Innovation Challenges: Demonstrating Medtech s Value in a Changing Payer World

Transcription

1 AdvaMed s Payment Policy Conference 2016 Innovation Challenges: Demonstrating Medtech s Value in a Changing Payer World April 6 & 7, 2016 Westin Crystal City 1800 Jefferson Davis Highway, Arlington, VA Wireless Internet Information: Network Name: WESTIN-MEETIING Network Passcode: PSAV1653 Keynote Speakers Sean Cavanaugh Deputy Administrator & Director Centers for Medicare & Medicaid Services Carmela Coyle President & CEO Maryland Hospital Association Ateev Mehrotra, MD Associate Professor of Health Care Policy and Medicine Harvard Medical School

2 Wednesday, April 6, :00 AM Registration & Networking Breakfast Provided 8:30 AM Welcome Session: Scott Whitaker, President and CEO, AdvaMed & Don May, Executive Vice President, AdvaMed Keynote: Payment Reform Priorities for CMS & the Role of Innovation Sean Cavanaugh, Deputy Administrator and Director, CMS 9:45 AM Demonstrating Value in a Changing Payer World 11:00 AM Break New payment and care delivery models are driving hospitals, physicians, and payers to think differently about care and focus on value. This has led to increased focus on healthcare cost and quality. Providers are looking for ways to improve quality and outcomes, while at the same time, reduce costs. But how does new medical technology fit into this new value based world and how do we define the value of medtech? Mary Cummins, Principal at Deloitte Consulting will lead this panel on the value of medtech and the case medical technology companies are making to show value in today s health system. Moderator: Mary Cummins, Life Sciences and Health Care Principal, Deloitte Dwight Denham, Vice President of Global Health Economics and Reimbursement, Danaher Corporation Jenny Gaffney, Senior Program Manager Economic Value, Medtronic Ed Pezalla MD, National Medical Director Pharmacy Policy and Strategy, Aetna 11:15 AM New Directions for Quality Measurement post SGR The annual race to stop doctor payment cuts under Medicare s old sustainable growth rate system has been replaced by a new race to implement the Medicare Incentive Payment System. Hear about CMS plans to implement the new quality-based payment systems for physicians and alternative payment models and how stakeholders are engaging to shape and respond to the new world of physician payment. Moderator: Tom Valuck, Partner, Discern Health Kathleen Blake MD, Vice President of Healthcare Quality, American Medical Association/PCPI Jason Goldwater, Senior Director, National Quality Forum Marjorie Kanof, Principal, Health Policy Alternatives 12:30 PM Keynote Lunch: How Hospitals are Managing Under Maryland s Global Payment Model Carmela Coyle, President and CEO, Maryland Hospital Association 1:45 PM Innovative Contracting Ideas & Risk Reimbursement Hospitals; physicians; post-acute providers health plans; Medicare; Medicaid agencies: They are all finding ways to share risk and innovate the reimbursement models to incentive high performance, lower costs, and share savings. Medical technology companies are starting to look for new ways to partner with their customers to improve patient care while at the same time winning coverage and payment for innovative technologies and treatments sooner than traditional paths currently allow. Hear about new risk-based payment models and how legal impediments are limiting medtech s options for innovating contracting with customers. Moderator: Chris White, Senior Executive Vice President of General Counsel, AdvaMed Elizabeth Carder-Thompson, Partner Life Sciences Health Industry Group, Reed Smith Kathleen Dunst, Senior Counsel, Bayer Healthcare advamed.org/ppc AdvaMed s Payment Policy Conference

3 Wednesday, April 6, 2016 (continued) 3:00 PM Break 3:15 PM Managing Healthcare Spending and Cost: From Fee-for-Service to ACOs & Beyond Accountable care organizations and other capitation and global payment models are fundamentally shifting the incentives for health care providers, encouraging population management and greater coordination among providers in order to reduce cost growth and improve care outcomes. This session will explore how these changes affect medtech and patient access to innovative treatment. Moderator: Al Dobson, President, Dobson Davanzo Health Care Consulting Tom Lubotsky, Vice President Supply Chain and Clinical Resource Management, Advocate Health Care Deborah O Connor MD, Vice President of Clinical Effectiveness, Advocate Health Care 5:00 PM Reception Thursday, April 7, :30 AM Networking Breakfast Provided 8:45 AM Breakfast: Washington s Health Care Policy Makers 9:45 AM Break Moderator: Duane Wright, Vice President Government Affairs, AdvaMed Brett Baker, Senate Finance Committee Jennifer Young, Partner, Tarplin, Downs & Young, LLC 10:00 AM Bundling Policy & Practice Both Medicare and private payers are moving aggressively forward with bundle payment models that aim to reduce costs and improve care outcomes across an episode of care that would encompass services across a number of different settings. This session will review the scope of activity in this area and the structure of key programs in the public and private sectors talk about how these programs are working, key policy concerns, and how technologies are impacted. Hear how data and policy-steeped organizations are helping providers manage these bundles and understand their costs, care patterns, and performance. Moderator: Yvonne Bokelman, Vice President Global Market Access, Zimmer Biomet Amy Bassano, Deputy Director, Center for Medicare and Medicaid Innovation, CMS Spencer Carucciu, Director of Episode Analytics, Remedy Partners Caroline Steinberg, Vice President Trends Analysis, American Hospital Association Jessica Walradt, Senior Payment Reform Specialist, Association of American Medical Colleges 12:00 PM Keynote Lunch: Opportunities & Challenges for Disruptive Technology in Health Care Delivery Ateev Mehrotra MD, Associate Professor of Health Care Policy, Harvard Medical School advamed.org/ppc AdvaMed s Payment Policy Conference

