This Roundtable supports partnerships between payer, provider and life science companies that accelerate deployment of new care models—including primary care, remote monitoring, expanded telehealth and retail care—that measurably improve patient health outcomes and health equity. This Roundtable will also explore the role of advanced diagnostics in care. Special attention will be given to hospital and primary care resilience during and after COVID and how this reconciles with the drive for efficiency and value over the past two decades. The goal of this Roundtable is to bring to scale models of care that can meet new demand and also advance operation in the new environment of constrained affordability and sustainability.
Each Forum Roundtable strikes a balance between near-term COVID-related challenges and long-term impact on major issues in the post-pandemic world through professional facilitation and deep subject matter expertise. The groups will develop and widely disseminate recommendations that will make an impact on provider, payer and life sciences CEOs, policymakers and thought leaders collaborating for industry-wide change.
Patrick Conway, MD, CEO of Care Solutions, Optum
Mark Ganz, former President & CEO, Cambia Health
Mark McClellan, MD, PhD, Director and Robert J. Margolis, MD, Professor, Duke University
Jaewon Ryu, MD, President & CEO, Geisinger
Penny Wheeler, MD, CEO, Allina Health
Kris Joshi, EVP & President, Network Solutions, Change Healthcare
Bill Miller, CEO, WellSky
Roy Schoenberg, Co-founder, President & CEO, Amwell
Mary Tolan, Co-Founder & Managing Partner, Chicago Pacific Founders
Michael Anderes, Inception Health, Froedtert Health
David Anderson, BlueCross BlueShield of Western New York
Tracy Bahl, The Bahl Group; Welsh, Carson, Anderson & Stowe; andros
Bruce Bodaken, Blue Shield of California
Jonathan Breslau, MD, Sutter Medical Group
Jonathan Broomberg, MD, Vitality Health International
Sunil Budhrani, MD, Innovation Health
Bill Bunker, Navigating Cancer
Norman Chenven, MD, Austin Regional Clinic
Chris Cigarran, Imagine Health
Patrick Conway, MD, Optum
Gaurov Dayal, MD, Everside Health
Natasha Deckmann, MD, AARP Services Inc.
John Deeken, INOVA Health System
Susan DeVore, Premier Inc.
Michael Dowling, Northwell Health
Esther Dyson, Wellville
Matt Eirich, Humana, Inc.
Joshua Flum, CVS Health
Tad Funahashi, MD, Kaiser Permanente
Mark Ganz, formerly of Cambia Health Solutions, Inc
Rebekah Gee, MD, LSU Health - Health Care Services Division (HCSD)
Doug Ghertner, IVX Health
Maryam Gholami, Providence St. Joseph Health
Beth Ginzinger, Blue Cross Blue Shield of Arizona
Robin Glass, Doctor on Demand
Sean Glass, Advantia Health
Joshua Golomb, Hazel Health
Mary Grealy, Healthcare Leadership Council
Steve Greene, ChenMed
Michelle Hood, American Hospital Association
Sarah Iselin, formerly of GuideWell
William Johnson, MD, MODA Health
Kris Joshi, Change Healthcare
Kim Keck, Blue Cross Blue Shield Association
Dave Kerwar, Mount Sinai Health System
Vinod Khosla, Khosla Ventures
Andrew Kobylinski, Primary Diagnostics, Inc.
Mark Laret, UCSF Health
Tom X Lee, MD, Galileo
Harlan Levine, City of Hope
Nick Loporcaro, Landmark Health
James Madara, American Medical Association
Thomas Maddox, MD, BJC HealthCare/Washington University School of Medicine
Paul Marchetti, Anthem, Inc
Trevor Martin, Mammoth Biosciences
Mark McClellan, MD, PhD, Duke University
Barbara McNeil, MD, PhD, Harvard Medical School
Rhonda Medows, MD, Ayin Health Solutions
Bill Miller, WellSky
Chris Miller, Paladina Health
Kristen Miranda, CVS Health/Aetna
Mario Molina, MD, Golden Shore Medical Group
Randall Moore, MD, Franciscan Health
Shawn Morris, Privia Health
Farzad Mostashari, MD, Adelade
Mike Mussallem, Edwards Lifesciences LLC
Griffin Myers, Oak Street Health
Colleen Nicewicz, Groups Recover Together
Margaret O'Kane, National Committee for Quality Assurance
Dean Ornish, MD, Preventive Medicine Research Institute
Peter Orszag, Lazard
Misha Palecek, DaVita Inc.
