Morning Plenary: The Next Frontier: Global Budgets and other Strategies to Tackle Health Care Costs
Tuesday, October 20, 2015
As more people secure health coverage and the rate of uninsured drops, questions about the affordability of that coverage and the underlying costs of health care take center stage. Maryland has long been a leader with its all payer hospital rate setting efforts and now Massachusetts and Vermont are working on comprehensive reforms –global budgets- to address health care costs. Learn more about how these three states are addressing the total cost of care and the cost conundrum.
Donna Kinzer, Executive Director of Maryland Health Services Cost Review Commission will address the state’s payer hospital rate-setting efforts. Hear David Seltz, Executive Director, Health Policy Commission, Commonwealth of Massachusetts, and Al Gobeille, Chair, Green Mountain Care Board how their states are working on comprehensive reforms and global budgets to address health care costs. NASHP Executive Director Trish Riley will moderate this plenary session. Learn more about how these three states are addressing the total cost of care and the cost conundrum.
Trish Riley, Executive Director, National Academy for State Health Policy (NASHP)
Trish Riley is Executive Director of the National Academy for State Health Policy and president of its corporate Board. She helped build NASHP as CEO from 1988-2003.
Previously she was a Senior Fellow in State Health Policy at George Washington University.
And at the Muskie School of Public Service, University of Southern Maine. From 2003-2011 she served as Director of the Governor’s Office of Health Policy and Finance, leading Maine’s effort to develop a comprehensive, coordinated health system in Maine including access to affordable health insurance. She was the principal architect of Dirigo Health Reform and served as the state’s liaison to the federal government and Congress, particularly during deliberations around national health reform. She chaired the Governor’s Steering Committee to develop a plan to implement the Affordable Care Act in Maine.
Riley has also held appointive positions under five Maine governors – directing the aging office, Medicaid and state health agencies, and health planning and licensing programs.
Riley has published and presented widely about state health reform. She serves as a member of the Kaiser Commission on Medicaid and the Uninsured, the Medicaid and CHIP Payment and Access Commission (MACPAC), The Health Services Committee of the Institute of Medicine, the National Academy for Social Insurance and the Board of Directors of Maine’s Co-Op insurance plan. She was a member of the Institute of Medicine’s Subcommittee on Creating an External Environment for Quality. She also previously served as a member of the Board of Directors of the National Committee on Quality Assurance. Riley holds a B.S. & M.S. from the University of Maine.
Donna Kinzer, Executive Director, Maryland Health Services Cost Review Commission
Al Gobeille Chair Green Mountain Care Board
Donna Kinzer the Executive Director of the Maryland Health Services Cost Review Commission (HSCRC). Ms. Kinzer took a leave from her position as a Director at Berkley Research Group, where she was a Director leading the Care Improvement and Payment Reform practice, to help lead the HSCRC staff through development and implementation of payment reforms. In that role, she has assisted leadership in developing the new All-Payer Model for Maryland and a obtaining a new Medicare Waiver. She has also led the staff in implementation of the new Model, including transitioning hospitals to global budgets, adapting Maryland’s quality improvement programs to the new Model, developing new payment policies, analyzing potentially avoidable utilization for each hospital, and implementing broad stakeholder input approaches that include consumers, physicians, nurses, other providers, payers, hospitals, and purchasers. Ms. Kinzer has focused her career on helping payers, providers, and other health care entities develop and implement new analytics, delivery approaches, payment models, and supporting infrastructure in response to transformational market shifts, changing customer demands, and health care reform. Ms. Kinzer’s 30+ years in the health care field has included extensive experience with provider payment development (hospital, physician, other sites of care) and large health care data sets including medical and pharmaceutical claims data, encounter data, cost reports, public and private benchmarks, market data, regulatory data sets, and other data sets.
David Seltz, Executive Director, Massachusetts Health Policy Commission
As Chairman of the Green Mountain Care Board, Al Gobeille is tasked with directing the board’s charge of curbing health care cost growth and reforming the way health care is provided to Vermonters. In addition, he owns and operates Gobeille Hospitality, a Burlington based restaurant and hospitality business that includes four popular restaurants and catering businesses: Shanty on the Shore, Burlington Bay Market and Café, Breakwater Café and Grill, and Northern Lights Cruises. Gobeille Hospitality employs 230 people.Mr. Gobeille served on the Town of Shelburne Select Board and has negotiated with the Town’s union employees on health insurance benefits. He was a board member of the Visiting Nurses Association of Chittenden and Grand Isle Counties, and served on the State of Vermont’s Payment Reform Advisory Committee.Mr. Gobeille is a graduate of Norwich University and has served as an officer in the United States Army. He lives in Shelburne.
David Seltz is the first Executive Director of the Massachusetts Health Policy Commission, which aims to modernize health care payment and delivery models to establish a more accountable, affordable system. Prior to this role, Mr. Seltz was the chief health care advisor for Senate President Therese Murray and then served as the Special Advisor on health care for Governor Deval Patrick (MA). Through these positions, Mr. Seltz helped shepherd passage of Chapter 58 of the Acts of 2006 and Chapter 224 of the Acts of 2012. Mr. Seltz is a 2003 graduate of Boston College and originally from Minnesota.
This plenary is supported by the Robert Wood Johnson Foundation