4 Thursday, April 7, 2016 (continued) 1:15 PM Telehealth & Digital Health: How Patient Care is Streaming Telehealth, remote monitoring, and mobile applications are changing the way care is provided, allowing better integration of care across all health settings, providing patient-generated data from inside the hospital and home, empowering patients, and shifting care from hospitals and the physician s office to the home. While more and more private payers are finding innovative ways to use these services, Medicare beneficiaries are being left behind. This session will highlight the new advances and policy approaches to expand access to telehealth and remote monitoring services. Moderator: Laurel Sweeney, Senior Director, Health Economics and Market Access, Philips Mario Gutierrez, Executive Director, Center for Connected Health Policy Kristi Henderson, Vice President, Virtual Care & Innovation for Seton Healthcare Family Ateev Mehrotra MD, Associate Professor of Health Care Policy and Medicine, Harvard Medical School John Peters, Acting Deputy Chief Consultant, Office of Connected Care, Department of Veterans Affairs 2:30 PM The Power of Data: What Providers, Plans, & Payers are Doing to Improve Care Outcomes BIG DATA. Will it be the game changer for healthcare? And what will it mean for medical technologies? This session will highlight how new data initiatives are identifying new cures and treatments and changing the way we think about healthcare innovation. Moderator: Don May, Executive Vice President, AdvaMed Nilay Shah MD, Associate Professor of Health Services Research, Mayo Clinic 4:00 Final Thoughts: Don May, Executive Vice President, AdvaMed advamed.org/ppc AdvaMed s Payment Policy Conference

5 A special thank you to all of our speakers, sponsors, and participants! advamed.org/ppc AdvaMed s Payment Policy Conference

6 Speaker Bios Brett Baker is currently a member of the U.S. Senate Finance Committee. He previously was a member of the Republican staff for the Committee on Ways and Means Subcommittee on Health. His focus at Ways and Means was on Medicare Part B, including the systems for making payments to physicians, hospital outpatient departments, ambulatory surgical centers, and dialysis facilities. His portfolio includes delivery models that aim to improve quality and reduce costs, and health information technology (IT) issues. Mr. Baker joined the Subcommittee on Health staff in 2011 after a long tenure with the American College of Physicians where he advocated for internists on payment issues and delivery system reform. Amy Bassano is the Deputy Director of the Center for Medicare and Medicaid Innovation (CMMI) at the Centers for Medicare and Medicaid Services. Prior to assuming this position in April 2016, Ms. Bassano was the Director of the Patient Care Models Group at CMMI leading CMS s efforts on bundled payments including the Bundled Payments for Care Improvement (BPCI) Initiative and the Comprehensive Care for Joint Replacement (CJR) model and the development of physician specialty models such as the Oncology Care Model. In addition, she was responsible for the Home Health Value Based Purchasing Model and the Medicare Care Choices Model. Ms. Bassano also held senior management positions in the Center for Medicare at CMS overseeing Medicare payment policy for a variety of areas including inpatient and outpatient hospitals, physicians, ambulatory surgical centers, clinical laboratories, and Part B drugs. Prior to her tenure at CMS, Ms. Bassano was a Program Examiner at the Office of Management and Budget where she was the lead Medicare analyst on Medicare Part B and D issues. Ms. Bassano has an M.A. in Policy Studies from Johns Hopkins University and a B.A. in history from Tufts University. Kathleen Blake, MD, MPH, is Vice President, Healthcare Quality at the American Medical Association and Executive Director of the PCPI which includes among its activities the National Quality Registry Network (NQRN ). Dr. Blake is responsible for ensuring the successful execution of all components of the PCPI strategic direction and the integrity of its measure portfolio. She is CoChair of the HIT Policy Committee of the Office of the National Coordinator for Health Information Technology and serves as co-chair of its Quality Measures Task Force. She is also a member of the FDA-sponsored National Medical Device Postmarket Surveillance Planning Board and the Medical Device Epidemiology Network Council. She has previously represented the Heart Rhythm Society (HRS) in the AMA House of Delegates and the PCPI and on the PCPI Work Group on congestive heart failure performance measures. As chair of the HRS Health Policy Committee, she led a team of physician volunteers and staff to address policy issues at the federal level and was a Founding CoChair of the Society s Measure Development Task Force. Prior to coming to AMA, Dr. Blake was Senior Research Director at the Center for Medical Technology in Baltimore, Maryland, overseeing 2 Public-Private Partnerships, Policy and Education and serving as advisor to two national clinical registries. Dr. Blake is a clinical cardiac electrophysiologist who received her medical degree from the University of Chicago, followed by post-doctoral training in internal medicine and cardiovascular diseases at Stanford University. From 1988 until 2011, Dr. Blake practiced at the New Mexico Heart Institute, where she also served as President. In 2011, she earned a Master of Public Health degree from the Johns Hopkins Bloomberg School of Public Health. Yvonne Bokelman, MBA, FACHE is the Vice President, Global Market Access, Health Economics & Reimbursement for Zimmer, Inc. As the executive leader for this function, she and her team are accountable for all global market access functions, including health economics, health policy, payer strategies, coding and reimbursement, customer and sales support. She oversees the development of strategies and programs to ensure appropriate reimbursement, minimize economic barriers to therapies, and gain timely patient access to new and existing Zimmer technologies. advamed.org/ppc AdvaMed s Payment Policy Conference

