Effective quality improvement (QI) begins by understanding the problem you are trying to solve. This mini plenary will discuss several tools that Medicaid and Children's Health Insurance Program (CHIP) agency staff can use to understand challenges and identify solutions for QI, as well as help identify the measures and partners needed to effect change. Participants will hear from an improvement advisor and state speaker who will describe these tools and how they applied them in their QI efforts. The class will also review new resources and tools developed by CMS to help state staff and their QI partners address other key areas of improvement in Medicaid and CHIP programs.
Deirdra Stockmann, PhD, MUP, (Moderator)
Director, Division of Quality and Health Outcomes, Center for Medicaid and CHIP Services, Centers for Medicare & Medicaid Services
Deirdra Stockmann, Ph.D., M.U.P. is the Director of the Division of Quality and Health Outcomes in the Center for Medicaid and CHIP Services at the Centers for Medicare & Medicaid Services (CMS). Since joining CMS in 2012, Deirdra has worked with state Medicaid and CHIP agencies and their partners to improve health outcomes by improving access to and quality of health services for people enrolled in Medicaid and CHIP. Before joining CMS, Deirdra worked on multi-stakeholder collaborations to address social determinants of health and other aspects of community wellbeing. Deirdra holds a Ph.D. and Masters in Urban Planning from the University of Michigan and a Bachelors from the University of Pennsylvania.
Jane Taylor, MHA, MBA, ED.D.
Improvement Advisor, Jane A. Taylor, ED.D., LLC
Jane Taylor is an improvement advisor who supports those interested in learning, improving, and innovating. She has worked in the areas of infant, child, youth, and adult health improvement – most recently focusing on State Medicaid and CHIP populations to improve asthma care, postpartum follow up visits, and to reduce low risk caesarian deliveries. In addition she has supported Minnesota’s Perinatal Quality Collaborative around opioid misuse and hypertension challenges among birthing people and to improve early hearing detection and intervention. Dr. Taylor participated in the innovation community that created the first oxytocin, second and third labor stage management bundles, and reduction of C-sections prior to 39 weeks.
Jane brings her enthusiasm and doctorate in adult learning and leadership to her improvement work and is interested in the intersection of equity, improvement,innovation and adult learning for Medicaid and Chip beneficiaries. Jane is keen on fostering improvement by collaborative relationships with payors, state government and the people they serve. Jane lives in Saint Paul, with her husband. She is an avid amateur violinist and ballroom dancer. She loves to sail and play with her rescue dog, Pepper.
Tony Richards, MPH, PMD Pro
Director, Office of Child Welfare, Center for Managed Care, Bureau for Medical Services, West Virginia Department of Health and Human Resources
Tony Richards, MPH, PMD Pro, is the Director, Office of Child Welfare, Center for Managed Care at the Bureau for Medical Services, WVDHHR. He oversees the State’s Foster Care MCO for Mountain Health Promise (MPH) and ensures quality services are available and provided to the state’s most vulnerable children. Formerly He began his civilian life as the Executive Director of Planned Approach To Community Health in Roane County WV. He served as Director of Development for Community Resources Inc. He was the National/International Senior Program Specialist for Psychosocial Support with Save The Children, and Master Trainer for the American Lung Association.
Mr. Richards has over 35 years’ experience in public health with a focus in prevention, social behavioral health, holding executive and senior management, policy development positions. He is a Navy Veteran, his career began stationed at Naval Hospital, Yokosuka, Japan, in the OR and managing the ER (TAD USS Midway). He then went to 1st Medical Battalion, 1st Field Service Support Group, Camp Pendleton, CA, (deployed to the Gulf War and TAD Tripler Army Hospital,) as a Fleet Marine Force corpsman, his last duty station was the USS West Virginia out of Kingsbay GA as an Independent Duty Hospital Corpsman where he was the sole Medical Representative, providing advance health and mental health care.
