2019
Presentations
Thriving With Managed Care: An OPEN MINDS Executive Seminar On Organizational Competencies & Best Practices In Health Plan Contract Management
In an evolving managed care marketplace new payer service delivery requirements and expectations are changing the way community mental health provider organizations deliver traditional mental health services. The partnership between payer and provider has resulted in the alignment of shared goals for timely access to treatment and services, client care coordination, targeted client outcomes, strategic market planning/ outreach, and intake and admissions processes. To be successful in this environment, provider organizations must be managed care ready and positioned as a “preferred provider” in this competitive market. In this seminar, OPEN MINDS Advisory Board Members Richard Louis, III and Ken Carr will present essential best management practices and the internal departmental supports necessary to succeed in a high volume and outcomes driven managed care environment.
In this seminar, we will discuss:
- Core themes related to customer centric intake and admission processes to ensure maximum client visits and reduce “no show rates”
- Development of winning marketing strategies and account management to drive and maintain maximum referral volume
- Customer focused care coordination for effective continued stay reviews, treatment updates and discharge planning
Richard Louis, III
Richard Louis, III has extensive experience as a behavioral healthcare administrator, business development specialist, and innovator of new service lines for behavioral healthcare organizations and currently serves the Vice President – Western Region at OPEN MINDS.
Previously, Mr. Louis was the Director of Development – Behavior & Addiction Medicine at Southern California Healthcare Systems Inc. / Prospect Medical. There, he was involved in many consulting projects focused on health care integration, developing new service lines, and health plan contract development. Most recently, he pioneered the development of a series of innovative and profitable integrated behavioral health treatment and population health management solutions that target high cost and complex behavioral health populations. These solutions have shown to reduce payer spend while improving client outcomes for acute care hospital systems, health plans, managed care organizations (MCO), managed service organizations (MSO), managed behavioral healthcare organizations (MBHO), medical groups (IPA) and social service agencies.
Mr. Louis was also the Executive Director of Strategic Development and Planning at Pathways – Molina Healthcare, a national for-profit behavioral healthcare company operating in 23 states. In this role, Mr. Louis developed and launched population health management program strategies that included in-community care management and in-home coordinated care services to reduce hospital readmissions, emergency department (ED) visits, and improve HEDIS scores for national health plans and Managed Care Organizations.
Mr. Louis is also a former Psychiatric Hospital Administrator and Assistant Director of Mental Health for San Bernardino County Department of Behavioral Health in CA, where he was responsible for behavioral health program management, clinical operations, strategic alliances, and outcome-based service delivery models for complex adult and youth populations.
Mr. Louis also served in various positions at College Health Enterprises (CHE), a Los Angeles based for-profit hospital system, most notably serving as Vice President of Government Operations. While in this role, he created the first public sector division for CHE by establishing new service lines, contracts, and new profit/revenue streams. His responsibilities included business and program development as well as administration of inpatient, outpatient, and residential continuums of care for public payers (i.e. county mental health systems, state department of developmental disabilities, county jail, state prison, and federal government agencies).
Mr. Louis is in his 32nd year as an active duty reserve police officer (volunteer) currently holding the rank of Captain, City of Monterey Park Police Department in Los Angeles County. He has worked closely with police, county sheriff’s departments, and healthcare systems to educate and craft “treatment versus incarceration” collaborations promoting treatment and cost-effective crisis triage interventions for persons with mental illness.
Mr. Louis graduated with a Bachelor of Arts in psychology from Whittier College and is a Police Academy Graduate from Rio Hondo College in Whittier, California.
Ken Carr
Ken Carr brings more than 20 years of finance, technology, data analysis, and reporting experience in the health and human services field to OPEN MINDS. He currently is a Senior Associate with the OPEN MINDS consulting practice. In this role, he has served as a subject matter expert leading numerous engagements in strategic planning, merger and acquisition prospecting, business process improvement, financial analysis of service lines, and technology selection.
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.
Making The Right Tech Investments For Your Organization: An OPEN MINDS Executive Seminar On Technology Budgeting & Planning
As technology takes a more central role to strategy, competitive advantage, and sustainability for health and human service organizations, it brings new issues for executive teams to grapple with: What technology to invest in? How much to spend on technology infrastructure? Who is responsible for technology purchasing, technology implementation, and technology optimization? The strategy questions are big ones. And the range of available technologies and tech-enabled functionality that shape and support strategy is large and growing rapidly. In this session, we’ll cover the big challenge facing executives as they lead their organization on the path to a tech-driven future, including:
- How to develop a technology strategy that aligns with your organization’s strategic plan
- How to establish a technology budget that allows your organizations to meet its strategic goals
- How to apply best practices in technology selection, implementation, and optimization
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.
Registration & Executive Networking Breakfast
Check-in at the registration desk to get your name badge and program materials, then join us in the exhibit hall for breakfast. Take some time to meet your fellow attendees, talk to our sponsors, and prepare for the day ahead.
Welcome & Announcement Of The Results From The 2019 OPEN MINDS Performance Management Executive Survey: Where Are We On The Road To Value
During this opening session, OPEN MINDS Chief Executive Officer, Monica E. Oss will open the institute by sharing the results of this year’s survey, The 2019 OPEN MINDS Performance Management Executive Survey: Where Are We On The Road To Value, and discussing their implications for health and human service organizations.
Monica E. Oss
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.
Building A New System For Private Insurance: Innovations & Emerging Models For Employer-Sponsored Health Plans
Over 65% of the U.S. population has private health insurance coverage. With health care costs rising, employers facing rising insurance premiums, and consumers shouldering more health care costs, we’ve seen a need for innovation and new financing models in the private sector. During this can’t-miss keynote presentation, we’ll learn about how one organization is disrupting the employer-sponsored health insurance market, and what the implications of this new model are for provider organizations. Homestead offers a new model for health care coverage for self-funded employer groups designed to deliver top quality care at the lowest possible cost. During his keynote presentation, Mr. Green will discuss how the Homestead model differs from traditional employer-sponsored health plans, how their innovative model changes provider organization contracting models, how innovations in health care coverage are impacting the market, and his perspective on the future of employer-sponsored health benefits.
Bill Green
Bill Green was appointed as the Chief Executive Officer of Homestead Strategic Holdings, Inc. effective May 1, 2018. He previously had served Homestead as Chief Legal Officer, Founder and Director since 2015.
Bill brings an extensive leadership background in both the public and private sectors. He was appointed as Chair of the Philadelphia School Reform Commission by Governor Tom Corbett in January 2014 and served on the Commission until June 2018 when Philadelphia took over local control of its School District. Immediately prior to his appointment he served as Philadelphia City Councilman At-Large from 2008-2014. Bill focused his work in City Council on fiscal discipline, government accountability, the application of technology, and improving the quality of life for city residents.
