The Strategic Advantages & Challenges Of Mergers & Acquisitions
Economies of scale and organizational size are an integral part of strategy for health and human service organizations. The question – how to develop a merger and acquisition plan that makes your organizational strategy successful. David Guth, the chief executive officer of Centerstone, has grown Centerstone from a local community mental health center to a multi-state provider of health care services over the past decade – and mergers have been a key part of that evolution. In his keynote address, Mr. Guth will discuss the challenges of making mergers and acquisitions work – selecting the right organizations, the M&A process, developing governance and management structures for a newly-merged organization, and the challenges of managing a bigger and more diverse organization.
David C. Guth, Jr.
David Guth is Chief Executive Officer and co-founder of Centerstone, one of the nation’s largest behavioral healthcare providers. The non-profit organization, headquartered in Nashville, Tennessee, serves nearly 142,000 individuals in facilities in Florida, Illinois, Indiana and Tennessee, and nationwide through our national provider network.
Guth has served in the capacity of chief executive for Centerstone since 1991. With 40 years of behavioral healthcare experience, 32 in executive leadership, his experience and expertise comprise a vast number of areas, both business and clinical. He has presented extensively before national and international audiences on the adoption of information technology in the healthcare industry, the integration of behavioral and primary healthcare, and the importance of improving the field of behavioral health through research-driven protocols. His insights on these topics and others have been featured in numerous professional journals.
The National Council for Behavioral Health published Guth’s first book in 2013 (now available in second edition since 2014) on mergers entitled, “Strategic Unions: A Marriage Guide to Healthy Not-for-Profit Mergers.” He has provided merger presentations through both the National Council and state trade associations and has consulted extensively with not-for-profits exploring mergers and with both for-profits and not-for profits in the areas of managing growth and business development. He is currently working on his second book entitled “Nonprofit Governance.”
Under Mr. Guth’s guidance, in 2013 Centerstone announced a joint venture with Unity Physician Partners to improve patient care and enhance the quality of healthcare across the U.S., by creating an environment in which primary care and mental health providers operate within a collaborative and co-located clinical model. Unity Medical Clinics are embedded within select Centerstone facilities today offering coordinated, whole-health care.
He is the recipient of numerous recognitions including the National Council 2010 Visionary Leadership award, and is recognized as one of Health Care’s Power Leaders in the March 2013 Nashville Business Journal.
Guth received his BA in Mathematics from Vanderbilt University and his MSSW in Social Work Administration and Planning from the University of Tennessee.
Market, Math & Metrics: Three Keys To Optimizing Your Strategy
When it comes to assessing how to move forward with a new strategy or to achieve the necessary performance, the number of potential resources and “first steps” for health and human service organizations can be daunting. However, in most cases, it comes down to three elements: market research for planning, math for decisionmaking, and metrics for management. Knowing the key market issues, the value of “math,” and the right performance metrics is essential to strategically superior decisionmaking in the current and future market. Join us for this essential session, where we will discuss:
- How to understand potential customers, contributors, and funders through market research
- How to carefully “do the math,” adjust the model, and make the right decisions when developing operational and financial models
- How to ensure you have the right measures, timely reporting, and staff information literacy to take data and turn it into meaningful, actionable information to improve performance
Joseph P. Naughton-Travers, Ed.M.
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.
Brian Hancock, Esq.
Brian Hancock is the Chief Operating Officer at Robins' Nest, a private, nonprofit 501(C) (3), children's services organization dedicated to ensuring the safety of children and enhancing their well-being in a family setting through a wide array of quality community-based residential and in-home services. Prior to this position, Mr. Hancock, as Deputy Division Director for the New Jersey Division of Child Behavioral Health, was responsible for policy, research, training and planning for New Jersey’s child mental health system, which serves 40,000 children annually. Previously, he was a senior assistant child advocate in the New Jersey Office of the Child Advocate, where he oversaw the Office’s juvenile justice advocacy and was a principal investigator and author of the Office’s report on conditions for children with mental health needs in the state’s juvenile detention centers. Mr. Hancock has done humanitarian and advocacy work with at-risk and incarcerated youth across the United States, and in Mexico, Ireland and Ukraine. He has received several awards for his work; including the Embracing the Legacy award from the Robert F. Kennedy Children’s Action Corps., and the Spirit of Crazy Horse award from Reclaiming Youth International. Mr. Hancock received a B.A., cum laude, from Wheaton College, and a Juris Doctor, cum laude, from Seton Hall University School of Law.
Moving Value-Based Payment From Concept To Contract: Developing Value-Based Payment Proposals, Pricing & Contracts
Policy, payer, and provider organization executives all seem to agree that our pay-for-volume, fee-for-service system needs to go. But for provider organizations, the ability to participate in the emerging value-based arrangements (either pay-for-performance and/or risk-based) bring the need for new management infrastructure and management knowledge. Your management team should have the ability to review and understand contract language about performance measurement, operational definitions of performance metrics, and incentive compensation payments and penalties – and be able to translate this information into projections of organizational performance and the financial impact of the contract terms. In this crucial session, we will review current performance-based contracting models, examples of pay-for-performance contracting initiatives, and the organizational management competencies that are needed to succeed with these new contracts.
