of Community Health Plans, an organization of non-profit, regionally based health plans. His work covers policy development, analysis, regulations, and advocacy in Medicare Advantage and other issue areas. He joined ACHP in 2008. Dr. Shapiro has extensive health policy experience in Washington, D.C. as a senior manager of membership organizations, including the American College of Physicians.
James Michel
Director of Policy, Better Medicare Alliance; Former Senior Director, American Health Care Association Washington, DC (Moderator)
Director of Policy, Better Medicare Alliance; Former Senior Director, American Health Care Association Washington, DC (Moderator)
James Michel is the Director of Policy at Better Medicare Alliance and has almost 10 years in health care policy analysis and consulting. Prior to BMA, James was a Senior Director at the American Health Care Association, the nation’s largest trade association representing post-acute and long-term care providers, where he managed much of the association’s Medicare and health information technology policy analysis and research. Before that, he worked for Booz Allen Hamilton and the Advisory Board Company, two leading, DC-based health care consulting firms.
10:15 am
Break
10:40 am
Keynote Address: Member of Congress
Earl Blumenauer, JD (D/OR)
Member, US House of Representatives, Washington, DC
Member, US House of Representatives, Washington, DC
Congressman Earl Blumenauer (OR-3) has devoted his entire career to public service. He was elected to the Oregon Legislature in 1972, where he served three terms and Chaired the House Education and Revenue Committee. In 1978, he was elected to the Multnomah County Commission, where he served for eight years before being elected to the Portland City Council.
Elected to the US House of Representatives in 1996, Mr. Blumenauer has created a unique role as Congress’ chief spokesperson for Livable Communities. He has served on the Transportation and Infrastructure Committee, where he was a strong advocate for federal policies that address transportation alternatives, provide housing choices, support sustainable economies and improve the environment. He was a member of the Foreign Affairs Committee, and vice-chair of the Select Committee on Energy Independence and Global Warming. He is currently a member of the Ways and Means Committee and the subcommittees on Health, Oversight, and Tax Policy.
Elected to the US House of Representatives in 1996, Mr. Blumenauer has created a unique role as Congress’ chief spokesperson for Livable Communities. He has served on the Transportation and Infrastructure Committee, where he was a strong advocate for federal policies that address transportation alternatives, provide housing choices, support sustainable economies and improve the environment. He was a member of the Foreign Affairs Committee, and vice-chair of the Select Committee on Energy Independence and Global Warming. He is currently a member of the Ways and Means Committee and the subcommittees on Health, Oversight, and Tax Policy.
11:00 am
Beneficiary Education
Kelly Brantley
Vice President, Avalere Health; Former Senior Program Manager, Families USA, Washington, DC
Vice President, Avalere Health; Former Senior Program Manager, Families USA, Washington, DC
Kelly Brantley is Vice President of Avalere Health and works with biopharmaceutical companies, health insurance plans, and patient organizations to develop customer-specific solutions that predict and respond to the ever-changing health policy landscape. Kelly has supported a broad range of our customers since 2010. Prior to joining Avalere, Kelly worked closely with the State Health Insurance Assistance Programs (SHIPs) at the Health Assistance Partnership, a project of Families USA. Before Families USA, Kelly consulted for the ECRI Institute, where she analyzed online tools promoting quality health and healthcare.
Joel White
President, Council for Affordable Health Coverage; Former Staff Director of the Health Subcommittee, US House Committee on Ways and Means, Washington, DC
President, Council for Affordable Health Coverage; Former Staff Director of the Health Subcommittee, US House Committee on Ways and Means, Washington, DC
Joel White is the President of the Council for Affordable Health Coverage. Joel runs CAHC’s campaigns on health care transparency and medication adherence. Joel spent twelve years on Capitol Hill as professional staff, where he helped enact nine laws, including the 2002 Trade Act, which created health care tax credits, the 2003 law that established the Medicare prescription drug benefit and Health Savings Accounts, the 2005 Deficit Reduction Act and the 2006 Tax Reform and Health Care Act, which reformed Medicare payment policies. Joel spent six years as staff on the Committee on Ways and Means, first as Professional Staff and then as Staff Director of the Health Subcommittee. Joel is regularly cited as an expert on health, affordability, transparency, medication adherence and cost issues. He is on the Boards of Directors of Arlington Bridge Builders, CAHC, the Citizen and Soldier Foundation, the Newborn Foundation, and Samaritan Inns.
