Medical Home Summit Conference
Medical Home Summit Conference
Medical Home Summit Conference
Medical Home Summit Conference
Medical Home Summit Conference
Medical Home Summit Conference



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NATIONAL MEDICAL HOME SUMMIT AGENDA:
DAY II
Tuesday, March 18, 2014

7:00 a.m. Registration Open; Networking Breakfast
OPENING PLENARY SESSION: THE CURRENT LANDSCAPE
8:00 a.m.

Welcome and Overview

Marci Nielsen, PhD, MPH
Chief Executive Officer, Patient-Centered Primary Care Collaborative, Washington, DC (Co Chair)

    Speaker Bio

    Dr. Marci Nielsen is Chief Executive Officer of the Patient-Centered Primary Care Collaborative (PCPCC). She previously served as Vice Chancellor for Public Affairs and Associate Professor within the Department of Health Policy and Management at the University of Kansas School of Medicine, where she was twice awarded Professor of the Year by her students. She also served on the Board of Directors of the Health Care Foundation of Greater Kansas City, TransforMED, and the MidAmerica Coalition on Health Care. She also has been a committee member on the Institute of Medicine's Leading Health Indicators for Healthy People 2020 and Living Well with Chronic Illness: A Call for Public Health Action. She serves as the first public (non-physician) member on the American Board of Family Medicine. Prior to rejoining the KU faculty, she was appointed by then-Governor Kathleen Sebelius to run the Kansas Health Policy Authority (KHPA). At the national level, she has worked as a legislative assistant to U.S Senator Bob Kerrey (D-Nebraska) and as the health lobbyist and assistant director of legislation for the AFL-CIO. She earned her MPH degree from George Washington University and her PhD in Health Policy and Management from the Johns Hopkins School of Public Health.
    Presentation Material (Acrobat)
8:15 a.m.

What Does the Research Tell Us?

Lisa M. Kern, MD
Associate Professor of Public Health; Associate Professor of Public Health in Medicine, Weill Cornell Medical College, New York, NY

    Speaker Bio

    Lisa M. Kern, MD, MPH, FACP is a general internist, health services researcher and national expert in the evaluation of interventions designed to improve health care. Dr. Kern is an Associate Professor of Healthcare Policy and Research and of Medicine at Weill Cornell Medical College. Dr. Kern is also Associate Director of Research for the Center for Healthcare Informatics and Policy, also at Weill Cornell Medical College, and a Deputy Director of the Health Information Technology Evaluation Collaborative (HITEC), a multi-institutional academic collaborative. Dr. Kern's work includes evaluation of electronic health records, health information exchange, and the Patient-Centered Medical Home. Dr. Kern received her undergraduate and medical degrees from Harvard University, completed her internship and residency in internal medicine at Mount Sinai Hospital in New York, and then completed the Robert Wood Johnson Clinical Scholars Program at Johns Hopkins University, where she also earned a master's degree in Public Health.
    Presentation Material (Acrobat)
Rob Lieberthal, PhD
Assistant Professor, Jefferson School of Population Health, Philadelphia, PA

    Speaker Bio

    Dr. Robert Lieberthal is an Assistant Professor at the Jefferson School of Population Health of Thomas Jefferson University. Prof. Lieberthal has extensive experience in economic analysis of insured populations, health systems and the impact of health finance on performance. His research has appeared in journals such as American Journal of Managed Care and Population Health Management, and has been funded by numerous outside sources, including the Agency for Healthcare Research and Quality and the Society of Actuaries. He teaches health economics and U.S. healthcare finance and reimbursement at the School of Population Health.
    Presentation Material (Acrobat)
Michael Paustian, PhD, MS
Health Care Manager, Clinical Epidemiology & Biostatistics, Blue Cross Blue Shield of Michigan, Ann Arbor, MI

    Speaker Bio

    Dr. Michal Paustian is Health Care Manager in the Department of Clinical Epidemiology & Biostatistics at Blue Cross Blue Shield of Michigan. He has worked there for the past five years in the development and evaluation of clinical programs aimed at practice transformation and improving health care value, including the Patient Centered Medical Home program and recently similar programs developed for specialist physicians. Prior to Blue Cross, Michael worked as a maternal & child health epidemiologist for five years at the Michigan Department of Community Health focused on pediatric health services, particularly for children with special health needs. He received his MS in epidemiology from the University of Iowa and his doctorate in epidemiological science from the University of Michigan.
    Presentation Material (Acrobat)
Debbie Peikes, PhD
Senior Fellow, Mathematica Policy Research, Princeton, NJ

    Speaker Bio

    Dr. Debbie Peikes is a senior fellow at Mathematica Policy Research in the Princeton office. She has technical and substantive expertise in studying how to improve the delivery of primary care through medical homes, and the effectiveness of care coordination and disease management for people with chronic illnesses -- a core component of the medical home. Dr. Peikes currently serves as the project director and/or principal investigator of a large initiative to improve the performance of 497 primary care practices in 7 regions for CMS, a foundational study of medical homes for AHRQ; and an evaluation of care coordination for CMS.

    She has also conducted studies of health policies and programs for the Robert Wood Johnson Foundation, the Medicare Chronic Care Practice Research Network, Aetna, United, the United Auto Workers, HRSA, and SSA. She holds an M.P.A. in economic policy and a Ph.D. in public policy from Princeton University, and was a Fulbright Scholar.
    Presentation Material (Acrobat)
    Presentation Material (Acrobat)
Melinda K. Abrams, MS
Vice President, Health Care Delivery System Reform, The Commonwealth Fund, New York, NY (Moderator)

    Speaker Bio

    Melinda K. Abrams, M.S., is a vice president of the Commonwealth Fund's Health Care Delivery System Reform program. Since coming to the Fund in 1997, Ms. Abrams has worked on the Fund's Task Force on Academic Health Centers, Commission on Women's Health, and most recently, the Child Development and Preventive Care programs. She played a lead role in conceptualizing and launching the Fund's Assuring Better Child Health and Development (ABCD) initiative, which awarded grants to state Medicaid programs to encourage innovation in the financing and delivery of preventive and developmental services provided to low-income, young children. Ms. Abrams sits on a number of national committees, including the Board of Managers of TransforMED, the PCMH Advisory Committee for the National Committee for Quality Assurance, and two Medical Home Expert Panels for the Agency for Healthcare Research and Quality (AHRQ). Ms. Abrams holds an M.S. in health policy and management from the Harvard School of Public Health.
9:00 a.m.