Sharon Hicks
Sharon Hicks, OPEN MINDS Senior Associate, has more than 20 years of experience in the health and human service field. She has extensive experience and wide range of expertise in health plan management, in clinical operations management, and technology.
Prior to joining OPEN MINDS, Ms. Hicks spent two decades in a number of executive positions within the University of Pittsburgh Medical Center (UPMC) system and within its health plan division. Ms. Hicks served as the Chief Operating Officer for Community Care Behavioral Health, a managed behavioral health organization. There she was responsible for all aspects of the organization’s operations including fiscal, information systems, the claims processing department, and the design of clinical systems. In addition, Ms. Hicks managed the day-to-day operations of including human resources, facilities, purchasing, and security.
Ms. Hicks also served as the Vice President, Internet Strategy, UPMC Insurance Services Division and, since 2002, as the Chief Executive Officer of Askesis Development Group, Inc. In this role, Ms. Hicks was responsible for the growth of the company, profitability of the company, and the direction of software development.
Ms. Hicks started her impressive health care career as a psychiatric social worker before being promoted to Assistant Director of Social Work. Prior to her executive promotions, Ms. Hicks served as a Clinical Administrator for both Ambulatory Services and Emergency and Intake Services at the UPMC Western Psychiatric Institute and Clinic. In this role, she managed the behavioral health division, the budgets for all departments, and implemented new software replacing paper billing for clinical services.
Ms. Hicks received both her Masters of Business Administration and Masters of Social Work degrees from the University of Pittsburg. Before pursuing her graduate education, Ms. Hicks received her Bachelor’s Degree in Psychology.
Don Fowls, M.D.
Don Fowls is a nationally known psychiatrist and health care consultant who previously served as Chief Medical Officer and Executive Vice President of Business Development for Value Options and its parent company, FHC Health Systems for eleven years. Don also served as EVP Business Development of Schaller Anderson and was CEO of its behavioral health subsidiary. He is the past President of the Arizona Psychiatric Society and a Fellow in the American Psychiatric Association.
Maurice Lelii, LMHC, NCC
Coming Soon!
Population Health Management In A Value-Based Market: Using Pharmacy Analytics To Increase Consumer Engagement & Improve Outcomes
Sponsored By Care Management Technologies
More value-based contracting means more responsibility for population health management for provider organizations. The challenge? Successful population health management requires a cross-system team-based approach to care management, the ability to utilize varied and new data sources, and to incorporate virtual team members for supporting and encouraging consumer engagement. By integrating clinical, financial, and administrative data in ways that distill information to provide insight for care management teams and pushing that analysis out to an extended cross system care team, provider organizations will be able to more likely engage consumers in overall health improvement, reduce unnecessary or avoidable utilization, and maximize their own value. In this session, we’ll discuss the importance of data analytics and decision support tools to provider organizations operating in a value-based system, and we’ll hear first-hand from one system that is using analytics to improve medication patterns by integrating pharmacy data and the pharmacists themselves into their care management strategy.
Susan Wilson, MPA
Susan Wilson, MBA joined the MPCA in September 2008 as Chief Operating Officer. Prior to beginning her work at the MPCA, she gained over twenty years of hands-on health center experience during her tenure as Finance Director and then CEO at Northwest Health Services, a multi-site, multi-specialty Community Health Center (FQHC) serving northwest Missouri.
She is the Director of the MPCA’s Center for Health Care Quality, and led MPCA’s creation of the Missouri Quality Improvement Network that provides data warehousing and clinical quality reporting for Missouri’s FQHCs. She is active in the National Association of Community Health Centers, immediate past chair of the Health Center Controlled Networks Task Force, and currently serves as Chair of the governing board of the Missouri Health Connection (Missouri’s Health Information Exchange.)
Ms. Wilson graduated from the University of Missouri-Columbia with a Bachelor’s Degree in Business and Public Administration, and completed an Executive Master’s in Business Administration at the University of Nebraska-Omaha. She was in the inaugural class of the University of California-Los Angeles and Johnson & Johnson Health Care Executive Program.
George L. Oestreich, Pharm.D., MPA
Dr. Oestreich is providing key strategic consulting on Medicaid issues including health information technology, decision support, program design and care coordination policy development. A major interest is developing transparent integrated patient care management and coordination solutions into current practice. He has unique and comprehensive experience in pharmacy benefit design coupling integrated pharmacy services into mainstream care coordination and service delivery.
Dr. Oestreich served as Deputy Division Director, Clinical Services, for MO HealthNet (MHD), the Missouri Medicaid agency from August 2006 until February 2011. In this position he developed clinical payment policy and related payment edits. He coordinated health information technology for monitoring, support of edits and decision support. Also in his venue was the development and implementation of disease management and care coordination services. The later resulted in a positive return on investment and improved patient outcome indicators.
