Institute Agenda


Print-friendly Agenda
Day One Wednesday February 12
Day Two Thursday February 13
Day Three Friday February 14
8:00 am - 3:30 pm

The OPEN MINDS Integration Summit: New Models For Primary Care, Behavioral Health & Social Service Integration

Executive Summit

A number of factors are driving the growth of integrated care models, including the shift away from traditional fee-for-service reimbursement models to value-based reimbursement (VBR), particularly where providers are responsible for the total cost of care for a defined population.  The growing emphasis on population health has also spurred not only the growth of models integrating physical and behavioral health, but also the integration of physical health, behavioral health, social services and public health.

These growing and evolving models can require the development of a new organizational infrastructure, as well as new technical and financial competencies to ensure sustainability and success.

This executive summit is designed to help organizations across the country ensure their teams are prepared for implementing and supporting integration models and have all the required competencies needed for success.

In the summit, executive teams of provider organizations will:

  • Learn about the integration efforts of providers, including opportunities and challenges
  • Review the key competencies organizations will need for integration models of the future, including leadership, organizational infrastructure and financial management; technology infrastructure functionality; clinical performance optimization; and consumer access and engagement.
  • Discuss how to assess whether developing integrated programming should be part of an organization’s strategy

View the complete agenda!

John F. Talbot, Ph.D.

Vice President of Corporate Strategy, Jefferson Center for Mental Health, & Senior Associate, OPEN MINDS

John F. Talbot, Ph.D., Advisory Board Member, has more than 30 years of experience in all aspects of healthcare, including upper management, consultation, education, direct clinical work, and serving as the president of a non-profit board. Dr. Talbot has provided consultation, training and operational assistance to behavioral health providers, nonprofit organizations, and managed care organizations across the country. His areas of focus for consultation and training include strategic planning, the development of successful strategic alliances, board development, organizational reengineering, operations management, management and leadership development, and change management. He is currently Vice President of Integration Development at Jefferson Center for Mental Health in Denver, Colorado.

Prior to his current position, Dr. Talbot served as the President of a network of agencies providing care to children and families. The innovative work of Colorado Care Management received national recognition, including participation in a Federal IV-E waiver study that demonstrated measurable superior clinical outcomes. In his role with Colorado Care Management, Dr. Talbot also led the development of a coalition of Colorado business executives to address the issues of providing care to abused and neglected children, and the establishment of a nationwide purchasing cooperative for non-profits. Dr. Talbot’s previous experience included serving as the Director of the Master of Health Systems Program, and Associate Dean of University College at the University of Denver. He also held senior management positions at Mount Airy Psychiatric Center in Denver, Colorado.

Dr. Talbot has been a featured speaker at a number of national and state venues including the National Council Community Behavioral Health, Mental Health Corporations of America, the American Association of Residential Treatment Centers, the Medical Group Management Association, the Colorado Behavioral Health Council, the Mental Health Council of Arkansas, the New Jersey Association of Mental Health Agencies, and the Florida Behavioral Health Council.

Dr. Talbot is the former publisher and editor of Today’s Healthcare Manager, a newsletter focusing on leadership and management skills for healthcare managers, and has written numerous articles, manuals, and book chapters. His volunteer work includes serving as the President of the Board of Human Services Inc. in Colorado.

×

Tine Hansen-Turton

President & Chief Executive Officer, Woods Services, Inc.

Tine Hansen-Turton is the President and Chief Executive Officer of Woods Services, a leading advocacy and service organization for people with exceptional challenges, disabilities and complex needs. Ms. Hansen-Turton formerly served as the Chief Operating Officer at Public Health Management Corporation, where she oversaw and led corporate strategy, operations, business development and M&A. Additionally, Ms. Hansen-Turton served as CEO of the National Nurse-led Care Consortium, a non-profit organization supporting the growth and development of over 500 nurse-managed and school health clinics.  Ms. Hansen-Turton still serves as the founding Executive Administrator for the Convenient Care Association (CCA), the national trade association of over 2200 private-sector retail clinic industry, serving 25 million people with basic health care services across the country.  Ms. Hansen-Turton also teaches public and social innovations, leading nonprofits, health policy and the social innovations lab at University of Pennsylvania Fels Institute of Government and School of Nursing. Ms. Hansen-Turton is founder and publisher of a social impact/innovation journal and has co-published eight books. She received her BA from Slippery Rock University, her Master of Government/Public Administration from University of Pennsylvania Fels Institute and her Juris Doctor from Temple University Beasley School of Law.

×

Joel Hornberger, MHS

Chief Strategy Officer, National Training and Consulting Director, Cherokee Health Systems

Joel Hornberger is the Chief Strategy Officer and National Training and Consulting Director at Cherokee Health Systems, a federally-qualified community health center and community mental health center in Tennessee. In this position, he is responsible for developing and executing the strategic direction of Cherokee, including strategic planning, mergers, acquisitions and new business development. He also provides practice consulting, focusing on integrated care, practice transformation, innovation, and alternative payment strategies. He consults extensively with national clients regarding integrated care operations, execution, integrated care financial sustainability, and value-based contracting. Previously, Joel served as Cherokee's Chief Operating Officer for 25 years, handling the day-to-day operations of its 46 integrated care practice sites across the State. (www.cherokeehealth.com).

Prior to joining Cherokee Health Systems, Joel worked in managed care at Blue Cross and Blue Shield of Florida, Hospital Corporation of America (HCA Health Plans) and Partners National Health Plan. In these positions, he worked on HMO start-ups, managed care and cost containment strategies.

Joel earned a Master's Degree in Health Services Administration at the Johns Hopkins University School of Public Health. He completed a 2-year, Kellogg-funded International Health Leadership Fellowship in the International Center for Health Leadership Development at the University of Illinois Chicago.

×

Lisa Kay

Clinical Program Manager, Cigna

Lisa is the Clinical Transformation Lead for Cigna Medical Group where she is responsible for executing on strategies to enhance care delivery and improve patient outcomes. She is passionate about a holistic approach to care that considers both the mind and body. Lisa holds Master’s degrees in Social Work and Business Administration. She is further certified as a Mental Health First Aid instructor.

Lisa has been a member of the Cigna team for 11 years. During that time she has held various positions organization including Behavioral Network, Training and Communications, Cigna Collaborative Care, and Clinical Program Development. As a part of her work she has convened the Cigna Behavioral Integration Advisory Council to bring providers and clients together to strengthen approaches to behavioral health and wellness. Further, Lisa is actively engaged in promoting mental health care for women as a member of the American Congress of Obstetricians and Gynecologists Expert Workgroup for Maternal Mental Health.

Lisa splits her time between Arizona and Maryland and spends much of her time off of work being a mom to her two daughters and pursuing their goal of visiting all 50 states by her eldest daughter’s high school graduation.

×

Michael Lawton

Chief Executive Officer, UnitedHealthcare Community Plan of Florida

Michael Lawton is the Chief Executive Officer of the UnitedHealthcare Community Plan of Florida. Leading a team of over 400 associates, helping the 350,000 members in Medicaid Managed Care, Long Term Care, Dual Special Needs Plan (DSNP) and Children’s Health Insurance Plan (CHIP), lead healthier lives and helping the health system work better.

Before joining UnitedHealthcare, Michael served as Vice President of Managed Care and Network Development for the University of Florida Health System and Shands Hospital, where he operated a Medicaid Provider Sponsored Organization on behalf the University and lead all managed care operations for over 2000 physicians and 7 hospitals. He has served for more than 25 years in various executive roles in health systems and managed care organizations and has served the health care industry in Michigan, Ohio, Kentucky, Missouri, and Florida.

×

Annette Lusko, D.O.

Deputy Chief Medical Officer, Community Bridges, Inc

Dr. Lusko graduated from Midwestern University with a B.S. in Biomedical Science, she continued her medical education at Midwestern University AZCOM. Dr. Lusko completed a Family Medicine Residency with Mountain Vista Medical Center and became boarded in Family Medicine. After residency she continued to work as an attending physician in a family medicine residency. While in primary care she became profoundly aware of how primary care, addiction, and mental health were aspects of medicine that needed a multidisciplinary approach for treatment to be successful. While working at a Federally Qualified Health Center in Apache Junction, AZ she began the first FQHC grant funded Medication Assisted Treatment Program, helping to develop a collaborative care model of mental health and primary care treatment.

At Community Bridges Dr. Lusko took on the role as Medical director for Physical Health and Addiction Medicine. Dr. Lusko has an active panel practicing in both primary care and addiction medicine in both inpatient and outpatient settings. Community Bridges has provided Dr. Lusko the tremendous support of the integration of behavioral health, physical health, and addiction medicine, that is truly the only way to treat the whole person. Dr. Lusko was named as Associate Program Director for Arizona’s first Addiction Medicine Fellowship through Honor Health and Community Bridges. As core faculty she works closely with the Addiction Fellows throughout their clinical rotations and didactics, she is strongly committed to providing an integrated training experience. The opportunity to train providers has allowed Dr. Lusko and CBI to take an active role in shaping the treatment and understanding of addiction, mental health, and Primary care.