The Patient as Partner

Michael Chilcoat
Patient Partner, Partners in Family Health, York, PA

    Speaker Bio

    Mike Chilcoat is currently a Patient Partner with Partners in Family Health, an independent practice in York, PA involved with the Aligning Forces 4 Quality (AF4Q) initiative. Wellspan Health is who Partners in Family Health works with in South Central Pennsylvania. As a Patient Partner, Mike and another partner try to make the practice a more effective and friendly place for all the patients to attend. Mike is also chairman of the Consumer Engagement Council. This is a group of patients and medical staff attempting to get patients involved in their personal health and to promote health issues in the community. Mike has been involved in this collaboration for three years and about to begin his fourth year.
Nancy Sipe
Patient Partner, Brockie Internal Medicine, WellSpan Health, York, PA

    Speaker Bio

    Nancy Sipe is a Patient Partner for Brockie Internal Medicine, a medical group practice in the WellSpan Health system. Based in South Central Pennsylvania, Brockie Internal Medicine provides physical exams, treatment of illnesses and injuries, and care of acute and chronic illnesses such as; diabetes, high blood pressure and asthma. Brockie Internal Medicine is just one of over 30 practices that participate in Aligning Forces for Quality, led by The Healthy York County Coalition. Nancy was born in York, PA and currently works for WellSpan Health as a Project Analyst in Supply Chain.
Dael M. Waxman, MD
CMC-Elizabeth Family Medicine, Charlotte, NC

    Speaker Bio

    Dr. Dael Waxman is the Interim Chair of the Department of Family Medicine at Carolinas HealthCare System in Charlotte, NC. He also serves as Medical Director for Patient-Centered Programming at Carolinas Medical Center-Mercy. Prior to joining the department at Carolinas HealthCare System in 1996, he served on the faculties of the University of Texas Medical Branch and the University of Connecticut. He completed a fellowship in family systems medicine at the University of Rochester (1991) and a faculty development fellowship and residency in family medicine at the University of Arizona (1989 and 1988 respectively). He is a graduate of the University of Kansas School of Medicine (1985). In addition to his medical background, he has received training in and has been integrating family therapy, clinical hypnosis, and other modalities of mind/body medicine into teaching and practice for over 20 years. An Associate Professor of Family Medicine at UNC Chapel Hill, he has taught regionally, nationally and internationally on: family influences on health, physician-patient communication, collaboration between mental health and primary care, physician wellness, and mind/body medicine.
Susan Frampton, PhD
President, Planetree, Inc., Derby, CT (Moderator)

    Speaker Bio

    Dr. Susan Frampton is President of Planetree, a not-for-profit advocacy, consultation, and membership organization working with a growing international network of provider organizations to implement Planetree's comprehensive patient-centered care model. She has authored numerous publications, the most recent including the third edition of Putting Patients First (Jossey-Bass Publishing, 2013), a series on patient-centered care in the American Journal of Nursing, and the Patient-Centered Care Improvement Guide. In 2013, she was appointed co-chair of the National Priorities Partnership (NPP), convened by NQF to identify strategies for improving safety, quality, and patient-centered outcomes for the U.S. healthcare system. She currently co-chairs the Patient Family Engagement Action Team. In addition, Dr. Frampton has participated on Joint Commission and IOM advisory panels and is a reviewer for the International Journal for Quality in Healthcare. In 2009 she was named one of "20 People who Make Healthcare Better" by Health Leaders Magazine.
9:45 a.m. Break
10:15 a.m.

Transforming the Safety Net: Lessons Learned and Challenges Ahead

Peter Cucchiara BSMIS, MBA
Managing Director, Performance Improvement, Primary Care Development Corporation, New York, NY

    Speaker Bio

    Peter Cucchiara is Chief Program Officer of Primary Care Development Corporation he oversees all Performance Improvement services and initiatives, including care management and coordination, medical home transformation and certification, practice redesign, patient access, health information management, Meaningful Use (MU), and emergency preparedness. Prior to PCDC, Peter was Vice President of Information Systems for Integramed America, Assistant Director of IT at The Hospital for Special Surgery, and Quality Assurance Manager for ADP Electronic Funds Transfer Division. He is a member of the College of Healthcare Information Management Executives (CHIME), Healthcare Information Management Systems Society (HIMSS), and the Technical Executives Networking Group (TENG). Peter received a BS in Management and Information Systems and an MBA in Information Technology from the New Jersey Institute of Technology.
Suzanne Daub, LCSW
Associate Director, Philadelphia Behavioral Health Integration Network, Health Federation of Philadelphia, Philadelphia, PA

    Speaker Bio

    Suzanne Daub is a Senior Integrated Heath Consultant for The National Council for Behavioral Health and consults nationally with behavioral health organizations on the clinical aspects of integrated care, operationalizing integration and building workforce skills. Prior to joining the National Council, Ms. Daub worked for 17 years as the Director of Behavioral Health in Primary Care at Delaware Valley Community Health, a Federally Qualified Health Center providing medical services to 40,000 poor and underserved residents of Philadelphia, PA. She maintains the role of Associate Director of the Philadelphia Behavioral Health Integration Network. Coordinated by Health Federation of Philadelphia, this network is composed of 14 primary care organizations across the Philadelphia region and claims membership of nearly 40 Behavioral Health Consultants.
Jonathan Sugarman, MD, MPH
President and Chief Executive Officer, Qualis Health, Seattle, WA

