Regarded as a forward-thinking thought leader, both in Pennsylvania and in the national health and human service field, Arthur C. Evans, Jr., Ph.D., Commissioner of Philadelphia’s Department of Behavioral Health & Intellectual disAbility Services has brought a new approach to his agency’s system of serving a wide range of individuals with complex needs. The transformation of the $1 billion Philadelphia system into a recovery-oriented, outcomes-focused system of care has leaned heavily on public health strategies that contribute to better population health. In addition, he has emphasized data-driven approaches to improve system performance. From innovative uses of emerging technology, to new roles for consumer self-direction, to community-based programs that engage a wide range of stakeholders in recovery, Dr. Evans’ team has created innovative service models that can be used by payers and provider systems alike. In this opening keynote session, Dr. Evans will discuss the emerging use of a public health framework to address population health management within the U.S. health care system and the changing role of behavioral health delivery systems in the evolving health care landscape.
Policymaker, clinical and community psychologist, healthcare innovator, Arthur C. Evans Jr., Ph.D, is the Commissioner of Philadelphia’s Department of Behavioral Health and Intellectual disAbility Service (DBHIDS) – a $1 billion healthcare agency.
Serving 120,000 people every year, DBHIDS has undergone a system-wide transformation under the leadership of Dr. Evans, focusing on recovery for adults, resilience for children and self-determination for people in need of intellectual disability services. The transformation of the Philadelphia service system has improved outcomes for people accessing services and has resulted in fewer inpatient admissions, visits to crisis centers, and significant cost savings that the City has reinvested in community-based services and supports. His work as Commissioner continues his lifelong commitment to serving people who are underserved and ensuring that effective, high-quality healthcare is accessible to all.
Dr. Evans holds faculty appointments at the University of Pennsylvania School Of Medicine and the Philadelphia College of Osteopathic Medicine and has held faculty appointments at the Yale University School of Medicine and Quinnipiac University.
Often hailed as a visionary, Dr. Evans has been recognized nationally for his work in behavioral healthcare policy and the transformation of service delivery systems. In 2013, he received the American Medical Association’s top government service award in health care, the Dr. Nathan Davis Award for Outstanding Government Service, for his leadership in transforming the Philadelphia behavioral health system, particularly around the adoption of a public health approach. Dr. Evans is also regarded as a strong advocate for people experiencing behavioral health conditions and was recognized by Faces and Voices of Recovery with the Lisa Mojer-Torres Award.
Dr. Evans has served in several national leadership roles, including: Chair of the federal Substance Abuse and Mental Health Services Administration (SAMHSA) Partners for Recovery Initiative Steering Committee, Chair of the National Advisory Committee for the Robert Wood Johnson Foundation’s Paths to Recovery Project, and President of the Board of Directors of the New England Institute of Addiction Studies. In 2014, the Melville Charitable Trust, the nation’s largest philanthropy focused exclusively on ending homelessness, announced that Dr. Evans has joined its Board of Directors.
Prior to his work in Philadelphia, Dr. Evans was the Deputy Commissioner for the Connecticut Department of Mental Health & Addiction Services, where he led major strategic initiatives for the Connecticut behavioral healthcare system. He was instrumental in implementing a recovery-oriented policy framework, addressing healthcare disparities, and increasing the use of evidence-based practices, leading edge research, and community engagement.
With a proven track record of innovative and effective solutions to complex systems change, Dr. Evans brings diverse training and experience as a scientist-practitioner and policymaker. He is in high demand as a resource for his fellow psychologists, healthcare administrators, and community, service, and government leaders. An adept and versatile public speaker, Dr. Evans speaks to behavioral health leaders and organizations across the country.
Arthur Evans lives in the great city of Philadelphia with his wife Claudene Pinder Evans; they have three daughters, Salihah, Akilah, and Jamila.
Like all service organizations, the single largest expense for health and human service organizations is talent, and the ability to manage your team effectively is a “must have” competency for organizational success. Adopting a performance-based compensation model can sometimes be the best way to ensure that you are getting the best return-on-investment (ROI) when it comes to your staff. In this session, Ken Carr, Chief Financial Officer, Guild Incorporated, & Advisory Board Member, OPEN MINDS will discuss best practices in performance-based compensation and productivity metrics. This session will review:
Ken Carr, Advisory Board Member, M.DIV., brings more than 18 years of finance, technology, and human resource experience in the health and human service field. He is currently the Chief Financial Officer of Guild Incorporated in St. Paul, Minnesota, a mental health treatment center. Mr. Carr started his career at Guild Incorporated in 1989 as Director of Finance and Administration, where he remained for eleven years before leaving the organization and returning in 2006. For the past eight years, in his role at Guild, Mr. Carr has used his expertise in change management and business process improvement to lead staff in the effort to implement Guild Incorporated’s electronic medical record system, which resulted in the organization’s ability to integrate its scheduling, service documentation, and billing. After eleven years, Mr. Carr went on to work with Goodwill Industries and the American Red Cross. While at Goodwill Industries, he served as the Manager of Financial Planning and Analysis, where he managed an operating budget of $26 million and oversaw financial planning and analysis of the growing organization. As the Director of Finance for the Red Cross, Mr. Carr was responsible for a budget of $12 million and led an effort to set standards and reorganize the financial systems. He also helped reorganize the timing and coordination of purchases to end emergency orders, resulting in a 38% reduction in shipping costs. Mr. Carr returned to Guild Incorporated in 2006 to serve in his current role as Chief Financial Officer.