7 Yvonne is active in a number of industry groups, and speaks nationally on topics related to market access and reimbursement. Yvonne s background includes thirteen years in hospital administration, and executive positions in healthcare consulting and healthcare IT companies. She has a unique background and leadership experience that combines medical device, hospitals, consulting, and healthcare information technology firms. The last ten years she has held leadership positions in the healthcare economic strategies/market access departments, working previously for Medtronic Spine & Biologics, before coming to Zimmer. Yvonne has her Bachelors of Science degree in Business Administration, as well as an MBA. Elizabeth Carder-Thompson is a member of the Life Sciences Health Industry Group, practicing in the area of health care regulatory law. She represents associations and individual providers and suppliers of health services, including manufacturers of drugs and devices; providers such as hospitals, hospices, nursing homes, physicians, and home health agencies; and suppliers of DMEPOS, diagnostic, laboratory, and other items and services. Elizabeth also provides regulatory, due diligence, and transactional assistance to financial services firms that support the health care industry. Her specific areas of responsibility include coverage and reimbursement, fraud and abuse matters, and regulatory, legislative, and enforcement issues, primarily involving Medicare, Medicaid, and third-party payors. For example, in the regulatory area, Elizabeth has assisted clients in obtaining Medicare and Medicaid coverage of new items and services; negotiated with the Centers for Medicare & Medicaid Services to rescind or modify coverage guidelines affecting reimbursement of services and equipment; obtained revisions to manual requirements governing reimbursement for therapeutic and diagnostic services; and served as health care regulatory counsel for a variety of public offering and financing transactions. In the area of fraud and abuse, Elizabeth provides counseling, transactional advice, and audit and enforcement representation. She has represented clients under investigation by the Office of Inspector General, the Department of Justice, and other investigatory bodies, including handling qui tam or whistleblower actions under the False Claims Act. She counsels clients on potential fraud and abuse aspects of promotional initiatives, mergers and acquisitions, joint ventures, contracts and other business arrangements by and between providers, manufacturers, and other entities. She has assisted many clients in developing and evaluating corporate compliance programs. Spencer Carrucciu is Director of Episode Analytics with Remedy Partners. Remedy Partners builds software to manage episodes of care. Mr. Carrucciu was formerly Senior Project Manager at Montefiore Medical Center and an Analyst, Outcomes Research with the Greater New York Hospital Association. His education includes New York University, Wagner School of Public Service, with an MPA in Health Policy and Management, Public Finance and also New York University - Leonard N. Stern School of Business with a BS in Finance and Statistics. Sean Cavanaugh is the Deputy Administrator and Director of the Center for Medicare at the Centers for Medicare & Medicaid Services. He is responsible for overseeing the regulation and payment of Medicare fee-for service providers, privately-administered Medicare health plans, and the Medicare prescription drug program. Medicare provides health coverage to 50 million elderly and disabled 3 Americans, with an annual budget of over $550 billion. Prior to assuming his current role, Sean was the Deputy Director for Programs and Policy in the Center for Medicare and Medicaid Innovation. In that capacity, he was responsible for overseeing the development and testing of new payment and service delivery models, including accountable care organizations and medical homes. Previously, Mr. Cavanaugh was director of health care finance at the United Hospital Fund in New York City. He has also served in senior positions at Lutheran Healthcare (Brooklyn, NY), the New York City Mayor s Office of Health Insurance Access, and the Maryland Health Services Cost Review Commission. He started his career on Capitol Hill working for a member of the Ways and Means Health Subcommittee. He attended the University of Pennsylvania and the Johns Hopkins School of Hygiene and Public Health. advamed.org/ppc AdvaMed s Payment Policy Conference