    Speaker Bio

    Dr. Jonathan Sugarman is President and CEO of Qualis Health, a nonprofit healthcare consulting and care management firm that is a national leader in improving the quality, safety, and efficiency of healthcare delivery. As principal investigator for the Safety Net Medical Home Initiative, he led a Commonwealth Fund-sponsored effort to support 65 safety net clinics in five states in efforts to transform the delivery of primary care. He plays an active leadership role in other Qualis Health projects focused on improving care in safety net and academic settings. He has served as President of the American Health Quality Association, President of the Washington Academy of Family Physicians and Chair of the American Academy of Family Physicians Commission on Quality, and is a member of the Executive Committee of the American Medical Association-convened Physician Consortium for Performance Improvement. A graduate of Harvard College, the Albert Einstein College of Medicine and the University of Washington School of Public Health and Community Medicine, he serves as Clinical Professor in the Departments of Family Medicine and Epidemiology at the University of Washington.
Mary Takach, BSN, MPH
Senior Program Director, National Academy for State Health Policy, Portland, ME (Moderator)

    Speaker Bio

    Mary Takach is a senior program director at the National Academy for State Health Policy where she focuses on issues related to patient-centered medical homes, federally qualified health centers, and delivery system reform. Her current projects include directing two Commonwealth Fund grants -- a multi-year project helping states advance medical homes and a project to build a Medicaid "Accountable Care" central resource center; a Cooperative Agreement from HRSA to build partnerships with Medicaid Directors and safety net providers; a CMS contract to analyze state policy implications for the evaluation of the Multi-Payer Advanced Primary Care Practice Demonstration; and a PCORI grant to develop a "Patient-Centered Outcomes Research and Comparative Effectiveness Research Roadmap for State Policymakers." She has worked on Capitol Hill as a Legislative Assistant for two Congressmen and in a wide variety of clinical settings as a Registered Nurse. She holds a MPH degree from The Johns Hopkins Bloomberg School of Public Health and a BSN degree with honors from Northeastern University.
11:00 a.m.

Population Health Management in the Medical Neighborhood

Richard Hodach, MD
Chief Medical Officer, Phytel, Dallas, TX

    Speaker Bio

    Dr. Richard Hodach is Phytel's Chief Medical Officer and Vice President of Clinical Product Strategy, responsible for providing strategic direction and clinical expertise to the development of Phytel's solutions. Dr. Hodach is a regular contributor to peer-review journals such as AJMC, Journal of Population Health Management, hfm, published by the Healthcare Financial Management Association, Group Practice Journal and more. He was instrumental in the CMS Innovation Award of a $20.75 million grant which Phytel, VHA Inc. and TransforMED received from The Center for Medicare & Medicaid Innovation (CMMI). Dr. Hodach also serves on the board of directors of the American College of Medical Quality. Before joining Phytel, he held senior leadership positions at Matria Healthcare and Accordant, and co-founded MED.I.A. He has a PhD in Pathology and an MD with Board Certification in Neurology and Electrodiagnosis, as well as a Master's in Public Health.
Jill Rubin Hummel, JD
President & General Manager, Anthem Blue Cross and Blue Shield of Connecticut, New York, NY

    Speaker Bio

    Jill Hummel is President & General Manager of Anthem BlueCross BlueShield of Connecticut ("Anthem"), accountable for its operations including sales, product, network and service. Ms. Hummel has been an associate of WellPoint, Inc., Anthem's parent company, since 2007, most recently as Vice President of Payment Innovation where she developed provider payment and delivery models that reward and support improvements in health care quality, patient safety, health outcomes, health status and access. Before joining Wellpoint, Ms. Hummel worked for UnitedHealthcare (2001 - 2007) in a variety of capacities including most recently as the Northeast Regional Vice President for Network Management. She currently serves on the board of the Patient Centered Primary Care Collaborative. She received her law degree from Washington University and her BA degree from the University of Rochester.
Maria Pitaro, MD
Associate Medical Director, Union Health Center, New York, NY

    Speaker Bio

    Dr. Maria Pitaro is Associate Medical Director at the Union Health Center (UHC). She received her MD from SUNY Downstate Medical Center in 1986 and trained in Primary Care Internal Medicine at Boston City Hospital. She worked as a clinician educator in Primary Care Internal Medicine for many years, and then in an Internal Medicine private practice for several years. She came to UHC in 2002 as Associate Medical Director where she led the center's initiative to utilize the EMR to improve chronic disease management. She is also responsible for clinical quality improvement and has been actively involved in the transformation of the model of care.
Jaan Sidorov, MD, MPH
Principal, Sidorov Health Solutions; Author, The Disease Management Care Blog, Harrisburg, PA

    Speaker Bio

    Dr. Jaan Sidorov is an independent consultant for Sidorov Health Solutions, Inc (Harrisburg, PA) and President of PMSLIC, the largest physician malpractice insurance company in Pennsylvania. He obtained his MD from Pennsylvania State University College of Medicine in Hershey, PA, where he was the recipient of the Mosby Award for Academic Achievement in Studies, and completed his residency in Internal Medicine at Dartmouth-Hitchcock Medical Center in Hanover, NH. He earned his Masters in Health Services Administration from Marywood University in Scranton, PA. He is certified as a Managed Care Executive by the American Association of Health Plans and has his certificate in Education from the National Association of Corporate Directors (NACD). He has numerous peer-reviewed publications and sits on the editorial advisory board for Managed Care, Disease Management Advisor, Medical Home News, and Disease Management/Population Health Management; as well as the advisory board of the Chronic Care Group of the HealthSciences Institute.
Amy Gibson
Chief Operating Officer, PCPCC, Washington, DC (Moderator)

