Monday, August 22nd 

[Full Slide Deck]


The Kickoff: What’s happening in payment reform?

  • Patrick Gordon, Associate Vice President (Rocky Mountain Health Plans)


Field Positions: A panel discussion on payment programs

  • Jessie Israel, System Director of Care Coordination in Population Health (SCL Health)
  • Sonja Madera, CPC+ Region Lead (Centers for Medicare & Medicaid Services Region VIII)
  • Barbara Martin, MSN-MPH, Interim SIM Office Director (Department of Health Care Policy & Financing)
  • Susan Mathieu, MPP, Manager Medicaid Accountable Care Collaborative (Department of Health Care Policy & Financing)
  • Dorien Rawlinson, Director of Mountain States Network (United Healthcare Group)


Play #1 - Community Integration in Action (Rocky PRIME at Mountain Family Health Centers)

  • Ross Brooks, Executive Director (Mountain Family Health Center)
  • Patrick Gordon, Associate Vice President (Rocky Mountain Health Plans)


Making Forward Progress Without Getting Flagged: Aligning payment incentives and penalties


It’s All About the Fans: Succeeding in payment reform with consumer engagement

 

Tuesday, August 23rd

[Full Slide Deck]
 

Return Kick: Innovations in care delivery

  • Holly Batal, MD,  Medical Director (Denver Health Medical Plan) 
  • Kevin Jenkins, Group Vice President of Ambulatory Care (Centura Health) 
  • Rebecca Rapport, MPH, Program Manager SIM Extension Service (Colorado Health Institute) 
  • Sarah Lampe, MPH, Program Director (Colorado Foundation for Public Health & Environment)


Play #2 -Community collaborative: Supporting Care Transitions through Nutrition (Project Angel Heart)

Huddle Up: The importance of strategic partnerships


MACRA, the new line of scrimmage

  • Dustin Allison, JD, Regional Innovation Lead (Centers for Medicare & Medicaid Services Region VIII)

Drive to the End Zone: Panel Discussion on putting it all together (no slides)

  • Jay Want, MD, Chief Medical Officer (Center for Improving Value in Health Care)
  • David Keller, MD, Children’s Hospital Colorado
  • Kyle Knierim, MD (University of Colorado Department of Family Medicine)
  • Michele Tusi, Regional Director of Strategic Development (Life Care Centers of America

 


Dustin Allison, JD, MBA

Centers for Medicare & Medicaid Services, Region VIII

After spending 3 years at CMS and the Innovation Center in Baltimore, Dustin returned home to the west last year to join the CMS Region VIII office (CO, MT, UT, WY, ND, and SD) and support and strengthen relationships between CMS Regional Offices, the CMS Innovation Center, and regional stakeholders. Dustin has earned graduate degrees in law and business and has gained expertise in Medicare and Medicaid health care transformation goals and activities, policy analysis, value-based payment models, performance measurement, and learning networks. In his prior life, he served as an Army Engineer Officer and Utah State Trooper. 

Holly Batal, MD, MBA

Denver Health Medical Plan

Holly is a board-certified Internal Medicine physician and is currently the Medical Director of Denver Health Medical Plan. Prior to taking this position, she was instrumental in helping to fund and develop the Department of Integrated Behavioral Health within Ambulatory Care Services at Denver Health, and served as the Director of General Internal Medicine at Denver Health overseeing five ambulatory clinics. Dr. Batal also served as the Principle Investigator for the three year $20 million service contract Denver Health received from the Centers for Medicare and Medicaid Services which concluded in 2015. As part of this project, she was one of the primary architects of the Intensive Outpatient Clinic. Dr. Batal is an Associate Professor of Medicine at the University of Colorado School of Medicine and also holds an MBA from the University of Colorado, Denver.

Ross Brooks

Mountain Family Health Centers

Ross has served as the Executive Director of Mountain Family Health Centers since 2012, after spending 10 years working with Community Health Centers in various roles at the Colorado Community Health Network.  Mountain Family’s mission is “to provide high quality, integrated primary, behavioral, and dental health care in the communities we serve, with special consideration for the medically-under served, regardless of ability to pay.” Ross oversees Mountain Family’s operations, finances, quality, and all healthcare services (including physical, medical, dental, and behavioral healthcare). He also serves on Colorado Health Services Corps Board, Colorado Community Health Network Board, Colorado Community Managed Care Network Board, and Community Health Association of Mountain/Plains States Board.