Dr. Oestreich served as Director of Pharmacy for the agency from 2001 to 2006. Under his leadership, the MHD was an early innovator in Medicaid pharmacy programs integrating aggressive maximum allowable pricing, clinically sound step therapy, productive supplemental rebate programs, high tech prior authorization and physician-pharmacist disease management. These programs provided cost avoidance for the agency that averaged over $100 million annually. In a recent program review the Lewin Group stated, “Pharmacy program leadership staff have an exceptional level of Medicaid and prescription drug management expertise and stand out among Medicaid pharmacy staff nationwide”
Dr. Oestreich earned his BS in Pharmacy from the University of Missouri-KC, his Master of Public Administration from University of Missouri-Columbia and his Doctor of Pharmacy from Kansas University.
Jennifer Kemp-Cornelius, R.Ph., Pharm.D.
Dr. Kemp-Cornelius has over twenty-five years of community pharmacy experience, over twelve years of State government experience as a clinical and technology vendor, and one year of consultant experience. As a consultant, Dr. Kemp-Cornelius is working with a technology vendor to help incorporate an analytic web tool and ad hoc reporting into daily operations for a chronic pain management program, a pharmacy integration project for diabetes and hypertension outcomes, and a health home program. Dr. Kemp-Cornelius was previously responsible for account management, service delivery, and operations for a large state contract with MO HealthNet (Missouri Medicaid). Responsibilities included working collaboratively with her IT department to drive major installations and system updates, managing a retrospective DUR program, managing the process for developing, testing and placing into production new prospective clinical and fiscal editing criteria for pharmacy and medical programs, overseeing the implementation of an inpatient pre-certification system and clinical helpdesk, overseeing deployment and operations of provider and patient electronic health record portals, and overseeing provider outreach and training on new web modules and programs. Prior to working with the state contract, Dr. Kemp-Cornelius practiced both as a staff pharmacist and pharmacy manager in a community pharmacy setting and is a licensed pharmacist in the State of Missouri. Dr. Kemp-Cornelius received both her Bachelor of Science in Pharmacy and Doctor of Pharmacy degrees from the St. Louis College of Pharmacy.
Carol Clayton, Ph.D.
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.
Medical Home & Health Home Accreditation – What Are The Options?
In an era of health care reform, what is the current and future role of accreditation for evolving care models? And where is ‘accreditation’ for medical and health homes heading? Join us for a discussion of the role of accreditation standards in your organization’s strategy, and an overview of the new standards being developed by accrediting organizations. This session will include an update from the key medical home and health home accrediting bodies, and a discussion about how accreditation requirements affect organizational strategy when it comes to implementation of medical and health home models.
Brandon Danz
Brandon Danz currently works as a Health Care Reform Consultant working with health systems and health care companies to help them navigate the fast-paced regulatory environment that dominates the health care industry. With Medicare and Medicaid making up and average 57 percent of hospital revenue nationwide, health systems, health care providers, and service vendors must successfully adapt to regulatory change in order to sustain long-term financial stability. Public policy has growing impact on operational margins, on service delivery models, use of technology, and on payment methodologies.
Mr. Danz is an active member in his community, participating in the American College of Healthcare Executives, Healthcare Financial Management Association, American Public Health Association, and the Institute for Healthcare Improvement. He also volunteers his time as the President of the Board of Directors of the Library System of Lancaster County.
Mr. Danz previously worked for the Pennsylvania Department of Human Services as a Special Advisor to the Secretary. The PA Department of Human Services (DHS) is one of the largest state human service agencies in the nation with over 17,000 staff and an annual operating budget of $32 billion. As Special Advisor to the Secretary of the Agency, he was deeply involved with change management at the executive level during a time of great uncertainty and fast-paced reform within the healthcare industry.
Mr. Danz received a Master of Health Administration from Pennsylvania State University, a Master of Public Administration from Shippensburg University, and Bachelor of Arts in History from Millersville University.
Peggy Lavin, LCSW
Peggy Lavin is the Senior Associate Director of the Behavioral Health Care Accreditation Program at The Joint Commission. In this role, she assists the Executive Director to identify new markets, familiarizes organizations with the accreditation process, and participates in new product development and the strategic development and tactical operations of the Behavioral Health Care Accreditation Program. Previously, Ms. Lavin managed and developed the surveyor cadre for the Behavioral Health Care Accreditation Program.
Ms. Lavin has more than 25 years experience in behavioral health care, focusing on residential, day treatment, in-home, outpatient, and therapeutic foster care programs. Prior to coming to The Joint Commission, Ms. Lavin worked for a Nashville-based accredited behavioral health care organization that provided services to children and youth in six states. As director of corporate quality improvement, she was responsible for ensuring quality organizational and clinical performance of all sites. Ms. Lavin also worked at the Illinois Department of Children and Family Services and the Illinois Department of Corrections, Juvenile Division. In addition, she has served on the Joint Commission’s Behavioral Health Care Professional and Technical Advisory Committee (PTAC).