    Speaker Bio

    Amy Gibson joined the Patient-Centered Primary Care Collaborative in 2010 as the Chief Operating Office, responsible for its daily operations of the organization for helping to develop strategic initiatives related to medical home, care delivery reform, and patient and family engagement. Prior to joining PCPCC, Amy served as the Assistant Director of the Boys Town Institute for Child Health Improvement in Omaha, Nebraska where she supported the widespread adoption of medical homes. Her previous positions include Director of the Division of Children with Special Needs at the American Academy of Pediatrics (AAP), as well as the Director for the National Center of Medical Home Initiatives for Children with Special Needs, a cooperative agreement between the AAP and the U.S. Maternal and Child Health Bureau/HRSA. In April 2013, Amy was named to the Patient-Centered Research Outcome's Institute's (PCORI) Patient Engagement Advisory Panel. She holds a BS in nursing from the University of Illinois at Chicago, and an MS in nursing with an emphasis in parent-child nursing from Northern Illinois University.
12:00 p.m. Networking Lunch

Optional Luncheon Networking Roundtables

Topic: Health Coaching in the Medical Home: Lessons from Leading Clinics/Systems
Hosts: William K. Applegate, PhD, CEO, Iowa Chronic Care Consortium, Des Moines, IA and Jody Hereford, RN, BSN, MS, FAACVPR, Clinical Program Consultant, Iowa Chronic Care Consortium, Des Moines, IA

Topic: Health IT for the Small Practice Medical Home
Host: Salvatore Volpe, MD, FAAP, FACP, CHCQM, NCQA Level 3 Recognition - Solo Practice, Staten Island, NY

Topic: Building Integrated Communities of Care
Host: Marjie Grazi Harbrecht, MD, Chief Executive Officer, HealthTeamWorks, Lakewood, CO

DAY II AFTERNOON - MEDICAL HOME SUMMIT MINI SUMMITS
MINI SUMMIT I: MEDICAL HOMES AND THE PRIMARY CARE WORKFORCE
1:15 p.m. Welcome and Overview of the Mini Summit

Maryjoan D. Ladden, PhD, RN, FAAN
Senior Program Officer, Robert Wood Johnson Foundation, Princeton, NJ (Mini Summit Chair)

    Speaker Bio

    Dr. Ladden is a nurse practitioner and Senior Program Officer at the Robert Wood Johnson Foundation. Her work at the Foundation focuses on building a diverse and well trained workforce and leadership in health and healthcare. Dr. Ladden manages most of the Foundation's nursing initiatives. She leads the Foundation's efforts in primary care and interprofessional collaboration. Prior to joining the Foundation, she served as interim Chief Programs Officer of the American Nurses Association (ANA), providing strategic direction, integration and coordination for all of ANA's programs.

    Dr. Ladden also spent over 20 years in Boston as a nurse practitioner, case manager, researcher, and Director of Continuing Professional Education at Harvard Pilgrim Health Care and as Assistant Professor at Harvard Medical School. Her work has focused on improving health care quality, safety and health professional collaboration.
    Presentation Material (Acrobat)
1:30 p.m. Health Career Academy: Building a Vision, Creating a Pipeline

Barry Mann, MD, FACS
Chief Academic Officer, Main Line Health, Wynnewood, PA

    Speaker Bio

    Dr. Barry Mann, Professor of Surgery at Jefferson Medical College, is Chief Academic Officer of the Main Line Health System. He also serves as program director of the Lankenau Medical Center Surgical Residency Program and Executive Director of the Annenberg Conference Center for Medical Education. He received the prestigious national Alpha Omega Alpha Robert P. Glaser Distinguished Teacher of Medicine Award from the American Association for Medical Colleges and the Outstanding Teacher of Surgery Award from the Association for Surgical Education. In 2009, Elsevier published Dr. Mann's textbook entitled SURGERY: A Competency-Based Companion, which subsequently became a series for which Dr. Mann is the series' editor. In his role of outreach to the community, Dr. Mann has developed several innovative programs demonstrating hospital-high school partnerships, including the Annenberg High School Science Symposium and the Health Career Academy.
Judy Spahr, MLS, MEd
Manager, Clinical Research Center, Lankenau Institute for Medical Research, Wynnewood, PA

    Speaker Bio

    Judy Spahr holds a Master's degree in Library Sciences from Simmons College (Boston, MA); a Master's degree in Education from Plymouth State University ( Plymouth NH); and is a candidate for the Master of Public Health degree from West Chester University (West Chester, PA). She holds certificates in Cancer Data Management, Clinical Research Administration, Technical Writing, and Grant Writing, and is certified as a clinical research professional. She has been the Manager of the Clinical Research Center in Main Line Health's Lankenau Institute for Medical Research since 2007. In this role she manages activities in clinical research, public health research, conducts training and educational programs across the Main Line Health system, and supports community outreach programs such as the Health Career Academy.
    Presentation Material (Acrobat)
2:00 p.m. Union Health Center -- New Roles for Medical Assistants

Audrey Lum, MPA
Chief Clinical Officer, Union Health Center, New York, NY

    Speaker Bio

    Audrey Lum is Chief Clinical Officer at the Union Health Center, overseeing quality improvement and innovative projects. Under her leadership the Center chieved and maintained NCQA recognition as a Level 3 PCMH since 2010. She has been a primary contributor to Center's medical assistant curriculum and training of health coaches which has led to the success of team-based care at the Center. She was a contributing author to the practice profile Transforming the Role of Medical Assistants in Chronic Disease Management; Health Affairs, May 2010. Ms. Lum has conducted workshops and presented on this topic for the Institute for Healthcare Improvement (IHI), The Center for the Health Professions at UCSF, Patient-Centered Primary Care Collaborative (PCPCC), New York City Health and Hospital Corporation and The California Health Care Safety Net Institute. She holds a BSN from City University of New York Hunter Bellevue and MPA from New York University Wagner School of Public Health.
Monica Guillen
RMA - Health Coach/Floor Coordinator, Union Health Center, New York, NY