Dustin Dodson, MBA

Independent Consultant

Dustin Dodson is a 25+ year veteran of health care and has worked in a variety of settings across the health care continuum including acute care, post acute/nursing home care, and inpatient and outpatient based entities--he particularly enjoys working in underserved areas and has a great deal of experience working with Indian Health Services and rural areas.  Dustin has been an early champion of person centered care, payment reform, and the Triple Aim of healthcare. He is a contributing author to the Long Term Care Improvement Guide and the author of Pitfalls of the MDS: A Primer for Researchers, which has been chosen as a national issue paper by CMS. Project participation includes The Community Living Advisory Group, which is the State of Colorado’s plan for implementation of the Olmstead Act and the No Wrong Door implementation. Dustin currently has an active consulting practice including clients such as CMS, Truven Health Analytics, and Mission Analytics. He is an active board member of the Colorado Health Care Association.


David Ducharme, JD, MBA

Colorado Department of Health Care Policy and Financing

David manages the Program Innovation Section in the Health Program Office at the Colorado Department of Health Care Policy and Financing (HCPF). In this role he oversees the design and implementation of new and innovative programs that are rolled out in the Health First Colorado program (Colorado’s Medicaid Program). Prior to being the Program Innovation Section Manager David worked on payment reform efforts at HCPF. David has a Bachelor of Arts in Political Science and an MBA from the University of Colorado, Denver as well as a Juris Doctor degree from the University of Colorado Law School.


Patrick Gordon, MPA

Rocky Mountain Health Plans

Patrick is the Associate Vice President of Community Integration for Rocky Mountain Health Plans. Patrick is accountable for an array of payment reform, health data exchange and behavioral health services integration initiatives in Western Colorado. He also leads the implementation of the Medicaid Accountable Care Collaborative project in western and northern Colorado. Patrick provides oversight of the Medicaid, Full Benefit Medicare/Medicaid Eligibles, and CHP+ programs supported by the health plan, as well as the CMS Innovation Center’s Comprehensive Primary Care initiative. Patrick has led several strategic initiatives for RMHP’s stakeholders, including the Colorado Beacon community demonstration, the design and implementation of an aligned payment arrangement with the State of Colorado and physicians to achieve Triple Aim objectives. Further, he serves on the Colorado State Innovation Model (SIM) Practice Transformation and Multi-payer Collaborative work groups. Prior to joining RMHP, Patrick held various positions within the Colorado Department of Health Care Policy & Financing related to policy development and program management.


Jessie Israel, MSN

SCL Health

Jessie is the system Director of Care Coordination for SCL Health.  She leads population health initiatives as well as supports all alternate payment models. She is the business owner for the implementation of the Comprehensive Care for Joint Replacement, CJR.  SCL Health was up and running on April 1st with teams on the ground to support CJR.  First quarter results show a dramatic reduction in overall cost of care.  Jessie is currently building out-patient care management for the 9 hospitals and 190+ clinic, furthering the health systems ability to perform in fee for value environment.  She has extensive Care Management Leadership background, led a home care acquisition, has a Masters in Nursing, and spend more than six years as a healthcare lobbyist.  Jessie is a self-proclaimed healthcare nerd and feels there has never been a better time to be in healthcare!


Kevin Jenkins, MHA

Centura Health

Kevin serves as the Vice President Ambulatory Care for the Mountains and North Denver Operating Group (MNDOG) of Centura Health.  Kevin has been instrumental in the execution of MNDOG’s ambulatory strategy and the development of our neighborhood health centers (NHCs) which include primary care and subspecialty clinics, free standing emergency departments, and emergent and urgent care centers. During the last couple of years, Kevin has opened 16 new Neighborhood Health Centers and 7 Emergency and Urgent Care Facilities on behalf of MNDOG. Previous to Kevin’s current role, he served as VP of Administration at St. Anthony North Hospital Kevin earned is BS in Business Management from Brigham Young University Idaho and his MHA from the University of Washington. He is active in the American College of Healthcare Executives. 


David Keller, MD

University of Colorado Medical School

Colorado Children's Hospital

David is Professor and first Vice Chair for Clinical Affairs and Clinical Transformation of the Department of Pediatrics of the University of Colorado School of Medicine and Colorado Children’s Hospital, responsible for leading initiatives to improve practice efficiency and effectiveness, developing the capacity of the faculty to provide high-quality care in a population health environment, and developing innovative collaborations to improve the health of children in a rapidly changing health care system.  He currently serves as co-Chair of the Health Impact on Lives Subcommittee of the Program Improvement Advisory Committee of the Colorado Accountable Care Collaborative, co-Chair of the Health Information Technology Workgroup for the implementation of the Colorado State Innovation Model (SIM) Award, and was recently appointed to the Standing Committee on Pediatric Measures of the National Quality Forum. 