Ms. Lavin is a licensed clinical social worker, a diplomat in clinical social work, and a member of the Academy of Certified Social Workers. She received her master’s degree in social work from the Jane Addams School of Social Work, University of Illinois, Chicago, and her bachelor’s degree in sociology and psychology from the University of Illinois, Urbana.
Mina Harkins, MBA, PCMH CCE
Ms. Harkins is the Assistant Vice President, Recognition Programs Policy and Resources with the National Committee for Quality Assurance (NCQA) in Washington DC. In this position, she is responsible for the content of and resources to support all Recognition Programs, which are focused on quality management of chronic conditions (such as diabetes and ischemic vascular disease), and the systems and processes utilized in a clinical practice including the Patient-Centered Medical Home, the Patient-Centered Specialty Practice Recognition, Patient-Centered Connected Care Recognition and Accountable Care Organization Accreditation programs.
Before joining the NCQA, Ms. Harkins worked with a laboratory accrediting organization, administered a large anatomic pathology operation, managed a number of departments in a multispecialty group practice and managed a multi-site laboratory operation for a staff model HMO.
Michael W. Johnson, M.A., C.A.P.
Michael Johnson is the Managing Director of Behavioral Health for CARF International, the leading accrediting body of behavioral healthcare organizations in the world. His responsibilities include developing and maintaining standards for the behavioral health market, training and consultation to the behavioral health industry, as well as market development.
Before coming to CARF International he was most recently the Assistant Director of Behavioral Health for Fresno County, California which is both a provider organization and the Mental Health Managed Care Plan for Medi-Cal with an annual budget of $142m. Prior to that, he served as the Chief Operating Officer for the DeKalb Community Service Board in Decatur, Georgia. Michael began working in behavioral health as a tech on a psychiatric inpatient unit in 1981, and since that time has worked in a variety of clinical and administrative roles in both mental health and substance abuse agencies. He has been a leader in the industry, providing expertise to national and state initiatives in quality, ethics, training, accreditation, and EMR adoption. Michael is passionate about the use of data and technology in our industry, and is a tireless advocate for increasing performance in behavioral health. He possesses a Master of Arts degree in Communications and a Bachelor of Arts degree in Interpersonal Communications from the University of Central Florida, and is a Certified Addictions Professional.
Susan Griffin, MSM
Coming Soon!
The Keys To Successful Management Of Capitated Contracts
Whether you are ready or not, capitation is becoming a chief form of contracting in the new health and human services landscape. Though this new model is significantly different from traditional fee-for-service reimbursement and requires a considerable change in organizational strategy and operations, it can be quite beneficial for cost-effective provider organizations. Under capitation, provider organizations must rethink their place in the delivery system – a full schedule no longer means large profits in a value-based system. In this crucial session, we will discuss how to properly manage a capitated contract through predictive modeling, efficient resource management, and preventive care measures.
Joseph P. Naughton-Travers, Ed.M.
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.
Jeff Richardson, M.B.A., LCSW-C
Jeff Richardson has served as the Executive Director of Mosaic Community Services (MCS) for twenty years and brings over thirty years of experience in behavioral health. He has been instrumental in Mosaic’s growth to become the largest community-based behavioral health service provider in Maryland serving over 27,000 people annually.
Mr. Richardson holds a master’s degree in social work from the University of Maryland and a master’s in business administration from Loyola University. Mr. Richardson serves on multiple nonprofits boards, state task forces, and academic positions, including The National Council for Behavioral Health, Mental Health Association of Maryland, Bon Secours Hospital, Itineris and Community Behavioral Association of Maryland.
Debbie Cagle
Debbie Cagle is well-known and respected in the healthcare marketing, behavioral health and managed care industries, with more than 20 years of experience in the field. She has worked at Centerstone in a variety of roles for more than ten years including executive leadership for Advantage Behavioral Health, a behavioral health managed care company; Centerstone Military Services, which provides programs and services to veterans and their families; and Centerstone Health Partners, which recently established integrated care clinics for clients with physical and behavioral healthcare needs. Today, she leads marketing and business development for Centerstone, creating and driving business strategy for revenue growth and market share. This includes strategy and oversight of payer relations and contracting, referral marketing, grant writing, branding and communications.
Prior to joining Centerstone, Debbie served as chief operating officer of ValueOptions of Tennessee; vice president of AdvoCare of Tennessee, a subsidiary of Magellan Health Services, and she has directed behavioral health managed care services contracting for HCA, Inc. and Vanderbilt University Medical Center. Debbie graduated from Texas Woman's University with a B.S., dually certified in Special Education, Mental Retardation/ Learning Disabilities and Elementary Education.
She graduated from Texas Woman's University with a B.S., dually certified in Special Education, Mental Retardation/Learning Disabilities and Elementary Education.
Why Health Care Is Not Like Google Or Amazon: The Challenges Of Fitting Ideal Data Models Into The Real World
Sponsored By Core Solutions, Inc.
Amazon and Google – these organizations have led the way when it comes to leveraging data to gain the competitive market advantage. While we can learn from the data innovations at these organizations, the health care market has its own challenges. In this essential executive session, we will explore the importance of data to a successful organizational strategy, the practical challenges of utilizing data in behavioral health, and examples of practical, real world data management solutions for behavioral health provider organizations.