Dr. Brannon is Director of Research and Organizational Development with Family Services of Western Pennsylvania where she is responsible for organizational outcomes, research projects, quality management and improvement, risk management and compliance, and staff training and development. She earned a master’s degree in adult education from the University of Pittsburgh and her doctorate in Industrial/Organizational Psychology from Northcentral University. She has over 15 years of experience in outcomes and program evaluation, staff development, adult learning, quality improvement, and integrating organization-wide efforts. She is trained in facilitation techniques, and enjoys providing training in both formal and informal venues.
Melanie Teves Bell is a senior manager, currently serving as the Senior Vice President of Clinical Services at Manatee Glens and has worked there for the past 14 ½ years. She has been working in the behavioral health field for the past 19 years with experience in crisis intervention, couples and family counseling and intensive outpatient and traditional outpatient services for children, adolescents, adults and co-occurring populations. She is also a Licensed Marriage and Family Therapist.
The federal Centers for Medicaid and Medicare Services’ Five-Star Quality Rating System compares health plan performance across five categories and 50 quality measures – allowing consumers to make better informed decisions when selecting a plan. This means health plans are looking for ways to improve their performance, giving provider organizations an opportunity to market themselves as part of that quality improvement strategy. In this session, Phil Micali, Senior Associate, OPEN MINDS will explain how executives of service provider organizations can benefit from helping health plans “fill the quality gap,” and discuss the benefits of improving the quality system ratings of their payers.
Philip Micali, Founder and Principal of bWell International, Inc., and Advisory Board Member, OPEN MINDS possesses over 30 years of experience developing, operating, and managing innovative health and wellness companies, in the U.S. and in Europe. His innovative work in designing and implementing public sector behavioral health programs and health savings account models of reimbursement has earned him national acclaim. In addition He has worked within two of the nation’s leading managed mental health companies, including Value Options and Magellan. Mr. Micali’s vast consultation portfolio includes IBM, Microsoft, Intel, Chevron, Thomson Reuters and States of Iowa and New York.
Since 2005, Mr. Micali has led a boutique consulting practice, bWell International, Inc., focused on marketing planning and execution of innovations in chronic care patient engagement, closing gaps of care, and health insurance marketplace (exchange) technologies. He also developed a software-as-a-service window shopper (consumer decision support) technology for private and public health insurance marketplaces, called bWell-informed, LLC. It enables exchanges to operate more transparently. In the early 2000s, he led sales and government program initiatives, as well as direct to consumer education programs at the nation’s leading consumer driven health plan, Lumenos, later sold to Wellpoint/Anthem.
Mr. Micali held other prestigious positions such as Managing Director of Eldercare and Family Caregiver Web Portal at Angelini Pharmaceutical Company in Rome, Italy, where he lived and worked for four years. And during his experience in Europe, Mr. Micali was one of the founding adjunct professors of the Masters in International Health Management Economics and Policy at the Bocconi University in Milan, Italy.
Mr. Micali studied Health Economics and Organizational Behavior at the University of Michigan and is currently enrolled in an Executive MBA Program – Healthcare at Baldwin Wallace University in Cleveland, Ohio.
Sponsored by Care Management Technologies
Health homes, ACOs, integrated practice – the ultimate goal of these new models of care is to reduce costs and improve the quality of care. As a leader, you need to drive performance in your organization, but how can you tell if you are translating your organization’s goals into meaningful outcomes that address real need? Data alone is not the answer, which is why provider organizations need a variety of tools at their disposal to deliver on this new value equation. During this engaging session, Mike Croghan, CTO of Care Management Technologies and black belt Six Sigma Quality Improvement, will discuss how using data analytics and decision support tools is a key for successful population health management and how your organization can use a six sigma approach to gain the competitive advantage in today’s integration-focused market. This session will review:
Michael Croghan has over 25 years of experience in software engineering and quality management in aerospace, commercial software and managed care industries. Before joining CMT, he was Director of Clinical Analytics at Affordable Care, Inc., a nationwide managed dental care company. He helped database software provider, Sybase grow from a $20 million to a billion dollar company, while holding the positions of Director of Data Warehousing & Business Intelligence, Director of Enterprise Applications and Vice President Global Infrastructure. Mr. Croghan’s career began as a software engineer in the aerospace industry at Lockheed with projects at NASA, DARPA and the NTSB. He earned his Bachelor’s degree at the University of South Carolina and completed graduate studies in computer science at the University of Southern California and the University of California at Berkeley.
W. Chad Stephens, M.D. is the Chief Medical Officer at CenterPoint Human Services, a Medicaid 1915bc waiver MCO in Winston Salem, NC. He graduated from Duke Medical School then the Family Medicine residency at Wake Forest University. He began his career in family medicine and has primary care experience in the US and in Kenya. He later retrained in psychiatry in the Wake Forest University Psychiatry residency. He has administrative experience in medical and behavioral health settings. He is board certified by the ABPN, the ABAM, and the APFM.
Joel Leonard, M.P.A. is the Quality Management Director of CenterPoint Human Services in Winston-Salem, NC. His 10 years of Quality Management experience include LME/MCO settings and a clubhouse model program for adults with mental illness. Joel has led or overseen URAC accreditation of the LME/MCO and ICCD (International Center for Clubhouse Development) accreditation for the clubhouse program. He currently oversees QM Compliance, QM Data Analysts and Grievances and Appeals, leads the QM Cross Functional Team and is the staff liaison to the Global Quality Improvement Committee and the Human Rights Committee. Joel has a Master’s degree in Public Administration and a B.S. degree in Finance and Economics. He is Six Sigma Green Belt Certified (SSGBC).