×

Donald Parker, LCSW

President, Hackensack Meridian Health Carrier Clinic

Donald J. Parker, a licensed clinical social worker, is president and chief hospital executive of Hackensack Meridian Health Carrier Clinic, the largest nonprofit behavioral health system in New Jersey, and president of Hackensack Meridian Health Behavioral Health Care Transformation Services/Integrative Medicine. In business for more than a century, Carrier Clinic operates an acute care mental health hospital, a residential treatment center for adolescents, a fully accredited special needs school for students grades 7 through 12, and the Blake Recovery Center, an inpatient unit focused on addiction recovery.

Don can offer unique insights into:
- The 25 percent rise in suicide rates across the United States
- Industry challenges, including the battle against opioid abuse
- The latest industry practices
- Emerging urgent care services in addiction and behavioral health
- Hospital and mental health center mergers
- Behavioral health center redesigns: a new functionality

Professional Background
Prior to joining Carrier Clinic in 2013, Parker served as the vice president for  physician services and ambulatory care at St. Joseph's Health System, Paterson, N.J. Previously, Parker was appointed as president/CEO of Atlantic Mental Health for 15 years and subsequently merged into the AtlantiCare

×

9:00 am - 12:00 pm

How To Develop A Strategic Plan: An OPEN MINDS Executive Seminar On Best Practices In Strategy, Portfolio Management & Scenario-Based Planning

Executive Seminar

In the current health and human service market, executives face their fair share of uncertainty. This leads many executive teams to either avoid or reluctantly initiate any major strategic initiatives that require long-term commitments. Unfortunately, “waiting for the dust to settle,” so to speak, isn’t a wise management choice. Regardless of the specifics of what lies ahead in the market, there are future developments that are likely and need to be addressed in the planning process. A successful strategic planning process will provide your organization with a roadmap – not only for developing plans in uncertain times, but also for putting those plans into action and evaluating their success. In this crucial seminar, we will discuss OPEN MINDS' three-phase approach to strategy development, including:

  • The OPEN MINDS best practice approach to building a strategic plan
  • A guide to strategy implementation planning
  • An in-depth review of how to manage strategy implementation for success

Drew Di Giovanni

Senior Associate, OPEN MINDS

Drew DiGiovanni, MPH, FACMPE, brings over thirty years of marketing, management, and strategy experience to the  OPEN MINDS team.  This broad knowledge has contributed to his success in service innovation, service line development, and market positioning.

Mr. DiGiovanni previously served as the Vice President of Quality for Premise Health/ CHS Services.  In this role Mr. DiGiovanni led the development and implementation of a performance management program 150 clinic locations in thirty-eight states.  When the organization completed a merger with Take Care, he led the integration plan for 500 service locations.   Throughout his tenure with Premise Health, Mr. DiGiovanni was also responsible for patient satisfaction, clinical quality, risk management, facilities and compliance auditing, operational efficiency and workflow redesign, policy management and document control, and patient safety programming.

Prior to his work with Premise Health, Mr. DiGiovanni served as the Director of Education and Distance Learning for the Medical Group Management Association (MGMA).  During his tenure, he directed a revenue center of over ten million dollars and maintained consistent increase in revenue with a ten to fifteen percent growth yearly.

In this role, Mr. DiGiovanni developed a comprehensive curriculum in ambulatory care administration, with focus on operational efficiency, finance, compliance, and executive leadership.   He also created a professional bootcamp for MGMA.

Earlier in his career, Mr. DiGiovanni served in multiple roles with the Mendocino Community Health Clinic in Ukiah, California including Director of Marketing & Strategic Planning, Director of Operations and Director of Support Services.

In addition to his commercial experience, Mr. DiGiovanni was also an  Associate Professor position at Regis University in Denver.   He developed and taught courses in marketing for for physicians and administrators in the university’s Healthcare MBA program.  Mr. DiGiovanni also co-developed the online curriculum for Healthcare Marketing for the institution.

×

1:00 pm - 4:00 pm

How To Build Value-Based Payer Partnerships: An OPEN MINDS Executive Seminar On Best Practices In Marketing, Negotiating & Contracting With Health Plans

Executive Seminar

Across the country, managed care organizations are successfully delivering treatment services to large populations and doing it in a way that saves states significant sums of money. These demonstrated savings show that value-based reimbursement and managed care arrangements aren’t going anywhere, which means that executives of provider organizations must find a way to position themselves to work closely with managed care companies.

How? By developing relationships with the payers in your market, considering what metrics they are tied to and how you can help them to meet their performance requirements, discussing how you can align programs and services with the goals of the payers and health plans in your market, and providing data that proves your service lines can achieve both high quality outcomes and lower costs. In this crucial seminar, we will discuss:

  • How to start strategic conversations with health plans
  • How to demonstrate your organization’s value in way that will capture health plan’s interest
  • How to secure and optimize service agreements with health plans

Paul Duck

Senior Associate, OPEN MINDS

Paul M. Duck brings over 40 years of experience in leadership and management focusing on managed care, health information technology organizations, strategy, business development, and market expansion, and customer experience optimization to the OPEN MINDS team.

Prior to joining OPEN MINDS, Mr. Duck served as the Vice President, Strategy & Development at Beacon Health Options. In this role, Mr. Duck led the organization’s strategy and business development efforts – responsible for a 30% increase in net revenue and initiated over $1 billion in revenue generation. Mr. Duck was active in national behavioral health initiatives as an executive of Beacon Health Options, including participating as a speaker at national and state association meetings.

Before joining Beacon Health Options, Mr. Duck was the Vice President of Business Development at Netsmart Technologies. During his tenure, Mr. Duck was responsible for business planning, including, the oversight of strategic activities including acquisitions, development, and execution of strategic initiatives, and positioning, and sales of large strategic customers. He also led the rollout of the company’s benchmarking and data analytics product suite.

Prior to Netsmart, Mr. Duck served as the Chief Executive Officer for Coastal Orthopedics and Pain Management, a large group practice with five clinic locations and two ambulatory surgical centers. As the organization’s chief executive officer, Mr. Duck was responsible for significant positive changes in leadership and corporate culture, financial and operational performance, compliance, and governance. Mr. Duck improved net collections by over $1 million per month and grew the practice through negotiating better contract rates with payers. He also implemented an organizational rebranding initiative and launched a new marketing campaign.

Prior to Coastal Orthopedics and Pain Management, Mr. Duck served as the President and Chief Executive Officer for Florida Radiology Imaging, one of the largest outpatient diagnostic imaging service companies serving the greater Orlando market. During his tenure, Mr. Duck led the construction of three new, full modality, diagnostic imaging locations. Mr. Duck revolutionized the company’s culture by creating a highly attractive and functional work environment.

Mr. Duck earned his Bachelor of Arts in Business Management from Case Western Reserve University. He earned his Associate of Arts in Electronic Engineering Technology from the Electronic Technology Institute. Mr. Duck received an award by Inc Magazine for leading Florida Radiology Imaging as one of America’s fastest-growing companies. Mr. Duck recently served as a contributing author to the book The New Health Age: The Future of Health Care in America.

×

6:30 am - 7:30 am

Morning Beach Walk

Activity

Begin your day by joining us for a refreshing hour long walk along the ocean on Clearwater Beach!  Bottled water to take on your walk will be provided by OPEN MINDS. Meet at the beach entrance by the towel stand at the swimming pool.


7:30 am - 8:30 am

Registration & Executive Networking Breakfast

Networking

Check-in at the registration desk to get your name badge and program materials, then join us in the exhibit hall for breakfast. Take some time to meet your fellow attendees, talk to our sponsors, and prepare for the day ahead.


8:30 am - 9:00 am

Announcement Of The Results From The 2020 OPEN MINDS Performance Management Executive Survey: Where Are We On The Road To Value?

Introduction

During this opening session, OPEN MINDS Chief Executive Officer, Monica E. Oss will present the results of The 2020 OPEN MINDS Performance Management Executive Survey: Where Are We On The Road To Value. In its fourth year, the survey tracks adoption of value-based reimbursement by specialty provider organizations including the dominant models and performance measures used. Ms. Oss will discuss the implications and provide advice on how to make sure your organization keeps pace with the rest of the field.

Monica E. Oss

Chief Executive Officer, OPEN MINDS

Monica E. Oss, M.S., Chief Executive Officer and Senior Associate, is the founder of OPEN MINDS. For the past two decades, Ms. Oss has led the OPEN MINDS team and its research on health and human service market trends and its national consulting practice. Ms. Oss is well known for her numerous books and articles focused on the strategic and marketing implications of the evolving health and human service field. She has unique expertise in payer financing models, provider rate setting, and service pricing. She has led numerous engagements with state Medicaid plans, county governments, private insurers, managed care programs, service provider organizations, technology vendors, neurotechnology and pharmaceutical organizations, and investment banking firms – with a focus on the implications of financing changes on delivery system design.

 

×

9:00 am - 10:00 am

Improving Care: Engaging Communities & Providers Is Key To Success In The Complex Consumer Market

Keynote Address

As more and more states look to serve the intellectual and/or developmental (IDD), population under a managed care model, the success of these alignments depend heavily on the engagement of all stakeholders. For years this population of people was served in institutional settings, yet as the institutions began to close there was a gap in developing the provider network and preparing the wider communities on the needs of this population. Medically and behaviorally this population can be challenging to support, especially when the community resources and provider infrastructures are not fully prepared. Developing these resources and infrastructure is imperative to success.