Prior to moving to Colorado, Dr. Keller spent 22 years on the faculty of the University of Massachusetts School of Medicine, where he practiced primary care pediatrics, initiated novel community-based programs with a variety of collaborators and served as an Associate Medical Director for Medicaid in Massachusetts.  He was a Robert Wood Johnson Foundation Health Policy Fellow in the office of the Assistant Secretary for Planning and Evaluation at HHS from 2009-10.   He was President of the Academic Pediatric Association from 2013-4, and currently serves at Chair of the Board of the Federation of Pediatric Organizations. 


Kyle Knierim, MD

University of Colorado Department of Family Medicine

Kyle is a board certified Family Medicine physician and Assistant Professor at the University of Colorado Department of Family Medicine, where he also completed fellowship training in Primary Care Practice Transformation. He cares for patients and trains students and residents at AF Williams Family Medicine Clinic in Denver, CO. In addition to clinical care, he is the Associate Director of Practice Transformation and oversee the clinical informatics support for primary care and specialist practices through several state and regional practice transformation projects including Colorado's State Innovation Model (SIM) and Transforming Clinical Practice Initiative both funded by CMMI, and the AHRQ-funded Evidence Now Southwest Cooperative. He serves on the core leadership team of several state and national committees including the including the Colorado Health Extension System, SIM HIT workgroup, and the PCPCC Collaborative of the Collaboratives. Dr. Knierim consults for other practice transformation organizations and speaks at regional, national and international conferences on topics related to using data to guide population health, behavioral health integration, care management, and patient engagement.


Sarah Lampe, MPH

Colorado Foundation for Public Health & the Environment

Sarah is the Program Director and the Colorado Foundation for Public Health and the Environment. Prior to joining CFPHE, Sarah served as the Project Manager with the Colorado Association of Local Public Health Officials (CALPHO), where she managed research projects related to Public Health Services and Systems Research. She has also done evaluation and project management for the Public Health Alliance of Colorado. Sarah has her Master’s in Public Health from the Colorado School of Public Health with an emphasis in Community and Behavioral Health and her undergraduate degrees in psychology and biology from Saint Louis University.


Sonja Madera, MS

Centers for Medicare & Medicaid Services Region VIII

Sonja joined the Centers for Medicare and Medicaid Services last September.  She began a career in global health at the National Institutes of Health and subsequently completed several assignments at US Embassy Nairobi with the President’s Emergency Plan for AIDS Relief. In 2012, she moved back to Colorado full-time.  Sonja joined Colorado’s Medicaid agency, coordinating the adult Medicaid expansion under the Affordable Care Act (ACA), and then transitioned to the Department of Veterans Affairs to support nationwide surgical quality improvement programs. Now at CMS, she partners with practices, payers, and stakeholders on programs that combine payment innovation, quality improvement, and population health under the ACA. 


Barbara Martin, RN, MSN, ACNP-BC, MPH

State Innovation Model Office

Barbara is a nurse practitioner with over 15 years of clinical and leadership experience in health care delivery, care coordination, and working across complex systems of care.  Barbara has been engaged with the Colorado SIM initiative since 2013 when she initially served on the core SIM team during the grant planning process. More recently, she led state efforts to implement population health strategies in support of the SIM initiative during her tenure as Director of the Health Systems Unit at the Colorado Department of Public Health and Environment. Ms. Martin joined the Colorado SIM Office in 2015, as the Director of the Transforming Clinical Practices initiative (TCPi), to lead state-wide efforts to build a program that will support clinicians and practices to ensure a successful transition into new care delivery and payment models that will achieve our goal of making Colorado the healthiest state while providing crucial support to our vital health care workforce. In March, 2016, Barbara stepped in as the interim SIM office director. 


Susan Mathieu, MPP

Colorado Department of Health Care Policy and Financing

Susan has more than 17 years of experience in health care policy and program development. Currently, she is the Manager of the Medicaid Accountable Care Collaborative program at the Colorado Department of Health Care Policy and Financing. In this role, Susan leads the development and growth of one of Colorado’s central health care reform initiatives, designed to promote coordinated care and good health outcomes while controlling health care costs. Susan works extensively with stakeholders to ensure that the program works for those covered by Medicaid, their providers and the state of Colorado. Susan holds a Master of Public Policy with a focus in health policy from Georgetown University, and a bachelor’s degree from Middlebury College. Susan and her family live in Denver. 