He is a graduate of the Naval Underwater Medical Institute, earned an RBA from WVUP and an MPH from WVU and is certified in Project Management forDevelopment Professionals (PMD-Pro).
Climate change represents an unprecedented threat to the health of people around the world, particularly certain groups that – for reasons of long-time discrimination, disenfranchisement, and underinvestment – are much more exposed to climate-related harm. Given this, the Biden Administration created a new Office of Climate Change and Health Equity (OCCHE) to mobilize all of HHS to act in support of communities and providers across the country addressing this challenge. In this session, the OCCHE team and colleagues from CMS will describe the scope and nature of climate-related threats to health, and tools and resources to support providers and other stakeholders in tackling them, including billions of dollars in tax credits and grants from the Inflation Reduction Act and forthcoming programming from CMS.
Anita Monteiro
Director, iQuality Improvement & Innovation Group Centers for Medicare & Medicaid Services
Anita Monteiro serves as the Director of the Quality Improvement & Innovation Group within the U.S. Centers for Medicare & Medicaid Services. Anita is passionate about and dedicated to her work, leading programs that improve the lives, health outcomes and the experience of care for the people that access healthcare services. The quality improvement work is accomplished by several teams of federal and contract staff across the U.S, as part of national programs that collectively serve as the primary driver for healthcare quality improvement for Medicare in the United States. Anita has previously served in leadership roles in CMS in the areas of Quality Measurement and Enforcement, and as a pediatric and neonatal ICU nurse, manager, and educator in both clinical and academic settings, and in several hospital administration roles in the private sector.
Joe McCannon
Special Expert and Senior Advisor, Agency for Healthcare Research and Quality/Office of Climate Change and Health Equity
Joe McCannon works as a Senior Advisor to the Director at the Agency for Healthcare Research and Quality and as part of the team standing up the new Office of Climate Change and Health Equity at HHS. He previously served the Obama Administration as Senior Advisor to the Administrator at the Centers for Medicare and Medicaid Services and was part of the founding leadership team at the Center for Medicare and Medicaid Innovation. Joe was also Vice President at the Institute for Healthcare Improvement (IHI), where he led large-scale improvement initiatives including the 100,000 Lives Campaign, and he was the co-founder and CEO of the Billions Institute, an organization which has supported hundreds of foundations, governments and nonprofits in scaling effective innovations. He has consulted on the topic of large-scale systems change to the Gates Foundation, World Health Organization and several nations, and he has taught graduate-level courses on large-scale change and quality improvement at the UPenn School of Social Policy and Practice and the Harvard T.H. Chan School of Public Health. Joe has served on committees of the President’s Council of Advisors on Science and Technology and the National Academy of Medicine, and spent 2019-2020 as Executive-in-Residence at the Rustandy Center at UChicago-Booth. His writing has appeared in several publications including JAMA, Health Affairs, Harvard Business Review and the Stanford Social Innovation Review, and he served on the Journal for Healthcare Quality editorial board. He is a graduate of Harvard University and was a Reuters Fellow at Stanford University.
CMS is committed to promoting clinician well-being through our efforts to support clinicians and systems in providing high quality care, and to identify and reduce administrative burden. A systems approach to promoting well-being and resilience in health care is a cornerstone of the National Academy of Medicine’s Action Collaborative on Clinician Well-Being and Resilience. This session will explore insights and tools from four leaders in this field who are working to strengthen and energize the health care workforce by better understanding the factors that lead to clinician burnout and promoting joy in health care. Speakers from the American Medical Association (AMA), the University of Colorado School of Medicine, Duke University Health System and Johns Hopkins Medicine will discuss the negative impact of health care worker burnout on both individuals and health care systems, and share strategies organizations can use to support well-being and resilience and create space for health care workers to stay energized and deliver excellent care.
