Pilot Programs / R&D and Venture Capital Formation

Early proponent of Shared Decision Making (SDM). Founding member of product design team; provided market readiness and competitive product assessment for clients exploring market opportunities in the emerging world of patient activation, engagement and decision support.

Innovation at Medical Training Company

Co-founder of R&D company developing second SDM program in the country; used instructional design, highly interactive, multi-media platform with branching logic to move patients seamlessly across alternative information vignettes, based on learning objectives and health literacy level. Worldwide patents secured and a Certificate of Comprehension reported for each patient’s PCP and surgeon.

Independent Practice Association

Developed unique approach to engage patients and providers for an IPA of 250 PCPs and specialists; 100+ NCQA Medical Homes.

Large IT Vendor

Provided SDM market and product assessment for industry-leading care coordination IT vendor.

Fortune 100 Company

Provided SDM evidence review, identified content and visual product solution providers.

California HMO

Worked with senior management team, raised development funds, worked with cable TV content provider and initiated pilot program in Colorado. Reduced incidents of back surgery by 40% over 18-months in this small-area comparison group study.    

Thought Leadership - Analytics with Trajectory Healthcare

Thought leader in 1990's vendor initiated, entrepreneurial phase of the demand and disease management (DM) industries, now known as Population Health Management.

Disease Management Association of America – Co-Chair

First Technology Committee: performed industry-wide survey on home monitoring and nurse call centers. Served as a conference speaker and panel moderator at numerous national conferences.

Sample engagements:

Center for Medicare and Medicaid Services – Domain Expert

Provided procurement strategy and vendor evaluation template, as “domain expert,” for CMS’s Medicare Health Support (Disease Management) Demonstration project.

AcademyHealth, D.C. – Medicaid Procurement Training

Delivered two-day training workshop for state Medicaid directors developing procurement strategies for disease management programs.

Colorado Medicaid (HCPF) – First Disease Management Pilots

Worked as program consultant for third Medicaid DM programs in the country. Worked with multiple state agencies, pharmaceutical companies and vendors.

Accenture (Anderson Consulting) – Global Health Team

Assembled team of thought leaders to support early-stage disease management client strategy and corporate acquisition team.

Pearson Government Solutions - London Market Strategy (Washington, D.C.)

Developed global market strategy for government sponsored care management programs.

Warberg-Pincus - Private Equity Firm Acquisition Support (New York)

Performed evaluation of hospital-affiliated care / disease management services entity.

Developing commercial project pilot from an ACO value-based perspective; aligning new care management partners in support of pay-for-performance financing. 

Stakeholder alignment work with:

• Integrated Physicians Network: Pilot program design
• United Healthcare, Anthem: Program endorsement
• Health TeamWorks: Guideline development
• CIVHC (Colorado Improving Value in Health Care): Payment reform, policy alignment workgroups

 

Claims-based assessments of vendor ROI / performance claims for high risk pool, state DM procurements with Trajectory Healthcare, Inc. www.trajectory-inc.com

Case Management Society of America (CMSA)

Training workshops in evidence-based program evaluation.

New England States Consortium Systems Organization (NESCSO)

Procurement model development based on verifiable claims data and program impact results.

Training a Dozen State Medicaid Directors

IT Vendor evaluation: procurement support for competitive state bidding processes.

State High Risk Pools

Evaluation of vendor claims for DM bidding process (Illinois).

Home and Community Based Services (HCBS), Long Term Services & Supports (LTSS) programs for people with physical disabilities.

Work with Centers of Independent Living (CILs), providing advocacy support, management consulting, QM program and business development. Policy work, including work on CMS’s 2012 Dually Eligible Demonstration project in Colorado.

Sample engagements:

The Independence Center - Colorado Springs

Dually eligible policy work, program development, Medicaid ACO program design, workshop development. Several documents developed resulting in significant statewide policy advancements. Awarded $48,000 planning grant to build community consensus on use of Nurse Practitioners for high medical need clients in home and community settings in Central Colorado, in collaboration with RCCO-7 and PACE providers. 

Colorado Long-Term Assistance Service Providers (CLASP)

Policy work with Department of Healthcare Policy & Finance on quality metric development for LTSS providers.

Disability Rights Network of Pennsylvania

Retained to spearhead state policy initiative, serve as expert witness at state public hearing.

Liberty Resources, Inc. - Pennsylvania

Long-term business planning and implementation support, QM, project management, advocacy support at Congressional and state level.

Fortune 500 and East Coast Managed Care Companies

State procurement support, proposal writing, state partnership development strategy.

Performed feasibility studies for over 50 ambulatory surgery center and related outpatient facilities for Certificate of Need regulatory approval. High success rate for national corporate clients, physicial groups and hospitals in 22 states.

Co-founder of 501(c) non-profit developing methodological standards, professional credentialing and program accreditation supporting science-based evaluation of ROI and other program performance claims by vendors. www.PHII.org

Co-author of Managing Health Care Demand (Aspin Publications, 1998)

Anticipated, 20 years before its time, many of the population health management programs now embedded in health care reform and ACO program designs.

* Required reading by organizations such as United Healthcare’s Optum care management group.

• Colorado Healthcare Reform Task Force
• Principal author of legislation creating the Colorado Blue Ribbon Health Care Reform (“The 208”) Commission
• Governor’s Council on TeleHealth
• Co-chair, DMAA’s IT Committee
• Medicaid IT Task Force, AHRQ and University of Massachusetts Medical School
• PHII co-founder, board member

University of California at Berkeley, California - Graduated with High Honors

BA, Rhetoric - Communications & Public Policy

BS, Political Science

University of Wisconsin at Madison, Wisonsin

Graduate studies in healthcare administration, health economics