Thought Leader Discussion With Bill Green, Chief Executive Officer, Homestead Smart Health Plans
Join us for a follow-up session with our keynote speaker, Bill Green, Chief Executive Officer, Homestead Smart Health Plans. Use this time to ask questions and continue the morning’s discussion with Mr. green and OPEN MINDS Chief Executive Officer Monica E. Oss.
Bill Green
Bill Green was appointed as the Chief Executive Officer of Homestead Strategic Holdings, Inc. effective May 1, 2018. He previously had served Homestead as Chief Legal Officer, Founder and Director since 2015.
Bill brings an extensive leadership background in both the public and private sectors. He was appointed as Chair of the Philadelphia School Reform Commission by Governor Tom Corbett in January 2014 and served on the Commission until June 2018 when Philadelphia took over local control of its School District. Immediately prior to his appointment he served as Philadelphia City Councilman At-Large from 2008-2014. Bill focused his work in City Council on fiscal discipline, government accountability, the application of technology, and improving the quality of life for city residents.
Monica E. Oss
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.
Optimizing Productivity: A Guide To New Performance-Based Compensation Models
To make value-based reimbursement a success, organizations need to serve a high volume of consumers to keep unit costs down—while also improving outcomes to meet performance requirements. Incentivizing staff productivity through a performance-based compensation model can be the best way to operationalize the demands of VBR models. But what are the best practices in performance-based compensation and what is the best strategy for implementation? This session will review some examples of current models being used by provider organizations, the benefits and challenges associated with each model, and how to implement once you have decided on the best model for your organization. In this session, we will discuss:
- How to develop a compensation strategy that works for your organization
- How to use productivity measurement to maximize your organization’s revenue potential
- Case study examples of performance-based compensation models from the field
John F. Talbot, Ph.D.
John F. Talbot, Ph.D., Advisory Board Member, has more than 30 years of experience in all aspects of healthcare, including upper management, consultation, education, direct clinical work, and serving as the president of a non-profit board. Dr. Talbot has provided consultation, training and operational assistance to behavioral health providers, nonprofit organizations, and managed care organizations across the country. His areas of focus for consultation and training include strategic planning, the development of successful strategic alliances, board development, organizational reengineering, operations management, management and leadership development, and change management. He is currently Vice President of Integration Development at Jefferson Center for Mental Health in Denver, Colorado.
Prior to his current position, Dr. Talbot served as the President of a network of agencies providing care to children and families. The innovative work of Colorado Care Management received national recognition, including participation in a Federal IV-E waiver study that demonstrated measurable superior clinical outcomes. In his role with Colorado Care Management, Dr. Talbot also led the development of a coalition of Colorado business executives to address the issues of providing care to abused and neglected children, and the establishment of a nationwide purchasing cooperative for non-profits. Dr. Talbot’s previous experience included serving as the Director of the Master of Health Systems Program, and Associate Dean of University College at the University of Denver. He also held senior management positions at Mount Airy Psychiatric Center in Denver, Colorado.
Dr. Talbot has been a featured speaker at a number of national and state venues including the National Council Community Behavioral Health, Mental Health Corporations of America, the American Association of Residential Treatment Centers, the Medical Group Management Association, the Colorado Behavioral Health Council, the Mental Health Council of Arkansas, the New Jersey Association of Mental Health Agencies, and the Florida Behavioral Health Council.
Dr. Talbot is the former publisher and editor of Today’s Healthcare Manager, a newsletter focusing on leadership and management skills for healthcare managers, and has written numerous articles, manuals, and book chapters. His volunteer work includes serving as the President of the Board of Human Services Inc. in Colorado.
Anna P. Hundley
Joined ATC in 1982
Masters in Special Education, Management & Supervision
Recognized nationally and internationally for nonprofit management and leadership skills
Past President, National Association of Residential Providers of Adults with Autism (NARPAA)
Member, National ASA Services TASK Force; Member, 32nd IRI, US Dept of Education
Vice Chair, Texas Council on Autism & Pervasive Development Disorders
National Advisory Task Force; SEDL; Chair, AFAA Leadership Council
Colleen Muncy, MBA
Colleen Muncy is the Owner/ Managing Director of ALIGN HealthCare Solutions, LLC and StarPRO, LLC who works with various members of the community to educate them on health care federal star ratings by creating more transparency and by visually simplifying otherwise overly complicated data. Colleen believes health care quality will improve by empowering patients to make more informed decisions. In order to accomplish this, she has assembled a team to create several industry relevant tools for different types of users in the health care space.
Colleen possesses more than 20 years of experience in health care operations and management including hospital, subacute rehabilitation, long-term care, and skilled nursing facility operations & management. Colleen specializes in optimizing operational performance, tracking, analyzing and benchmarking data using Key Performance Indicator (KPI) Dashboards and strategic reimbursement models.
Colleen holds a M.B.A. in Finance and Management from Niagara University and B.A. in Communications and Marketing from State University at Buffalo. Colleen is also a graduate of the Leader Fellows Program through Health Foundation of Western and Central New York. You can contact her at colleen@alignhcs.com or get more information at www.getstarpro.com and www.alignhcs.com.
David E. Young, MBA
David Young, MBA, brings more than 30 years of executive experience in technology, new product development, and strategic planning in the health and human service field to the OPEN MINDS team. In addition to holding executive-level positions at prominent healthcare organizations, Mr. Young has also co-developed several start up organizations. He has extensive experience in the telemedicine field, specifically working with autism, children and adolescents, corrections and long-term care markets.
Prior to joining OPEN MINDS, Mr. Young served as the Chair of the Board and the Chief Marketing Officer of Raiven Healthcare in Tennessee. In this position, he provided leadership and strategic vision for the cutting edge artificial intelligence company. While leading the Board, he also served as the Chief Marketing Officer, providing direction in branding and imaging in the marketplace. Together, Mr. Young and the Chief Executive Officer oversaw the budgeting process and developed the direction of the board policy.
Previously, Mr. Young served as the Co-Founder, President, and Chief Operating Officer of MindCare Solutions Group, Inc., a national telemedicine organization providing tele-psychiatry and tele-primary care to institutional providers. In these roles, Mr. Young designed the corporate structure and directly managed sales, account management, and government relations. Prior to his departure at MindCare Solutions Group, Inc., Mr. Young obtained three of the largest customers in the behavioral health space as clients, when the organization was not yet three years old.
