2018 Agenda At-A-Glance
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“A Commercial Health Plan’s Perspective”: Magellan’s Philosophy & Approach To Value Based Payment Arrangements
Plenary Address | February 15, 9:00 am
Gus Giraldo
President, Commercial Markets, Magellan Healthcare
Gus Giraldo joined Magellan Healthcare in 2016, and serves as the president of commercial markets. In this role, he leads the strategic development and management of the commercial markets team, including the account management and sales functions, and leverages customer service, claims and clinical operations to ensure customer satisfaction and engagement. An actuary by training, Giraldo came to Magellan with more than 20 years of leadership and expertise in the insurance industry, including a strong track record of growing global business through a focus on consumers, product innovation and analytics-driven solutions. In addition, Giraldo’s background includes many years delivering multinational healthcare benefits programs. With a focus on running organizations that focus on retail consumerism, Giraldo’s recent past experience includes time at Chubb’s Latin American life, accident and health business. Previously, he was at Cigna, where he spent more than 15 years in the company’s international business, including serving as chief operating officer for Cigna’s life insurance business and as chief executive officer of their Thailand business. In these roles, he helped create and launch Cigna’s healthcare strategy for China, Southern Asia/Oceania. He also achieved double‐digit top and bottom line growth, managed business integration efforts and sales channel diversification, and significantly improved net promoter scores. Giraldo’s background is particularly strong in the consumer and retail market spaces, having transitioned traditional business‐to‐business companies to direct‐to‐consumer models. A member of the Fellow of the Society of Actuaries, Giraldo earned his bachelor’s degree in mathematics from The Florida State University and his master’s degree in business administration from the University of Pennsylvania’s Wharton School of Business. ×
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Overcoming The Impediments To Value-Based Reimbursement
Plenary Address | February 16, 9:00 am
Carole A. Matyas, MSW
Vice President, Behavioral Health Operations, Wellcare Health Plans, Inc.
Carole Matyas is the Vice President of WellCare’s Behavioral Health Operations. She oversees enterprise wide behavioral health operations for the company, and a key focus for Carole is to assure that WellCare develops a fully integrated medical/behavioral program that is centered in whole person attention and care.
Carole has more than 30 years of behavioral health-related experience, with 15 of those years of experience in health plan operations. She joined WellCare in 2011 and previously worked for Magellan Health Services, first as a general manager for call center operations, and then as Chief of Clinic Operations, where she led practice management and operations of 23 mental health clinics and a psychiatric urgent care center in Arizona. Her additional experience includes serving as Vice President of Public Sector Operations for Schaller Anderson, a Medicaid managed care organization and helped to develop their integrated model; and as Vice President for Value Options, a managed behavioral health care company whose contracts included carve out managed care for state and government agencies, where Carole was executive lead on a large carve out program in Texas. Carole spent her early career as a licensed social worker providing direct clinical services in a group practice, community mental health and a residential treatment center.
In February 2013, Carole was appointed to serve on the Board of Directors for Drug Abuse Comprehensive Coordinating Office, Inc. (DACCO) in Tampa, Fl. Carole has been the recipient of awards from Mental Health America and NAMI for her dedication to mental health advocacy Carole earned both her undergraduate and Master of Social Work degrees from Marywood University in Scranton, Pennsylvania. ×
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How To Develop A Value Based Reimbursement Agreement: The Centerstone/Passport Health Case StudyBreakout Session | February 15, 10:15 am
Ken Carr
Senior Associate, OPEN MINDS
×Ken Carr brings over 20 years of finance, technology, data analysis and reporting experience in the health and human service field to OPEN MINDS. Before joining the OPEN MINDS team, he served as the Chief Financial Officer of The Centers, a community mental health center in Ocala, Florida. In this position, Mr. Carr led a realignment of the organization’s financial management functions. This included revenue cycle management, EHR bill implementation and reporting, cash management enhancement, and strategic financial analysis.
Prior to his role at The Centers, Mr. Carr served as Chief Financial Officer of Guild Incorporated, an organization providing residential and community based mental health services in St. Paul, Minnesota. As CFO, Mr. Carr led the financial, billing, IT, quality, informatics, compliance, and facilities activities. During his tenure at Guild Incorporated, Mr. Carr used his expertise in change management and business process improvement to lead the EHR implementation team, align service data reporting and financial performance, and lead the financial and data capture activities for new service initiatives.
Mr. Carr has also held the positions of Administrative Director and Finance Director at the St. Paul National Testing Laboratory, a biomedical testing facility of the American Red Cross. In those positions he oversaw activities to enhance inventory management, align financial results to industry standards, and improve financial and facilities performance through problem analysis and quality management initiatives. He also was involved in directing human resource functions during laboratory closing near the end of his tenure.
Mr. Carr earned a Bachelor of Science in Business Administration from the University of South Dakota, and a Master of Divinity Degree from Sioux Falls Seminary. He maintains an active CPA license with the State of South Dakota.