    Speaker Bio

    Monica Guillen started her career at the Union Health Center as a Registered Medical Assistant before she became Health Coach /Floor Coordinator. She attributes her new-found skills to the Health Center's innovative care model and training program for medical assistants. Ms. Guillen was selected as a member of the Center's first primary care medical home team and trained using the Center's curriculum in chronic care management and self management skills. In her role as Health Coach/Floor Coordinator, she mentors new medical assistants around education and self management skills, assists providers with complex patients and ensures efficient flow of patients for her team. Ms Guillen was selected as an Emerging Leader in the Primary Care Team: Learning from Effective Ambulatory Practices (LEAP) a program funded by the Robert Wood Johnson Foundation. Ms. Guillen has an AAS in Liberal Arts from Borough of Manhattan Community College and MA Certificate from Stanford Brown Institute.
    Presentation Material (Acrobat)
2:30 p.m. 11th Street Family Health Services -- Integrating Behavioral Health and Other Services into the Primary Care Team

Emily Duffy, LCSW
Behavioral Health Consultant, 11th Street Family Health Services of Drexel University, Philadelphia, PA

    Speaker Bio

    Emily Duffy is a Licensed Clinical Social Worker who has been practicing within integrated primary care as a behavioral health consultant for over six years. She holds a Master's degree in Social Services from Bryn Mawr Graduate School of Social Work and Social Research. As one of the first behavioral health consultants in Philadelphia, she is recognized as a leader in the growing field. Emily has developed pediatric, prenatal, and substance abuse programs within this care model. Along with her colleagues, she has published, spoken nationally, and trained others in behavioral health consultation. Additionally, Emily is currently participating in the Robert Wood Johnson's LEAP Emerging Leaders Fellowship.
Patricia Gerrity, PhD, RN, FAAN
Associate Dean for Community Programs, Director, Eleventh Street Family Health Services of Drexel University, Philadelphia, PA

    Speaker Bio

    Dr. Patricia Gerrity is Associate Dean for Community Programs at Drexel University's College of Nursing & Health Professions. She focuses on providing access to health care for underserved populations through the advancement of nurse-managed health centers. She also serves as the Director of the Eleventh Street Family Health Services, a nurse managed, Federally qualified health center in North Philadelphia. The center also serves as a site for research, education and practice for the college's faculty and students. She completed a prestigious three-year fellowship through the Robert Wood Johnson Executive Nurse Fellows Program where she conducted a leadership project to expand the health center into a healthy living center with a strong community-based health promotion component. She earned a PhD in Health Planning, an MSN, and BSN from the University of Pennsylvania.
    Presentation Material (Acrobat)
3:00 p.m. Networking Break in the Exhibit Hall
3:30 p.m. University of Rochester -- Preparing Residents for Preventive and Primary Care

Gina Lamanna, MS
Program Manager, Highland Family Planning; Project Director, Hospital-Medical Home Demonstration Project, University of Rochester, Highland Family Medicine, Rochester, NY

    Speaker Bio

    Gina Lamanna is currently Project Director for the New York State Hospital Medical Home Demonstration Project at Highland Hospital and the Family Medicine Residency Program in Rochester, NY and Program Manager for Highland Hospital's Title X Family Planning Clinic. She is coordinating $5.1 million in projects and grants related to the provision of primary care and family medicine residency training. In addition, Gina coordinates the practice's Patient Centered Medical Home initiative, including facilitating process change, advising practice leadership regarding project implementation and attending to the minutiae of NCQA PCMH recertification.

    Gina is one of 19 Emerging Leaders participating this year in a yearlong professional development program through the Learning from Effective Ambulatory Practices (LEAP) initiative sponsored by the Robert Wood Johnson Foundation and led by the McColl Center for Healthcare Innovation of the Group Health Research Institute.
Stephen H. Schultz, MD
Highland Family Medicine, University of Rochester Medical Center, Rochester, NY

    Speaker Bio

    Dr. Stephen Schultz has served as the Family Medicine residency program director at the University of Rochester for the past 12 years, where he is an Associate Professor of Family Medicine. He serves on the Board of Directors of the Association of Family Medicine Residency Directors (AFMRD). During his tenure as program director, he established Global Health Track and a Political Advocacy and Leadership Track. His residency program was one of 14 family medicine programs nationwide that participated in a 6 year pilot program called "Preparing Personal Physicians for Practice" (P4) from 2006 - 2012. His program was recognized in 2013 by Robert Wood Johnson Foundation as one of the 31 best models of practice for team-based care in the country with their inclusion in the Learning from Effective Ambulatory Practices (LEAP), a designation only two other residency programs in the country received.
4:00 p.m. Interprofessionalism -- Training the Workforce of Tomorrow

Maryjoan D. Ladden, PhD, RN, FAAN
Senior Program Officer, Robert Wood Johnson Foundation, Princeton, NJ

    Speaker Bio

    Dr. Ladden is a nurse practitioner and Senior Program Officer at the Robert Wood Johnson Foundation. Her work at the Foundation focuses on building a diverse and well trained workforce and leadership in health and healthcare. Dr. Ladden manages most of the Foundation's nursing initiatives. She leads the Foundation's efforts in primary care and interprofessional collaboration. Prior to joining the Foundation, she served as interim Chief Programs Officer of the American Nurses Association (ANA), providing strategic direction, integration and coordination for all of ANA's programs.