Mr. Young served as the Vice President of Tele-Psychiatry at Optum/UnitedHealth Group from 2011 – 2013, where he served as the national leader of the tele-psychiatry service line. He developed service lines, and created all aspects of the business development process. Working with senior level executives, he co-developed a design for fee-for-service and alternative payment systems.
Mr. Young received his Bachelor of General Studies, Administrative and Community Services, from Samford University, Birmingham, Alabama in 1985. He then went on to earn his Masters of Business Administration, Health Services Administration, from the University of Dallas, in Texas, in 1990.
Edward Farbenblum
Edward O. Farbenblum Esq. is an attorney admitted to practice in New York and the Federal Courts for the Southern and Eastern District of New York along with the Second Circuit Court of Appeals. He has substantial experience in both the healthcare and real estate industries. Mr. Farbenblum worked for the New York office of Arent Fox in its healthcare transactional practice, specializing in the purchase, sale, financing, and the regulation of skilled nursing facilities and hospitals.
After leaving the law firm, Mr. Farbenblum oversaw many real estate and health care transactions focusing on the turning around of distressed assets, most notably the transactional and operational aspects of two major government owned nursing home privatizations in New York. Mr. Farbenblum previously sat on the Healthcare Advisory Panel for the think tank Pattern for Progress.
CFO Roundtable On Value-Based Reimbursement: A Facilitated Discussion By Financial Leaders For Financial Leaders
In this roundtable, led by James Stewart, President & CEO, Grafton Integrated Health Network, we will discuss the essential strategies chief financial officers need to meet the challenges their organizations are facing in the transition to value-based reimbursement. Come prepared to discuss your organization’s challenges, learn through your colleagues’ experiences, and hear different perspectives from financial leaders across the complex care continuum.
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.
John M. Corneilson, MBA
John Corneilson was named Chief Financial Officer in May 2016 after serving as Vice President of Finance and Accounting / Comptroller since 2014. Prior to joining Meridian, John served as Director at Luther Springs Camp and Retreat Center in Hawthorne, Fla., after 22 years in industrial accounting as Controller at manufacturing facilities stretching from Ocala, Fla., Poplar, Bluff; Mo., and Boone; Iowa., to Reynosa, Mexico. He was awarded a Bachelor of Arts in Accounting and Business Management at Augustana College; and, received a Master’s in Business Administration and Accounting from Northern Illinois University.
Keith Neal, MBA, MHL, CHFP
Keith joined Advocates in September 2018 as Senior Vice President and Chief Financial Officer. He is responsible for directing all aspects of the organization’s financial affairs; leading key strategic and tactical initiatives; continuously evaluating systems and performance; and identifying areas for operational redesign and leading improvement efforts. He is also a faculty member at Brown University, where he is a Teaching Associate for Financial Decisions in the Changing Healthcare Landscape.
Prior to Advocates, Keith worked at Brown Emergency Medicine (formerly University Emergency Medicine Foundation) where he was Chief Financial Officer. There he led the accounting, finance, and revenue cycle functions, which handled over 270,000 patient encounters. He also assisted in managing the corporate governance aspects of the Foundation. While there, he helped develop and implement quality and gain-sharing programs with Commercial and Medicaid managed care payors. Prior to that, Keith worked for EMC Corporation for nearly 15 years in a variety of leadership roles.
Keith received his bachelor’s degree in economics from Wheaton College. He also has an MBA from Clark University, and a Master of Healthcare Leadership from Brown University, where he focused his studies on the development and implementation of quality-based payment programs and alternative payment models. He is an Eagle Scout, 6-sigma Greenbelt, and a Certified Healthcare Financial Professional. He occasionally lectures on the topic on healthcare finance, and was recently published in Academic Emergency Medicine, contributing to a manuscript on the financial viability of emergency department observation units.
Michelle Aponte-Pacheco, MSW, MBA
Michelle Aponte-Pacheco, Chief of Revenue Cycle for Emergence Health Network, has more than fifteen years of experience in the behavioral health arena first starting as a case manager with EHN, but what was then called El Paso MHMR. As chief of revenue cycle for El Paso County’s Mental Health/Intellectual Disabilities Authority for El Paso County, Ms. Aponte-Pacheco is responsible for services involving benefit assistance, credentialing, pre-authorization, UMUR and Reimbursement Departments, while ensuring compliance with cost-sharing rules, social security rules and guidelines.
Previously, Ms. Aponte-Pacheco served as Director of Benefits Assistance, Preauthorization’s, Reimbursements and Utilization Management for EHN; as well as Director of Provider Relations for Sun City Behavioral Health Care, Emergence’s non-profit subsidiary. She also has extensive experience in the private behavioral health sector, serving as Director of Utilization Management at University Behavioral Health in El Paso and Case Management Supervisor at Mesilla Valley Hospital Outpatient in Las Cruces, New Mexico.
Ms. Aponte-Pacheco received both her Master’s and Bachelor’s Degree in Social Work from New Mexico State University.
The Capitalization & Integration Of The US Behavioral Health Market
Sponsored by Credible Behavioral Health Software
Billion dollar buyouts, national and local mergers, Federal and State mandates, and the reality of integrated care are driving significant investment, consolidation and changes in Behavioral Health and the technology supporting the delivery of care. Join Credible Behavioral Health’s Founder and CEO, for a fast-paced, thought-provoking, solution oriented session providing tools for successful strategies to not just survive the future, but to excel, and to grow your organization’s behavioral health awareness and success.
Matthew M. Dorman
Bio coming soon!
Building A New Performance Management Dashboard: How To Use KPIs To Manage Performance In A Value-Based Market
Coordinated care, value-based payment, and competitive bidding are just a few of the big drivers forcing health and human service organizations to change management processes and strategy. In order to make those changes and improve decision-making, executive teams need to using metrics-based management. One method of metrics-based management is the development of a key performance indicator (KPI) system. An effective KPI system captures financial and non-financial measures, and is driven by structured data based upon an organization’s strategic objectives. This session will discuss the steps to developing applicable measures and the uses of these measures for strategy and process management—including:
- The strategic importance of real-time performance management in a value-based market
- Best practices in building an effective KPI system
- Case study presentations from organizations that have developed their own performance management system
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.
Diana Salvador, Psy.D.
Diana Salvador, PsyD, is a licensed Clinical Psychologist in both New Jersey and New York and currently serves as the Vice President of Quality Assurance & Risk Management at CPC Behavioral Healthcare in Monmouth County, NJ. CPC provides a continuum of mental health, substance use, and special education services to children, adults, and families and is a certified CCBHC and the recent recipient of the SAMHSA CCBHC and MAT Expansion grants. In her role she develops and monitors outcomes to support a value-based system of care and leads quality improvement initiatives. Prior to coming to CPC, Dr. Salvador worked at Rutgers University Behavioral Health Care providing oversight for residential, school and community programs for youth and families throughout NJ. She is a volunteer Faculty member of the Robert Wood Johnson Medical School and an Affiliate of the National Child Traumatic Stress Network. Her specialties include program development, continuous quality improvement, workforce development and the creation of innovative system change to reduce health disparities.