Randy Parker, GeniusRX
Hal Paz, MD, The Ohio State University
Tim Petrikin, CityLife Health
Brian Pieninck, CareFirst BlueCross BlueShield
Sanjay Pingle, PWNHealth
Mark Prather, DispatchHealth
Tom Priselac, Cedars-Sinai Health System
Deb Rice-Johnson, Highmark Inc.
Matt Rill, MD, Emergency Resources Group and Telescope Health
Chad Robins, Adaptive Biotechnologies
Javier Rodriguez, DaVita Inc.
Iyah Romm, Cityblock
Katherine Ryder, Maven Clinic
Jaewon Ryu, MD, Geisinger Health System
Lee Sacks, MD, Advocate Aurora Health
Dean Sawyer, Freespira
Paul Scheel, Washington University School of Medicine
Roy Schoenberg, Amwell
Lou Shapiro, Hospital for Special Surgery
Sheri Shapiro, Trinity Health
Mark Shaver, Welltower
David Shulkin, MD, Shulkin Solutions
Michael Shumer, Crucial Care
Mona Siddiqui, MD, Humana, Inc.
Lynn Simon, MD, Community Health Systems, Inc.
Kevin Slawin, Trustmark Companies
Scott Smith, Three Rivers Provider Network
Nitin Thakor, GeBBS Healthcare Solutions
Marshall Thomas, MD, Colorado Access
Warner Thomas, Ochsner Health System
Mary Tolan, Chicago Pacific Founders
Kathryn Torres, HCA Healthcare
Susan Turney, Marshfield Clinic Health System
Sara Vaezy, Providence St. Joseph Health
Andrew Watson, MD, University of Pittsburgh Medical Center
David Weingard, Cecelia Health
Penny Wheeler, MD, Allina Health
Bryony Winn, Anthem, Inc.
Martha Wofford, Blue Cross Blue Shield of Rhode Island
John Woolley, Hatfield Medical Group
Felicity Yost, Tia Inc
Work Groups are chartered by Roundtables to go deep on a key issue over a three-year period, and to make recommendations to Roundtable Fellows for pronouncements or actions that should be taken by the Roundtable, the Forum or by all CEOs. Work Groups are focused on:
Health care systems implementing value-based payment (VBP) care models have demonstrated their potential for improving efficiency and patient outcomes by reducing hospitalizations, specialty care and emergency room visits. However, despite years of public policy and private market efforts, VBP arrangements represent the minority of reimbursement to the industry, and most health care systems have numerous specific, often conflicting, VBP arrangements from health plans, Medicare and other contractors. Beyond this, only a small share of VBP arrangements are two-sided, containing both incentives for better performance and downsides for worse performance. Although the steady revenue stream from VBP arrangements has given some relief to at-risk providers during the COVID-19 pandemic, the future of VBP arrangements in a future of austerity and profound access-to-care issues is uncertain. The overarching goal of this Work Group is to increase the prevalence of VBP arrangements among providers and payers by identifying and reducing barriers to adoption in order to improve efficiency and patient outcomes.
Primary care has moved over time from solo practices and small groups to being vertically integrated into hospital systems or horizontally integrated into corporate groups, a trend that is being accelerated by the financial pressure from the impact of COVID-19 on primary care practices. At the same time, new primary care models are emerging such as at-risk primary care groups, concierge services, telemedicine and retail-based models. More will be demanded from primary care practices as the country emerges from the pandemic and as its citizens continue to age to provide better preventative care for patients. More than ever, payer, provider and life science organizations have the opportunity to provide more continuous health care through multi-channel platforms in order to optimally meet the needs of those they serve. The goal of this Work Group is to develop templates for operating primary care practices across sites based on the type of provider and patient population that optimizes use of new technologies and leverages the skills of the entire health care workforce.
Chronic conditions plague many Americans and are a significant driver of high health care costs, and COVID-19 has only exacerbated these conditions as homebound elderly and at-risk patients delay much-needed medical care. This has led to the propagation of new models for managing chronic care that rely on combinations of telemedicine, home visits from PCPs and specialists or advanced practitioners, remote patient monitoring, at-home treatments like IVs and nebulizers, and full-on “hospital in the home” models. Providers and payers need to understand how these models can most efficiently be combined to improve access and quality of care for patients with chronic conditions both during and after COVID-19. The goal of this Work Group is to develop best practices for innovative models of chronic care management that improve patient outcomes and to drive their adoption by payer, provider and life science CEOs.