8 Carmela Coyle is President and CEO of the Maryland Hospital Association (MHA), the advocate for Maryland s hospitals, health systems, and the communities and patients they serve. She played a leading role in the effort to rethink the future of hospital payment in Maryland by preserving and modernizing the state s unique Medicare waiver, which allows the state to set the rates hospitals can charge. In 2015 she was elected to a three-year term on the Board of Trustees of the American Hospital Association (AHA). She also serves on the boards of the Maryland Patient Safety Center, the Maryland Healthcare Education Institute, the Living Legacy Foundation, Wellness House of Annapolis, and the Caring Bridge Consumer Advisory Group. Prior to joining MHA she spent 20 years with AHA where, as a member of the executive management team, she led the development of AHA s policy positions. She also managed AHA's team responsible for the analysis of legislation and regulation, policy issues, data collection, and trend analysis. She served as a national media spokesperson for AHA and represented the organization in various health care and other forums. Before joining AHA, Coyle spent six years as an analyst for the Congressional Budget Office in Washington, D.C. Mary Cummins is a Principal at Deloitte for Life Sciences and Health Care Strategy, and is the lead for Life Sciences in the fast-growing Value Based Care practice. She is currently leading multiple valued-based care cross-sector initiatives with clients including working with AdvaMed on our 2016 Value Framework initiative. Mary collaborates with Deloitte s Center for Health Solutions to publish new insights on the changing nature of innovation as care funding and delivery shifts from volume to a value basis, and is also a frequent speaker at industry conferences and events. Mary has a track record over more than 20 years of delivering growth and improved profitability for a broad portfolio of clients in Life Sciences as well as providers and payers. Mary works with client teams to redefine strategy and achieve operational transformation in the changing health care ecosytem. Her work has included corporate and business-unit growth strategies, M&A, and operating model redesign. Prior to joining Deloitte Mary was a Partner at the Boston Consulting Group and also served on the board of the Visiting Nurse Service of New York, the largest nonprofit home health agency in the US. Mary received her MBA with a major in Finance from the Wharton School, and previously earned her MA with Honors from Cambridge University in Electrical Engineering. Dwight Denham is VP, Global Health Economics & Reimbursement with Danaher Corp. He leads the Danaher Diagnostics & Life Sciences Global Health Economics & Reimbursement Team. His group supports multiple operating companies under the Danaher Diagnostics and Life Sciences segment in their early global market access planning and implementation. A frequent speaker on the value of Clinical Lab Diagnostics, Mr. Denham and his group, are active in healthcare payment policy surveillance, influence, and interpretation. Mr. Denham has previously lead teams for clinical research focused on registration and pre-market commercialization studies, health policy teams focused on evidence development for medical decision making. He also has global product management and marketing experience introducing new products to multiple stakeholders in both commercial and government sectors. Allen Dobson, PhD, is a health economist and President of Dobson DaVanzo. Before he cofounded the firm, Dr. Dobson spent eighteen years with The Lewin Group where he was Senior Vice President and directed the Health Care Finance Group. In this position, Dr. Dobson led numerous 4 large scale studies for both Federal and private sector clients. Prior to work at The Lewin Group, Dr. Dobson served as Director in the Office of Research at CMS (then the Health Care Financing Administration) when the Medicare Inpatient Prospective Payment System (PPS) was being developed and implemented. Dr. Dobson has studied Medicare s various PPSs (e.g., acute care hospitals, long term care hospitals, skilled nursing facilities, inpatient rehabilitation facilities, home health agencies, and ambulatory surgery centers) for over twenty-five years and has directed numerous efforts to model the impact of Medicare and Medicaid payment policies on health care providers using a variety of statistical and econometric methodologies. He also worked for 10 years for CMS advising on the methodology for determining physician practice expenses, and most recently on Medicare Disproportionate Share Hospital (DSH) policy. Currently, at Dobson DaVanzo, Dr. advamed.org/ppc AdvaMed s Payment Policy Conference

9 Dobson co-leads the firm s bundled payment research activities, which supported the American Hospital Association and the Association of American Medical Colleges in policy development and is currently supporting numerous providers, other entities, and conveners in their implementation of the CMS Bundled Payment for Care Improvement (BPCI) Initiative. Dr. Dobson has also directed numerous private sector study efforts using linked CMS research identifiable data under DUAs with CMS. The findings of many of these studies have been reported to CMS, MedPAC, and various Congressional committees. Dr. Dobson was selected as one of the nation's most influential health care policy leaders by Faulkner and Gray, when included in their first edition of "The Health Care 500." Dr. Dobson is a frequent speaker at conferences and has testified before the U.S. Congress, MedPAC, and various state, federal, and presidential commissions on health care finance, provider payment, and health policy issues. Over the years, he has testified before Pennsylvania, Illinois, Mississippi, Maine, and Nevada state legislatures and commissions on a variety of health care finance issues. He has published his work widely, including in the New England Journal of Medicine, Journal of the American Medical Association, Inquiry, Journal of Managed Care, Health Affairs, and Health Care Financing Review. Dr. Dobson is a Phi Beta Kappa graduate from the University of Washington in Seattle, and earned his Ph.D. in economics from Washington University in St. Louis, Missouri. Kathleen Dunst is Senior Counsel for Bayer Healthcare. She previously was counsel for McNees Wallace & Nurick LLC and an attorney with Buchanan Ingersoll & Rooney PC. Her education includes John Carroll University and the University of Pittsburgh School of Law. Jenny Gaffney is a Senior Health Policy Manager in Medtronic s Health Economics, Policy and Payment group within Medtronic s Cardiovascular division. Jenny works across the portfolio to ensure Medtronic s therapies and services deliver economic value and benefits for customers in addition to clinical outcomes in the U.S. and abroad. Her responsibilities include generating economic data on Medtronic s therapies and services and developing innovative business models in which Medtronic shares direct accountability with health systems for the impact of our products on system costs and patient outcomes. Before joining Medtronic, Jenny was a Director at Avalere Health, a healthcare consulting company based in Washington DC. In her eight years at Avalere, Jenny worked with drug and devices manufacturers, including Medtronic to: (1) ensure the evidence generated for new therapies addressed the varying demands of payers, providers, and health technology assessment organizations; (2) tailor product value propositions to resonate with key decision-makers; and (3) understand and stay ahead of the transition to pay for value in the United States. Jenny received her B.A. from Harvard University in Government with minors in Economics and Health Policy. Jason C. Goldwater is currently a Senior Director at the National Quality Forum, where he oversees activities related to the evaluation of electronic clinical quality measures (ecqms) as well as projects focused on the use of electronic health to improve the quality, safety and efficiency of health care. Mr. Goldwater has been in the field of health information technology (health IT) for 16 years and has led a number of projects on the utilization of health IT for improved health care delivery. Prior to working at the NQF, Mr. Goldwater was a Senior Vice President for Clinovations Government Solutions, where he led projects in developing a health IT strategic plan for DC Government, and governance and business models for a public health data platform for the Association of State and 5 Territorial Health Officials (ASTHO). Mr. Goldwater has also served as a Health IT Project Manager for NORC at the University of Chicago, where he served as the Principal Investigator for a number of projects, including an evaluation of the Strategic Health Advanced Research Projects (SHARP) program and a Study and Report on the Use of Open- Source Health information Technologies for Safety-Net Populations. Mr. Goldwater also worked for SRA International, a systems integrator based in Fairfax, VA, where he led a project to examine the use of clinical decision support systems within the Veterans Information Systems and Technology Architecture (VisTA) EHR system. Mr. Goldwater also spent a decade with the Federal Government, design software applications to assess the quality of advamed.org/ppc AdvaMed s Payment Policy Conference