Tonya D. Copeland, MBA, Vice President, I/DD Services at UnitedHealthCare Community Plan will discuss their efforts to address these challenges in Tennessee, their work with LTSS providers to build an infrastructure for a fully integrated model of care and how UnitedHealth Care of Tennessee is working side by side with provider organizations.

Tonya Copeland

Vice President, I/DD Services & Employment & Community First CHOICES, UnitedHealth Care

Tonya is Vice President of Intellectual and Developmental Disability Services at UnitedHealthcare Community Plan of Tennessee. UnitedHealthcare Community Plan is the local operation of UnitedHealthcare Community & State, which is a division of UnitedHealth Group (NYSE: UNH), a diversified health and well-being company with a mission to help people live healthier lives and help make the health system work better for everyone.

In this role, Tonya is responsible for leading, implementing and managing the Employment and Community First CHOICES program that serves people with Intellectual and/or Developmental Disabilities (I/DD). She also oversees the team that manages people with I/DD on other state run waivers who receive their medical and behavioral care from UnitedHealthcare.

Prior to her current role, Tonya served as an executive in the provider community for over 20 years. She worked at two regional provider agencies that deliver residential and other community based supports. Tonya also served on the statewide provider association board for over 10 years. She chaired the Governmental Affairs committee for more than seven of those years, and was instrumental in advocating for continued improvements in service delivery as well as appropriate reimbursement structures for the providers.

Tonya completed a Bachelor’s degree in Social Work from Tennessee State University in Nashville, TN. She also holds a Master of Business Administration degree from Bethel University.

×

10:15 am - 11:00 am

Bridging The Gap Between Mind & Body Through Integrated Technology

Product Theater Demonstration

Sponsored by Streamline Healthcare Solutions

Health care providers and government officials understand that an individual’s mental health is just as important as their physical health and how closely the two are related. The holistic approach to care has, and continues to improve the overall well-being of clients and provides benefits to the providers and payers. Kevin Sullivan, Director of Client Solutions with Streamline will demonstrate how SmartCare, Streamline’s fully web-based Electronic Health Record, incorporates documentation for both behavioral health and primary care to create a complete, fully integrated client record.

Join us and learn how SmartCare’s intuitive platform will support your organization and the clients you serve now and in the future!

Kevin Sullivan

Director of Client Solutions, Streamline Healthcare Solutions

Kevin joins Streamline with over 25 years of healthcare experience. He worked in direct client care positions in both mental health and substance use, as well as inpatient and outpatient settings. For the latter part of the 1990’s, Kevin managed the admissions department at the Betty Ford Center. Beginning in 2000, Kevin’s focus shifted from direct client care to working more behind the scenes on the technical side of behavioral healthcare systems; supporting the systems that enable clinicians and support staff to do their work more efficiently. Kevin continued working with healthcare software, implementing solutions for small agencies all the way up to large county applications. Kevin holds a Bachelor of Arts in Psychology and Master’s Degree in Computer Science.

×

10:15 am - 11:30 am

Thought Leader Discussion Session With Tonya Copeland, Vice President, I/DD Services & Employment & Community First CHOICES, UnitedHealth Care

Breakout Session

Join us for a follow-up session with our keynote speaker, Tonya Copeland, Vice President, IDD Services & Employment & Community First CHOICES, UnitedHealth Care. Use this time to ask questions and continue the morning’s discussion with Ms. Copeland and OPEN MINDS Chief Executive Officer Monica E. Oss.

Tonya Copeland

Vice President, I/DD Services & Employment & Community First CHOICES, UnitedHealth Care

Tonya is Vice President of Intellectual and Developmental Disability Services at UnitedHealthcare Community Plan of Tennessee. UnitedHealthcare Community Plan is the local operation of UnitedHealthcare Community & State, which is a division of UnitedHealth Group (NYSE: UNH), a diversified health and well-being company with a mission to help people live healthier lives and help make the health system work better for everyone.

In this role, Tonya is responsible for leading, implementing and managing the Employment and Community First CHOICES program that serves people with Intellectual and/or Developmental Disabilities (I/DD). She also oversees the team that manages people with I/DD on other state run waivers who receive their medical and behavioral care from UnitedHealthcare.

Prior to her current role, Tonya served as an executive in the provider community for over 20 years. She worked at two regional provider agencies that deliver residential and other community based supports. Tonya also served on the statewide provider association board for over 10 years. She chaired the Governmental Affairs committee for more than seven of those years, and was instrumental in advocating for continued improvements in service delivery as well as appropriate reimbursement structures for the providers.

Tonya completed a Bachelor’s degree in Social Work from Tennessee State University in Nashville, TN. She also holds a Master of Business Administration degree from Bethel University.

×

Monica E. Oss

Chief Executive Officer, OPEN MINDS

Monica E. Oss, M.S., Chief Executive Officer and Senior Associate, is the founder of OPEN MINDS. For the past two decades, Ms. Oss has led the OPEN MINDS team and its research on health and human service market trends and its national consulting practice. Ms. Oss is well known for her numerous books and articles focused on the strategic and marketing implications of the evolving health and human service field. She has unique expertise in payer financing models, provider rate setting, and service pricing. She has led numerous engagements with state Medicaid plans, county governments, private insurers, managed care programs, service provider organizations, technology vendors, neurotechnology and pharmaceutical organizations, and investment banking firms – with a focus on the implications of financing changes on delivery system design.

 

×


Workforce Innovation In A Complicated Market: Using Technology To Augment Staff & Increase Clinical Effectiveness

Breakout Session

For any service provider organization, their workforce is their most important strategic asset, and managing that asset is a critical competency and a challenge. Strategically, the goal for every organization is to bring maximum value for their investment in human capital. Although the path to achieving that maximum value is multi-faceted — using technology as a substitute or as an enhancement of human labor can play a significant role in addressing this complex issue.

In this exciting session, we will take a look at how technology is being used to augment staff and hear from organizations that are seeing results from using such tech tools.

James Stewart

President & CEO, Grafton Integrated Health Network & Advisory Board Member, OPEN MINDS

Jamie Stewart brings to OPEN MINDS over twenty years of experience in the healthcare field. Mr. Stewart has helped develop and modify Healthcare plans and benefits, Retirement Plans and benefits, and PTO Plans for multiple behavioral healthcare providers. He has also had an integral role in program development and business planning for new strategic business lines. Additionally, he has led multiple teams in the selection, implementation, and use of multiple Electronic Health Record Systems at several behavioral health care entities.

Mr. Stewart currently serves as the Chief Executive Officer at Grafton Integrated Health Network. He previously served as the Executive Vice President, Chief Administrative Officer, where he was responsible for the supervision of the Finance Departments, Contracting (both payer and vendor), Information Technology, Human Resources, Risk Management, Facilities Department, The Infant and Toddler Program, and the Education Department. He has participated and enabled the expansion of services through the acquisition of facilities and extension of the organization’s IT/HR network into Florida, West Virginia and Australia. He also spearheaded the process of developing and implementing a new paperless Electronic Health Record, as well as a new accounting software that integrated with the Electronic Clinical Record and Billing System.

Prior to working at Grafton, Mr. Stewart was the Chief Financial Officer for the Center for Behavioral Health at Centerstone. In this position, he managed the coordination of a multi-disciplinary team through development and implementation of a Davies Award Winning Electronic Health Record. He developed new clinical programs to meet identified locality needs and established a merger between Non-Profit CMHC’s, which crossed state boundaries.

Mr. Stewart received his MBA with a Healthcare Administration focus from Indiana Wesleyan University. He received a Bachelor of Science degree in Accounting from the University of Kentucky.

×

Dimitrios Cavathas, LCSW-C

Chief Executive Officer, Lower Shore Clinic

Dimitrios has been the CEO of the Lower Shore Clinic (LSC) since 2016, a private non-profit organization established in 1979. The organization has 160 employees serving over 2000 persons in the Wicomico, Worcester, Somerset, & Dorchester communities of the Eastern Shore of Maryland. Services provided include primary care, heath home services, outpatient behavioral healthcare, medicated assisted treatment, substance abuse treatment, vocational services, psychosocial & residential rehabilitation, supportive housing, residential crisis beds, & assertive community treatment teams. He is a Licensed Certified Social Work-Clinical & holds a Certificate in Child & Adolescent Treatment from the University of Maryland School of Social Work (UMSSW) & is a subject matter expert on homelessness & assertive community treatment. Prior to his current role he was an Adjunct Associate Professor at the UMSSW for 11 years teaching Advanced Mental Health & Social Policy & has been in Non-Profit Executive Leadership for 21 years in urban, suburban, and now rural settings. In his leadership he strives every day to promote the recovery of all. This means that the community & the people LSC serves are healthy, have a stable & safe place to live, find a purpose they find meaningful for their life, & experience support, friendship, love, & hope.

