Shifting Sands at the Provider Level, What’s a State to Do?

Thursday, August 16th
10:00am – 11:30am

Delivery and payment reforms that require providers to bear financial risk are growing in popularity as states seek to curb increasing health care costs. How should these reforms be designed and implemented to encourage provider participation, ensure consumers receive quality, coordinated care and still address costs? During this session, a national expert will highlight results from a recent relevant study and a state and a provider representative will explore the issues from their own perspectives.   

This session was made possible with support from the Robert Wood Johnson Foundation.

Moderator

Jeremy Vandehey, Director, Health Policy and Analytics Division, Oregon Health Authority

Jeremy Vandehey is the Director of Health Policy and Analytics for the Oregon Health Authority. He oversees a 160-person team that is responsible for developing and implementing the state’s vision for health reform. His teams’ work includes policy analysis, reporting on health care costs and quality of care, expanding use of electronic health records, developing evidence-based clinical and benefits coverage guidance, providing technical assistance to advance payment reform and quality improvement, and leveraging the state’s purchasing power in pharmaceutical and public employee health benefit programs to improve care and lower costs. Jeremy is currently leading work to establish the goals for the next five years of the Oregon Health Plan, the state’s Medicaid program. Previously, Jeremy served as Health Policy Advisor to Governor Kate Brown from 2015 to 2017 where he helped renew Oregon’s 1115 Medicaid waiver, pass legislation to expand care coverage to all children regardless of citizenship status, and negotiated a state budget package to maintain the Medicaid expansion through the ACA—despite a $1 billion state funds deficit. Prior to 2015, Jeremy led government relations for Kaiser Permanente’s Northwest Region and served as the legislative director for OHA during the design and implementation of the state’s nationally recognized Medicaid coordinated care organizations. Jeremy received his Juris Doctor from the University of North Dakota School of Law and his undergraduate degree in public policy and administration from Western Oregon University.

 

Speakers

Greg Poulsen, Senior Vice President, Intermountain Healthcare

Greg Poulsen is Senior Vice President, Policy for Intermountain Healthcare. Mr. Poulsen had direct responsibility for strategy development, research and planning, marketing, IT development and policy for more than 25 years. He joined Intermountain Healthcare in 1982. Mr. Poulsen is Board Chair of the Utah Hospital Association. He serves as a Trustee for the American Board of Internal Medicine Foundation, which focuses on advancing medical professionalism, and assisted in developing and promoting the Foundation’s Choosing Wisely campaign. He has been a consultant to the Swedish Health Ministry and has provided counsel on health policy development in several countries, including Great Britain, Canada, France, New Zealand, Australia, Norway, and Germany. He was a Commissioner for the Commonwealth Fund in Washington, DC, and participated in the development of the policy papers and initiatives Bending the Curve, and Why Not the Best, which have helped shape the discussion on health policy in America for many years. He is a national guest scholar at the Stanford University School of Medicine and a guest lecturer at the Stanford Graduate School of Business. He serves as a Policy Lead for the World Economic Forum and serves on their international Value in Healthcare Committee. He has appeared frequently before Congressional committees and participates in many national and international health policy forums. He has authored and coauthored several health policy articles over many years including, The Case for Capitation, published in the Harvard Business Review. Mr. Poulsen holds a bachelor’s degree in biophysics and an MBA, both from Brigham Young University. Based in Salt Lake City, Intermountain Healthcare includes 22 hospitals and associated delivery services in the Intermountain West.

 

David Seltz, Executive Director, Massachusetts Health Policy Commission

David Seltz is the first Executive Director of the Massachusetts Health Policy Commission. Prior to this role, Mr. Seltz was the chief health care advisor for then-Senate President Therese Murray and served as the Special Advisor on health care for former Governor Deval Patrick (MA). Through these positions, Mr. Seltz advised the 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. He was a recipient of Modern HealthCare’s 2015 Up and Comer Award, which recognizes young executives that have made significant contributions in the areas of healthcare administration, management or policy.

 

Erin Taylor, Senior Consultant, Bailit Health Purchasing, LLC

Erin Taylor is a Senior Consultant at Bailit Health. Erin offers experience in health care policy analysis, public health, and payment reform. She advises state purchasers, health plans, and providers on strategies to improve health care quality and reduce cost growth. Erin’s work has included researching risk-bearing provider organization regulations and state certification processes for accountable care organizations and evaluating payment models for Medicaid long-term services and supports (LTSS). Erin has co–authored briefs on state oversight of risk-bearing organizations, integrating public health functions with health care delivery, and value-based payment for LTSS for the Robert Wood Johnson Foundation. Before joining Bailit Health, Erin supported the implementation of the CMS Financial Alignment Initiative at the Massachusetts Office of Medicaid. She earned a Bachelor of Science degree from the University of Florida and a Master of Public Health degree from Boston University.