10 care for older adults in nursing homes and hospitals; examining how State Medicaid data could be used for public health; and how to incorporate public health initiatives, such as immunizations, into State Medicaid programs. Mr. Goldwater has both Bachelor s and Master s degrees from Emerson College and a Master s of Public Administration degree from Suffolk University. Mario Gutierrez is executive director of the Center for Connected Health Policy. Mr. Gutierrez joined CCHP in May 2010 as a senior policy associate, and brings with him more than thirty years of experience in California s nonprofit health and health philanthropy sectors. Mr. Gutierrez served as a program director with The California Endowment for twelve years prior to joining CCHP, where he led several major health care initiatives including the foundation s ten-year, $20 million investment in telehealth deployment throughout California. He also served as the Endowment s lead person for Rural and Agricultural Worker Health Programs and Policy. Previously, he served for six years as a senior program officer with The Sierra Health Foundation. In recognition of his achievements in the field, Mr. Gutierrez received the prestigious 2007 Terrance Keenan National Leadership Award in Health Philanthropy. Mr. Gutierrez currently serves on the board of directors of the California State Rural Health Association, a nonprofit, nonpartisan, grassroots organization that works to improve the health of rural Californians and the quality and accessibility of the heath care they receive. He also serves on the board of directors of OCHIN, one of the nation s largest and most successful non-profit health information networks. OCHIN is nationally recognized for its innovative use of Health IT to improve the integration and delivery of health care services across a wide variety of practices, with an emphasis on safety net clinics and small practices, as well as critical access and rural hospitals. He currently serves as chairman of the Rural Policy Research Institute (RUPRI) Rural Human Services Advisory Panel, which provides agencies of the federal government with policy analysis and recommendations to promote livable rural communities. Dr. Kristi Henderson is vice president of Virtual Care and Innovation for Seton Healthcare. Henderson develops ways to use technology to improve the health of Central Texans and increase access to high-quality, affordable medical care. Henderson has 20 years of experience as an innovator, educator, researcher and clinician. She came to Seton from The University of Mississippi Medical Center (UMMC), where she was Chief Telehealth & Innovation Officer. In that role, she led the development of a statewide telehealth program recognized as a national model. As a recognized leader in healthcare innovation, she has testified before the U.S. Senate Committee on Commerce, Science and Transportation s Subcommittee on Advancing Telehealth through Connectivity, as well as the Subcommittee on Rural Health and the White House Domestic Policy Council. She has made numerous presentations across the country to advance telehealth policy and practice, including giving a TEDx talk in November 2014 and being selected to speak at the 2016 SXSW event in Austin. Her other leadership roles include service as a board member of the American Telemedicine Association; executive director of the Mississippi Telehealth Association; and board member of the Mississippi Health Information Network. She is also a Fellow with the Emergency Nurses Association. Henderson received her Doctorate of Nursing Practice degree from the University of Alabama at Birmingham; her master s degree in nursing from the Mississippi University for Women; and her bachelor s degree in nursing from Mississippi College. She maintains national certification as a family and acute care nurse practitioner. Marjorie Kanof, MD, serves as managing director of the U.S. Government Accountability Office s (GAO s) Health Care team, whose work involves federal health-related programs that have expenditures representing approximately one-quarter of all federal spending. Dr. Kanof joined GAO 6 as the director of civilian and military health care issues. She previously served in a variety of leadership positions at the Centers for Medicare & Medicaid Services (CMS), most recently as deputy director for payment policy in the Center for Medicare Management and deputy director for contractor management. Before joining CMS, Dr. Kanof was medical director for the Senior Division and government programs at Blue Cross Blue Shield of Massachusetts. She was also an assistant professor of pediatrics at Harvard advamed.org/ppc AdvaMed s Payment Policy Conference