×

Kristen D. Daugherty, LISW, LCSW, MBA

Chief Executive Officer, Emergence Health Network

Kristi Daugherty, CEO for Emergence Health Network, has over fifteen years of experience in the behavioral health arena. As chief executive for El Paso County’s Mental Health/Intellectual Disabilities Authority for El Paso County, Ms. Daugherty is responsible for all clinical and oversight services delegated through performance contracts with Texas Health & Human Services.

Previously, Ms. Daugherty served as Chief Clinical Officer for Emergence and as Director for Sun City Behavioral Health Care, Emergence’s non-profit subsidiary. She also has extensive experience in the private behavioral health sector, serving as Director of Clinical Services University Behavioral Health in El Paso and Director of Outpatient Services Mesilla Valley Hospital in Las Cruces, New Mexico.

Ms. Daugherty is a Licensed Clinical Social Worker in the State of Texas and a Licensed Independent Social Worker in the State of New Mexico. She has a Master’s Degree in Social Work from New Mexico State University and is a graduate of the Executive MBA Program at the University of Texas at El Paso.

×


Tech Budgeting For Integrated Care & Value-Based Reimbursement

Knowledge Partner

Sponsored by Qualifacts Systems, Inc.


11:45 am - 1:00 pm

What Does It Take To Be A Center Of Excellence? The Changing Market Role For Specialty Provider Organizations

Breakout Session

Centers of Excellence (COEs) have been a strategy to promote quality and achieve healthcare cost savings for a variety of conditions in the medical space for some time. COEs leverage pre-defined quality and cost measures to form a narrow network with benefit designs used to reward consumers to use the most effective, high value treatment providers. While this approach has been in place for over a dozen years in the medical arena, this is a relatively new approach for conditions related to behavioral health and substance use. In this session we will hear from payers on how they are designing and implementing COEs tied to behavioral health conditions including reimbursement approaches, selection criteria, impact on consumer quality outcomes and healthcare cost savings. We will also hear from provider organizations that have earned COE status on their experiences including best practices and lessons learned.

Deb Adler

Senior Associate, OPEN MINDS

Deb Adler brings more than 20 years of experience in executive health care roles, serving in a variety of capacities including network executive, quality management executive and chief operating officer, to the OPEN MINDS team.

Her consultant work with OPEN MINDS spans a broad range of customers (provider organizations, payors and government programs) and topics, including: collaborative care models/medical behavioral integration, provider network functions– contracting, network designs/tiering, recruitment, telehealth network implementation, and strategic planning. In addition, Ms. Adler has a special interest in helping technology-enabled providers in “go-to-market” strategies and streamlining network functions.

Since entering the managed behavioral health care field, she has become an industry-recognized leader in value-based contracting and alternative payment models. An innovator known for her ability to execute results, she has facilitated network designs and benefit plan approaches that achieve both quality outcomes and healthcare cost savings.

Before joining OPEN MINDS, Ms. Adler served as Senior Vice President of Network Strategy for Optum (now UnitedHealth Group) where she was responsible for behavioral health network development, contracting, and strategy for over 185,000 providers. In this role she developed the largest, performance-tiered behavioral health network, largest telemental health network, and largest medication assisted treatment (MAT) network. She was also responsible for implementing network initiatives to promote medical/behavioral integration, improve member outcomes, and reduce total cost of care through collaborative care models.

Prior to joining Optum/UnitedHealth, Ms. Adler spent over 12 years with ValueOptions, Inc. (now Beacon Options) where she held a variety of senior leadership roles including, Executive Vice President of National Networks; Chief Executive Officer, Health Plan Division; Vice President, Network Operations; Executive Director, Corporate Quality Management; and Executive Director, Quality & Information Systems. She was responsible for quality management and coordinated NCQA and URAC accreditation efforts.

Ms. Adler spent her early career in health care quality, serving as a quality director in two state-run psychiatric centers.

Ms. Adler received her Master’s degree in educational psychology and evaluation from Catholic University of America and is a Certified Professional in Health Care Quality (CPHQ).

×

Erin Boyd

Behavioral Network Strategy, Solutions & Program Director, Cigna

Erin Boyd is the Behavioral Network Strategy, Solutions and Program Director for Cigna Behavioral responsible for network marketing and communications, developing network strategy and overseeing network programs and solutions to drive innovation, cost-savings, improved outcomes and better care for Cigna customers. Erin has been with Cigna for three years. She provides a unique perspective to this role having most recently served as Senior Director of Business Development and Marketing for a behavioral hospital system as well as having 20 years of experience in medical healthcare communications, marketing, public relations and strategic planning.

×

Pablo McCabe, LCSW

Director, National & Strategic Accounts Team, Hazelden Betty Ford

Bio Coming Soon!

×

Debra Nussbaum, Ph.D., LCSW

Senior Director, Behavioral Product, Optum

Deb started with Optum in 2009 as Director of Clinical Operations. In 2013, Deb moved into national role as a Sr. Director of Behavioral Health Product. Deb is a co-founder and clinical lead for Optum's national substance use disorder (SUD) initiatives. Deb has successfully championed many projects within Optum designed to improve member access to evidence based services, the development of the nation's largest MAT network and the 24/7 SUD helpline and live chat capabilities.

Debra's clinical background has been primarily in substance use services in progressive leadership roles managing and developing treatment programs aimed at improving outcomes in addiction treatment services. Deb has a PhD in organizational psychology and is LCSW licensed in Florida and in New York.

×


Rethinking Revenue Cycle Management: How To Optimize Operations For A Value-Driven World

Breakout Session

In a value-driven world, one of the most important changes organizations have to make is expanding their revenue cycle management model. To facilitate an effective transition away from fee-for-service reimbursement structures, focus must be placed on expanding an organization’s healthcare revenue cycle management strategies. Provider organizations that understand how to manage costs, while delivering quality service and better outcomes, will be in the best positioned to thrive.

In this session, attendees will learn about how to broaden their thinking on revenue cycle management and how to optimize their revenue cycle for value-based reimbursement.

Joseph P. Naughton-Travers, EdM

Senior Associate, OPEN MINDS

Joseph P. Naughton-Travers, Ed.M., Senior Associate, has more than 30 years of experience in the health and human service field. In this tenure as senior associate with OPEN MINDS since 1998, he has served as lead of dozens of client initiatives, served as editor of OPEN MINDS publications, and is the author of many groundbreaking articles and presentations.

Mr. Naughton-Travers brings to OPEN MINDS a broad range of experiences in private and public sector delivery of behavioral health and social services. He started his career as a behavioral health clinician, working in both child welfare and community mental health clinic settings. Subsequently, Mr. Naughton-Travers held a senior business operations management position for a psychiatric hospital system and its community mental health clinics.  Later, he was vice president of a firm specializing in information systems and billing and receivables management for community-based mental health programs.

Since joining OPEN MINDS, Mr. Naughton-Travers has developed business solutions for provider and professional organizations, state and county government, technology companies, and venture capital firms. His primary areas of expertise include strategic planning and metrics-based management, electronic health record (EHR) and technology selection and implementation, operations improvement, and corporate compliance. For the past decade, over half his consulting practice has focused on aiding organizations in technology selection and implementation, including all aspects of strategic technology planning, functional specifications development, request for proposal development, vendor selection, and contracting.

He has written numerous articles, including “Winning the Human Resource Wars: Tried, True and New Strategies for Behavioral Health and Social Service Organizations,” “Five Pillars of Management Competency,” “Data Driven Decision Making: Moving to an Organizational Measurement Culture,” “Survival of the Smartest: What is Your Organization’s Information Literacy IQ?,” and “Strategic Human Resource Management: Aligning Compensation with Employee Performance and Organizational Strategy.” Mr. Naughton-Travers is also a nationally recognized speaker, having conducted hundreds of executive and professional executive training events around the nation.

Mr. Naughton-Travers received his Bachelor’s degree from Miami University of Ohio and his Masters’ of Education in Counseling Psychology from Boston University.

×

Vanessa R. Lane, MBA

Vice President, Revenue Cycle Management/ Data Analytics, Grafton Integrated Health Network

Vanessa Lane is the Director of Revenue Cycle Management at Grafton Integrated Health Network.  She has over twenty years of experience in the healthcare field. Ms. Lane has experience managing accounts receivable, contracting, admissions, authorizations and front desk functions in a healthcare setting. She also has extensive experience in working with multiple state Medicaid systems to develop and implement policy changes.  Additionally, she has participated in multiple teams in the selection, implementation, and use of multiple Electronic Health Record Systems.

Prior to working at Grafton, Ms. Lane was the Manager of Accounts Receivable for the Center for Behavioral Health at Centerstone. In this position, she managed the revenue cycle through multiple Electronic Health Record Implementations and several mergers between Non-Profit CMHCs.

Ms. Lane received her MBA with a Healthcare Administration focus from Indiana Wesleyan University. She received a Bachelor of Science degree in Business Management from Indiana Wesleyan University.

×

1:00 pm - 2:30 pm

Lunch On Your Own

Networking

The institute hotel is located on Clearwater Beach, steps away from many local favorite restaurants. Stop by the registration desk for a listing of restaurants.