    Dr. Ladden also spent over 20 years in Boston as a nurse practitioner, case manager, researcher, and Director of Continuing Professional Education at Harvard Pilgrim Health Care and as Assistant Professor at Harvard Medical School. Her work has focused on improving health care quality, safety and health professional collaboration.
    Presentation Material (Acrobat)
4:30 p.m. Faculty Panel

Maryjoan D. Ladden, PhD, RN, FAAN
Senior Program Officer, Robert Wood Johnson Foundation, Princeton, NJ (Mini Summit Chair)

    Speaker Bio

    Dr. Ladden is a nurse practitioner and Senior Program Officer at the Robert Wood Johnson Foundation. Her work at the Foundation focuses on building a diverse and well trained workforce and leadership in health and healthcare. Dr. Ladden manages most of the Foundation's nursing initiatives. She leads the Foundation's efforts in primary care and interprofessional collaboration. Prior to joining the Foundation, she served as interim Chief Programs Officer of the American Nurses Association (ANA), providing strategic direction, integration and coordination for all of ANA's programs.

    Dr. Ladden also spent over 20 years in Boston as a nurse practitioner, case manager, researcher, and Director of Continuing Professional Education at Harvard Pilgrim Health Care and as Assistant Professor at Harvard Medical School. Her work has focused on improving health care quality, safety and health professional collaboration.
5:15 p.m. Adjourn

MINI SUMMIT II: HEALTH PLAN INCENTIVES AND SUPPORT FOR THE MEDICAL HOME
1:15 p.m. Welcome and Overview of the Mini Summit

David K. Nace, MD
Vice President, Clinical Development, McKesson Corporation; Chair, Board of Directors, Patient Centered Primary Care Collaborative (PCPCC), King of Prussia, PA (Mini Summit Chair)

    Speaker Bio

    Dr. David Nace is Chairman of the PCPCC and Vice President, Clinical Development for McKesson Corporation. Prior to McKesson, he served as a Senior Vice President and Chief National Medical Officer with Aetna, and subsequently with United Health Group. He is a Board Member for the Integrated Healthcare Association, a statewide multi-stakeholder group in California, and the Care Continuum Alliance based in Washington, DC. He also served as an advisor to the American Medical Association, the National Business Group on Health, the World Health Organization, and the International Labor Organization on issues ranging from health promotion and wellness to employer policy and health care financing issues. Dr. Nace earned his medical degree from the University of Pittsburgh.
    Presentation Material (Acrobat)
1:30 p.m. Independence Blue Cross

Richard Snyder, MD
Senior Vice President and Chief Medical Officer, Independence Blue Cross, Philadelphia, PA

    Speaker Bio

    Dr. Richard Snyder is the senior vice president and chief medical officer at Independence Blue Cross (IBC). In this role, he is the company's chief clinical spokesperson, and he has overall corporate responsibility for medical management, quality management, and all clinical policies and programs. He currently leads IBC's efforts to improve the quality of patient care by transforming all primary care delivery to the patient-centered medical home model, which focuses on a team approach to well-coordinated primary care. Dr. Snyder serves on the board of directors for the Pennsylvania Health Care Quality Alliance and HealthShare Exchange of Southeastern Pennsylvania, a regional health information organization. He is a member of the AMA, the Pennsylvania Medical Society, the American Academy of Family Physicians, and the Pennsylvania Academy of Family Physicians. A graduate of Franklin & Marshall College and the Medical College of Pennsylvania, he is board certified by the American Board of Family Medicine.
    Presentation Material (Acrobat)
2:00 p.m. UPMC Health Plan

Roseann DeGrazia, MEd, BSN
Executive Director of Clinical Business Development, UPMC Insurance Services Division, UPMC Health Plan, Pittsburgh, PA

    Speaker Bio

    Roseann DeGrazia is the Executive Director for Clinical Business Development at UPMC Health Plan. In her current role Ms. DeGrazia is responsible for developing clinical business with ACOs and hospital systems across the state of Pennsylvania. She has extensive leadership experience in managed care Utilization Management, Case and Disease Management, Quality Management, Compliance, Network Management, and Policy Development. Ms. DeGrazia has over 35 years of clinical experience at UPMC. She has held a number of positions including Sr. Director of Utilization Management, Director of Quality Improvement, Senior Director of Compliance, Senior Director of Medicare Compliance & Operations, and Network Management. Her experience also includes Director of Quality for the Primary Care Network at the West Penn Allegheny Health System, Director of Quality at Magee Women’s Hospital in Pittsburgh, and over 15 years of direct patient care. She has a BSN from the University of Pittsburgh and a MEd from Penn State University. She is a graduate of the Pittsburgh Regional Health Initiative Toyota University and Leadership Pittsburgh. She has published several clinical abstracts and has presented at numerous national conferences.
    Presentation Material (Acrobat)
2:30 p.m. CDPHP

Eileen F. Wood, RPh, MBA
Vice President, Pharmacy and Health Quality Programs, Capital District Physicians Health Plan (CDPHP), Albany, NY

    Speaker Bio

    Eileen Wood joined Capital District Physicians' Health Plan (CDPHP) in 2005 and currently serves as vice president of pharmacy and health quality programs. She is responsible for the pharmacy benefit, clinical pharmacy programs, health care performance management, and quality management teams. Eileen is also focused on moving the company's Enhanced Primary Care initiative, a patient-centered medical home model, toward achieving the Triple Aim and delivering health care value to stakeholders. Through strategic partnerships with practitioners and the delivery of actionable information for patient populations, CDPHP seeks meaningful improvements in the total cost of care and health care quality indicators. Prior to joining CDPHP, Eileen served as vice president of clinical services and director of pharmacy services for Seton Health System in Troy, NY, part of the Ascension Health System. Eileen earned an MBA from Rensselaer Polytechnic Institute in Troy, NY, and a BS degree in pharmacy from St. John's University in Jamaica, N.Y. She is a licensed as a pharmacist in New York State.
    Presentation Material (Acrobat)
3:00 p.m. Networking Break in the Exhibit Hall
3:30 p.m. Priority Health