Dr. Carol Clayton is a licensed, psychologist with 30 years of health care experience in the public and private sector, including non-profit and private practice work. Prior to joining OPEN MINDS as a Senior Consultant, she retired as the Translational Neuroscientist for Relias, where she specialized in health care solutions targeting workforce development and population health outcome improvement. Before joining Relias, Dr. Clayton was the CEO of Care Management Technologies, a health IT data analytics company. She also served as the Executive Director of the NC Council of Community Programs from 2000-2006. The NC Council is the predecessor organization to i2i.
In health and human services, payers have led the charge in measuring system and provider performance, and moving to align provider organization compensation with that performance. Navigating this changing system requires provider organizations not only to meet the requirements of their payers, but to be able to accurately measure and report their performance as well. Join us for a discussion of payer performance measurement systems and their implications for provider organizations. This exciting session will cover:
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, more than half of 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.
Mr. Condit is the Head of Behavioral Health Program Development for Aetna Behavioral Health, reporting directly to the Chief Medical Officer. His psychiatric nursing career includes work in the Pennsylvania State Hospital system, as well as clinical roles in both adult and adolescent residential treatment. He has been involved in managed behavioral healthcare for over 16 years, developing experience in the areas of utilization management, network development, appeals and program development, with an emphasis on the use of technology. He is a Certified Case Manager, as well as a member of the American Telemedicine Association and the American Organization of Nurse Executives.
Ms. Soutier joined the Cigna organization in 1995 and has held positions across the Total Health and Network Organization, most notably within the Behavioral Clinical and Network Operations divisions. In her current role, Anita is a member of the Behavioral Network Management Team and is responsible for the development and oversight of the Behavioral Contracting, Reimbursement and Unit Cost Strategy. Over the last 2 years Anita has been a key contributor in the development and implementation of Cigna’s Pay for Performance for Behavioral Hospitals Initiative. Anita received her Bachelor’s degree from the University of Massachusetts in Psychology.
As vice president of network, Matt Miller is responsible for the oversight and direction of the provider Network department for Magellan’s Behavioral Health business. In this role, Matt leads Magellan’s network development, management and provider relations activities for new business development opportunities, and implementation of new programs and manages Network activities in Magellan’s existing behavioral programs nationwide including unit cost and reimbursement strategies.
Matt has extensive experience working with commercial and public sector programs and stakeholders to develop effective systems of care. Prior to his current role, he served as vice president of network and as director of business development for Magellan’s public sector division. His responsibilities included strategic planning and proactive outreach to providers and other key stakeholders related to new business opportunities. His background also includes serving as network director for Magellan’s HealthChoices programs in Pennsylvania. There his role included developing network strategy, provider reimbursement methodologies, monitoring and reporting mechanisms and implementing a meaningful provider relations-based approach to ensure provider input into the system. Matt also led the efforts in Pennsylvania to develop new programs and services for the HealthChoices program while serving as service systems development manager.
Prior to joining Magellan, Matt held many positions within community mental health centers and freestanding psychiatric hospitals in and around the Philadelphia area. He holds a Bachelor of Arts degree from Gustavus Adolphus College in St. Peter, Minnesota where he majored in Psychology and Criminal Justice.
Over the past few year, the National Committee for Quality Assurance (NCQA) has added new quality measures for treating schizophrenia and bipolar disorder to the Healthcare Effectiveness Data and Information Set (HEDIS). The seven new SMI measures focus on screening and monitoring of chronic conditions for adults, and the use of antipsychotics in children.These new measures are a game changer for the mental health field in many ways – for both service provider organizations and managed behavioral health programs working with consumers. In this session, we’ll discuss the new HEDIS measures, how they are shaping the field, and what executives need to know to prepare their organizations.
Monica E. Oss, M.S. is the founder of OPEN MINDS and serves as its chief executive officer, executive editor of its publications and websites, and executive lead of its consulting engagements. For the past three decades, Ms. Oss has led the OPEN MINDS team and its research on health and human service market trends and its national consulting practice. She is well known for her numerous books and articles focused on the strategic and marketing implications of the evolving health and human service field – and its focus on the verticals of the field serving consumers with chronic conditions and complex support needs.
Ms. Oss has extensive experience in developing and implementing growth strategies for a wide array of organizations in the field. She has expertise in industry trend analysis, reimbursement, rate setting, and creating actionable plans for market success. In her role, she has led numerous engagements with state Medicaid plans, county governments, private insurers, and health plans, 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.
Prior to founding OPEN MINDS, Ms. Oss served as an executive with a nationally managed behavioral health organization, responsible for market development, actuarial analysis, and capitation-based rate setting. She also held a position as vice president of the U.S. risk management and underwriting division of an international insurance company.
Ms. Oss has been the keynote speaker at the conferences of dozens of national associations and has been published in a wide range of professional journals and trade publications. She has provided Congressional and state legislative testimony on issues as diverse as the financial impact of parity and payer medication access policies.
Ms. Oss has led a range of industry research and consultation initiatives, serving as principal investigator on research projects that include the examination of national managed care enrollment and service patterns, development of provider rate structures for government entities, creation of return-on-investment models for technology investments; design of performance-based compensation models within public and private health plans; and analysis of the economic impact of changes in benefit design, adoption of evidence-based practices, and new technologies.