Bridging The Gap Between Employee Experience & Financial Sustainability

Invitation-Only-Lunch

Sponsored by DATIS HR Cloud

Your organization begins and ends with the people that make up your workforce. Taking care of your employees first has increasingly become not just a best practice, but an industry standard. But how can we strike the right balance between a focus on employees and the financial requirements of keeping your organization running? In this session, Erik Marsh, CEO of DATIS, will explore how these two seemingly conflicting priorities are actually more related than they appear at first glance. Join us as we explore the building blocks for developing a successful workforce management strategy that works for both your people and your organization.

Erik Marsh

President and CEO, DATIS HR Cloud

As the President and CEO of DATIS HR Cloud, Erik Marsh is focused on delivering value, productivity, and efficiencies for nonprofit organizations through Human Capital Management software. Erik graduated from Indiana University, Bloomington with a B.S. in Finance. After graduation, Erik worked for 5 years in various financial roles before joining Oracle, where he worked for 15 years. With over 20 years of experience in finance and software, Erik combines this knowledge to help organizations implement best-in-class technology that drives innovation and growth.

×


The ABC's Of Reporting: The Value Of Reporting To Multiple Payers Simultaneously

Invitation-Only-Lunch

Sponsored by Streamline Healthcare Solutions

The demands for additional data from payers continues to grow. As this market shift occurs, the burden on organizations to capture and report outcomes data becomes an unwieldy target. When it comes to reporting outcome measures, it is essential to know how to incorporate this process into your daily workflows so you are retrieving quality data from your Electronic Health Record (EHR). In this valuable learning session, Katie Morrow, LBSW, MPA, VP of Compliance will discuss the outcome measure requirements of major reimbursement models overlap with one another and how you can take advantage of this to maximize reimbursement. We will discuss how to reduce the burden on the staff responsible for capturing this data and tools for adapting your reporting as the behavioral health reimbursement process evolves.

In this session, attendees will learn how to:

  • Reduce your administrative oversight by knowing how the reporting requirements across payers overlap and how to take advantage of these overlaps
  • Identify the important factors and considerations when implementing new reporting techniques.
  • Leverage the data you are collecting for payers to improve your organization’s services and performance

Katie Morrow

Vice President of Compliance, Streamline Healthcare Solutions

Katie Morrow is a Licensed Bachelor’s Social Worker with seven years’ experience in the clinical field. In her clinical experience she was a Case Manager for adults with mental illness and developmental disabilities. After receiving a Master’s Degree in Public Administration, she transitioned to also doing quality improvement tasks as a Performance Improvement Clinician, which included coordination of The Joint Commission and State audit reviews, data analysis of the electronic health record data, and staff training for her agency on the use of Streamline products. She began working directly for Streamline in August of 2011. With Streamline, Katie has been the project manager on several implementations as well as providing training and support to Streamline’s customers.

×

2:30 pm - 3:45 pm

Population Health Management For The Complex Consumer Market: How To Utilize Data To Coordinate Services Across The Care Continuum

Breakout Session

Data is the key for care coordination, but many organizations struggle with what data is needed and how to effectively leverage this data. To understand the risks their consumers are facing and in order to provide effective services that best meet their consumers’ needs, providers must gather a variety of data, clinical and financial, from a number of different types of providers and sources. Combing these data sources into a single actionable record is paramount to improving care and outcomes for individuals.

In this session, we will hear from executives of organizations with experience bringing together disparate types data and how they are utilizing this data for care coordination.

James Stewart

President & CEO, Grafton Integrated Health Network & Advisory Board Member, OPEN MINDS

Jamie Stewart brings to OPEN MINDS over twenty years of experience in the healthcare field. Mr. Stewart has helped develop and modify Healthcare plans and benefits, Retirement Plans and benefits, and PTO Plans for multiple behavioral healthcare providers. He has also had an integral role in program development and business planning for new strategic business lines. Additionally, he has led multiple teams in the selection, implementation, and use of multiple Electronic Health Record Systems at several behavioral health care entities.

Mr. Stewart currently serves as the Chief Executive Officer at Grafton Integrated Health Network. He previously served as the Executive Vice President, Chief Administrative Officer, where he was responsible for the supervision of the Finance Departments, Contracting (both payer and vendor), Information Technology, Human Resources, Risk Management, Facilities Department, The Infant and Toddler Program, and the Education Department. He has participated and enabled the expansion of services through the acquisition of facilities and extension of the organization’s IT/HR network into Florida, West Virginia and Australia. He also spearheaded the process of developing and implementing a new paperless Electronic Health Record, as well as a new accounting software that integrated with the Electronic Clinical Record and Billing System.

Prior to working at Grafton, Mr. Stewart was the Chief Financial Officer for the Center for Behavioral Health at Centerstone. In this position, he managed the coordination of a multi-disciplinary team through development and implementation of a Davies Award Winning Electronic Health Record. He developed new clinical programs to meet identified locality needs and established a merger between Non-Profit CMHC’s, which crossed state boundaries.

Mr. Stewart received his MBA with a Healthcare Administration focus from Indiana Wesleyan University. He received a Bachelor of Science degree in Accounting from the University of Kentucky.

×

Cathy Lipton, M.D., CMD

National Medical Director, Institutional Programs, Optum

Cathy Lipton, M.D., CMD, is on the Corporate Medical Director team for Optum Complex Care Management (CCM), and has been affiliated with UnitedHealth Group since the original Evercare demonstration program expanded to Atlanta, Georgia, in the 1990’s. Optum’s clinical models of care support UnitedHealthcare’s Institutional (nursing home) and Dual (community-based) Special Needs Plans (SNPs) as well as the Post Acute care needs for other Medicare and private health plans. Optum’s programs focus on strong collaboration between Advanced Practice Clinicians (APCs) and Primary Care Physicians (PCPs) to enhance primary care for vulnerable populations.

Dr. Lipton has lived in Atlanta, Georgia, since the time she attended Medical School at Emory University as well as completing both her Internal Medicine Residency and Geriatric Fellowship programs there. Following training she worked at Emory’s Geriatric campus for a number of years in the clinical and academic arenas, including providing the medical direction for Emory’s skilled and intermediate care nursing facilities. Dr. Lipton has been a Certified Medical Director since 1997. She moved into an Adjunct Clinical capacity with Emory once she formally affiliated with UnitedHealth Group. Prior to her regional role, Dr. Lipton served as the Optum Market Medical Director for Georgia for many years, during which time the market provided clinical expertise in a variety of health plans including Institutional, Dual, and Chronic SNPs, as well as an End Stage Renal Disease pilot with CMS. She earned an innovation award for a telepsychiatry pilot program in 2013.

Dr. Lipton has twice been President, and is presently a long-standing Board member, of the Georgia Medical Directors Association, Georgia’s chapter of the Society for Post-Acute and Long Term Care (formerly AMDA). She sits on the Georgia Medical Care Foundation Nursing Home Quality Initiative Advisory Board, and has served on the American Health Care Association's Clinical Practice Committee and Professional Development Workgroup. Dr. Lipton’s interests include improved access to quality behavioral health care for under served populations, medical-behavioral integration, telemedicine, and remote monitoring technologies.

×

Dianne Shaffer, LMSW

Director of Systems Development , Integrated Services of Kalamazoo

Dianne Shaffer has worked for Integrated Services of Kalamazoo (ISK) since November 2012, first as a Program Manager for Youth and Families and now as Director of Systems Development. In her role as Director of Systems Development, she serves in a leadership capacity to develop, promote and support the ISK relationship with Health Care systems in the county serving as a primary contact with health care organizations, facilitating and assisting with planning initiatives that support the integration of primary and behavioral health care. Dianne also assists with grant writing, program development and implementation. Prior to ISK, Dianne was the Executive Director of Advocacy Services for Kids (ASK). During her tenure with ASK, she was involved in the implementation of federal SAMHSA grants in both Kalamazoo and Kent Counties, and provided trainings on family-driven, youth-guided mental health services at the local, state, and national levels. After earning a Master of Social Work degree from Western Michigan University (WMU) in 1997, Dianne served families in Kalamazoo and Southwest Michigan for 10 years prior to moving into administrative roles.

×

Sarah Green, RN, BSN, MBA, HCS-D, COS-D

Senior Integrated Healthcare Specialist, Southwest Michigan Behavioral Health

Sarah Green has over 10 years of leadership and management experience and clinical nursing experience in the healthcare industry. She works as Senior Integrated Healthcare Specialist at Southwest Michigan Behavioral Health (SWMBH) where she completes and oversees coordination of high-risk members with managed care plans and providers. Sarah is also integral in development and management of integrated care projects at SWMBH.

She has experience in behavioral health managed care, public policy involvement, care management, project development and implementation, home health care nursing, home health consultation, case management, hospice and hospital floor nursing (including medical-surgical and labor and delivery). Her passion is in improving patient outcomes (including quality of life and person-centered goals), project development and implementation, efficient operational structures, regulation compliance, process-flow development and implementation, and improving efficiency.

Sarah received a Master of Business Administration from Grand Valley State University in Grand Rapids, MI and a Bachelor of Science in Nursing from Western Michigan University in Kalamazoo, Michigan.