Lotte Dyrbye, MD, MHPE
Senior Associate Dean of Faculty and Chief Well-being Officer, University of Colorado School of Medicine
Dr. Dyrbye is Senior Associate Dean of Faculty and Chief Well-being Officer at the University of Colorado School of Medicine, and is a thought leader in physician burnout and engagement. She has conducted numerous national and multi-institutional studies, conducted randomized clinical trials of possible solutions, and been an innovator. Dr. Dyrbye is frequently invited to give presentations both nationally and internationally and has authored >130 journal articles, abstracts and other written publications related to physician well-being. She has received 11 competitive research grants to support her work and co-developed the Well-Being Index and an interactive web-tool that provides a validated instrument for self-assessment, access to tailored resources, and organization level reports with comparisons to national norm. Dr. Dyrbye is a member of National Academy of Medicine (NAM) Action Collaborative on Clinician Well-Being and Resilience and co-authored the National Academies of Sciences, Engineering, and Medicine consensus study report, Taking Action Against Burnout: A Systems Approach to Professional Well-Being, was released in the fall of 2019. The report calls upon leaders in health care organizations to prioritize major improvements in clinical work environments to prevent and mitigate clinician burnout and foster professional well-being.
Lee Daugherty Biddison, MD, MPH
Chief Wellness Officer, Director of Credentialing, Associate Professor, Johns Hopkins School of Medicine
Dr. Lee Daugherty Biddison is Associate Professor of Medicine in the Johns Hopkins Division of Pulmonary and Critical Care Medicine and Chief Wellness Officer for Johns Hopkins Medicine. Dr. Daugherty Biddison’s research interests include hospital operations, patient safety, critical care disaster response, and physician well-being. In addition to her research responsibilities, Dr. Daugherty Biddison also serves as Director of Credentialing for Department of Medicine in the Johns Hopkins School of Medicine. She chairs the School of Medicine Physician Wellness Advisory Council and co-chairs the Mental, Emotional, and Spiritual Health (MESH) Collaborative. She also serves as a member of the Johns Hopkins Hospital’s Credentials Committee. Immediately prior to becoming Chief Wellness Officer, she served on the Dean’s Task Force on Joy in Medicine. As part of that work, she co-chaired the Working Group on Culture and Work-life Balance and served as lead author of the summary report of the Task Force. She currently represents Johns Hopkins on both the National Academy of Medicine Action Collaborative on Clinician Well-Being and Resilience and the Administrative Board of the Stanford Healthcare Professional Wellness Academic Consortium. She co-chairs the Epic Well-Being Steering Committee.
Dr. Daugherty Biddison completed her undergraduate studies in journalism at Washington and Lee University, magna cum laude, and received her medical degree from Georgetown University School of Medicine, cum laude. She is a member of the Phi Beta Kappa and Alpha Omega Alpha Honor Societies. She completed her internal medicine residency at the University of Pennsylvania and her Pulmonary and Critical Care Medicine fellowship at Johns Hopkins, where she also earned her Master of Public Health degree.
Christine Sinsky, MD
Vice President of Professional Satisfaction, American Medical Association
Dr. Sinsky is Vice President of Professional Satisfaction at the American Medical Association. Dr. Sinsky leads initiatives at the American Medical Association to improve opportunities for joy, purpose and meaning in work for physicians and their teams. Publications on “The Quadruple Aim”, “Joy in Practice”, “Creating a Manageable Cockpit for Clinicians,” “The Solution Shop and the Production Line — The Case for a Frameshift for Physician Practices” and “Digital Minimalism” have added to the national conversation. She has also contributed to research regarding the prevalence, drivers and solutions to burnout among physicians, the use of EHR audit-log data to better characterize the work environment, and to resources for individual physicians and for health systems to improve practice efficiency and organizational culture. A general internist, Dr. Sinsky practiced at Medical Associates Clinic in Dubuque, Iowa for 32 years. She has served as a Director for the American Board of Internal Medicine and a Chair of the ABIM Foundation Board of Trustees. She currently serves on the National Academy of Medicine’s Action Collaborative on Clinician Well-Being.