Revenue Cycle Management: A New Model For A New Market
Most organizations typically only collect 80% of Medicaid services that are billed. Although many organizations have revenue cycle management systems in place, most have not evolved their systems to tightly measure and manage cost, care, and outcomes across the entire episode of care. But provider organizations that understand how to manage costs, while delivering quality service and better outcomes, will be the best positioned to thrive in the value-based world. In this session, we will cover:
- How to assess your organization’s revenue cycle management, from point of service to billing
- How to optimize your revenue cycle for value-based reimbursement
- Examples of revenue cycle management systems from provider organizations
David E. Wawrzynek, MBA
David Wawrzynek, MBA brings more than 40 years of public behavioral health, clinical, financial, and management experience to the OPEN MINDS team. He brings a truly unique combination of experience with his clinical, business, and financial experience, as well as a demonstrated history of efficient and effective management of behavioral health services.
Mr. Wawrzynek currently serves as a Senior Associate and Subject Matter Expert in the OPEN MINDS Consulting Practice, where he leads projects related to value-based purchasing, financial modeling, and clinical and financial data analysis. In recent years, Mr. Wawrzynek has focused on the development of analytic modeling tools, communication platforms, and knowledge management supports to transform raw data into meaningful information, to enable more effective strategic and operational insights and decision-making.
Before joining OPEN MINDS, Mr. Wawrzynek served 18 years as the Senior Vice President, Finance and Chief Financial Officer at Spectrum Human Services, a private, non-profit community mental health organization in Western New York. In this role, Mr. Wawrzynek designed, implemented and monitored systems to support information technology, human resources, billing, budgeting, financial modeling and reporting, site operations, risk management, security, as well as change management.
Previously, Mr. Wawrzynek served as the Vice President of Finance and Chief Fiscal Officer with Health Management Group in Buffalo, New York. In this role, he managed the corporate financial resources through the supervision and coordination of the functions of reimbursement, budget, banking, and general accounting.
Previously, Mr. Wawrzynek served his first 14 year tenure with Spectrum Human Services as Director of Financial Operations. In this role, he was responsible for the fiscal, facility, personnel, and business functions of the corporation. In addition he was responsible for data analysis and worked closely with the Clinical and Quality Assurance Directors in the development and monitoring of performance and outcome indicators.
Before joining Spectrum, Mr. Wawrzynek served as an Outpatient Psychiatry Supervising Counselor with Buffalo General Hospital Community Mental Health Center. In this role, he held dual clinical and administrative responsibilities and assisted in the daily operation of the department, acted as a liaison to other hospital departments, and supervised staff activities.
Mr. Wawrzynek began his career as a clinical Supervising Counselor for the City of Buffalo’s Division of Drug Abuse Services where he was responsible for supervision of all counseling and clinical activities at a community-based drug treatment center and provided counseling services for clinic patients.
In recognition of his professional successes, Mr. Wawrzynek was named as the 2007 Not-for-profit Chief Financial Officer of the Year by Buffalo Business First.
In addition to his professional experience, Mr. Wawrzynek has served in a number of leadership roles for affiliations including past President for the New York State Cerner Software User Group; past Board President for Child Resource Network; and Treasurer for Spectrum Human Services Foundation.
Mr. Wawrzynek earned his Master of Business Administration and his bachelors in psychology from SUNY at Buffalo and his Master of Science in Rehabilitation Counseling from Syracuse University.
Vanessa R. Lane, MBA
Vanessa Lane is the Director of Revenue Cycle Management at Grafton Integrated Health Network. She has over twenty years of experience in the healthcare field. Ms. Lane has experience managing accounts receivable, contracting, admissions, authorizations and front desk functions in a healthcare setting. She also has extensive experience in working with multiple state Medicaid systems to develop and implement policy changes. Additionally, she has participated in multiple teams in the selection, implementation, and use of multiple Electronic Health Record Systems.
Prior to working at Grafton, Ms. Lane was the Manager of Accounts Receivable for the Center for Behavioral Health at Centerstone. In this position, she managed the revenue cycle through multiple Electronic Health Record Implementations and several mergers between Non-Profit CMHCs.
Ms. Lane received her MBA with a Healthcare Administration focus from Indiana Wesleyan University. She received a Bachelor of Science degree in Business Management from Indiana Wesleyan University.
The Intersection Of Consumer Data & Technology – How To Craft A Strategy Today & Prepare For The Future
Sponsored by Netsmart
Access to care, speed to delivery, and matching consumer need to available service lines is rapidly moving from a goal to a requirement. In this session you will learn how Centerstone of America, a dynamic organization covering 5 states, is leveraging the power of consumer data from multiple sources to establish customer relationship management (CRM) best practices, transition from inquiry to service delivery, and deliver ongoing consumer engagement. In addition, you will learn about the value of using an integrated CRM to improve efficiencies today, uncover hidden consumer risks, and enable possibilities for the future.
Scott Green
Scott Green is senior vice president and general manager, Behavioral Health and CareGuidance business units at Netsmart. In this role, Mr. Green oversees Netsmart’s solutions and services offerings to the behavioral health, social services, addiction services, IDD and child welfare communities. He also leads the teams charged with aligning the company’s population health, consumer engagement, clinical content, analytics and interoperability strategies and solutions to the user communities Netsmart serves. Green works closely with Netsmart’s product, clinical and operational teams, and drives collaboration with clients to maximize the benefits of their investment in healthcare information technology.
Prior to joining Netsmart, Mr. Green held a variety of positions in the pharmaceutical industry, including roles in government relations, marketing, sales and managed markets. Mr. Green’s experience includes leveraging technology to enable operational and clinical teams to develop and deploy innovative initiatives and programs designed to drive improved standardization of care and outcomes. He has a bachelor’s degree in psychology from Kansas State University and a graduate certificate in healthcare leadership from Park University.
Debbie Cagle Wells
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.
Framing Value Propositions With Discovery-Data-Mining
Sponsored by TenEleven Group
Your agency has value in places you haven’t even thought to look!
With the introduction of Value-Based-Payments, comes the emphasis on Behavioral Health agencies being able to prove value. But what does value look like? How do you articulate the value you offer? But most importantly, what is the value you offer?