×


Key Performance Indicators For Value-Based Care: How To Use Performance Metrics To Build A Value Proposition For Health Plans

Breakout Session

More competition and more value-based reimbursement (VBR) are making performance metrics more important than ever for health and human service organizations. Finding the right performance metrics to demonstrate value to health plans has been a big challenge for many executive teams.

One method of metrics-based management is the development of a key performance indicator (KPI) system. An effective KPI system captures financial and non-financial measures, and is driven by structured data based upon an organization’s strategic objectives. This session will discuss the steps to developing applicable measures and the use of these measures for building a value proposition for health plans. We will also hear case study presentations from organizations that have developed performance metrics and have used them to create a strategy for successfully working with health plans.

Deb Adler

Senior Associate, OPEN MINDS

Deb Adler brings more than 20 years of experience in executive health care roles, serving in a variety of capacities including network executive, quality management executive and chief operating officer, to the OPEN MINDS team.

Her consultant work with OPEN MINDS spans a broad range of customers (provider organizations, payors and government programs) and topics, including: collaborative care models/medical behavioral integration, provider network functions– contracting, network designs/tiering, recruitment, telehealth network implementation, and strategic planning. In addition, Ms. Adler has a special interest in helping technology-enabled providers in “go-to-market” strategies and streamlining network functions.

Since entering the managed behavioral health care field, she has become an industry-recognized leader in value-based contracting and alternative payment models. An innovator known for her ability to execute results, she has facilitated network designs and benefit plan approaches that achieve both quality outcomes and healthcare cost savings.

Before joining OPEN MINDS, Ms. Adler served as Senior Vice President of Network Strategy for Optum (now UnitedHealth Group) where she was responsible for behavioral health network development, contracting, and strategy for over 185,000 providers. In this role she developed the largest, performance-tiered behavioral health network, largest telemental health network, and largest medication assisted treatment (MAT) network. She was also responsible for implementing network initiatives to promote medical/behavioral integration, improve member outcomes, and reduce total cost of care through collaborative care models.

Prior to joining Optum/UnitedHealth, Ms. Adler spent over 12 years with ValueOptions, Inc. (now Beacon Options) where she held a variety of senior leadership roles including, Executive Vice President of National Networks; Chief Executive Officer, Health Plan Division; Vice President, Network Operations; Executive Director, Corporate Quality Management; and Executive Director, Quality & Information Systems. She was responsible for quality management and coordinated NCQA and URAC accreditation efforts.

Ms. Adler spent her early career in health care quality, serving as a quality director in two state-run psychiatric centers.

Ms. Adler received her Master’s degree in educational psychology and evaluation from Catholic University of America and is a Certified Professional in Health Care Quality (CPHQ).

×

Ashley Sandoval

Associate CEO, Emergence Health Network

×

4:00 pm - 5:00 pm

The Payer Perspective: An OPEN MINDS Forum On The Performance Management Metrics That Health Plans Are Looking For From Providers

Panel

As reimbursement shifts to value-based reimbursement, health care providers continue to ask how payers define value and what metrics prove that their investments in consumer care result in better outcomes and the reduction in or avoidance of unnecessary health care costs. Join us for a straightforward discussion with health plan representatives who will share organizational strategies for measuring and rewarding success with value-based reimbursement models.

Ray Wolfe, J.D.

Senior Associate, OPEN MINDS

Raymond “Ray” Wolfe, J.D. brings over 40 years of experience in the health and human services sector to the OPEN MINDS team. Mr. Wolfe currently serves as a Senior Associate, a position in which he utilizes his expertise to successfully lead varying projects for OPEN MINDS. His areas of expertise include financial analysis and management, mergers and acquisitions, performance improvement, and strategic planning.

Before joining OPEN MINDS, Mr. Wolfe served in a 22 year tenure with Pittsburgh Mercy Health System in Pittsburgh, Pennsylvania. Most recently, Mr. Wolfe served as the organization’s Chief Operating Officer (COO) where he was responsible for oversight of all system operations, strategic planning, and performance management. Under his direction Pittsburgh Mercy achieved over $850K in value-based reimbursement contract quality bonus awards, integrated three organizations through merger/acquisition, and adopted a new performance management program for managers.

Before acting as Pittsburgh Mercy’s COO, Mr. Wolfe served as the organization’s Chief Financial Officer (CFO) and was responsible for the development of internal costing methodologies, contract rate negotiations, and financial forecasting activities. In addition, he coordinated an integrated care program with local partner hospitals to develop a series of diversion and respite programs, as well as, specialized primary care, integrated care management and high utilizer teams, while maintaining 15 straight years profitability.

Mr. Wolfe was promoted to CFO after serving as the Director of Fiscal and Information Security/Compliance for the health system. In this role, he was responsible for managing the transition of service contracts from fee-for-service (FFS), leading all compliance activities, and implementing a next generation electronic health record (EHR) system.

Prior to his time at Pittsburgh Mercy Health System, Mr. Wolfe served as Chief Fiscal Officer with the Summit Center for Human Development in Clarksburg, West Virginia, where he was responsible for reporting and budgeting functions and preparing Summit Center’s programs for FFS billing.

Previously, Mr. Wolfe served in billing and collections for two Pennsylvania-based hospitals. First, as an Accounts Receivables Manager for Brownsville General Hospital in Brownsville, PA, where he managed the accounting and billing system transition systems. Later as a Patient Account Manager for St. Francis Medical Center in Pittsburgh, PA, where he improved collections to hit 95% rate through the implementation of new billing software and department reorganization.

Prior to working in the health and human services market, Mr. Wolfe spent five years practicing as a Lawyer with at Law Offices of Arch A. Moore in Moundsville, WV. In this role he provided general legal practice, created and established bylaws for multiple corporation, and handled West Virginia licensing of first vision insurance plan.

Mr. Wolfe earned his Juris Doctor from the West Virginia University School of Law in Morgantown, WV and his Bachelor’s degree with a focus in Political Science and Sociology from West Liberty University, in Wheeling, WV, where he graduated Magna Cum Laude.

×

Cathy Lipton, M.D., CMD

National Medical Director, Institutional Programs, Optum

Cathy Lipton, M.D., CMD, is on the Corporate Medical Director team for Optum Complex Care Management (CCM), and has been affiliated with UnitedHealth Group since the original Evercare demonstration program expanded to Atlanta, Georgia, in the 1990’s. Optum’s clinical models of care support UnitedHealthcare’s Institutional (nursing home) and Dual (community-based) Special Needs Plans (SNPs) as well as the Post Acute care needs for other Medicare and private health plans. Optum’s programs focus on strong collaboration between Advanced Practice Clinicians (APCs) and Primary Care Physicians (PCPs) to enhance primary care for vulnerable populations.

Dr. Lipton has lived in Atlanta, Georgia, since the time she attended Medical School at Emory University as well as completing both her Internal Medicine Residency and Geriatric Fellowship programs there. Following training she worked at Emory’s Geriatric campus for a number of years in the clinical and academic arenas, including providing the medical direction for Emory’s skilled and intermediate care nursing facilities. Dr. Lipton has been a Certified Medical Director since 1997. She moved into an Adjunct Clinical capacity with Emory once she formally affiliated with UnitedHealth Group. Prior to her regional role, Dr. Lipton served as the Optum Market Medical Director for Georgia for many years, during which time the market provided clinical expertise in a variety of health plans including Institutional, Dual, and Chronic SNPs, as well as an End Stage Renal Disease pilot with CMS. She earned an innovation award for a telepsychiatry pilot program in 2013.

Dr. Lipton has twice been President, and is presently a long-standing Board member, of the Georgia Medical Directors Association, Georgia’s chapter of the Society for Post-Acute and Long Term Care (formerly AMDA). She sits on the Georgia Medical Care Foundation Nursing Home Quality Initiative Advisory Board, and has served on the American Health Care Association's Clinical Practice Committee and Professional Development Workgroup. Dr. Lipton’s interests include improved access to quality behavioral health care for under served populations, medical-behavioral integration, telemedicine, and remote monitoring technologies.

×

Susanna Kramer, MA

Director of Performance Evaluation, Community Behavioral Health

Susanna Kramer has been working in behavioral health program development and evaluation for over 15 years. She currently serves as Director of Performance Evaluation with Community Behavioral Health (CBH), Philadelphia County's Behavioral Health Medicaid Managed Care Organization. Since coming to CBH in August 2014, she has overseen program evaluation initiatives such as pay-for-performance and value-based purchasing. Prior to joining CBH, Ms. Kramer worked at Drexel University's Center for Nonviolence and Social Justice in developing trauma-informed systems of care and the University of Pennsylvania's Center for Mental Health Policy and Services Research in evaluating public behavioral health systems. She has worked clinically with children in Philadelphia and with adults in a day treatment program in Portland, Oregon. She holds a Masters degree in Clinical Psychology from West Chester University and a Bachelor of Fine Arts degree from the University of Pennsylvania.