Dr. Junqing Liu, a behavioral health researcher, joined the National Committee for Quality Assurance in 2011 as a research scientist. Dr. Liu serves as a researcher and project director on several federally funded child and adult behavioral health measurement projects at NCQA. As the champion of NCQA’s behavioral health measures, Dr. Liu guides the re-evaluation and updates of HEDIS behavioral health measures. Dr. Liu’s research focuses on access to mental health services, evidence-based treatment for behavioral health problems, and child welfare services. Prior to joining NCQA, Dr. Liu was a research assistant professor at University of Maryland School of Social Work and conducted the evaluation of a federally funded research project on the implementation of evidence-based practices in child welfare systems in six states. She holds a Ph.D. and a Master in Social Work from University at Albany, State University of New York. She received her undergraduate degree from China Youth University for Political Sciences.
Sponsored by Qualifacts Systems, Inc.
Culture change is a massive effort for any organization to undertake; couple that with imposing performance measurement requirements and your staff are sure to resist. This session will present a concrete framework you can implement to facilitate change and key strategies to combat staff resistance in the creation of a culture of measurement. Dr. Karen Brannon will share some of her experience in implementing and refining this culture at Family Services of Western Pennsylvania. She will also discuss how they were able to successfully move from paper data collection of the PHQ-9 to utilizing CareLogic IMPACT to improve the performance measurement process as part of an ongoing demonstration project.
Ms. Winter is the Manager of Clinical Informatics and Outcomes for Qualifacts. At Qualifacts, Christy is responsible for assisting customers with outcomes measurement, analyzing and benchmarking outcomes data, and providing guidance for product development. Prior to that role, she was the Director of Continuous Quality Improvement (CQI) and Practice-based Research at Families First in Atlanta. During her 10-year tenure at Families First, she conducted and managed multiple program evaluation and research projects, and developed and implemented an extensive outcomes measurement and CQI system for the agency. Christy has conducted numerous CQI, performance management, and outcomes measurement trainings nationally and internationally. Christy received her Bachelor’s degree from Emory University in Psychology and her Master’s degree in Social Work from Georgia State University.
Dr. Brannon is Director of Research and Organizational Development with Family Services of Western Pennsylvania where she is responsible for organizational outcomes, research projects, quality management and improvement, risk management and compliance, and staff training and development. She earned a master’s degree in adult education from the University of Pittsburgh and her doctorate in Industrial/Organizational Psychology from Northcentral University. She has over 15 years of experience in outcomes and program evaluation, staff development, adult learning, quality improvement, and integrating organization-wide efforts. She is trained in facilitation techniques, and enjoys providing training in both formal and informal venues.
How To Leverage & Lead In The Shift From Fee-For-Service To Pay-For-Performance
Presented by Paul Duck, VP Business Development, Netsmart
Complimentary lunch included during presentation.
In markets with declining revenues and margins, increasing demand for performance measurement, and greater fiscal accountability, organizations are finding that their finance departments need new competencies for success, along with more robust information systems to support business decision-making. In this important session, OPEN MINDS Senior Associate Joseph Naughton-Travers will review the financial best practices mental health organizations need to succeed in a competitive market, and discuss how to apply financial modeling tools in your organization.
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, more than half of 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.
Sponsored by Relias Learning
Join the discussion with Mercy Maricopa Integrated Care Plan, the nation’s largest fully integrated physical/behavioral carve out plan, and Providence Service Corporation, a national leader in the management and provision of the highest-quality human social services. Hear about the challenges and successes of developing and maintaining a training program for thousands of providers and employees to assure compliance with contract requirements. This session will include:
Ms. Mariner has over 25 years of business development experience in health and human services. Over the past decade, she has focused her efforts on the field’s growing e-learning and training market, including her current role with Relias Learning where she leads the development of educational contracts for large provider organizations and government agencies. Prior to this endeavor, Ms. Mariner worked as the director of business development for an electronic health record software company.
Having held executive management and operations positions with community mental health and social service agencies in several states, Ms. Mariner has diverse expertise in the behavioral health, Medicaid, child welfare, intellectual and developmental disabilities, addictions, and managed care industries. She was actively involved in Arizona’s early implementation of capitated Medicaid and was one of the early CEOs of a Regional Behavioral Health Authority (RBHA) when that system was first launched. Ms. Mariner was also heavily involved in the development and implementation of the Washington D.C. Medicaid Rehabilitation waiver program and has extensive business development and sales experience with many leading national managed care organizations. She has worked as a national, senior level consultant for government entities and private sector organizations. Ms. Mariner holds a Bachelors Degree in Social Work and a Masters in Business Management.
Amrita Sethi, M.B.A., D.H.A., is the Training and Workforce Administrator for Mercy Maricopa Integrated Care, the nation’s largest fully integrated physical/behavioral carve out plan. Amrita has been employed in the field of Medicaid managed care for 10 years working for Schaller Anderson, Aetna and Mercy Maricopa. Previous to her training management roles within Aetna Medicaid, Amrita led corporate training teams for the financial industry, and educators in allied health professions. Amrita’s passion is to continue researching the Medicaid consumer experience throughout the nation.