Ravi Ganesan
Ravi Ganesan is President and CEO of Core Solutions, Inc. and is a recognized healthcare business leader, entrepreneur, visionary and evangelist for behavioral health technology. Mr. Ganesan is passionate about helping behavioral healthcare organizations improve care and manage costs by using technology as a strategic tool.
Over the past 20 years, Ravi has built a strong reputation for bringing innovation to the health and human services industry. He has lead Core Solutions, Inc. from a startup company into a dynamic, well respected, growth leader in the behavioral health arena. During his leadership at CORE, the company has witnessed consistent growth, saved millions of dollars for its customers, helped improve client outcomes and created quality jobs for the local economy.
Sharon Hicks
Sharon Hicks, OPEN MINDS Senior Associate, has more than 20 years of experience in the health and human service field. She has extensive experience and wide range of expertise in health plan management, in clinical operations management, and technology.
Prior to joining OPEN MINDS, Ms. Hicks spent two decades in a number of executive positions within the University of Pittsburgh Medical Center (UPMC) system and within its health plan division. Ms. Hicks served as the Chief Operating Officer for Community Care Behavioral Health, a managed behavioral health organization. There she was responsible for all aspects of the organization’s operations including fiscal, information systems, the claims processing department, and the design of clinical systems. In addition, Ms. Hicks managed the day-to-day operations of including human resources, facilities, purchasing, and security.
Ms. Hicks also served as the Vice President, Internet Strategy, UPMC Insurance Services Division and, since 2002, as the Chief Executive Officer of Askesis Development Group, Inc. In this role, Ms. Hicks was responsible for the growth of the company, profitability of the company, and the direction of software development.
Ms. Hicks started her impressive health care career as a psychiatric social worker before being promoted to Assistant Director of Social Work. Prior to her executive promotions, Ms. Hicks served as a Clinical Administrator for both Ambulatory Services and Emergency and Intake Services at the UPMC Western Psychiatric Institute and Clinic. In this role, she managed the behavioral health division, the budgets for all departments, and implemented new software replacing paper billing for clinical services.
Ms. Hicks received both her Masters of Business Administration and Masters of Social Work degrees from the University of Pittsburg. Before pursuing her graduate education, Ms. Hicks received her Bachelor’s Degree in Psychology.
Lunch Break
Lunch On Your Own
Invitation-Only Lunch Sponsored by Credible Behavioral Health Software
Reaping The Rewards Of Pay For Performance
Presented by Matt Dorman, CEO, Credible Behavioral Health Software and Hope Winkowski, Billing Manager, Credible Behavioral Health Software
Complimentary lunch included during presentation.
Moving To Value-Based Purchasing In An Era Of Integration – A Guide For Managing High Cost Members
Sponsored By Relias Learning
Across the country, we’re seeing the emergence of integrated care coordination and pay-for-value models to manage high-cost, complex consumers. The challenges for health plan and provider organization executives is in the design, the analytics, and the delivery system reengineering. In this session, we’ll discuss how to incorporate value-based purchasing through a strategic road map that considers clinical, financial, operational, and cultural aspects – including developing an ability to measure and improve performance through data analytics and training. Join Don Fowls, M.D., President, Don Fowls & Associates for a discussion on applying value-based purchasing when developing integrated models of care and managing high cost, complex members, including real case study examples of tactics that have (and haven’t) been successful.
Don Fowls, M.D.
Don Fowls is a nationally known psychiatrist and health care consultant who previously served as Chief Medical Officer and Executive Vice President of Business Development for Value Options and its parent company, FHC Health Systems for eleven years. Don also served as EVP Business Development of Schaller Anderson and was CEO of its behavioral health subsidiary. He is the past President of the Arizona Psychiatric Society and a Fellow in the American Psychiatric Association.
Strategic Unions: Continuing The Discussion Of Non-Profit Mergers With David Guth
As a follow-up to this morning’s keynote presentation, David Guth, CEO of Centerstone, and author of Strategic Unions: A Marriage Guide for Healthy Not-for-Profit Mergers, will answer questions and share an insider’s perspective on non-profit mergers. In this important session, David Guth will leverage his personal merger experience and three decades as a non-profit behavioral health executive to discuss what makes a successful merger, provide examples of mergers that were successful, as well as those that failed, and share his thoughts on current M&A activity in the healthcare industry.
David C. Guth, Jr.
David Guth is Chief Executive Officer and co-founder of Centerstone, one of the nation’s largest behavioral healthcare providers. The non-profit organization, headquartered in Nashville, Tennessee, serves nearly 142,000 individuals in facilities in Florida, Illinois, Indiana and Tennessee, and nationwide through our national provider network.
Guth has served in the capacity of chief executive for Centerstone since 1991. With 40 years of behavioral healthcare experience, 32 in executive leadership, his experience and expertise comprise a vast number of areas, both business and clinical. He has presented extensively before national and international audiences on the adoption of information technology in the healthcare industry, the integration of behavioral and primary healthcare, and the importance of improving the field of behavioral health through research-driven protocols. His insights on these topics and others have been featured in numerous professional journals.