×

Melissa Nichols, MHA

SVP, Network Performance & Planning, Beacon Health Options

Melissa has over 20 years’ experience in managed care with a focus on network management and payer contracting strategies. In her current role as SVP, Network Performance & Planning at Beacon Health Options, she is responsible for national network strategy, network development, provider relations, and credentialing for over 110,000 providers. She has led both physical and behavioral health network activities within the Medicaid and Medicare space while working for many of the large managed care organizations. Her focus over the past 10 years has included the development of integrated care models, the development of risk contract models for behavioral health, and increasing access to care through comprehensive telehealth models and incentive programs. Most recently, she led the network and operational implementation in a Beacon joint-venture provider sponsored health plan for IDD and SMI membership. She holds a Bachelor of Science degree in Psychology and a Master’s degree in Healthcare Administration.

×

5:00 pm - 6:00 pm

Executive Networking Reception

Networking

Wrap up the day by taking time to network with your colleagues and partners. Take some time to discuss the day's events while enjoying a drink and hors d'oeuvres.


7:00 am - 8:00 am

Start Your Day With Yoga... On The Beach!

Activity

Breathe in the fresh, salty air! Rejuvenate your creativity, focus, and mindfulness by starting your day with yoga. This class will wake you up and get you going for the rest of the day!

Open to all levels. Bring your own mat or use one of ours. Bottled water will be provided by OPEN MINDS. 

Meet Joe Naughton-Travers, Senior Associate, OPEN MINDS at the beach entrance by the towel stand at the swimming pool. If the weather does not cooperate, the class will be held in Sand Dollar on the 8th floor.

Joseph P. Naughton-Travers, EdM

Senior Associate, OPEN MINDS

Joseph P. Naughton-Travers, Ed.M., Senior Associate, has more than 30 years of experience in the health and human service field. In this tenure as senior associate with OPEN MINDS since 1998, he has served as lead of dozens of client initiatives, served as editor of OPEN MINDS publications, and is the author of many groundbreaking articles and presentations.

Mr. Naughton-Travers brings to OPEN MINDS a broad range of experiences in private and public sector delivery of behavioral health and social services. He started his career as a behavioral health clinician, working in both child welfare and community mental health clinic settings. Subsequently, Mr. Naughton-Travers held a senior business operations management position for a psychiatric hospital system and its community mental health clinics.  Later, he was vice president of a firm specializing in information systems and billing and receivables management for community-based mental health programs.

Since joining OPEN MINDS, Mr. Naughton-Travers has developed business solutions for provider and professional organizations, state and county government, technology companies, and venture capital firms. His primary areas of expertise include strategic planning and metrics-based management, electronic health record (EHR) and technology selection and implementation, operations improvement, and corporate compliance. For the past decade, over half his consulting practice has focused on aiding organizations in technology selection and implementation, including all aspects of strategic technology planning, functional specifications development, request for proposal development, vendor selection, and contracting.

He has written numerous articles, including “Winning the Human Resource Wars: Tried, True and New Strategies for Behavioral Health and Social Service Organizations,” “Five Pillars of Management Competency,” “Data Driven Decision Making: Moving to an Organizational Measurement Culture,” “Survival of the Smartest: What is Your Organization’s Information Literacy IQ?,” and “Strategic Human Resource Management: Aligning Compensation with Employee Performance and Organizational Strategy.” Mr. Naughton-Travers is also a nationally recognized speaker, having conducted hundreds of executive and professional executive training events around the nation.

Mr. Naughton-Travers received his Bachelor’s degree from Miami University of Ohio and his Masters’ of Education in Counseling Psychology from Boston University.

×

8:00 am - 9:00 am

Registration & Executive Networking Breakfast

Networking

Check-in at the registration desk to get your name badge and program materials, then join us in the exhibit hall for breakfast. Take some time to meet your fellow attendees, talk to our sponsors, and prepare for the day ahead.


9:00 am - 10:00 am

New Models For Complex Consumers: The Role Of Vertical/Specialty Consumer Health Plans

Keynote Address

States are increasing the development of health plans that serve only complex consumer populations such as those with serious mental illness, HIV, in the child welfare system, or with an intellectual/developmental disability. The expectation of payers for these specialty plans is that they will coordinate the physical, behavioral, pharmacy, and social aspects of care. To make this happen, payers are increasingly looking towards bundled payments and alternative payment models. For provider organizations, these models increase the need to share data; make and track referrals; collect and report performance data; and accept some form of reimbursement linked to value become basic requirements.

In this keynote session, we will hear from the payers who are operating these models including an overview of their model, what is working well, and where there are pain points. The payers will also discuss what they are looking for in a provider partner.

Ray Wolfe, J.D.

Senior Associate, OPEN MINDS

Raymond “Ray” Wolfe, J.D. brings over 40 years of experience in the health and human services sector to the OPEN MINDS team. Mr. Wolfe currently serves as a Senior Associate, a position in which he utilizes his expertise to successfully lead varying projects for OPEN MINDS. His areas of expertise include financial analysis and management, mergers and acquisitions, performance improvement, and strategic planning.

Before joining OPEN MINDS, Mr. Wolfe served in a 22 year tenure with Pittsburgh Mercy Health System in Pittsburgh, Pennsylvania. Most recently, Mr. Wolfe served as the organization’s Chief Operating Officer (COO) where he was responsible for oversight of all system operations, strategic planning, and performance management. Under his direction Pittsburgh Mercy achieved over $850K in value-based reimbursement contract quality bonus awards, integrated three organizations through merger/acquisition, and adopted a new performance management program for managers.

Before acting as Pittsburgh Mercy’s COO, Mr. Wolfe served as the organization’s Chief Financial Officer (CFO) and was responsible for the development of internal costing methodologies, contract rate negotiations, and financial forecasting activities. In addition, he coordinated an integrated care program with local partner hospitals to develop a series of diversion and respite programs, as well as, specialized primary care, integrated care management and high utilizer teams, while maintaining 15 straight years profitability.

Mr. Wolfe was promoted to CFO after serving as the Director of Fiscal and Information Security/Compliance for the health system. In this role, he was responsible for managing the transition of service contracts from fee-for-service (FFS), leading all compliance activities, and implementing a next generation electronic health record (EHR) system.

Prior to his time at Pittsburgh Mercy Health System, Mr. Wolfe served as Chief Fiscal Officer with the Summit Center for Human Development in Clarksburg, West Virginia, where he was responsible for reporting and budgeting functions and preparing Summit Center’s programs for FFS billing.

Previously, Mr. Wolfe served in billing and collections for two Pennsylvania-based hospitals. First, as an Accounts Receivables Manager for Brownsville General Hospital in Brownsville, PA, where he managed the accounting and billing system transition systems. Later as a Patient Account Manager for St. Francis Medical Center in Pittsburgh, PA, where he improved collections to hit 95% rate through the implementation of new billing software and department reorganization.

Prior to working in the health and human services market, Mr. Wolfe spent five years practicing as a Lawyer with at Law Offices of Arch A. Moore in Moundsville, WV. In this role he provided general legal practice, created and established bylaws for multiple corporation, and handled West Virginia licensing of first vision insurance plan.

Mr. Wolfe earned his Juris Doctor from the West Virginia University School of Law in Morgantown, WV and his Bachelor’s degree with a focus in Political Science and Sociology from West Liberty University, in Wheeling, WV, where he graduated Magna Cum Laude.

×

Julia Brillhart, RN, MSN

Vice President, Operations, Magellan Complete Care

Bio coming soon!

×

John Selig

Vice President, Optum Public Sector

×

10:15 am - 11:30 am

Keynote Thought Leader Discussion

Breakout Session

Join us for a follow-up session with our keynote speakers, Julia Brillhart, RN, MSN, Vice President, Operations, Magellan Complete Care and John Selig, Vice President, Optum Public Sector. Use this time to ask questions and continue the morning’s discussion with Ms. Brillhart, Mr. Selig and OPEN MINDS Senior Associate Ray Wolfe, J.D.

Ray Wolfe, J.D.

Senior Associate, OPEN MINDS

Raymond “Ray” Wolfe, J.D. brings over 40 years of experience in the health and human services sector to the OPEN MINDS team. Mr. Wolfe currently serves as a Senior Associate, a position in which he utilizes his expertise to successfully lead varying projects for OPEN MINDS. His areas of expertise include financial analysis and management, mergers and acquisitions, performance improvement, and strategic planning.

Before joining OPEN MINDS, Mr. Wolfe served in a 22 year tenure with Pittsburgh Mercy Health System in Pittsburgh, Pennsylvania. Most recently, Mr. Wolfe served as the organization’s Chief Operating Officer (COO) where he was responsible for oversight of all system operations, strategic planning, and performance management. Under his direction Pittsburgh Mercy achieved over $850K in value-based reimbursement contract quality bonus awards, integrated three organizations through merger/acquisition, and adopted a new performance management program for managers.

Before acting as Pittsburgh Mercy’s COO, Mr. Wolfe served as the organization’s Chief Financial Officer (CFO) and was responsible for the development of internal costing methodologies, contract rate negotiations, and financial forecasting activities. In addition, he coordinated an integrated care program with local partner hospitals to develop a series of diversion and respite programs, as well as, specialized primary care, integrated care management and high utilizer teams, while maintaining 15 straight years profitability.

Mr. Wolfe was promoted to CFO after serving as the Director of Fiscal and Information Security/Compliance for the health system. In this role, he was responsible for managing the transition of service contracts from fee-for-service (FFS), leading all compliance activities, and implementing a next generation electronic health record (EHR) system.