Mindy Olivarez, MBA
Director, Talent Mobility, Spectrum Health, Grand Rapids, MI

    Speaker Bio

    Mindy Olivarez is Director of Talent Mobility for Spectrum Health in Grand Rapids, Michigan, a not-for-profit health system based in West Michigan that includes hospitals, medical groups, and the health plan Priority Health. She was program manager for the Priority Health pilot project with TransforMED, a wholly owned subsidiary of the American Academy of Family Physicians, to transform five primary care practices in the Priority Health network to Patient-Centered Medical Homes. Previously she was Director of Healthcare Innovation at Priority Health, a nationally recognized health plan serving half a million people and 8,500 employers across 65 counties of Michigan's Lower Peninsula.
    Presentation Material (Acrobat)
4:00 p.m. Anthem Blue Cross & Blue Shield - Connecticut

Peter N. Bowers, MD
Lead Medical Director, Connecticut Market, Anthem Blue Cross & Blue Shield, Wallingford, CT

    Speaker Bio

    Dr. Peter Bowers is Chief Medical Officer of Anthem Blue Cross and Blue Shield in Connecticut, responsible for clinical affairs, development and execution of medical management, cost of quality care, and clinical support for sales in the Connecticut marketplace. Additionally, he has served as Medical Director for Anthem National Accounts and WellPoint's Payment Innovation which created novel value-based models of care delivery and transformation. He joined Anthem Blue Cross and Blue Shield in 2006 from the faculty of the Yale University School of Medicine as a Pediatric Cardiologist where he was active in teaching, clinical practice and biomedical research. Widely published, he has received awards from the Society of Pediatric Research, the American Academy of Pediatrics, the American College of Cardiology, and the American Heart Association. A cum laude graduate of Colby College and the University of Connecticut School of Medicine, his did his post graduate medical training in pediatrics at the University of Rochester and his fellowship training in pediatric cardiology and human molecular genetics at Yale.
    Presentation Material (Acrobat)
4:30 p.m. Faculty Panel and Audience Q&A

David K. Nace, MD
Vice President, Clinical Development, McKesson Corporation; Chair, Board of Directors, Patient Centered Primary Care Collaborative (PCPCC), King of Prussia, PA (Moderator)

    Speaker Bio

    Dr. David Nace is Chairman of the PCPCC and Vice President, Clinical Development for McKesson Corporation. Prior to McKesson, he served as a Senior Vice President and Chief National Medical Officer with Aetna, and subsequently with United Health Group. He is a Board Member for the Integrated Healthcare Association, a statewide multi-stakeholder group in California, and the Care Continuum Alliance based in Washington, DC. He also served as an advisor to the American Medical Association, the National Business Group on Health, the World Health Organization, and the International Labor Organization on issues ranging from health promotion and wellness to employer policy and health care financing issues. Dr. Nace earned his medical degree from the University of Pittsburgh.
5:15 p.m. Adjourn

MINI SUMMIT III: MEDICAL HOMES AND THE MEDICAL NEIGHBORHOOD
1:15 p.m. Welcome and Overview of the Mini Summit

Bruce Bagley, MD, FAAFP
President and Chief Executive Officer, TransforMED, Leawood, KS (Mini Summit Chair)

    Speaker Bio

    Bruce Bagley, MD, FAAFP, serves as president and CEO of TransforMED, a wholly owned subsidiary of the American Academy of Family Physicians. TransforMED provides ongoing consultation and support to physicians as they seek to implement the patient-centered medical home model of care in their practices. Previously, he served as the medical director for quality improvement for both the AAFP and TransforMED. Prior to joining the TransforMED staff in 2011, he enjoyed a long history of leadership with the AAFP where he also served as the organization's president from 1999 to 2000 and its board chair from 2000 to 2001. Later, his expertise was recognized on the national quality stage when he served from 2005 to 2007 as a Malcolm Baldrige Quality Award examiner. Dr. Bagley has been board-certified by the American Board of Family Medicine since 1976. He earned his medical degree from Albany Medical College in Albany, N.Y., and completed his family medicine residency at Saint Joseph's Hospital family medicine residency program in Syracuse, N.Y.
1:30 p.m. An Online Resource Database for the Neighborhood

Chinwe Onyekere, MPH
Director, Ambulatory Services and Business Development, Lankenau Medical Center, Wynnewood, PA

    Speaker Bio

    Chinwe Onyekere is Director of Ambulatory Services and Business Development at Lankenau Medical Center/Main Line Health. She is responsible for implementing innovative models for primary care medicine at the Lankenau Medical Associates: An Integrated Health Practice (NCQA Level 3 Patient Centered Medical Home Recognized Practice), developing a robust community health program and building relationships with community-based organizations in the Philadelphia area. In a prior position as a Program Officer at the Robert Wood Johnson Foundation, she focused on reducing health care disparities, reversing the childhood obesity epidemic, and identifying innovative ideas for breakthroughs in health and health care. Ms. Onyekere has also served as the Executive Director for Health Leads New York, where she established a new model of health care delivery in which patients' unmet resource needs are addressed as a standard element of patient care.
Madelaine Saldivar, MD, MPH
Director, Internal Medicine Clinical Care Center, Lankenau Medical Center, Wynnewood, PA

    Speaker Bio

    Dr. Madelaine Saldivar received her medical degree from Jefferson Medical College and her master's degree in Public Health from Columbia University. She practiced medicine in Baltimore, New York City, and Boston before returning home to Philadelphia. Her career interests include resident and patient education, population health management, and increased awareness of early prevention and intervention in disease management. Her clinical experience includes caring for underserved patients in urban, economically- and socially-challenged environments.

