Western New York: The Shift to Value Based Payment

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Speakers

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Jason Helgerson
Jason Helgerson served as New York State’s Medicaid Director from January 2011 thru February 2018.

Jason also served as the Executive Director for New York’s Medicaid Redesign Team, nationally recognized as a 2015 Innovation in American Government Finalist by the Harvard Kennedy School of Government. In this capacity, he leads Governor Cuomo’s effort to fundamentally reshape the state’s Medicaid program in order to both lower costs and improve health care quality. In 2015, Jason was recognized as a Public Official of the Year by Governing Magazine.

Prior to arriving in New York, Jason was Wisconsin’s Medicaid Director. In that capacity, he administered the state’s nationally recognized BadgerCare Plus program for children and families (Wisconsin’s Medicaid, and SCHIP); BadgerCare Plus Core Plan; SeniorCare (Pharmacy Plus Waiver); FoodShare (Supplemental Nutrition Assistance Program); and Wisconsin’s Chronic Disease Program.

Jason was also the principle project sponsor for BadgerCare Plus, former Wisconsin Governor Jim Doyle’s signature health care initiative. Through this program, 98% of Wisconsin residents have access to affordable health care, including all children.

Jason served as Executive Assistant/Policy Director to the Secretary of the Wisconsin Department of Health and Family Services (DHFS) from February 2005 to March 2007. Prior to joining DHFS, Jason served as the Executive Assistant for the Wisconsin Department of Revenue.

Prior to joining the Doyle Administration, Jason served as the Senior Education Policy Advisor for Mayor Ron Gonzales of the City of San Jose, CA. In this role, he provided advice and counsel to the Mayor on all issues related to children.

Before joining Mayor Gonzales' staff, Jason worked for the Milwaukee Public Schools (MPS) where he served as both the chief lobbyist for the district and as a deputy budget director. Prior to taking the position with MPS, Jason worked for Milwaukee Mayor John Norquist where he was the Education Policy Advisor and served as a senior official in the Mayor's Budget Office.

Jason received his Master of Public Policy degree from the University of Chicago in 1995, and his B.A. in Political Science from American University in Washington, DC in 1993. Jason is also a Clinical Associate Professor at the State University of New York at Albany, School of Public Health.
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Kristin Woodlock
Kristin Woodlock is the CEO of Woodlock & Associates. Kristin delivers results for government, healthcare payors, hospital systems, nonprofits and community-based organizations across the country. As both the Executive Deputy and Acting Commissioner of the New York State Office of Mental Health (OMH), Kristin oversaw the largest public mental health system in the United States. She was a Crisis CEO for FEGS Health and Human Services, one of the County's largest non-profits to enter Chapter 11 bankruptcy. As a subject-matter expert in behavioral health, she is a faculty member of major initiatives with the National Council for Behavioral Health. Kristin is sought out by healthcare systems for her unique ability to lead complex health and behavioral health projects. She received her Bachelors of Science in Nursing and Masters in Public Administration from Syracuse University.
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Kent Bottles MD
Dr. Kent Bottles teaches health policy and payment reform at The Thomas Jefferson University College of Population Health in Philadelphia and regularly consults and presents on population health, health care reform, digital medicine, and the future of the doctor patient relationship. He has been a Professor and Chair of academic medical school pathology departments, a Chief Medical Officer of a state-wide integrated delivery system, a President and CEO and DIO of an educational and research collaborative in Grand Rapids, Michigan, a President and CEO of an evidence-based medicine health care consortium in Minneapolis, and a President and Chief Knowledge Officer of a genomics bio-tech start-up company in Cambridge, Massachusetts.