This Lunch & Learn will introduce you to the concept of Discovery-Data-Mining and how you can leverage your EHR data to form succinct data-driven value propositions for use with payers, private funders, or any stakeholder that needs to know exactly what you do well.
Please email Chuck Calhoon at ccalhoon@10e11.com to request an invitation and start making your data talk!
Tristan Keelan
Tristan Keelan is the Marketing Strategist at TenEleven Group. Tristan holds a BA in English from Elmira College and an MBA from St. Bonaventure University. He uses his experiences working in Government, Non-profit National Service, and Banking to bring business process and analytics driven insights to the behavioral health industry.
Tristan is the Co-Author of the TenEleven training course Data, Analytics, & You, which explores how to manipulate your EHR data in a business analytics tools for maximum visibility into behavioral health agency outcomes. In this capacity Tristan is responsible for delivering training that is designed to help behavioral health agencies incorporate analytics into their strategic plan and management of clinical outcomes measures.
You can read blog posts from Tristan here.
What’s New In Workforce Management? Exploring The Latest Trends For HHS Organizations
Sponsored by DATIS HR Cloud
The way we work is constantly changing. As we push ahead in 2019, it’s important to stay on top of the dynamic nature of workforce management. This session will dig into the latest workforce trends that are currently transforming the way Health and Human Services organizations operate. Discover new insights from DATIS’ 2019 State of Workforce Management Report and learn about the key priority areas that continue to shape the behavioral health landscape in this engaging, can’t-miss session.
Key learning objectives for this session include exploring the top trends currently facing the Health and Human Services industry and discovering innovative solutions to top challenges at these organizations. We will also analyze the priorities, challenges, and goals of executives and explore how initiatives have evolved in recent years.
Erik Marsh
As the President and CEO of DATIS HR Cloud, Erik Marsh is focused on delivering value, productivity, and efficiencies for nonprofit organizations through Human Capital Management software. Erik graduated from Indiana University, Bloomington with a B.S. in Finance. After graduation, Erik worked for 5 years in various financial roles before joining Oracle, where he worked for 15 years. With over 20 years of experience in finance and software, Erik combines this knowledge to help organizations implement best-in-class technology that drives innovation and growth.
The Valant EHR: An Intuitive Platform
Sponsored by Valant
When searching for an EHR for example, an intuitive user experience and configurable workflows are increasingly important. When it comes to an approachable, straightforward workflow, The Valant Platform EHR is one that must be seen to be believed. The interface looks like a modern experience we have come to expect from current technology, but is unique in the Behavioral Health market.
This brief demo will cover the foundation of Valant EHR technology and how it’s different from what you’re using today. We’ll dive a bit into the interface to show how this underlying technology creates incredibly easy, straightforward workflows and reporting that takes little to no training. We hope you’ll join us in this talk about how modern technology enables an intuitive EHR.
Brian Gann
Brian Gann has been on the Valant team for over five years and is an expert in connecting behavioral health administrators with usable and sustainable technology. He is a technical expert who can explain complex functions in relatable language. Brian graduated from the University of Washington with a degree in history before changing course to work in healthcare and technology.
Implementing A New Model Of Integration: The Cigna Collaborative Care Model
Historically, the distinction between the organizations that provide services and the organizations that manage financial risk for a population has typically been quite clear—but that traditional model has been changing. In our shifting value-based market, provider organizations are taking on more risk and health plans are developing and acquiring service delivery capacity. One example of an innovative collaboration is the Arizona-based Cigna Medical Group, division of Cigna HealthCare of Arizona, Inc.. The Cigna Medical Group is a multi-specialty group practice with 20 health care centers in the Phoenix area. Owned by Cigna, the medical group provides primary care and other services to more than 100,000 customers. In this session, we’ll learn more about this model from the perspectives of Cigna, a physician champion, and a specialty behavioral provider partner.
Richard Louis, III
Richard Louis, III has extensive experience as a behavioral healthcare administrator, business development specialist, and innovator of new service lines for behavioral healthcare organizations and currently serves the Vice President – Western Region at OPEN MINDS.
Previously, Mr. Louis was the Director of Development – Behavior & Addiction Medicine at Southern California Healthcare Systems Inc. / Prospect Medical. There, he was involved in many consulting projects focused on health care integration, developing new service lines, and health plan contract development. Most recently, he pioneered the development of a series of innovative and profitable integrated behavioral health treatment and population health management solutions that target high cost and complex behavioral health populations. These solutions have shown to reduce payer spend while improving client outcomes for acute care hospital systems, health plans, managed care organizations (MCO), managed service organizations (MSO), managed behavioral healthcare organizations (MBHO), medical groups (IPA) and social service agencies.
Mr. Louis was also the Executive Director of Strategic Development and Planning at Pathways – Molina Healthcare, a national for-profit behavioral healthcare company operating in 23 states. In this role, Mr. Louis developed and launched population health management program strategies that included in-community care management and in-home coordinated care services to reduce hospital readmissions, emergency department (ED) visits, and improve HEDIS scores for national health plans and Managed Care Organizations.
Mr. Louis is also a former Psychiatric Hospital Administrator and Assistant Director of Mental Health for San Bernardino County Department of Behavioral Health in CA, where he was responsible for behavioral health program management, clinical operations, strategic alliances, and outcome-based service delivery models for complex adult and youth populations.
Mr. Louis also served in various positions at College Health Enterprises (CHE), a Los Angeles based for-profit hospital system, most notably serving as Vice President of Government Operations. While in this role, he created the first public sector division for CHE by establishing new service lines, contracts, and new profit/revenue streams. His responsibilities included business and program development as well as administration of inpatient, outpatient, and residential continuums of care for public payers (i.e. county mental health systems, state department of developmental disabilities, county jail, state prison, and federal government agencies).
Mr. Louis is in his 32nd year as an active duty reserve police officer (volunteer) currently holding the rank of Captain, City of Monterey Park Police Department in Los Angeles County. He has worked closely with police, county sheriff’s departments, and healthcare systems to educate and craft “treatment versus incarceration” collaborations promoting treatment and cost-effective crisis triage interventions for persons with mental illness.
Mr. Louis graduated with a Bachelor of Arts in psychology from Whittier College and is a Police Academy Graduate from Rio Hondo College in Whittier, California.
Erin Boyd
Erin Boyd is the Behavioral Network Strategy, Solutions and Program Director for Cigna Behavioral. Ms. Boyd is responsible for network marketing and communications, developing network strategy and overseeing network programs, and solutions to drive innovation, cost-savings, improved outcomes, and better care for Cigna customers. Ms. Boyd has been with Cigna for three years and provides a unique perspective to this role having most recently served as Senior Director of Business Development and Marketing for a behavioral hospital system. In addition, she has 20 years of experience in medical healthcare communications, marketing, public relations, and strategic planning.