Drew Moldane

CirrusMD

Drew is Vice President of Strategy at CirrusMD. He brings over 10 years of experience in strategy, operations, finance and sales, and focuses on driving value in various company initiatives and goals. Before joining CirrusMD, Drew worked in mergers and acquisitions at Zayo Group and played a key role in the company’s international expansion and integration leading up to its IPO. 


Erin Pulling, MNM

Project Angel Heart

Master of Nonprofit Management, Regis University 1999.  Graduate, Denver Community Leadership Forum (1999) and Leadership Denver (2012). Past-president of Community Shares of Colorado and the Dining Out for Life International Association. Current board member of Dining Out for Life International Association and Colorado Nonprofit Association. Former board member of Association of Nutrition Service Agencies. Named 2010 Livingston Fellow via the Bonfils-Stanton Foundation, 2012 Outstanding Professional by the Colorado Restaurant Association and a Forty Under 40 awardee by the Denver Business Journal in 2008. Employed at Project Angel Heart since 1995. President & CEO of Project Angel Heart since 2004.


Rachael Raab, MPA

Project Angel Heart

Former Program Coordinator for the New Venture Fund and the Sixteen Thirty Fund. Current Co-Chair of the Food Is Medicine Coalition’s Research Committee, member of the Colorado Prevention Alliance’s Food Insecurity Task Force. Holds her Master’s in Public Administration with a Concentration in Nonprofit Management from the University of Colorado, Denver 2013. Employed at Project Angel Heart since 2013, Director of Strategic Partnerships since 2016.
 


Rebecca Rapport, MPH

Colorado Health Institute

Rebecca joined the Colorado Health Institute in 2016 as a Program Manager for the State Innovation Model (SIM) Extension Service, supporting Regional Health Connectors and their host organizations throughout Colorado, as well as program development, training and stakeholder engagement activities. Previously, Rebecca worked with Colorado Foundation for Public Health and the Environment (CFPHE) as the Program Manager for Community Engagement. In this role, she provided technical assistance for community-academic partnerships developing health research questions. She also coordinated contract monitoring, communications, and program development. Rebecca holds a master’s degree in public health from the University of Illinois Chicago. 


Dorien Rawlinson

UnitedHealth Care

Dorien is the Director of Mountain States Network Management at UnitedHealth Care, where she oversees managed care contracting in Colorado and Wyoming, and the Regional network lead for the Colorado SIM Grant, CPC and CPC+.  Prior to this role, Dorien worked for UnitedHealth Military & Veterans Services (UMVS) establishing the Central Region provider network following UMVS’s successful bid for the TRICARE West Region Managed Care Support Contract servicing 2.9 million TRICARE beneficiaries in 21 states. She has extensive background in healthcare policy, administration, and regulatory compliance gained from her time spent and the Grants and Finance Manager for the Department of Orthopedics at the University of Colorado Denver, Director of Provider Administration with Rocky Mountain Health Management Corporation, and Health Policy and Research Analyst with the State of Colorado’s Division of Insurance. She has served on the Board of Directors for the Women’s Foundation of Colorado and the Colorado Women’s Foundation in Health Administration.


Kevin Riddleberger, PA, MBA

DispatchHealth

Kevin is Chief Strategy Officer at DispatchHealth. He brings over 15 years of experience in the healthcare industry as a clinician and in management. Prior to DispatchHealth he was the head of clinical solutions and strategy at an industry leading consumer mobile health app company called iTriage. Kevin has been a board certified physician assistant for over a decade. Over the years Kevin has served as a clinical preceptor for area physician assistant students, served on numerous boards and committees including; quality improvement committees, EMR deployment committees as a provider “champion”, president of the Colorado Academy of Physician Assistants and currently a board trustee at 9HealthFair. He is an active advisor in the healthcare industry start-up community locally in Colorado providing both business and clinical expertise. Kevin has received a MBA with a concentration in healthcare administration from the University of Colorado at Denver, a master of science degree from the Rosalind Franklin University of Medicine and Science in Chicago, IL and his undergraduate degree from the State University of New York at Plattsburgh.


Margaret Sabin

Penrose-St. Francis Health Services

Margaret has served as the President and CEO of Penrose-St. Francis Health Services since 2008. She oversees the daily operations of the 522-bed system which includes Penrose Hospital, St. Francis Medical Center, and three urgent care facilities. In 2009 she was also named president of Centura’s South State Operating Group, overseeing operations at all Centura hospitals in southern Colorado. She currently serves as chair of Centura’s Trauma Council, leading the first integrated health care network nationally to establish a trauma system linked to its own facilities and services with 20 facilities and a variety of essential services.  Prior to joining Centura, Margaret was the CEO of Sutter Health Partners and Vice President of New Product Development in Sacramento, CA.