Dr. Bottles has received the following awards and honors: Phi Beta Kappa, The Rodney T. West Literary Achievement Award for the most important article on medical management in 2001 from the American College of Physician Executives, the Resident Teacher of the Year Award from the University of Iowa Department of Pathology, the UC San Francisco Class of 1991 Certificate of Distinction in Teaching
for a Major Contribution, the UC San Francisco Class of 1990 Certificate of Distinction in Teaching for a Stimulating Lecture Series, and the Henry J. Kaiser Award for Excellence in Teaching at UC San Francisco for Basic Science.
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Brett Friedman
Brett Friedman is a partner in the health care group and co-head of the firm’s Digital Health practice. Since joining Ropes & Gray, Brett has gained significant experience in advising clients on a variety of complex transactional, enforcement and regulatory matters within the health care and digital health industries. His clients have included hospitals, managed care plans, pharmacy and dental benefit managers, home care agencies, health IT and telehealth providers, pharmaceutical and device manufacturers, and community-based providers of care to individuals with mental illness and developmental disabilities.

Brett has particular experience counseling both payer and provider clients in responding to the transition to accountable care and value-based payment, including the development of provider risk-bearing organizations, Accountable Care Organizations (“ACOs”), independent practice associations (“IPAs���), and other integrated delivery networks. Brett also routinely advises clients in the course of government investigations, audits, and self-disclosures concerning potential violations of Medicare and Medicaid regulatory authorities and health care fraud and abuse laws. In addition, Brett’s transactional experience includes advising private equity, for-profit and tax-exempt clients regarding health care due diligence, regulatory and reimbursement issues.
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Eric Linzer
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Brad Helfand
Brad Helfand is a proficient strategic advisor, with years of experience leading strategic and operational engagements for his clients. His expertise includes enterprise growth and financial planning, service line distribution for integrated delivery networks, health reform preparedness, emerging payment models, population health management, and insurance exchanges.

Prior to joining HealthScape Advisors, Brad served as a Vice President for the Sg2 Consulting team. Before his career at Sg2, he held leadership roles in surgical services at Loyola University Health System and the University of Chicago Medical Center. During his tenure at Loyola, he oversaw the business operations of 35 inpatient and outpatient operating room suites. Brad began his career in the healthcare provider strategy and operations practice at Deloitte Consulting and completed an administrative fellowship with Advocate Health Care.

Brad holds a BA in political science and sociology and MA in sociology from Northwestern University in Evanston, IL, as well as an MPH in health policy and administration from Yale University in New Haven, CT. He is a current fellow of the American College of Healthcare Executives and an active member of the Healthcare Financial Management Association.
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Ian Shaffer MD
Ian Shaffer, MD, MMM, CPE is Vice President and Executive Medical Director, Behavioral Health for Healthfirst responsible for behavioral health program management. Prior to this he was Vice President Behavioral Health Program Design and Research for Health Net Federal Services responsible for behavioral health program design and research with a specific focus on the military and veteran populations and their families. Previously at Health Net, Inc. Shaffer was MHN’s Chief Medical Officer, responsible for setting the company’s clinical policies and guidelines and ensuring clinical excellence. Dr. Shaffer oversaw MHN’s quality improvement and disease management units, and was accountable for the coordination and quality assurance of clinical care.

In addition, Dr. Shaffer has overseen quality and outcomes monitoring for the Military & Family Life Consultant Program services and collaborated with his Health Net Federal Services colleagues to ensure optimal care and service delivery for TRICARE beneficiaries.

Prior to joining MHN in 2003, Dr. Shaffer served as executive vice president and chief medical officer of a national managed behavioral health organization, working closely with several Fortune 100 companies. He three times served as chairman of the Association for Behavioral Health and Wellness (ABHW) (formerly the American Managed Behavioral Healthcare Association – AMBHA), and he has also served on several federal government committees, including a three-year term on the National Advisory Committee for the Center for Mental Health Services arm of SAMHSA. He remains involved in national behavioral health policy issues, including parity and autism.

As the President of Behavioral Health Management Solutions, LLC Dr. Shaffer has provided consultation to a variety of start up and ongoing behavioral health programs that have been redesigning to meet the changing needs of health care delivery and reimbursement.