Jean Moody-Williams, RN, MPP
Deputy Director, Center for Clinical Standards and Quality, Centers for Medicare & Medicaid Services
Jean D. Moody-Williams, RN, MPP, is the current Deputy Center Director for the Center for Clinical Standards and Quality (CCSQ) at the Centers for Medicare & Medicaid Services (CMS). She has served since 2008 under multiple administrations in the Senior Executive Service (SES) Corp. She currently is a part of a leadership team responsible for one of CMS’ Centers that has nearly 800 employees and a $3 billion annual budget. She is responsible for leading quality improvement, value based purchasing, and delivery system reform. She provides oversight to multiple kidney health activities including regulations for organ procurement and transplantation programs and learning networks, development of conditions of participation for dialysis facilities and healthcare systems, oversight of ESRD Networks for quality improvement and the ESRD Quality Incentive Program. She works to ensure better healthcare, healthier populations and smarter spending of healthcare dollars for more than 90 million Americans.
Chiquita Brooks-LaSure
Administrator, Centers for Medicare & Medicaid Services
Chiquita Brooks-LaSure is the Administrator for the Centers for Medicare and Medicaid Services (CMS), where she will oversee programs including Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), and the Affordable Care Act (ACA) health insurance Marketplaces.
A former policy official who played a key role in guiding the ACA through passage and implementation, Brooks-LaSure has decades of experience in the federal government, on Capitol Hill, and in the private sector.
As deputy director for policy at the Center for Consumer Information and Insurance Oversight within the Centers for Medicare & Medicaid Services, and earlier at the Department of Health & Human Services as director of coverage policy, Brooks-LaSure led the agency’s implementation of ACA coverage and insurance reform policy provisions.
Earlier in her career, Brooks-LaSure assisted House leaders in passing several health care laws, including the Medicare Improvements for Patients and Providers Act of 2008 and the ACA, as part of the Democratic staff for the U.S. House of Representatives’ Ways and Means Committee.
Brooks-LaSure began her career as a program examiner and lead Medicaid analyst for the Office of Management and Budget, coordinating Medicaid policy development for the health financing branch. Her role included evaluating policy options and briefing White House and federal agency officials on policy recommendations with regard to the uninsured, Medicaid and the Children’s Health Insurance Program.
Andrea Palm
Deputy Secretary
Department of Health and Human Services
Andrea Palm is the Deputy Secretary of the Department of Health and Human Services (HHS). As Deputy Secretary, she is the Chief Operating Officer and is responsible for overseeing the day-to-day operations of the Department.
Palm most recently served as Secretary-designee of the Department of Health Services (DHS), overseeing one of the largest state agencies in Wisconsin as a member of Governor Tony Evers' cabinet. In this role, she had responsibility for the state's Medicaid program, its Supplemental Nutrition Assistance Program (SNAP), and behavioral health programs, among others. DHS is also Wisconsin's public health agency, and as such, Palm led the state's response to the COVID-19 pandemic.
Previously, Palm held a number of policy and operational roles in the Obama-Biden Administration at HHS, including Acting Assistant Secretary for Legislation, Counselor, Chief of Staff and Senior Counselor to the Secretary. During her eight-year tenure, she worked on a variety of Administration priorities, including the Affordable Care Act, as well as providing leadership for the Department's work to combat the opioid epidemic.
Palm was born and raised in rural, upstate New York. She holds a Bachelor's degree from Cornell University and a Master's degree from Washington University in St. Louis.