The National Council for Behavioral Health published Guth’s first book in 2013 (now available in second edition since 2014) on mergers entitled, “Strategic Unions: A Marriage Guide to Healthy Not-for-Profit Mergers.” He has provided merger presentations through both the National Council and state trade associations and has consulted extensively with not-for-profits exploring mergers and with both for-profits and not-for profits in the areas of managing growth and business development. He is currently working on his second book entitled “Nonprofit Governance.”
Under Mr. Guth’s guidance, in 2013 Centerstone announced a joint venture with Unity Physician Partners to improve patient care and enhance the quality of healthcare across the U.S., by creating an environment in which primary care and mental health providers operate within a collaborative and co-located clinical model. Unity Medical Clinics are embedded within select Centerstone facilities today offering coordinated, whole-health care.
He is the recipient of numerous recognitions including the National Council 2010 Visionary Leadership award, and is recognized as one of Health Care’s Power Leaders in the March 2013 Nashville Business Journal.
Guth received his BA in Mathematics from Vanderbilt University and his MSSW in Social Work Administration and Planning from the University of Tennessee.
Models For Physician Compensation & Productivity Management: How Provider Organizations Are Negotiating Clinical Staff Contracts
Productivity-based compensation for clinical staff continues to dominate the market, but as we move toward a value-based reimbursement model for provider organizations, physician compensation models are expected to mirror the pay-for-value trend. As reimbursement shifts from volume to value, provider organization executives need to consider if productivity-driven compensation models are creating the right incentives, or if it’s time for physician compensation to be tied to performance on quality metrics and patient satisfaction scores. Though many health systems are starting off small when it comes to incorporating performance-based incentives, provider organizations need to ask themselves the question: why pay clinicians for volume in a value-based world? In this exciting session, we will discuss the tools your organization needs for adequate reporting capabilities, how to develop a compensation strategy that works for your organization, and how to align physician performance with value-based care goals.
Joseph P. Naughton-Travers, Ed.M.
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.
Carrie Nelson, M.D.
Dr. Carrie Nelson is Senior Medical Director with Advocate Physician Partners (APP), an organization of approximately 5000 clinically integrated physicians. Dr. Nelson’s primary focus is population health strategies, government programs and consulting with other healthcare systems on Advocate’s clinical integration program and accountable care organization success strategies.
Board-certified in family medicine, Dr. Nelson has practiced family medicine for more than 20 years and has been working on issues of health care quality and patient safety since 1999. She has held several professional roles for health care improvement in both hospital and the ambulatory environments.
Dr. Nelson completed medical school at Rush Medical College in Chicago. She also completed a graduate degree at the University of Wisconsin – Madison in administrative medicine and population health. Additionally, Dr. Nelson has held the role of president of the Illinois Academy of Family Physicians, the Institute of Medicine of Chicago, and Chair of the American Academy of Family Physicians Commission on Health of the Public and Science.
Refresh & Recharge Ice Cream Break In The Institute Exhibit Hall
Sponsored By Genoa, a QoL Healthcare Company
Take a break from the day’s sessions during this networking break, sponsored by Genoa, a QoL Healthcare Company. Spend this time in the exhibit hall networking with speakers, faculty, and colleagues while enjoying a “create your own” ice cream sundae bar with all the toppings! Fresh chocolate chip cookies and assorted drinks will also be available for attendees.
Moving A Capitated System From Implementation To Operation: A Town Hall Discussion
In 2014, Magellan Complete Care launched the first Medicaid health plan specifically designed for consumers with serious mental illness (SMI) in the state of Florida. To better serve the needs of their beneficiaries, the Magellan Complete Care model provides integrated behavioral and physical health care under a capitated arrangement – with a focus on care coordination for health promotion, disease management, case management, and utilization management. In this thought-provoking town hall session, Kerry McDonald, Chief Executive Officer, Magellan Complete Care of Florida, will discuss the challenges and opportunities for specialty organizations in the transition to a capitated integrated care management system.
Kerry McDonald
Kerry has more than 30 years of healthcare experience at the executive management level including managing health plan operations, as well as financial services and information support systems.
Currently, Kerry is the Chief Executive Officer of Magellan Complete Care in Florida. In this role he provides leadership in overseeing and ensuring operational compliance with business, financial, quality, and employee objectives. He focuses on cost-effective delivery of high-quality, clinically focused service and operations. In addition, he ensures that quality management plans and protocols are implemented and continually monitored.
Previously, Kerry served as the start-up Chief Executive Officer of Liberty Health Advantage, a Medicare Advantage; VP of Regional Operations for Americhoice, a managed Medicaid payer in NY and NJ; and the Chief Operating Officer of a TennCare plan (THP). During his career, Kerry led the implementation of a new Amsys claims system, and was a significant contributor to the turnaround of an 85,000 member book-of- business, going from a $30 million loss to a $2.5 million profit, after a 90 day implementation period. Additionally, he conceptualized and implemented a complex rate analysis for UnitedHealth Group that enabled the network management team to re-contract with more than 20,000 providers which resulted in an annual savings of more than $11M for their New York managed Medicaid plan. Furthermore, Kerry has led the IT implementation of many software system projects unique to health plans, by building teams of people to accomplish these tasks while achieving significant financial results in extremely short time frames.