Natasha (Tasha) S. Walsh is the Chief Learning Officer for Providence Service Corporation. She has played many roles in her 19 year tenure with the organization and led the effort to establish the Corporate University of Providence. Tasha currently directs the efforts of the Corporate University of Providence in providing key strategic resources and guidance in leadership and professional development and replication of evidence based practices.
In today’s health and human service market, most provider organizations are struggling to increase the financial resources available for program development and service delivery. One often overlooked solution is to improve the collection rate for the services that are rendered. We have entered a new era of shrinking funds – where reluctant creditors, unmatched government funds, and a move away from cost-based reimbursement means the already important issue of cash flow will take on a new earnestness. A long list of factors contribute to the varying speed of payment for services: billing cycles, prior authorization documentation, clinical documentation, service coding requirements, etc. In this session, we will explore best practices for revenue cycle management by examining the various administrative factors – insurance verification, communicating with the patient about their financial responsibility, clinical authorization, billing (insurance and self-pay), and denial management.
Ken Carr, Advisory Board Member, M.DIV., brings more than 18 years of finance, technology, and human resource experience in the health and human service field. He is currently the Chief Financial Officer of Guild Incorporated in St. Paul, Minnesota, a mental health treatment center. Mr. Carr started his career at Guild Incorporated in 1989 as Director of Finance and Administration, where he remained for eleven years before leaving the organization and returning in 2006. For the past eight years, in his role at Guild, Mr. Carr has used his expertise in change management and business process improvement to lead staff in the effort to implement Guild Incorporated’s electronic medical record system, which resulted in the organization’s ability to integrate its scheduling, service documentation, and billing. After eleven years, Mr. Carr went on to work with Goodwill Industries and the American Red Cross. While at Goodwill Industries, he served as the Manager of Financial Planning and Analysis, where he managed an operating budget of $26 million and oversaw financial planning and analysis of the growing organization. As the Director of Finance for the Red Cross, Mr. Carr was responsible for a budget of $12 million and led an effort to set standards and reorganize the financial systems. He also helped reorganize the timing and coordination of purchases to end emergency orders, resulting in a 38% reduction in shipping costs. Mr. Carr returned to Guild Incorporated in 2006 to serve in his current role as Chief Financial Officer.
David is a Senior Director Fiscal Practice Improvement for CCSI and for 32 years was Senior Vice President for Finance and Chief Financial Officer at Spectrum Human Services which is a private, nonprofit community mental health organization in Western NY. David has more than 44 years’ experience in public behavioral health and in his career, has worked as a Substance Abuse Counselor, Mental Health Clinician/Supervisor, Clinical Program Director and Executive Management CFO. David has joined his clinical training and experience with his business/financial training and experience to bring a unique perspective and set of skills to the efficient and effective management of behavioral health services. As a member of Executive management David has designed, implemented, and monitored systems to support Information Technology, Human Resources, billing, budgeting, financial modeling and reporting, site operations, risk management, security, and change management. Over the last 15 years David has focused on the development of analytic data and financial modeling tools and communication and knowledge management supports to transform raw data into meaningful information to enable more effective strategic and operational insights and decision-making.
In Partnership With The Leadership Council For Children’s Services
How do two organizations decided to merge – and why? What are the benefits and challenges to partnering with another organization? Over the past few years the pace of mergers and acquisitions in the health and human service field has picked up, and analysts predict that we’re only likely to see more in the years ahead. Yet successfully consolidating two organizations can be a difficult feat to handle. If your organization is considering, or in the midst of, this type of large-scale change, how do you begin to manage the transition? This distinctive session will include a review of best practices in planning and undertaking a merger, and an in-depth discussion with a health care executive who has participated in successful mergers in the past.
Mr. Shiffman has over 30 years of successful organizational and business experience in human service fields including expertise in executive management, strategic planning, business development, finance, marketing, market intelligence research, fundraising, and board development. He has hands-on expertise that comes from successful management and consulting with a number of programs. Prior to joining OPEN MINDS Mr. Shiffman served as Chief Executive Officer of Griffith Centers for Children, a COA-accredited, full-service treatment program for severely troubled youth and their families. He also developed one of the first offense-specific sex offender program in the United States.
Tom Tantillo, Advisory Board Member, brings 30 years of experience as a senior level manager in non-profit, academic, governmental, and for-profit health care and human service organizations on both the provider and payer side. He is a seasoned behavioral healthcare executive with expertise in entrepreneurial organizational design and development, start-up and operations, proposal and business development and risk based third party contracting. Mr. Tantillo currently holds the position of Vice President at Penn Foundation Behavioral Health where he is the chief marketing and business development officer. Before his transition to VP he was Executive Director of Penn Foundation’s Recovery Center, responsible for top rated ambulatory and residential substance use disorder programs. Concurrently, Mr. Tantillo is a subject matter expert for NIATx and the National Council for Behavioral Health, advising providers on behavioral health financing, payer contracting and managing culture change associated with migrating from program funding to fee-for-service or P4P. He recently retired after 17 years on the adjunct faculty of the University of Pennsylvania School of Social Policy and Practice.
Before his tenure at Penn Foundation, Mr. Tantillo served for 12 years as the Chief Administrative and Financial Officer of the Department of Child and Adolescent Psychiatry at The Children’s Hospital of Philadelphia (CHOP). In this role he merged the operations and culture of three precursor organizations, developed a model billing compliance program for CHOP, and planned and oversaw installation of multiple information systems.
Prior to his position at CHOP, Mr. Tantillo was the principal at Managed Healthcare Solutions. In this consulting practice, he led the design and implementation for the complete infrastructure of a 200,000-member managed behavioral health organization (MBHO).