Adjoa Adofo, MS
Director of Communications, Better Medicare Alliance; Former Communications Director, Rep. Jan Schakowsky (D-IL), Washington, DC (Moderator)
Director of Communications, Better Medicare Alliance; Former Communications Director, Rep. Jan Schakowsky (D-IL), Washington, DC (Moderator)
Adjoa Adofo brings a decade of strategic communications and health public affairs experience, both on and off the Hill. She previously worked on Capitol Hill as Communications Director for Rep. Jan Schakowsky (D-IL), co-chair of the Congressional Task Force on Seniors and a member of the House Energy and Commerce Committee. In her role, Adofo managed communications and media relations strategies on issues such as Medicare, Medicaid and the Affordable Care Act. After Capitol Hill, Adofo ran health public affairs and media relations campaigns at Schmidt Public Affairs and IR Media LLC.
11:45 am
Flexibility and Social Determinants in Plan Design
Ellie Hollander
President and Chief Executive Officer, Meals on Wheels America; Former Executive Vice President and Chief People Officer, AARP, Arlington, VA
President and Chief Executive Officer, Meals on Wheels America; Former Executive Vice President and Chief People Officer, AARP, Arlington, VA
Ellie Hollander leads a nationwide network committed to assuring the health, safety and independence of America’s seniors. Her career spans both the forprofit and non-profit sectors, including Chief Strategy Officer and EVP, Business Development at Good360, and EVP and Chief People Officer and Interim Associate Executive Director of Membership at AARP. Ellie graduated from Duke with double-majors and later from its Fuqua School of Business’ Advanced Management Program. She is a 2016 Silver Stevie® Award Female Executive of the Year winner and was recently named a “Moneyball for Government Nonprofit All-Star” by Results for America for her commitment to evidence-based work.
Andrew Renda, MD, MPH
Director, Bold Goal (Population Health), Humana, Louisville, KY
Director, Bold Goal (Population Health), Humana, Louisville, KY
Dr. Andrew Renda is Humana’s Director, Bold Goal (Population Health). His work includes leading strategy, pilots, metrics, research, knoweldge management tools and communications related to making progress towards Humana’s Bold Goal of improving community health by 20% by 2020. CDC’s Healthy Days survey instrument is used as the primary means of assessing population health. This is supported by leading indicators, business performance metrics and a robust research agenda that drives insights on how best to improve community health. He is a published author and speaker in the fields of population health, social determinants of health and chronic disease.
Bill Roth
President, SCAN Health Plan, Former President, Individual and Small Business Markets, CIGNA HealthCare in Connecticut, Long Beach, CA
President, SCAN Health Plan, Former President, Individual and Small Business Markets, CIGNA HealthCare in Connecticut, Long Beach, CA
As President of SCAN Health Plan, Bill Roth oversees the organization’s operating and financial performance. Bill works closely with SCAN’s executive team to ensure the company is able to deliver on its mission now and in the future by maintaining a sustainable, positive margin, continued growth and long-term viability.
An accomplished healthcare executive, Bill has more than 20 years of managed care experience. Prior to joining SCAN in 2011, he served as president of individual and small business markets at CIGNA HealthCare in Connecticut where he led the company’s nationwide entry into the individual and small group markets. He also served as business leader when CIGNA acquired Great-West Healthcare. Prior to working at CIGNA, Bill served as a senior vice president at Aetna where he ran the company’s small group, individual, Medicare and Medicaid businesses. He has also held senior executive positions at Blue Cross of California and WellPoint.
An accomplished healthcare executive, Bill has more than 20 years of managed care experience. Prior to joining SCAN in 2011, he served as president of individual and small business markets at CIGNA HealthCare in Connecticut where he led the company’s nationwide entry into the individual and small group markets. He also served as business leader when CIGNA acquired Great-West Healthcare. Prior to working at CIGNA, Bill served as a senior vice president at Aetna where he ran the company’s small group, individual, Medicare and Medicaid businesses. He has also held senior executive positions at Blue Cross of California and WellPoint.
John Rother, JD
President and Chief Executive Officer, National Coalition on Health Care; Former Executive Vice President for Policy, Strategy, and International Affairs, AARP, Washington, DC (Moderator)
President and Chief Executive Officer, National Coalition on Health Care; Former Executive Vice President for Policy, Strategy, and International Affairs, AARP, Washington, DC (Moderator)
John Rother is President and CEO of the National Coalition on Health Care. Prior to joining the Coalition, Mr. Rother served as the longtime Executive Vice President for Policy, Strategy, and International Affairs at AARP. There he led the development of AARP’s policy positions and advocacy strategies. Under his leadership, AARP engaged in robust public policy research and analysis, public education, and advocacy on health and retirement issues at the federal, state and international levels. From 1981 to 1984, Mr. Rother was Staff Director and Chief Counsel for the U.S. Senate Special Committee on Aging under the direction of Chairman John Heinz (R-PA). He also served as Special Counsel for Labor and Health to U.S. Senator Jacob Javits (R-NY). He is a member of the DC Bar, the National Academy of Social Insurance, and the Gerontological Society of America. In 2010 Mr. Rother received the Robert Ball Award for Outstanding Achievements in Social Insurance.
12:30 pm
Adjournment