Linda Sample

Citizens for Patient Safety

Linda is the Vice President at Citizens for Patient Safety and has over 25 years of experience in health care working with diverse stakeholders spanning the continuum of care delivery. Throughout her career she has developed and led numerous cross-functional teams to standardize and optimize corporate-wide processes and training programs. In addition, she recently led the Corporate Quality & Strategic Initiatives team at the Colorado Foundation for Medical Care, providing oversight over the development and implementation of the organization’s Quality Improvement Plan and comprehensive quality management system. In addition to quality and process improvement, Linda has extensive experience designing curriculum, training and coaching. She is also very passionate about being part of the solution and engaging and empowering patients and families to manage their own health having lost her father to untreated mental illness.


Patty Skolnik

Citizens for Patient Safety

Patty is the President and CEO,  and founded Citizens for Patient Safety to reduce medical harm and promote engagement. She lost her only son Michael to poor communication and medical error. Taught by harrowing real-life experience, Patty has become a patient safety expert and an advocate for shared decision-making, informed consent and improving patient/provider relationships in healthcare. Patty travels worldwide to educate consumers, train medical professionals, and advise lawmakers about fostering relationships, systems and environments based on shared decision-making and transparency. She is the proud recipient of the National MITSS HOPE Award, the Colorado Patient Safety Coalition Patient Safety Leadership Award, the Transparent Health Leadership Award and The Colorado Trial Lawyers Consumer Protection Award in honor of her son. 

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Michele Tusi, MS

Life Care Centers of America

Michele Tusi has worked for Life Care Centers of America since 2010 as the Regional Director of Strategic Development. She oversees business development and strategic growth for 11 Denver metro post-acute facilities as well as a robust Clinical Liaison program. Graduating from Northeastern University in 1991 with a Masters of Science, Michele started her career in the acute setting as Wellness Director for Cleveland Clinic Hospital in Fort Lauderdale, FL. Her career in post-acute started in 2002 over-seeing the business development activities for 5 SNFs and 2 ALFs for a small privately held company in Wilton Manors, FL. In 2004 Michele moved to Colorado to work for Vivage, formerly know as Pinon Management where she held a Regional Business Development position for two years before moving onto Sava Senior Care in the same role.  After a short stint as a Clinical Liaison at Colorado Acute Hospital, she landed her dream job with Life Care Centers of America. Michele brings a strong passion for partnerships and care coordination to her position at Life Care and chairs many care transitions committees in the area.

 


Jay Want, MD

Center for Improving Value in Health Care

Want Healthcare, LLC

Jay is Chief Medical Officer at the Center for Improving Value in Health Care (CIVHC) as well as the owner and principle of Want Healthcare, LLC. At CIVHC he is responsible for engaging providers and contributing to CIVHC's overall strategic direction to support achieving the Triple Aim. Want served as founding chairman of the board for CIVHC until early 2012. For 8 years he was President and CEO of Physician Health Partners, LLC. He currently serves on the board of the non-profit Rocky Mountain Health Plan, and was appointed as one of the initial Innovation Advisors to CMS in January 2012. Jay has served on task forces for the Colorado Division of Insurance, The Colorado Trust, the Colorado Hospital Association, and the Governor’s Blue Ribbon Commission on Health Care Reform. He also served as chairman of the Northwest Denver Care Transitions Steering Committee, a program that successfully lowered hospital readmissions by 10%. He is a board-certified internal medicine physician trained at University of Colorado Health Sciences Center and practiced primary care for ten years.


Donna Weimer, M.A. LNHA

Collaborative Consulting

Donna is the President of Collaborative Consulting. She has worked in healthcare for over 30 years, beginning her career as a licensed nursing home administrator. She has held positions in large for-profit organizations as Regional Director of Operations, Chief Operating Officer, and Vice President of Business Development for HCR Manor Care and Extendicare. Donna has also contracted and continues to consult to post-acute organizations across the United States. She is passionate and committed to leading change and finding solutions in healthcare for health populations. These solutions include strategic business development, revenue and payment strategies, quality care and cost efficacy.  Prior to her current position, Donna served as Vice President of Business and Strategic Development for Mid-Atlantic Health Care in Baltimore, Maryland. She holds a Masters in Gerontology and a certificate in Executive Coaching.