Dr. Shaffer, a Life Fellow of the American Psychiatric Association, is a psychiatrist board-certified in psychiatry and addiction medicine, and has received fellowship training in child psychiatry. He received his medical degree from the University of Manitoba and psychiatry and child psychiatry training at the University of Southern California. Dr. Shaffer, a Certified Physician Executive also holds a Master’s degree in Medical Management from Tulane University.
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Scott Wetzler PhD
Dr. Wetzler is the Vice Chairman of the Department of Psychiatry overseeing population health initiatives. He is also the CEO of University Behavioral Associates, a behavioral management services subsidiary of Montefiore Medical Center. In this role, he oversees behavioral health care management for Montefiore's risk business; care management for Montefiore's Health Home; specialized case management for substance abusers under contracts with NYC Human Resources Administration; child welfare programs under contracts with NYC Administration for Children's Services and a Regional Partnership Grant to Improve Child Welfare Outcomes Among Substance Abusers funded by US Department of Health and Human Services Children's Bureau; health care workforce development funded by a Health Professions Opportunity Grant from the US Department of Health and Human Services; a NYS certified workforce investment organization; a relationship education program funded by the US Department of Health and Human Services Administration for Children and Families; and a Practice Transformation Network for Severely Mentally Ill funded by the Center for Medicaid and Medicare Innovation. Dr. Wetzler has published widely on these topics and testified at the US House of Representatives Ways and Means Committee.
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Mark Rucci
Mark A. Rucci, CEBS
Mr. Rucci is the ACO Product Manager for SpectraMedix, a healthcare analytics software company whose mission is to help hospitals, providers, clinically integrated networks, and payers transition to, and succeed under, value-based programs in the Medicaid, Medicare, and commercial markets through innovative data intelligence.

Mark has 35 years of experience providing healthcare analytics, actuarial, claims audit, and benefits consulting services to self-insured employers and healthcare provider organizations involved in risk-based contracts.

Before coming to SpectraMedix, Mark served as the President of Partners In Care, Corp., a physician-owned IPA with over 700 physician members in NJ, where he managed the Partners In Care ACO, a Medicare Shared Savings Program ACO with over 15,000 assigned beneficiaries, as well as an array of ACO contracts in the commercial and Medicare Advantage insurance markets on behalf of another 60,000 beneficiaries.

Prior to that, Mark spent 20 years as the Senior Vice President for Healthcare Analytics in the Princeton, NJ office of Gallagher Benefit Services, Inc., an international employee benefits consulting firm, where he led the company’s Healthcare Analytics, Provider Consulting and Health Care Claim Audit practices in addition to serving as a senior sales representative and client manager.
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Ryan Ashe
Ryan is a passionate champion of healthcare transformation and payment reform. He believes in aligning incentives that support public sector domains to fundamentally improve people’s quality of life. Prior to leading NYS’ Medicaid payment reform efforts, Ryan advised State governments on major health & human services transformations, including Affordable Care Act implementation and developing integrated service delivery capabilities. Ryan is a veteran of NYS policy, having advised on a number of issue areas in the NYS Legislature. He has also supported a parliamentary strengthening project for the government of Kenya, resulting in a publication that examines the relationship between public benefit and constituency development funding. He is a former Sergeant in the U.S. Marine Corps and was born and raised in upstate New York.
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Frank Winter
Frank M. Winter works as the Partnership Manager in the Centers for Medicare & Medicaid Services (CMS) New York Regional Office and is responsible for conducting outreach and building partnerships with providers, beneficiaries, and community organizations. Frank planned CMS’s first Regional conference on Medicare Modernization for the Asian American Community, and partnered with the NYC Office of Viral Hepatitis to hold the first CMS special issues training for organizations serving patients with hepatitis. Frank has collaborated with NJ-HITEC, the New York e-Health Collaborative, the NYC REACH and other partners to conduct a variety of educational events linking HIT with health delivery system reform, including “Bringing the Affordable Care Act Home” conferences in NY and NJ. He is a a frequent co-host on the Regional Office’s “CMS & You” cable program, the Regional Office training lead, and in 2013 served as its lead trainer on the Health Insurance Marketplace in New Jersey and the New York State of Health. Frank is now in the midst of conducting a outreach on MACRA, Innovation, and reducing clinician burden with his CMS colleagues.
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