11 Medical School and a guest scientist at the National Institute of Allergy and Infectious Diseases. She received her MD degree from the University of Kansas and an MPH degree from the Harvard University School of Public Health. Tom Lubotsky is Vice President Supply Chain and Clinical Resource Management with Advocate Health Care. Mr. Lubotsky is a broad based healthcare executive with 30 years in leadership roles among integrated delivery systems including clinical services and ambulatory development, physician practices, and healthcare alliances. Mr. Lubotsky is responsible for the overall leadership of Advocate Health Care s supply chain operations including sourcing and value analysis, procurement, logistics and operations, and performance and technology development. This position sets the strategic vision, core strategies, organizational framework, and operating plan for supply chain including managing key relationships among suppliers, distributors, clinicians, group purchasing, and associates. A critical focus extends to developing the supply chain intelligence capability to drive evidenced based use of supplies, equipment and technology. Mr. Lubotsky s experience also includes seven years in account management and operating roles at Premier, Inc., a leading healthcare group purchasing alliance whose core business purpose centers on accelerating clinical improvement and supply chain performance. Mr. Lubotsky was responsible for the overall leadership/general management of strategy and goal deployment, performance management, supply chain improvement planning, field operations, customer relationship management and business partner relationship support. Mr. Lubotsky has held various management positions with large integrated delivery systems including academic settings and for-profit outpatient corporations. He has a verifiable reputation as an innovative values-based leader for delivering results and building stronger healthcare delivery systems. Particular expertise includes Supply Chain and Clinical Resource Management, Clinical Service Line Management, Physician\Hospital Joint Ventures\Partnerships, Relationship Management\Team Building, P&L\Operations Analytics, Performance Based Accountability\Management, Strategic Planning\Transformational Leadership, and New Business and Product Development. Mr. Lubotsky is a Fellow in the American College of Healthcare Executives (ACHE), a professional member of the Association for Healthcare Resource & Materials Management (AHRMM) and an active member of the Strategic Marketplace Initiative (SMI), a professional forum of leading healthcare systems and suppliers working collaborative toward addressing supply chain related issues and challenges. Don May is executive vice president, payment and health care delivery policy with AdvaMed. He is responsible for leading AdvaMed s advocacy efforts on payment and health care delivery policy, and serve as the association s lead representative on payment, coverage and access issues. May formerly served as vice president for policy at the American Hospital Association, leading AHA's policy development activities for Medicare and Medicaid payment. In his 12 years at AHA, he helped set policy positions for the association through member outreach and consensus building, supported legislative and regulatory advocacy, and served as an AHA spokesman. Prior to AHA, May was a senior manager with The Lewin Group, where he provided policy analysis and consulting on federal health care legislation, trends in hospital financial performance, Medicaid payment adequacy and community health. He also previously served as a health services policy analyst for the Ohio Medicaid hospital program. May most recently was managing director with the Farragut Square Group, where he led FSG s health care facilities research since September He has a master of public administration degree from The Ohio State University and a bachelor s degree in political science from Ohio University. Ateev Mehrotra, MD, MPH is an Associate Professor of Health Care Policy and Medicine at Harvard Medical School and a Hospitalist at Beth Israel Deaconess Medical Center. Dr. Mehrotra s 7 research focuses on interventions to decrease costs and improve quality of care. Much of his work has focused on innovations in delivery such as retail clinics and e-visits and their impact on quality, costs, and access to health care. He is also interested in the role of consumerism and whether price transparency and public reporting of quality can impact patient decision making. Related work has focused on quality measurement including how natural language processing can be used to analyze advamed.org/ppc AdvaMed s Payment Policy Conference

12 the data in electronic health records to measure the quality of care. Dr. Mehrotra received his B.S. from the Massachusetts Institute of Technology, his medical degree from the University of California, San Francisco and completed his residency in internal medicine and pediatrics at the Massachusetts General Hospital and Children s Hospital of Boston. His clinical work has been both as a primary care physician and as an adult and pediatric hospitalist. He also has received formal research training with a Masters of Public Health from the University of California, Berkeley and a Masters of Science in Epidemiology from the Harvard School of Public Health. In 2008, he received the Milton W. Hamolsky Award for Outstanding Scientific Presentation by a Junior Faculty Member by the Society of General Internal Medicine. In 2013, he received the Alice S. Hersh New Investigator Award from AcademyHealth for health services researchers early in their careers who show exceptional promise. Deborah O Connor is vice president of clinical effectiveness for Advocate Health Care. Dr. O Connor oversees initiatives to decrease our variation in clinical care. Additionally, Dr. O Connor is responsible for developing programs that result in meaningful improvements in the safety and quality of care for our patients and support cost savings efficiencies. Formerly, Dr. O Connor served as medical director for Advocate Physician Partners Specialty Service Line/Clinical Effectiveness Project. Additionally, she is medical director for Advocate Good Shepherd Hospital s PHO. Previously, Dr. O Connor held the positions of PHO medical director, program director for the osteopathic transitional rotating internship and osteopathic DME at Advocate Illinois Masonic Medical Center. Earning her Doctor of Osteopathic Medicine degree at Chicago Osteopathic Medical School, Dr. O Connor received her Bachelor of Science degree in biology from Loyola University in Chicago. She completed her residency in family medicine and served as chief resident at Illinois Masonic. She is board certified in family medicine. Dr. O Connor resides in Park Ridge, Ill. with her husband and has three children. John Peters is the Acting Deputy for VA Telehealth Services. John has worked in VA Telehealth Services since 1999, collaborating with the VA's clinical, technical, and administrative leaders to help create, enhance, and expand VA's telehealth programs. Prior to joining the VA, John worked as a biomedical engineer at the US Naval Medical Logistics Command providing medical equipment for US Navy hospitals, clinics and ships. John received his Bachelor of Science degree in mechanical engineering from the University of Notre Dame in 1987, and continued his studies at the graduate level in biomedical engineering at Georgetown University, where he received his Master of Science degree in Edmund J. Pezalla, MD, MPH is Vice President and National Medical Director for Pharmaceutical Policy and Strategy at Aetna. Dr. Pezalla is a recognized leader in the development of advanced coverage and payment systems for pharmaceuticals. Dr. Pezalla is Aetna s lead executive for public policy related to pharmaceuticals and is also responsible for public policy coordination and quality of care in the Office of the Chief Medical Officer, Aetna. Dr. Pezalla has consulted on projects related to technology development and coverage decisions for the President s Council of Advisors on Science and Technology, the American Academy of Pediatrics, the Institute for Clinical and Economic Review and the Brookings Institution. He is a member of the Board of Directors of the Pharmacy Quality Alliance and the Connecticut Biosciences Innovation Fund. Dr. Pezalla received his bachelor s degree in Biophysics and his degree in Medicine from Georgetown University, and Masters in Public Health from the University of California at Berkeley. He was as health services research fellow and PhD student at the University of Michigan in Ann Arbor where he completed all but the dissertation in the program in Health Services Organization and Policy. Niley Shah, MD is Associate Professor of Health Services Research with the Mayo Clinic. Dr. Shah's research is focused on studying and improving the health care delivery system. Dr. Shah has 8 an ongoing research agenda for evaluating alternative models of chronic disease care delivery, medication adherence in chronic disease, policy implications of shared decision making and disparities in care. Other areas of ongoing research include optimizing advamed.org/ppc AdvaMed s Payment Policy Conference