Debbie Cagle Wells
Chief Marketing Officer, Centerstone
Debbie Cagle is well-known and respected in the healthcare marketing, behavioral health and managed care industries, with more than 20 years of experience in the field. She has worked at Centerstone in a variety of roles for more than ten years including executive leadership for Advantage Behavioral Health, a behavioral health managed care company; Centerstone Military Services, which provides programs and services to veterans and their families; and Centerstone Health Partners, which recently established integrated care clinics for clients with physical and behavioral healthcare needs. Today, she leads marketing and business development for Centerstone, creating and driving business strategy for revenue growth and market share. This includes strategy and oversight of payer relations and contracting, referral marketing, grant writing, branding and communications.
Prior to joining Centerstone, Debbie served as chief operating officer of ValueOptions of Tennessee; vice president of AdvoCare of Tennessee, a subsidiary of Magellan Health Services, and she has directed behavioral health managed care services contracting for HCA, Inc. and Vanderbilt University Medical Center. Debbie graduated from Texas Woman's University with a B.S., dually certified in Special Education, Mental Retardation/ Learning Disabilities and Elementary Education.
She graduated from Texas Woman's University with a B.S., dually certified in Special Education, Mental Retardation/Learning Disabilities and Elementary Education. ×
Kelley Gannon, LCSW
Chief Operating Officer, Centerstone
Ms. Gannon is the Chief Operating Officer for Centerstone Kentucky, formally Seven Counties Services. As COO of Centerstone KY she is responsible for setting the strategic direction for four lines of service, Adult Mental Health, Child and Family Behavioral Health, Addiction Services and Intellectual and Development Services. Centerstone KY is the leading provider of behavioral healthcare in the Louisville region serving over 34,000 people annually.
Ms. Gannon has worked in the behavioral health field for twenty eight years. She has extensive experience in strategic planning and implementation and proven leadership in the application of Evidence Based Practices. She has leadership skills in coordinating and promoting collaborative relationships with community providers and key stakeholders to create real collective impact and positive outcomes. She has adept knowledge for developing practice management opportunities to support the mission of behavioral health. She earned her master’s degree in social work in 1994 from the University of Kentucky and her independent licensure in 2002. Most recently she earned her MBA from the University of Louisville.
Liz McKune
Vice President, Health Integration, Passport Health Plan
Liz McKune has worked with organizations in a variety of leadership roles over the past twenty years. She presently serves as the Director of Behavioral Health with Passport Health Plan. She previously served as President of the Kentucky Brain Injury Alliance and the Kentucky Psychological Association. She is a former member of the American Psychological Association Business of Practice Network Steering Committee, Director of Mental Health for the Kentucky Department of Corrections, and is a fellow of the Kentucky Public Health Leadership Institute. She previously served as a Clinical Associate Professor with the Spalding University School of Professional Psychology.
Specialties: Areas of expertise include: public health policy; program design and evaluation; integrated care; forensic mental health; leadership coaching; enhancing team member engagement; succession planning; and strategic planning with plan execution. ×
2018 Venue
Sheraton Sand Key Resort
1160 Gulf Blvd, Clearwater Beach, FL 33767
Reserve your room by January 24, 2018 and mention OPEN MINDS to get the discounted group rate of $214/night!
The only executive event focused on performance measurement and management in the areas of the health and human services field serving consumers with complex needs
The health and human services field is in a time of transition when it comes to financing and reimbursement models – particularly in the sectors of the field that serve consumers with complex needs.
And this transition is uneven – depending on the services an organization provides, its consumer base, and its geographic location. But the goal of this shift is the same across all payers – from Medicaid, to Medicare, to commercial payers, value-based care is the name of the game.
Weathering this transition from fee-for-service to value-based reimbursement is easier said than done for the executives of many provider organizations. What separates a successful shift to value from an unsuccessful one, is an organization embracing a new way of doing business – from top to bottom. This fundamental change in reimbursement is more than just a change in strategy, it requires a change in how organizations operate – their financial management systems, their performance metrics, and their talent management strategy.
Learn from the voices of experience in developing value-based reimbursement arrangements and making them work at The 2018 OPEN MINDS Performance Management Institute. This event is a “deep dive” into negotiating sustainable contracts with payers and health plans, building your organizational infrastructure for new business models, and realigning your management, financial, and clinical operations to optimize performance and success.
This year, attendees will:
- Gain an understanding of how to structure value-based contracts so they are mutually beneficial for you and your payers
- Discuss new techniques and strategies for improving performance
- Learn how to successfully manage multiple health plan value-based contracts
- Become skilled at identifying key considerations for partnering with ACOs
Whether you’ve already seen a shift away from fee-for-service, or are still anticipating the transition, join us this February in Clearwater, Florida to learn from industry thought leaders, innovators, and market experts who are making value-based care a success.