Kerry holds a BA in finance from Notre Dame of Maryland University, and will graduate with an MS degree in Analytics and Knowledge Management in December 2015. He also was a hospital corpsman in the US Navy.
Networking Reception
Wrap up the first day of the institute with an exclusive networking reception in the Exhibit Hall. During this time, you will be able to continue your discussions from the days sessions with our faculty and network with your fellow attendees.
Executive Networking Breakfast In The Institute Exhibit Hall
Start off the morning right with breakfast and time for networking with colleagues. Use this time to catch up with fellow attendees, speak with faculty about their presentations, and get ready for the day’s sessions.
The Health Plan Perspective On Improving Performance & The Future Of Value-Based Contracting
For executives of provider organizations, strategically navigating relationships with payers is increasingly complex. With more focus on “whole-person-centered care” through integrated care management, the market is turning to new treatment models with innovative payment structures, including value-based purchasing, pay-for-performance, and the use of person-centered medical homes (PCMH) and integrated health homes. In this new era, how do providers structure their organizations to meet payer expectations and performance requirements? Join Carole Matyas, Vice President of Behavioral Health Operations for Wellcare Health Plans, for a discussion of what payers need and expect in terms of performance of provider organizations in general – and with integration models in particular – and the challenges of working with provider organizations to develop new partnerships.
Carole A. Matyas, MSW
Carole Matyas is the Vice President of WellCare’s Behavioral Health Operations. She oversees enterprise wide behavioral health operations for the company, and a key focus for Carole is to assure that WellCare develops a fully integrated medical/behavioral program that is centered in whole person attention and care.
Carole has more than 30 years of behavioral health-related experience, with 15 of those years of experience in health plan operations. She joined WellCare in 2011 and previously worked for Magellan Health Services, first as a general manager for call center operations, and then as Chief of Clinic Operations, where she led practice management and operations of 23 mental health clinics and a psychiatric urgent care center in Arizona. Her additional experience includes serving as Vice President of Public Sector Operations for Schaller Anderson, a Medicaid managed care organization and helped to develop their integrated model; and as Vice President for Value Options, a managed behavioral health care company whose contracts included carve out managed care for state and government agencies, where Carole was executive lead on a large carve out program in Texas. Carole spent her early career as a licensed social worker providing direct clinical services in a group practice, community mental health and a residential treatment center.
In February 2013, Carole was appointed to serve on the Board of Directors for Drug Abuse Comprehensive Coordinating Office, Inc. (DACCO) in Tampa, Fl. Carole has been the recipient of awards from Mental Health America and NAMI for her dedication to mental health advocacy Carole earned both her undergraduate and Master of Social Work degrees from Marywood University in Scranton, Pennsylvania.
Transitioning Your Current Reporting & Performance-Management System From Fee-For-Service, To Pay-For-Value
Payer cost pressures and health care reform are pushing the use of value-based contracting and pay-for-performance (P4P) initiatives – both in reimbursement of health plans and of service provider organizations. As organizations transition to reimbursement systems that offer financial rewards for achieving or exceeding performance standards on specified quality, cost, or other benchmarks, it is crucial to have information systems that provide real-time performance data. In this value-based market, tracking the status of key performance measures on a weekly (or at least monthly) basis is a must – your management team needs an early warning system if organizational performance is off course. Don’t miss this exciting session, where we will discuss how these system changes are affecting operations management – and how to adapt your performance and reporting systems to help your organization succeed in value-based care.
James Stewart
James Stewart brings to OPEN MINDS more than 20 years of experience in the healthcare field. Mr. Stewart has helped develop and modify health care plans and benefits, retirement plans and benefits, and paid time off (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 (EHR) 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 and West Virginia in the United States and also in Australia. Mr. Steward also spearheaded the process of developing and implementing a new paperless EHR, 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.
Building The Infrastructure & The Team To Manage Medical Homes & Health Homes: The OPEN MINDS Readiness Assessment
The fundamentals of the business of behavioral health are changing. Does your organization have the enhanced infrastructure and team competencies to properly manage risk? The OPEN MINDS managed care readiness assessment tool covers the important competencies and strategies that will be necessary to succeed in the new managed care environment. Join us for this essential session to address a range of essential organizational skills in the areas of revenue cycle management, margin management, quality and compliance management, metrics management, and human resources.
Sharon Hicks
Sharon Hicks, OPEN MINDS Senior Associate, has more than 20 years of experience in the health and human service field. She has extensive experience and wide range of expertise in health plan management, in clinical operations management, and technology.