Preceding his consultation practice with Managed Healthcare Solutions, as Senior Vice President of Managed Care Programs at Northwestern Human Services (NHS), Mr. Tantillo directed strategic efforts to move corporate focus from a traditional public sector program funded model to fee-for-service reimbursement, and developed an internal management service organization for contracting and intake of NHS’s Pennsylvania based programs. Earlier in his career, Mr. Tantillo developed and was Executive Director of a Physician Hospital Organization that was a partnership between major Philadelphia acute care and psychiatric health systems, and participated in the genesis of managed behavioral health care in the Eastern U.S. as Vice President for Provider Relations at AGCA, one of the pre-curser MBHO’s that came to be Magellan.
Mr. Tantillo earned his MBA at La Salle University, his MSW at the University of Pennsylvania, and his BA at Villanova University.
Sponsored by Inflexxion
Only 7.8% of the nearly 9 million adults with co-occurring mental health and addiction disorders receive treatment for both of their conditions. Integrating treatment for co-occurring conditions has been shown to improve outcomes and reduce costs; but first, provider organizations need to understand the individual’s needs – this is where proper assessment comes into play. While some assessment tools can be time-consuming and expensive, using an online platform that is mobile-ready and can be integrated into an electronic health record (EHR), streamlines the process. The newly launched Behavioral Health Index-Multimedia Version (BHI-MV), with a core Addiction Severity Index (ASI) data set, is an online, evidenced-based tool that allows clinicians to standardize the assessment process, improve treatment planning and track progress over time. During this engaging session, we will discuss how consumer administered, online assessment tools can make a difference in treating individuals with co-occurring disorders. In this session you will:
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, more than half of 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.
Albert J. Villapiano, Ed.D., is Vice President of Clinical Development for Inflexxion, Newton, MA and is in charge of the behavioral health product line. He is also a licensed Psychologist who received his doctorate from Boston University. Dr. Villapiano has over 25 years of experience as a clinician, trainer, researcher, administrator and consultant. He is a co-principal investigator on several National Institute of Health (NIH) grants at Inflexion and is interested in the development and implementation of innovative processes and tools to improve the quality of behavioral health assessment, treatment and education. He leads Inflexxion’s efforts in the ongoing clinical enhancement of Addiction Severity Index—Multimedia Version (ASI-MV) and the Comprehensive Health Assessment for Teens (CHAT). He has held academic appointments at Harvard University and Boston University Medical Schools, and the Northeastern Society for Group Psychotherapy Training Program. Among his publications is Time-Effective Treatment: A Best Practices Manual for Substance Abuse Professionals, (2003). Chiauzzi, E., Villapiano, A., Budman, S., & Goldman, R., Center City, MN: Hazelden Foundation.
Philip O. Toal is the Senior Vice-President of Residential Services for Aspire Health Partners the largest Behavioral Health Care Provider in Florida. Philip is a Florida State Licensed Mental Health Counselor and has worked in the area of behavioral health care and substance abuse for over 35 years. Philip’s work has included stress management, pain management and biofeedback, behavioral medicine, psychoneuroimmunology, depression, HIV/AIDS, sex therapy and substance abuse. He has helped to develop and conduct stress management for an inpatient cardiac unit. He has worked with the Central Florida AIDS community since 1985 and his work using relaxation and imagery with AIDS patients has been widely recognized. He is also an adjunct Professor at Valencia College in the areas of Sex Therapy and Substance Abuse Disorders. He is currently a member of the Florida Bureau of HIV and AIDS Prevention Planning Group as well as the chair of the Florida Substance Abuse and Mental Health Planning and Advisory Council with the Florida Department of Children and Families Substance Abuse and Mental Health office. Philip graduated from the University of Central Florida with a Master of Science in Clinical Psychology and Doctorate in Clinical Sexology from The Institute for the Advanced Study of Human Sexuality.
Last summer, Magellan Complete Care launched the first Medicaid health plan specifically designed for consumers with serious mental illness (SMI). The state of Florida selected Magellan to launch a specialty managed care plan to provide integrated behavioral and physical health care to Medicaid beneficiaries with SMI throughout most of the state. To better serve the needs of their beneficiaries, the Magellan Complete Care model focuses on care coordination for health promotion, disease management, case management, and utilization management. In this thought-provoking keynote address, Manuel Arisso, JD, LHRM, CEO of Magellan Complete Care of Florida, will discuss how Magellan is involving consumers, caregivers, and professionals in an integrated care management system – and his thoughts on the future of care coordination for consumers with chronic, complex conditions.
As Chief Executive Officer, Manny’s leadership ensures the mission of Magellan Complete Care is the foundation for all aspects of the specialty health plan. The challenge of transforming a system to better serve individuals dealing with serious mental illness starts with the commitment to help members, caregivers, providers and community share the success of brighter futures and a better life. Magellan Complete Care believes innovation starts by always doing the right thing. As a result, the member is the center of the care model and Magellan Complete Care strives to do what’s right for them.
The specialty health plan in Florida is fortified by Manny’s experience in management, compliance, legal, health policy, health delivery systems, governmental affairs, public health, Medicaid and managed care. He has expertise in Florida state affairs; a deep understanding of important issues to the State and can effectively navigate the regulatory environment. He holds a juris doctor from Florida State University College of Law and a bachelor of arts in Political Science from Florida International University. Additionally, he achieved certification in Health Care Risk Management from the University of South Florida and certification in Rate Setting and Regulation from Michigan State University.