Lisa Kay
Lisa is the Clinical Transformation Lead for Cigna Medical Group where she is responsible for executing on strategies to enhance care delivery and improve patient outcomes. She is passionate about a holistic approach to care that considers both the mind and body. Lisa holds Master’s degrees in Social Work and Business Administration. She is further certified as a Mental Health First Aid instructor.
Lisa has been a member of the Cigna team for 11 years. During that time she has held various positions organization including Behavioral Network, Training and Communications, Cigna Collaborative Care, and Clinical Program Development. As a part of her work she has convened the Cigna Behavioral Integration Advisory Council to bring providers and clients together to strengthen approaches to behavioral health and wellness. Further, Lisa is actively engaged in promoting mental health care for women as a member of the American Congress of Obstetricians and Gynecologists Expert Workgroup for Maternal Mental Health.
Lisa splits her time between Arizona and Maryland and spends much of her time off of work being a mom to her two daughters and pursuing their goal of visiting all 50 states by her eldest daughter’s high school graduation.
Lora Fisher
Lora Fisher is a Clinical Program Manager at Cigna with responsibilities for furthering advancement of behavioral integration in the medical setting. She has been with Cigna for 13 years and held several positions within the organization supporting customers to improve their behavioral health outcomes. Her current focus are on initiatives to enable consent to share behavioral information to better identify patients’ holistic needs in the primary care setting as well as developing clinical programs for the unique needs of various populations. Lora is a licensed clinical professional counselor with experience providing mental health therapy in various settings.
Sheila Sudhakar, M.D.
Sheila Sudhakar is currently a Senior Medical Director for Cigna Medical Group’s (CMG) East area. Board certified in Internal medicine, she joined CMG in 2003 as a primary care provider practicing outpatient internal medicine. During clinical practice, her passions included chronic disease management, prevention, and patient education of lifestyle-based disease processes. Her specialty focus areas included diabetes, hypertension, and hyperlipidemia, and she approached her patients holistically by emphasizing optimal health for the mind and body focusing on nutrition, exercise, stress-management, and living an overall healthy life. Currently, she coaches and mentors clinicians and clinician leaders, manages 10 clinics in the East Region of CMG in conjunction with her operational dyad partner, and leads organizational clinical initiatives to improve patient outcomes including the integration of behavioral health into primary care and management of chronic disease.
Outside of her work at CMG, Sheila enjoys playing music, cooking, hiking, and participating in philanthropic athletic events with her husband, son, and daughter.
Have You Optimized Your Organization For Value-Based Reimbursement? The OPEN MINDS VBR Assessment
This shift away from traditional fee-for-service reimbursement models to value-based reimbursement (VBR) has turned “business as usual” on its head for many specialty provider organizations. It has forced executive teams to continue their current operations, while simultaneously preparing for the move to value-based reimbursement and population health models. The move to VBR requires the development of a new organizational infrastructure, as well as new technical and financial competencies to make the transition successfully. For executive teams of provider organizations, developing these new functional capabilities is key to sustainability and success. This session is designed to help organizations across the country ensure their teams are prepared for value-based contracting and have all the required competencies needed for success. In this session, OPEN MINDS Advisory Board Member, Dr. John F. Talbot will:
- Review the key competencies their organizations need to prepare for value-based reimbursement, including leadership, organizational infrastructure and financial management; technology infrastructure functionality; provider network management and clinical performance optimization; and consumer access and engagement.
- Discuss how to assess their organization’s preparedness for VBR and steps to address gaps in organizational readiness
- Explore examples of organizations that have gone through the readiness assessment process to prepare for value-based contracts
John F. Talbot, Ph.D.
John F. Talbot, Ph.D., Advisory Board Member, has more than 30 years of experience in all aspects of healthcare, including upper management, consultation, education, direct clinical work, and serving as the president of a non-profit board. Dr. Talbot has provided consultation, training and operational assistance to behavioral health providers, nonprofit organizations, and managed care organizations across the country. His areas of focus for consultation and training include strategic planning, the development of successful strategic alliances, board development, organizational reengineering, operations management, management and leadership development, and change management. He is currently Vice President of Integration Development at Jefferson Center for Mental Health in Denver, Colorado.
Prior to his current position, Dr. Talbot served as the President of a network of agencies providing care to children and families. The innovative work of Colorado Care Management received national recognition, including participation in a Federal IV-E waiver study that demonstrated measurable superior clinical outcomes. In his role with Colorado Care Management, Dr. Talbot also led the development of a coalition of Colorado business executives to address the issues of providing care to abused and neglected children, and the establishment of a nationwide purchasing cooperative for non-profits. Dr. Talbot’s previous experience included serving as the Director of the Master of Health Systems Program, and Associate Dean of University College at the University of Denver. He also held senior management positions at Mount Airy Psychiatric Center in Denver, Colorado.
Dr. Talbot has been a featured speaker at a number of national and state venues including the National Council Community Behavioral Health, Mental Health Corporations of America, the American Association of Residential Treatment Centers, the Medical Group Management Association, the Colorado Behavioral Health Council, the Mental Health Council of Arkansas, the New Jersey Association of Mental Health Agencies, and the Florida Behavioral Health Council.
Dr. Talbot is the former publisher and editor of Today’s Healthcare Manager, a newsletter focusing on leadership and management skills for healthcare managers, and has written numerous articles, manuals, and book chapters. His volunteer work includes serving as the President of the Board of Human Services Inc. in Colorado.
Donald J. Dauman, MBA, LCSWR
Mr. Dauman graduated from the University at Buffalo with an MSW in 1989 and an MBA in 2001. He has a 28-year career in behavioral health in a variety of direct service positions and has served in Program Management roles and Executive Leadership roles. He also has a 10-year career as the Erie County Department of Mental Health Fiscal Administrator. Mr. Dauman has extensive experience in new program development, grant writing, system reform initiatives and innovative program and fiscal management models.
In 2010 Mr. Dauman joined the staff of Spectrum Health and Human Services as the Assistant Chief Financial Officer and was promoted in 2017 as their Senior Vice President of Finance and Chief Financial Officer. Spectrum Health and Human Services is one of the largest and most comprehensive behavioral health organizations in Western New York. Mr. Dauman is an avid Buffalo Sabres fan and lives in Lancaster, New York with his wife of 28 years and two children Zachary and Amber.
Utilizing Technology To Build A High Performance Organization In A Value-Based Environment
Sponsored by Core Solutions, Inc.