Prior to joining OPEN MINDS, Ms. Hicks spent two decades in a number of executive positions within the University of Pittsburgh Medical Center (UPMC) system and within its health plan division. Ms. Hicks served as the Chief Operating Officer for Community Care Behavioral Health, a managed behavioral health organization. There she was responsible for all aspects of the organization’s operations including fiscal, information systems, the claims processing department, and the design of clinical systems. In addition, Ms. Hicks managed the day-to-day operations of including human resources, facilities, purchasing, and security.
Ms. Hicks also served as the Vice President, Internet Strategy, UPMC Insurance Services Division and, since 2002, as the Chief Executive Officer of Askesis Development Group, Inc. In this role, Ms. Hicks was responsible for the growth of the company, profitability of the company, and the direction of software development.
Ms. Hicks started her impressive health care career as a psychiatric social worker before being promoted to Assistant Director of Social Work. Prior to her executive promotions, Ms. Hicks served as a Clinical Administrator for both Ambulatory Services and Emergency and Intake Services at the UPMC Western Psychiatric Institute and Clinic. In this role, she managed the behavioral health division, the budgets for all departments, and implemented new software replacing paper billing for clinical services.
Ms. Hicks received both her Masters of Business Administration and Masters of Social Work degrees from the University of Pittsburg. Before pursuing her graduate education, Ms. Hicks received her Bachelor’s Degree in Psychology.
Dee Werline
Dee Werline, MA, LPP is Vice President of Administration at bluegrass.org. Ms. Werline has more than 25 years of experience in behavioral healthcare. She holds a Master’s Degree in Clinical Psychology from Morehead State University and is a Licensed Psychological Practitioner. Ms. Werline’s experience in administration and clinical work extends across inpatient settings, intermediate care facilities, outpatient clinics, community-based residential care, vocational training, and day treatment centers. This work has included both behavioral health and developmental disabilities programs.
Reengineering Your Unit Costs: How To Reduce Your Unit Costs When Market Rates Go Down
As we move to a more customer-driven competitive market, our customers (both payers and consumers) don’t always care about our costs to deliver a service. They only care about the rate we charge – and how that rate (and the other attributes of the service) compares to that of our competition. For most, payers are not giving rate increases – but the costs of doing business (health benefits, salaries, technology investments, etc.) are increasing. This environment makes unit cost management a critical management team competency that can be addressed through target costing – a pricing method which takes into account a desirable profit margin as well as the rates of competitors – and value reengineering – a key tool for reducing unit costs through the redesign of processes and infrastructure. In this important session, we’ll discuss the shifting reimbursement market, as well as how to manage unit costs in the shifting landscape to accommodate the market rate, while improving quality and increasing sales.
Joseph P. Naughton-Travers, Ed.M.
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.
Ken Carr
Ken Carr brings over 20 years of finance, technology, data analysis and reporting experience in the health and human service field to OPEN MINDS. Before joining the OPEN MINDS team, he served as the Chief Financial Officer of The Centers, a community mental health center in Ocala, Florida. In this position, Mr. Carr led a realignment of the organization’s financial management functions. This included revenue cycle management, EHR bill implementation and reporting, cash management enhancement, and strategic financial analysis.
Prior to his role at The Centers, Mr. Carr served as Chief Financial Officer of Guild Incorporated, an organization providing residential and community based mental health services in St. Paul, Minnesota. As CFO, Mr. Carr led the financial, billing, IT, quality, informatics, compliance, and facilities activities. During his tenure at Guild Incorporated, Mr. Carr used his expertise in change management and business process improvement to lead the EHR implementation team, align service data reporting and financial performance, and lead the financial and data capture activities for new service initiatives.
Mr. Carr has also held the positions of Administrative Director and Finance Director at the St. Paul National Testing Laboratory, a biomedical testing facility of the American Red Cross. In those positions he oversaw activities to enhance inventory management, align financial results to industry standards, and improve financial and facilities performance through problem analysis and quality management initiatives. He also was involved in directing human resource functions during laboratory closing near the end of his tenure.
Mr. Carr earned a Bachelor of Science in Business Administration from the University of South Dakota, and a Master of Divinity Degree from Sioux Falls Seminary. He maintains an active CPA license with the State of South Dakota.
Are You Really Ready For Value-Based Payment? Planning Your Move To Pay-For-Value
Both provider organization executives and payer organization executives have tired of the "vendor" relationship between payers and providers that is the basis of the current fee-for-service (FFS) reimbursement system. For provider organizations, it often means low rates, lots of administrative expenses, and unpredictable service volume. For payers, it is a high-cost administrative situation - lots of contracts, lots of preauthorization, lots of claims, and lots of audits. For those reasons, and many others, there is a shared desire of both payer organizations and provider organizations to shift from a FFS vendor relationship to a value-based partner relationship. The challenge? How to get there. 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 a performance-driven market.
Monica E. Oss
Monica E. Oss, M.S., Chief Executive Officer and Senior Associate, is the founder of OPEN MINDS. 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. 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.
Closing Remarks & Raffle Prize Drawings
Immediately following the closing keynote, we will head over to the exhibit hall for the raffle prize drawing. We have lots of great prizes, provided by our institute sponsors - but you must be present to win!