13 treatment decisions in diabetes, decision analytic modeling of diagnostic strategies across a spectrum of diseases, evaluating the evidence base for quality measurement. Dr. Shah also has extensive experience working with large databases such as the Medical Expenditure Panel Survey (MEPS), National Ambulatory Medical Care Survey (NAMCS), and various payor and provider-based administrative data. Dr. Shah also has extensive experience with and continues to work on various topics related to pharmaceutical policy. Caroline Rossi Steinberg, Vice President, Trends Analysis, joined the American Hospital Association (AHA) in 2002 after 14 years in health care consulting. Ms. Steinberg oversees teams of researchers, data analysts and consultants to conduct policy research, trends analysis and data analytics to support AHA s advocacy needs broadly defined to include regulatory, legislative, legal and public/media relations activities. Prior to moving to the AHA, Ms. Steinberg was a vice president at The Lewin Group, where she spent nine years working with both public and private provider organizations to develop strategies to confront changes in the health care environment. She also led the intensive site visit component of the Community Tracking Study under contract with the Center for Studying Health System Change. In prior consulting positions, she has worked to improve the operations of hospitals and health systems and conducted data-driven redesign of the health care benefit packages for unionized workers for a Fortune 500 company. She holds a masters of business administration (MBA) from the Tuck School at Dartmouth College where she was named an Edward Tuck Scholar and a bachelor s degree from Harvard University. Laurel Sweeney is Senior Director, Global Health Economics & Market Access with Philips Healthcare. Laurel has more than 20 years of diverse experience in the hospital and medical device industry including health policy planning, health economics, reimbursement, government relations, marketing, and communications. She developed and leads the global health economics and market access team for Philips. This includes the establishment of reimbursement pathways for new technologies and applications, integrating reimbursement into the product development and acquisition processes, and a focus on the evidentiary requirements necessary to prove value to providers, payers and health technology assessment bodies. She serves as the subject matter expert in health reform implementation for Philips and, in this role, consults with Philips businesses and customers on its implications, participates in speaking engagements and key events, and prepares written materials. She has taken a leadership role within Philips in identifying and prioritizing key policy issues and trends that can affect successful implementation of Philips strategy. Philips policy positions serve as anchors for global advocacy and thought leadership. Laurel has served on several boards of directors including the Massachusetts Health Data Consortium, the Massachusetts Healthcare Purchasers Group, United Way, and the local Chamber of Commerce. She currently represents Philips on the Board of Directors for the New England Council and serves as the co-chair of the Council s Healthcare Committee. She also represents Philips on industry association committees. In 2010, she was appointed by the Governor of Massachusetts to the Group Insurance Commission on which she served as Commissioner until Most recently she was appointed to the Advisory Committee of the Massachusetts Health Policy Commission. Tom Valuck joined Discern Health in October 2013, bringing the firm national leadership experience in quality and performance-based payment from his positions at the Centers for Medicare & Medicaid Services (CMS) and the National Quality Forum (NQF). He helps private and public sector clients who are transforming the health care system on the front lines to achieve better health and healthcare outcomes at lower cost. Tom joined Discern after four years at NQF, where he was Senior Vice President for Strategic Partnerships. In that role, he oversaw the NQFconvened partnerships the Measure Applications Partnership (MAP) and the National Priorities Partnership (NPP) as well as NQF s engagement with states and regional community alliances. These NQF initiatives promote the use of performance measurement information for public reporting, payment incentives, accreditation and certification, and systems improvement. Tom also served as a Senior 9 Advisor and Medical Officer at CMS, where he advised senior agency and Department of Health and Human Services leadership regarding Medicare payment and quality of care, advamed.org/ppc AdvaMed s Payment Policy Conference