Across the health and human service field, we are seeing an end to fee-for-service (FFS) reimbursement. What comes next is yet to be defined – but there are a range of pay-for-performance and/or risk-based reimbursement models that are loosely referred to as “value-based purchasing.” Adopting a case rate payment system ensures that providers are incentivized to manage care within a recognized cost structure, while encouraging patient care and outcomes to remain the top priorities. In this important session, we’ll discuss the benefits of accepting risk-based compensation, and how to develop a case rate model for your organization. The discussion will include:
George Braunstein, M.A., FACHE, Senior Associate, brings more than 35 years of experience in leading both private and public sector health and human service organizations – in both institutional and ambulatory settings. Prior to joining OPEN MINDS, Mr. Braunstein served as executive director of the Fairfax-Falls Church Community Services Board (CSB) in Fairfax, Virginia, which provides community-based mental health, substance abuse and developmental disabled services. During his six-year tenure with the CSB, which had a $150+ million budget and over 1,200 employees, he both reduced the budget and increased service access. Before his role in Fairfax County, Mr. Braunstein was the executive director of the Chesterfield County CSB. In his eight years in that role, he restructured management to flatten the organization, which improved both service and budget performance and eliminated a $1.5 million deficit with no reductions in staff. Mr. Braunstein also served as the head of behavioral health for Aurora Healthcare in Milwaukee – the largest integrated healthcare system in Wisconsin with 13 hospitals, 20,000 employees and $1.5 billion in annual revenue. Additionally, Mr. Braunstein brings managed care experience to the OPEN MINDS team, having served as the director of behavioral health for Family Health Plan Cooperative, a Wisconsin HMO. Well respected in the behavioral health community, Mr. Braunstein has served on several boards of local and national associations including the SAMHSA National Leadership Council, and the National Association of Community Behavioral Health. He is also a fellow with the American College of Healthcare Executives.
Sonia Handforth-Kome, M.A., Chief Operating Officer, has been working in medical and behavioral health care systems for over 27 years. Her first job in the medical field was in 1987, as an office manager for a physical and occupational therapy management company in North Carolina. Sonia’s experience in health system management has run the gamut from providing technical support on practice management systems and electronic health record systems, to coding, medical transcription, billing and collections, organizational change management, EHR/EPM selection and implementation, grant writing, strategic planning, advocacy and policy development; and from for-profit urban office-based specialty care to non-profit rural/frontier facility-based integrated care, including primary care, emergency care, dental, substance abuse, mental health, and alternative medicine.
Sonia has worked in health systems in North Carolina, California, Alaska and Washington, and in payment systems including fee-for-service, capitated, grant-funded, and case rate. In July of 2001 she moved from an OB/Gyn physician practice in California to a position as Executive Director for the Iliuliuk Family and Health Services, Inc. community health center/frontier extended stay clinic in Unalaska, Alaska. During her time as ED of IFHS, Sonia also served on the board of the Alaska Primary Care Association (as President for five years), and on the board of the Northwest Regional Primary Care Association (as a member of the Executive Committee of that board for four years). Sonia also volunteered with many community organizations, including the Ballyhoo Lions Club and the Aleutian Arts Council, as well as serving for eleven years on the School Board, and for ten years as a Yoga instructor for the local community center. In October 2011 she retired as ED of IFHS and started consulting with local non-profits and CHCs in the state of Alaska.
In June 2013 she began working for Valley Cities Counseling and Consultation, a community behavioral health center in Washington as Chief Operating officer.
Sonia received her Bachelor’s degree in Physics with Honors from the University of North Carolina at Chapel Hill, and her Masters’ degree in Organization Management from the University of Phoenix in Oakland.
When it comes to new finance and service delivery models, value is the name of the game – with a focus on improving outcomes and lowering costs. In this market, care coordination models, such as accountable care organizations (ACOs) and health homes, are increasingly seeing reimbursements tied to performance. For provider organizations involved in these care coordination models, understanding the financial risk/reward equation is the key to success. In this session, we will discuss the performance metrics guiding ACOs and health homes and how these metrics are shaping care coordination.
Steven Ramsland, Ed.D., Senior Associate, has more than 25 years of experience in the development and delivery of health and human service programs. He has held senior leadership positions in the development of several innovative service systems including Medicare Shared Savings Program ACOs, a primary care provider network, several national managed behavioral health initiatives, and innovative community programming.
Dr. Ramsland recently served as chief executive officer at Redwood Community Health, a network of 17 community health centers, with over 40 sites in northern California. The organization provides primary care, behavioral health and oral health to over 240,000 patients each year. While at Redwood he managed the implementation of an ACO, a capitated Medicaid managed care contract, and a pay-for-performance quality improvement program.
Prior to this, he was the executive director of Buckelew Programs, a leading provider of community-based, recovery-oriented behavioral health programs in Northern California. The organization provides supported housing and employment, and recovery supports, as well as two social enterprise businesses.
Dr. Ramsland was previously vice president and practice leader for United Behavioral Health’s Public Sector Practice (now Optum). In that role, he analyzed opportunities and implemented strategies to expand public sector business – and collaborated with executive leadership at United to design and build organizational capabilities in public sector behavioral health, disease management, and consumer-directed care to support revenue growth.