In this session, Core Solutions’ President & CEO, Ravi Ganesan, will explore how complex care organizations can utilize technology solutions to build a high performance organization while navigating changing regulatory landscapes to achieve desired outcomes around whole person care.
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.
Health Plan/Provider Data Exchange In Pay-For-Performance: A Town Hall Discussion On Meeting The Connectivity Challenge
Sponsored by Credible Behavioral Health Software
The health and human service market is steadily moving toward more reimbursement based on some measure of performance or value. But to make these value-based relationships work, both health plan and provider organization need real-time electronic data exchange to optimize system performance.
But, there are challenges in making that happen. In this town hall, our expert panel will share their experiences in making data exchange work. From the operational issues in establishing data exchange to the development of analytic reporting to better manage consumer care and population health, this session will focus on the practical issues. The panelists will offer advice to organizations in how to leverage data to build a true partnership for better consumer care.
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.
Charles Gross, Ph.D.
Charles Gross, Ph.D. is the Vice President Behavioral Health Operations at Anthem Blue Cross Blue Shield. In this role he is responsible for integrated behavioral health services for more than 8.3 million combined Medicaid and Medicare covered lives as well as over 18.4 million Commercially covered lives. Dr. Gross has over 20 years of clinical and operational managed care experience in the public and private sectors, including; direct clinical work with the Health and Hospital Corporation of New York, extensive private practice experience, clinical and management experience with Kaiser Permanente, ValueOptions, United Health and Anthem Blue Cross Blue Shield.
Dr. Gross received his undergraduate degree from the University of Michigan, and his PhD. from Yeshiva University.
William Camp, MBA
Bio Coming Soon
Jaclyn O’Donnell
Ms. O’Donnell serves as Credible’s Executive Vice President. With over 15 years of experience in corporate administration, project management, and technology, Ms. O’Donnell leads initiatives at Credible to drive corporate efficiencies and scalability, the execution of Credible’s Two Year Strategic Plan, as well as oversee all of Credible’s Partner-facing and corporate departments.
During her time at Credible, Credible has experienced unprecedented growth sextupling in Partners, revenues, and clients served. It has been Ms. O’Donnell’s responsibility to manage that growth and oversee the establishment and expansion of multiple departments to further foster and scale the organization’s growth. Prior to joining Credible, Ms. O’Donnell served as a consultant for organizations such as the World Health Organization focused on international education and telecommunication projects in developing countries. Ms. O’Donnell’s background also consists of inter-department management and oversight at Northrop Grumman, a Fortune 500 company, US telecom fiber project management at Advanced Communications Technology, and management with the University of Maryland’s Center for Advanced Study of Language, the first and only national resource dedicated to addressing the language needs of the Intelligence Community. Ms. O’Donnell earned her B.A. in Government & Politics with a minor in French and Executive MBA from the University of Maryland, College Park.
Innovative Collaborations & Partnerships For Long-Term Services: The Anthem Perspective
In recent years, there has been a major shift in moving long-term services and supports (LTSS) services to competitive managed care models. The policy goals driving this shift are straightforward: to improve consumer health status and decrease costs through better care coordination for consumers with multiple chronic conditions and disabilities. But this change in financing model presents many new challenges for specialty provider organizations. The move to managed care requires the development of new administrative competencies, the creation of new services and programs, and the ability to build of new partnerships across the care continuum. In this keynote address, Leigh Davison, Staff Vice President, LTSS Specialty Organization of Anthem, will discuss the challenges of moving to this new model, how it changes the relationship between provider organizations and health plans, and her perspective on the future of LTSS.
Leigh Davison
Leigh Davison is the Staff Vice President, LTSS Specialty Organization at Anthem, Inc. with responsibility for leading the organization’s LTSS business development, strategy and execution, program oversight, and operations. With more than27 years’ experience in the health care industry, she has been with Anthem for 13 years and held several positions within the organization both at a corporate and health plan level. She has an extensive background in marketing, network development, provider relations and operations both in Government and Commercial health care industry. Prior to working with Anthem, Inc. and Amerigroup Corporation, Leigh held several positions with Aetna, Inc. and U.S. Healthcare/Corporate Health Administrators.
Thought Leader Discussion With Leigh Davison, Staff Vice President, LTSS Specialty Organization, Anthem, Inc.
Join us for a follow-up session with our keynote speaker, Leigh Davison, Vice President, LTSS Specialty Organization, Anthem, Inc. Use this time to ask questions and continue the morning’s discussion with Ms. Davison and OPEN MINDS Chief Executive Officer Monica E. Oss.
Leigh Davison
Leigh Davison is the Staff Vice President, LTSS Specialty Organization at Anthem, Inc. with responsibility for leading the organization’s LTSS business development, strategy and execution, program oversight, and operations. With more than27 years’ experience in the health care industry, she has been with Anthem for 13 years and held several positions within the organization both at a corporate and health plan level. She has an extensive background in marketing, network development, provider relations and operations both in Government and Commercial health care industry. Prior to working with Anthem, Inc. and Amerigroup Corporation, Leigh held several positions with Aetna, Inc. and U.S. Healthcare/Corporate Health Administrators.
Monica E. Oss
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.
Keeping Consumers In The Equation: Best Practices In Consumer Experience & Engagement
A running theme in the market shift to value-based care is the importance of consumer engagement—both to increase consumer participation in the management of complex conditions and to increase consumer satisfaction. If your organization has consumers who are engaged in their health care, chances are, you have an edge over your competitors – because your consumers are better informed, are more proactive in their health care and insurance coverage, have better outcomes, and cost less. In this session we’ll discuss consumer engagement strategies in the new world of value-based care, including:
- Why consumer engagement is essential in a value-based market
- How to develop a consumer engagement strategy to improve performance and increase consumer satisfaction
- Case studies from provider organizations who have successfully implemented consumer engagement strategies
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.
Blake A. Martin, MHA
Blake is a business development and marketing professional with ten years of experience in building relationships that lead to improved revenue streams and brand awareness. Currently working in the non-profit health and human services industry as Chief Development Officer, he is responsible for strategic oversight of a large real estate portfolio, business development with private and public Managed Care Organizations (MCOs), resource development, and marketing functions for Monarch, one of North Carolina’s largest mental health and human services companies. Blake holds his MHA degree from Pfeiffer University.
Chris Thompson
As Senior Vice President of Operations, Behavioral Health, Chris Thompson is responsible for overseeing all of Monarch’s behavioral health operations across North Carolina.
Having worked with non-profit organizations for more than 10 years, Chris joined Monarch more than six years ago. He holds a Bachelor of Science degree in accounting and finance from Winthrop University and earned his Master’s in Health Administration at Pfeiffer University.