14 particularly value-based purchasing. While at CMS, Tom was recognized for his leadership in advancing Medicare s performance-based payment initiatives, receiving both the 2009 Administrator s Citation and the 2007 Administrator s Achievement Awards. Before joining CMS, Tom was the Vice President of Medical Affairs at the University of Kansas Medical Center, where he managed quality improvement, utilization review, risk management, and physician relations. Before that he served on the Senate Health, Education, Labor, and Pensions Committee as a Robert Wood Johnson Health Policy Fellow; with the White House Council of Economic Advisers, where he researched and analyzed public and private healthcare financing issues; and at the law firm of Latham & Watkins as an associate, where he practiced regulatory health law. Tom has degrees in biological science and medicine from the University of Missouri-Kansas City, a master s degree in health services administration from the University of Kansas, and a law degree from the Georgetown University Law School. Jessica Walradt leads the AAMC s policy, advocacy and data analytic efforts surrounding alternative payment models. She directly supports over 30 academic medical centers efforts to implement Medicare bundled payment programs. Prior to this role, Jessica spent two years as a Health Policy Analyst helping providers to navigate federal ACA regulations and complex Medicare payment policy issues. She also completed graduate internships with the White House Office of Management and Budget s Health Division and Partners HealthCare s Finance Department. Jessica holds an M.S. in Health Policy and Management from the Harvard School of Public Health and a B.A. in Political Science from the University of Richmond. Christopher L. White, Esq. is Senior Executive Vice President and General Counsel of the Advanced Medical Technology Association (AdvaMed). Mr. White serves as the Association s Chief Legal Officer and manages AdvaMed s Legal Committee to develop and promote legal policy positions enhancing patient access to medical technology. Mr. White also leads the Association s global working groups on compliance, Physician Payment Sunshine, and device tax implementation. He testified before state and federal legislative committees on Physician Payment Sunshine, Conflict of Interest and Industry-Physician relationships issues; led the drafting team substantially revising the AdvaMed Code in ; and leads AdvaMed s Code of Ethics related programs and activities. He led the negotiating team to draft the Kuala Lumpur Principles, harmonizing industry Codes of Ethics in Asia. He serves as a frequent speaker and author on industry legal and compliance issues. As Chief Legal Officer, he also manages the Association s HR team, and provides counsel on contract, corporate, tax exemption, HR, and legislative and regulatory matters. Duane Wright is Vice President, Government Affairs at the Advanced Medical Technology Association (AdvaMed). His current portfolio includes diagnostic and payment issues. Mr. Wright previously worked the Government Relations department at The Glover Park Group and America s Health Insurance Plans. Mr. Wright also worked on Capitol Hill for Representative Jim Davis (D-Fl), as well as Senators Bob Graham (D-Fl) and Tom Carper (D-DE). Mr. Wright is a graduate of The George Washington University Law School and the University of North Carolina at Chapel Hill. Jennifer B. Young served as the Assistant Secretary for Legislation at the Department of Health and Human Services, as well as Senior Counselor to Secretary Mike Leavitt before cofounding Tarplin, Downs & Young, LLC in January She was an integral part of the Administration s efforts during the development, passage and implementation of the Medicare Modernization Act and oversaw all legislative efforts on behalf of HHS. Prior to joining HHS, Young was on the staff of the House Ways and Means Committee and the Senate Finance Committee. In addition to her federal experience, Young also headed the health care team at the National Governor s Association. advamed.org/ppc AdvaMed s Payment Policy Conference

15 Attendees Participant Name Company Title Arapoff, Chris Medtronic Director- Care Continuum Baker, Andrew Stryker Corporation Director of Health Policy and Reimbursement, Stryker Baker, Brett United States Senate Committee on Finance Bassano, Amy Centers for Medicare & Medicaid Deputy Director of CMMI Services Beckman, Alan LivaNova PLC National Reimbursement/Market Access Manager Bermel, Peggy Deloitte & Touche LLP Consultant Blake, Kathleen American Medical Association Vice President, Healthcare Quality Bockoff, Eileen Abbott Director, Corporate Reimbursement Bokelman, Yvonne Zimmer Biomet Vice President, Global Market Access, Health Economics & Reimbursement Bostic, Robin St. Jude Medical, Inc. VP Reimbursement, Health Econ & Guidelines Branham, Chandra AdvaMed Vice President, Payment and Health Care Delivery Policy Brennan, Patrick Life Science Conference Group (LSCG) Director, Business Development Brenner, Jonathan Bayer HealthCare LLC Senior Director, Market Access, Radiology, Americas Region Bridger, Perry Edwards Lifesciences Corporation Vice President, Global Value, Payer Access & Public Policy Brooks, Cynthia AdvaMed Manager, Meetings and Conferences Brotman, Steven AdvaMed Senior Vice President, Payment and Healthcare Delivery Policy Calderwood, James AdvaMed Policy Analyst Caller, Danna Abbott Director, Coporate Reimbursement Carder-Thompson, Elizabeth Reed Smith LLP Partner Carrucciu, Spencer Remedy Partners Director of Episode Analytics Cartwright, Donna Integra LifeSciences Corporation Senior Director, reimbursement Services, National Policy and Payer Access Cavanaugh, Sean Centers for Medicare & Medicaid Deputy Administrator & Director Services Conniff, Thomas Johnson & Johnson Assistant General Counsel Coyle, Carmela Maryland Hospital Association President & CEO Cummins, Mary Deloitte & Touche LLP Principal, Life Science & Health Care Dale, Nancy Edwards Lifesciences Health Economics Manager Dawidczyk, Patricia Medtronic Manager, Payer Relations Delhougne, Gary Smith & Nephew, Inc. Director, Market Access advamed.org/ppc AdvaMed s Payment Policy Conference