In addition to his work with Optum, Dr. Ramsland also served as the chief development officer and Public Sector President for Comprehensive Behavioral Care, and as vice president, Government Programs, for ValueOptions. He has worked with government policy leaders throughout the nation to develop new, recovery-oriented approaches to delivering behavioral health and integrated medical services. He was also the Chief Executive Officer of a community mental health center, SERV Behavioral Health in New Jersey.
Dr. Ramsland earned a Doctoral Degree in Psychology from Rutgers University, a Master’s Degree in Psychology from Duquesne University, and a Bachelor’s Degree in Psychology and English from Trinity College.
Sheila Fusé is CEO of Primary Partners, LLC, an independent-physician Accountable Care Organization, located in Clermont, Florida. Sheila led Primary Partners, LLC through the regulatory application process to successfully receive one of the nation’s first ACOs approved in April 2012 and a second time with the approval of Primary Partners’ second ACO, Primary Partners ACIP, LLC in January of 2013. Sheila is a national speaker and educator on Accountable Care Organizations.
After working 12 years in global banking with RBS and JPMorgan Chase, Sheila is well-versed in risk management, client-relationship management, process re-engineering, bank mergers and operational integrations.
In 2008, she served as Chief of Staff for the Chief Risk Officer at RBS Americas. Seeing the change coming in regulations, Sheila moved into regulatory risk and compliance. She worked for the global head of compliance where she developed and ran a global team and then worked with regulators, regulatory waivers and managing onsite visits utilizing her strategic and regulatory affairs skills. Forecasting a similar tsunami of change, Sheila then transitioned into health care.
Prior to her career in global banking, she was Managing Partner at PC Education Systems, LLC a consulting and executive training services company. She began her career as a business analyst and today has two decades of experience successfully working with small businesses and Fortune 500 companies developing, implementing and overseeing strategic business solutions.
Sheila is involved in the local and regional business community and is a Health Information Technology Advisory Committee Member of Lake Sumter State College. Sheila holds a Bachelor of Science in Information Systems with a business concentration from the University of Massachusetts and an Advanced Certificate in Regulatory Risk & Compliance from the International Compliance Association.
In our current era of technology and metrics, it’s likely that your management team has a lot of data. Now the question is how do you use that data to improve your organization’s performance? In this session, Joseph Naughton-Travers, Senior Associate, OPEN MINDS will review the cornerstones of data that organizations need to drive innovation, enhance care quality, and improve operational performance. This session will cover:
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, more than half of 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.
David is a Senior Director Fiscal Practice Improvement for CCSI and for 32 years was Senior Vice President for Finance and Chief Financial Officer at Spectrum Human Services which is a private, nonprofit community mental health organization in Western NY. David has more than 44 years’ experience in public behavioral health and in his career, has worked as a Substance Abuse Counselor, Mental Health Clinician/Supervisor, Clinical Program Director and Executive Management CFO. David has joined his clinical training and experience with his business/financial training and experience to bring a unique perspective and set of skills to the efficient and effective management of behavioral health services. As a member of Executive management David has designed, implemented, and monitored systems to support Information Technology, Human Resources, billing, budgeting, financial modeling and reporting, site operations, risk management, security, and change management. Over the last 15 years David has focused on the development of analytic data and financial modeling tools and communication and knowledge management supports to transform raw data into meaningful information to enable more effective strategic and operational insights and decision-making.
The health and human service market is undergoing rapid changes in the fundamentals of both financing and service delivery; these changes are driving the executive teams of both provider and payer organizations towards one goal: value-based care. Value is the ratio of quality to cost. In the health and human service market, quality is a combination of clinical quality, system operational performance, customer experience, and customer perception. The new executive team challenge is not only managing to the “market rates” in the market place, but also tracking how your organization compares on a variety of quality measures. In this closing session, OPEN MINDS CEO Monica Oss will cover everything executives need to know to prepare and position their organizations to compete in the new value-driven market.
Monica E. Oss, M.S. is the founder of OPEN MINDS and serves as its chief executive officer, executive editor of its publications and websites, and executive lead of its consulting engagements. For the past three decades, Ms. Oss has led the OPEN MINDS team and its research on health and human service market trends and its national consulting practice. She is well known for her numerous books and articles focused on the strategic and marketing implications of the evolving health and human service field – and its focus on the verticals of the field serving consumers with chronic conditions and complex support needs.
Ms. Oss has extensive experience in developing and implementing growth strategies for a wide array of organizations in the field. She has expertise in industry trend analysis, reimbursement, rate setting, and creating actionable plans for market success. In her role, she has led numerous engagements with state Medicaid plans, county governments, private insurers, and health plans, 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.
Prior to founding OPEN MINDS, Ms. Oss served as an executive with a nationally managed behavioral health organization, responsible for market development, actuarial analysis, and capitation-based rate setting. She also held a position as vice president of the U.S. risk management and underwriting division of an international insurance company.
Ms. Oss has been the keynote speaker at the conferences of dozens of national associations and has been published in a wide range of professional journals and trade publications. She has provided Congressional and state legislative testimony on issues as diverse as the financial impact of parity and payer medication access policies.
Ms. Oss has led a range of industry research and consultation initiatives, serving as principal investigator on research projects that include the examination of national managed care enrollment and service patterns, development of provider rate structures for government entities, creation of return-on-investment models for technology investments; design of performance-based compensation models within public and private health plans; and analysis of the economic impact of changes in benefit design, adoption of evidence-based practices, and new technologies.