    At Lankenau Medical Center, Dr. Saldivar is the Medical Director of Lankenau Medical Associates, a multispecialty-practice that is the primary ambulatory medicine teaching site for Lankenau Internal Medicine Residency program and 5 subspecialty fellowship programs. As a teaching site, the practice engages in continuous quality improvement and clinical research projects. Most recently, the practice was also awarded the prestigious National Committee for Quality Assurance (NCQA) Level 3 designation as a patient-centered medical home. Dr. Saldivar was a leader in transforming the practice.
2:00 p.m. Greater Baltimore Medical Center at Hunt Valley

Robin M. Motter, DO
Family Physician, Greater Baltimore Medical Center at Hunt Valley; Department Chairman of Family Medicine, Greater Baltimore Medical Center, Hunt Valley, MD

    Speaker Bio

    Dr. Motter-Mast is Physician Leader for Patient-Centered Medical Home and Neighborhood at the Greater Baltimore Medical Center (GBMC). She oversees transformation of the health system's primary care offices into a standardized group of NCQA Level 3 PCMHs. She helped develop the care coordination and care management structure for the outpatient medical care team, while collaborating with the inpatient hospital team to create an organizational transition of care process. She and her organization are working on a CMMI grant with TransforMED on the development of a Patient Centered Medical Neighborhood. Dr. Motter-Mast sits on the board of GBMC's Accountable Care Organization and also serves as their Department Chairman of Family Medicine. She is a volunteer faculty member at the University of Maryland Medical School and System, where she completed her Family Medicine Residency in 2001.
    Presentation Material (Acrobat)
2:30 p.m. Atrinea Health

Philip D. Briggs, MD, MBA, FAAFP
Founder and Owner, Atrinea Health, Albuquerque, NM

    Speaker Bio

    After graduating from Stanford University with a BS in biology, Dr. Philip Briggs returned to New Mexico to study at the UNM School of Medicine. He opened his solo family practice in Santa Fe, NM after completing his residency program in 1980 and became involved in national medical advocacy and public health policy. He progressed through the offices of the NM chapter of the American Academy of Family Physicians and represented the state to the National Congress of Delegates. Dr. Briggs founded and built a surgical hospital in Santa Fe where he created an Independent Physician Association comprised of forty primary care physicians. In 2010, Dr. Briggs founded Atrinea Health, an urgent care and family medical home. The franchise concept frees up providers so they can practice medicine and leave the business operations to the corporate office. Currently Atrinea Health has 14 clinics in New Mexico and Arizona.
    Presentation Material (Acrobat)
3:00 p.m. Networking Break in the Exhibit Hall
3:30 p.m. Integrating Primary Care and Oral Health

Eric Penniman, DO
District Medical Director - Primary Care, Marshfield Clinic, Wausau, WI

    Speaker Bio

    Dr. Eric Penniman is currently the medical director for primary care for Marshfield Clinic. Dr Penniman has been instrumental in helping to lead the clinic's efforts in becoming recognized by NCQA as a tier 3 patient centered medical home for all of the primary care sites. Prior to serving as medical director for primary care, he served as the assistant medical director for quality improvement from 2004-2011. Within the past year, Dr. Penniman has gotten involved in leading efforts to better integrate oral health care into Marshfield Clinic's primary care medical homes. He is working with Marshfield Clinic's FQHC dental centers to help with this integration. The concept of reaching outside of the medical clinic setting to the "medical neighborhood" in order to maximize the health of the population of patients that Marshfield Clinic serves is now a top priority. Dr. Penniman graduated from the Kirksville College of Osteopathic Medicine in 1992. He graduated from his family medicine residency with the University of Wisconsin in 1995. He has practiced family medicine his entire career with the Marshfield Clinic.
    Presentation Material (Acrobat)
4:00 p.m. Engaging Medical Home Neighbors to Prevent Unnecessary Hospital Readmissions

Lisa M. Letourneau, MD, MPH
Executive Director, Maine Quality Counts, Manchester, ME

    Speaker Bio

    Dr. Lisa Letourneau serves as the Executive Director of Maine Quality Counts, a regional health improvement collaborative, and serves as physician champion for several quality improvement efforts, including the Maine Aligning Forces for Quality initiative and the Maine Patient Centered Medical Home (PCMH) Pilot. Dr. Letourneau is a graduate of Brown University and the Dartmouth-Brown Program in Medicine and is a board-certified internist who practiced emergency medicine for seven years before beginning her work in clinical quality improvement.

    Dr. Letourneau holds a Master's degree from the Harvard School of Public Health, and has a particular interest in helping to build connections between public health and clinical care, and the role of physicians in helping to develop and lead health improvement efforts.
    Presentation Material (Acrobat)
4:30 p.m. Faculty Panel

Bruce Bagley, MD, FAAFP
President and Chief Executive Officer, TransforMED, Leawood, KS (Moderator)

    Speaker Bio

    Bruce Bagley, MD, FAAFP, serves as president and CEO of TransforMED, a wholly owned subsidiary of the American Academy of Family Physicians. TransforMED provides ongoing consultation and support to physicians as they seek to implement the patient-centered medical home model of care in their practices. Previously, he served as the medical director for quality improvement for both the AAFP and TransforMED. Prior to joining the TransforMED staff in 2011, he enjoyed a long history of leadership with the AAFP where he also served as the organization's president from 1999 to 2000 and its board chair from 2000 to 2001. Later, his expertise was recognized on the national quality stage when he served from 2005 to 2007 as a Malcolm Baldrige Quality Award examiner. Dr. Bagley has been board-certified by the American Board of Family Medicine since 1976. He earned his medical degree from Albany Medical College in Albany, N.Y., and completed his family medicine residency at Saint Joseph's Hospital family medicine residency program in Syracuse, N.Y.
5:15 p.m. Adjourn


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