Prior to his time at Pittsburgh Mercy Health System, Mr. Wolfe served as Chief Fiscal Officer with the Summit Center for Human Development in Clarksburg, West Virginia, where he was responsible for reporting and budgeting functions and preparing Summit Center’s programs for FFS billing.

Previously, Mr. Wolfe served in billing and collections for two Pennsylvania-based hospitals. First, as an Accounts Receivables Manager for Brownsville General Hospital in Brownsville, PA, where he managed the accounting and billing system transition systems. Later as a Patient Account Manager for St. Francis Medical Center in Pittsburgh, PA, where he improved collections to hit 95% rate through the implementation of new billing software and department reorganization.

Prior to working in the health and human services market, Mr. Wolfe spent five years practicing as a Lawyer with at Law Offices of Arch A. Moore in Moundsville, WV. In this role he provided general legal practice, created and established bylaws for multiple corporation, and handled West Virginia licensing of first vision insurance plan.

Mr. Wolfe earned his Juris Doctor from the West Virginia University School of Law in Morgantown, WV and his Bachelor’s degree with a focus in Political Science and Sociology from West Liberty University, in Wheeling, WV, where he graduated Magna Cum Laude.

×

Julia Brillhart, RN, MSN

Vice President, Operations, Magellan Complete Care

Bio coming soon!

×

John Selig

Vice President, Optum Public Sector

×

11:30 am - 1:15 pm

Lunch On Your Own

Networking

The institute hotel is located on Clearwater Beach, steps away from many local favorite restaurants. Stop by the registration desk for a listing of restaurants.


1:15 pm - 2:30 pm

The Future Of Residential Treatment: How Technology & Innovative Program Models Are Redefining Service Delivery Models

Breakout Session

Residential treatment continues to have an important and evolving place in the continuum of care for patients with complex needs. Join us to learn how provider organizations are turning to technology to improve both the quality and efficiency of care.

This session will focus on:

  • The changing residential treatment landscape
  • Different technologies that are re-defining service models
  • How organizations have created innovative solutions for residential programs

John F. Talbot, Ph.D.

Vice President of Corporate Strategy, Jefferson Center for Mental Health, & Senior Associate, OPEN MINDS

John F. Talbot, Ph.D., Advisory Board Member, has more than 30 years of experience in all aspects of healthcare, including upper management, consultation, education, direct clinical work, and serving as the president of a non-profit board. Dr. Talbot has provided consultation, training and operational assistance to behavioral health providers, nonprofit organizations, and managed care organizations across the country. His areas of focus for consultation and training include strategic planning, the development of successful strategic alliances, board development, organizational reengineering, operations management, management and leadership development, and change management. He is currently Vice President of Integration Development at Jefferson Center for Mental Health in Denver, Colorado.

Prior to his current position, Dr. Talbot served as the President of a network of agencies providing care to children and families. The innovative work of Colorado Care Management received national recognition, including participation in a Federal IV-E waiver study that demonstrated measurable superior clinical outcomes. In his role with Colorado Care Management, Dr. Talbot also led the development of a coalition of Colorado business executives to address the issues of providing care to abused and neglected children, and the establishment of a nationwide purchasing cooperative for non-profits. Dr. Talbot’s previous experience included serving as the Director of the Master of Health Systems Program, and Associate Dean of University College at the University of Denver. He also held senior management positions at Mount Airy Psychiatric Center in Denver, Colorado.

Dr. Talbot has been a featured speaker at a number of national and state venues including the National Council Community Behavioral Health, Mental Health Corporations of America, the American Association of Residential Treatment Centers, the Medical Group Management Association, the Colorado Behavioral Health Council, the Mental Health Council of Arkansas, the New Jersey Association of Mental Health Agencies, and the Florida Behavioral Health Council.

Dr. Talbot is the former publisher and editor of Today’s Healthcare Manager, a newsletter focusing on leadership and management skills for healthcare managers, and has written numerous articles, manuals, and book chapters. His volunteer work includes serving as the President of the Board of Human Services Inc. in Colorado.

×

Dyann Roth

President & Chief Executive Officer, Inglis

Prior to joining Inglis as President & CEO in 2017, Dyann was the Chief Executive Officer/President of RHD – a diversified human services not-for-profit based in Philadelphia, with more than 160 programs across 15 states supporting people with disabilities and other vulnerable populations. She began her association with RHD working part-time throughout high school and college. Beginning in 2008, Ms. Roth was selected for future executive leadership within RHD, and held significant operational roles until she was chosen as the next CEO in 2013. Ms. Roth and RHD helped more than 40 social entrepreneurs through the organization’s incubator, taking their not-for-profit ideas to reality. RHD’s programming focuses on intellectual and developmental disabilities, behavioral health, homelessness, addiction recovery and more. Under Dyann’s leadership, RHD was honored multiple times by the Philadelphia Business Journal as one of the city’s Best Places to Work.

“I am incredibly excited to have the opportunity to join the Inglis community and to learn from and work with the people Inglis supports each day to live as independently and fully as possible”, says Dyann.

Dyann received her Bachelor of Arts from Penn State University and her Masters of Science in Organizational Dynamics from the University of Pennsylvania.

×

John Stupak

Chairman, Sequel Youth & Family Services

Mr. Stupak is the Chairman of Sequel Youth and Family Services and has more than 40 years experience in the behavioral health industry. Mr. Stupak is the former Board Chair of the National Association for Behavioral Healthcare. Prior to becoming Sequel's Chairman, Mr. Stupak held several roles at Sequel including Chief Executive Officer, Chief Operating Officer, and Chief Administrative Officer. Before joining Sequel, he worked for NHS Human Services, a large and diversified provider of behavioral health and human services. In addition to NHS, Mr. Stupak worked in an executive capacity for the Mentor Network. He graduated from Temple University with a master's degree from the School of Social Administration with a concentration in planning, research, and evaluation.

×

Jason Willetts

President, Willetts Technology, Inc

Mr. Willetts leads a team of software developers, network engineers and tech support agents at his Company which specializes in human service technology solutions. Willetts has 23 years of experience in the technology industry and is an entrepreneur and tech evangelist. He is passionate about leveraging technology to achieve human service organizational and individual goals. Mr. Willetts graduated from James Madison University and resides in Cumberland, Maryland with his wife and four children.

×

Marianne Birmingham, MS, CMUP

Regional Director of Compliance & Quality, Sequel Youth & Family Services

Marianne Birmingham is the Regional Director of Compliance and Quality for Sequel Youth & Family Services' Child Welfare Division. She has been with Sequel since 2010, starting as a Direct Care Employee, then rising through the ranks to where she is today. During her tenure with Sequel, Marianne has spearheaded several initiatives that leaned heavily on the successful adoption of new technologies that aimed to reduce the company's overall risk while increasing performance - including the development of Sequel's new proprietary mobile healthcare application, myPANDA, and 5 years of successfully attesting Meaningful Use, up to and including Stage 3. Marianne is an exceptional employee who has received several honors at Sequel, including Sequel's most prestigious "HIPP Award", an award given to the employee who most exemplifies Sequel's core values and beliefs. Marianne graduated Magna Cum Laude with her Bachelor of Arts from Western Michigan University and Cum Laude honors with her Master of Science in Psychology from Capella University. She also holds her Certified Meaningful Use Professional certification.

×

2:30 pm - 3:00 pm

Networking & Raffle Prize Drawing

Networking


3:00 pm - 4:00 pm

The Integration Imperative: What You Need To Know & Do To Remain Relevant

Keynote Address

The health care landscape continues to shift - shaped by payer preference for integration, the shift to reimbursement for value, consumerism, and technology. This evolution has changed the key strategic question for executive teams of specialty provider organizations - is your organization relevant? Will it continue to be relevant?

The question is shaped by the two ends of the service delivery continuum. Are you positioned to participate in increasingly 'integrated' systems? Do you have a clearly defined specialty and are you 'best of breed' in that specialty? The answer to these questions lies in the numbers. Do you outcomes demonstrate good consumer health and efficient service utilization? Do consumers find your services convenient to use with a great experience? Are you a 'good deal', financially speaking?

Learn how executive teams are answering these questions - and managing to better value in the closing keynote address of Monica E. Oss, the CEO and Founder of OPEN MINDS. In her closing, she will focus on the current status of performance and performance management, the strategic implications of building a data-driven organization, and how to use performance data to craft a sustainable future strategy.

Monica E. Oss

Chief Executive Officer, OPEN MINDS

Monica E. Oss, M.S., Chief Executive Officer and Senior Associate, is the founder of OPEN MINDS. For the past two decades, Ms. Oss has led the OPEN MINDS team and its research on health and human service market trends and its national consulting practice. Ms. Oss is well known for her numerous books and articles focused on the strategic and marketing implications of the evolving health and human service field. She has unique expertise in payer financing models, provider rate setting, and service pricing. She has led numerous engagements with state Medicaid plans, county governments, private insurers, managed care programs, service provider organizations, technology vendors, neurotechnology and pharmaceutical organizations, and investment banking firms – with a focus on the implications of financing changes on delivery system design.

 

×