Chris lives in Fort Mill, S.C., with his wife, Courtney, and their two teenage children, Jonathan, and Ashton.
Philip O. Toal, Ed.D., LMHC, CET
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.
Rate Setting For Value-Based Reimbursement: A Guide To Developing Capitated Payment Models
Thoroughly understanding how to develop bundled payments/case rates will ensure that your clinical services deliver outcomes-based care and provide the necessary revisions needed for billing, financial reporting and data tracking are made to fit this new payment model. This session will provide attendees with a guide to developing and managing a successful case rate payment model and will include:
- The drivers of the move to case rates and other value-based reimbursement models
- A guide to developing a case rate proposal and preparing your organization for managing case rate contracts
- Examples of successful case rate contracting models
David E. Wawrzynek, MBA
David Wawrzynek, MBA brings more than 40 years of public behavioral health, clinical, financial, and management experience to the OPEN MINDS team. He brings a truly unique combination of experience with his clinical, business, and financial experience, as well as a demonstrated history of efficient and effective management of behavioral health services.
Mr. Wawrzynek currently serves as a Senior Associate and Subject Matter Expert in the OPEN MINDS Consulting Practice, where he leads projects related to value-based purchasing, financial modeling, and clinical and financial data analysis. In recent years, Mr. Wawrzynek has focused on the development of analytic modeling tools, communication platforms, and knowledge management supports to transform raw data into meaningful information, to enable more effective strategic and operational insights and decision-making.
Before joining OPEN MINDS, Mr. Wawrzynek served 18 years as the Senior Vice President, Finance and Chief Financial Officer at Spectrum Human Services, a private, non-profit community mental health organization in Western New York. In this role, Mr. Wawrzynek designed, implemented and monitored systems to support information technology, human resources, billing, budgeting, financial modeling and reporting, site operations, risk management, security, as well as change management.
Previously, Mr. Wawrzynek served as the Vice President of Finance and Chief Fiscal Officer with Health Management Group in Buffalo, New York. In this role, he managed the corporate financial resources through the supervision and coordination of the functions of reimbursement, budget, banking, and general accounting.
Previously, Mr. Wawrzynek served his first 14 year tenure with Spectrum Human Services as Director of Financial Operations. In this role, he was responsible for the fiscal, facility, personnel, and business functions of the corporation. In addition he was responsible for data analysis and worked closely with the Clinical and Quality Assurance Directors in the development and monitoring of performance and outcome indicators.
Before joining Spectrum, Mr. Wawrzynek served as an Outpatient Psychiatry Supervising Counselor with Buffalo General Hospital Community Mental Health Center. In this role, he held dual clinical and administrative responsibilities and assisted in the daily operation of the department, acted as a liaison to other hospital departments, and supervised staff activities.
Mr. Wawrzynek began his career as a clinical Supervising Counselor for the City of Buffalo’s Division of Drug Abuse Services where he was responsible for supervision of all counseling and clinical activities at a community-based drug treatment center and provided counseling services for clinic patients.
In recognition of his professional successes, Mr. Wawrzynek was named as the 2007 Not-for-profit Chief Financial Officer of the Year by Buffalo Business First.
In addition to his professional experience, Mr. Wawrzynek has served in a number of leadership roles for affiliations including past President for the New York State Cerner Software User Group; past Board President for Child Resource Network; and Treasurer for Spectrum Human Services Foundation.
Mr. Wawrzynek earned his Master of Business Administration and his bachelors in psychology from SUNY at Buffalo and his Master of Science in Rehabilitation Counseling from Syracuse University.
Debbie Cagle Wells
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.
Data Sharing & Reporting In A Value-Based Market: Adapting To Ever Changing Reporting Requirements While Enhancing Your Own Organization’s Performance
Sponsored by Streamline Healthcare Solutions
As states and other payers move towards the value-based payment models, adjusting your operations and technology infrastructure to meet new data sharing and reporting requirements can be daunting. Whether there is a statewide financing system overhaul, or a Medicaid managed care entity making minor modifications to existing reporting requirements, these shifts can have big implications for behavioral health provider. To master this challenge, executive teams will need to leverage new technology, build a data-driven management model, and form new partnerships with stakeholders to be successful. In this session, Central Florida Behavioral Health Network will review how they are working with behavioral health provider organizations to manage data sharing and reporting in the state of Florida – they’ll discuss how they are using technology to adapt to the new state reporting model and how they are leveraging the data to improve their own systems of care.
Learning Objectives:
- Identify important factors and considerations when implementing new reporting that integrates data sets to improve reporting quality.
- Learn how to overcome barriers of organizational coherence in the process of collecting and reporting the new data and adapting to the change.
- Learn how to leverage technology to meet payer data reporting requirements and to internally improve systems of care.
Katie Morrow
Katie Morrow is a Licensed Bachelor’s Social Worker with seven years’ experience in the clinical field. In her clinical experience she was a Case Manager for adults with mental illness and developmental disabilities. After receiving a Master’s Degree in Public Administration, she transitioned to also doing quality improvement tasks as a Performance Improvement Clinician, which included coordination of The Joint Commission and State audit reviews, data analysis of the electronic health record data, and staff training for her agency on the use of Streamline products. She began working directly for Streamline in August of 2011. With Streamline, Katie has been the project manager on several implementations as well as providing training and support to Streamline’s customers.
Larry Allen
Larry Allen is the Chief Operating Office at CFBHN in Tampa, Florida. Mr. Allen has masters’ degrees in Social Work and Business Administration and is a Licensed Clinical Social Worker and a Licensed Healthcare Risk Manager. He has over 25 years experience in clinical practice, performance improvement and risk management and has worked in a variety of settings including hospital, outpatient treatment programs and with administrative organizations. Mr. Allen is responsible for Clinical, Utilization Management, Consumer and Family Affairs, Quality, Risk Management, and IT operations within CFBHN.
The New Financial Normal: Moving Value-Based Reimbursement From Concept To Practice
If you are at the helm of a provider organization, the slow march towards value-based reimbursement (VBR) is familiar territory by now. But over the last year, we’ve seen new movement from payers and health plans that indicate the pace seems to be accelerating. This push towards VBR from health plans means that provider organizations need to ramp up their preparations and position their organization to compete in this new market. Finding a place in these new VBR models should be the number one strategic priority for health and human service provider organizations. In her always-popular closing keynote address, Monica E. Oss, OPEN MINDS Chief Executive Officer will discuss the sweeping culture, contracting, staffing, workflow, and operational changes that the shift to VBR demands — and how you can ensure your organization is ready to face the new financial normal.
Monica E. Oss
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.