Elizabeth “Liz” Fowler, PhD, JD
Deputy Administrator and Director, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services
Dr. Elizabeth Fowler is Deputy Administrator and Director of the Center for Medicare and Medicaid Innovation at CMS. Dr. Fowler previously served as Executive Vice President of programs at The Commonwealth Fund and Vice President for Global Health Policy at Johnson & Johnson. Before that, she was special assistant to President Obama on health care and economic policy at the National Economic Council. From 2008 to 2010, she was Chief Health Counsel to Senate Finance Committee Chair, Senator Max Baucus (D-MT), where she played a critical role developing the Senate version of the Affordable Care Act. She also played a key role drafting the 2003 Medicare Prescription Drug, Improvement and Modernization Act (MMA). Dr. Fowler has over 25 years of experience in health policy and health services research. She earned a bachelor’s degree from the University of Pennsylvania, a Ph.D. from the Johns Hopkins Bloomberg School of Public Health, and a law degree (J.D.) from the University of Minnesota. She is admitted to the bar in Maryland, the District of Columbia, and the U.S. Supreme Court. Dr. Fowler is a Fellow of the inaugural class of the Aspen Health Innovators Fellowship and was elected to the National Academy of Medicine in 2022.
Meena Seshamani, MD, PhD
Deputy Administrator and Director, Center for Medicare, Centers for Medicare & Medicaid Services
Dr. Seshamani also brings decades of policy experience to her role, including recently serving on the leadership of the Biden-Harris Transition HHS Agency Review Team. Prior to MedStar Health, she was Director of the Office of Health Reform at the US Department of Health and Human Services, where she drove strategy and led implementation of the Affordable Care Act across the Department, including coverage policy, delivery system reform, and public health policy. She received her B.A. with Honors in Business Economics from Brown University, her M.D. from the University of Pennsylvania School of Medicine, and her Ph.D. in Health Economics from the University of Oxford, where she was a Marshall Scholar. She completed her residency training in Otolaryngology-Head and Neck Surgery at the Johns Hopkins University School of Medicine and practiced as a head and neck surgeon at Kaiser Permanente in San Francisco.
Dora Hughes, MD, MPH
Acting Chief Medical Officer & Acting Director, Center for Clinical Standards and Quality, Centers for Medicare & Medicaid Services
Dora Hughes, M.D., M.P.H., is Chief Medical Officer at the CMS Innovation Center at the Centers for Medicare & Medicaid Services. She leads the Center’s work on health equity, provides clinical input on models, liaises with stakeholder groups, and directs CMMI’s clinician community.
Previously, Dr. Hughes served as an Associate Research Professor of Health Policy & Management at George Washington University, where her work focused on the intersection of clinical and community health, health equity, healthcare quality and workforce. Prior to this role, Dr. Hughes was a Senior Policy Advisor at Sidley Austin, where she advised on regulatory and legislative matters in the life science industry. Additionally, Dr. Hughes served as the Counselor for Science & Public Health at the U.S. Department of Health & Human Services in the Obama Administration, helping to implement the Affordable Care Act and providing guidance to the Public Health Service Act authorized agencies and Food and Drug Administration. Dr. Hughes began her career in health policy as Senior Program Officer at the Commonwealth Fund, and subsequently was Deputy Director for the HELP Committee for the late Senator Edward M. Kennedy and Health Policy Advisor to former Senator Barack Obama. Dr. Hughes received a B.S. from Washington University, M.D. from Vanderbilt and M.P.H. from Harvard. She completed an internal medicine residency at Brigham & Women’s Hospital.
Daniel Tsai
Deputy Administrator & Director, Center for Medicaid and CHIP Services, Centers for Medicare & Medicaid Services
Daniel Tsai is the Deputy Administrator and Director of Center for Medicaid and CHIP services at the Center for Medicare and Medicaid Services (CMS) where he leads the Center in addressing disparities in health equity and serving the needs of individuals and families who rely on these essential programs.
Aditi Mallick, MD
Acting Director, Office of Minority Health Centers for Medicare & Medicaid Services
Aditi Mallick, M.D. is the Chief Medical Officer for the Center for Medicaid and CHIP Services, where she leads the Center’s clinical strategy and cross-center work on health equity, social determinants of health, and innovation in whole-person care among other areas.
Before joining CMCS, Dr. Mallick led the COVID-19 Response Command Center for the North Carolina Department of Health and Human Services (NCDHHS) where she oversaw strategic and operational efforts around vaccination, testing, case investigation, and contact tracing statewide. A core focus of her COVID-19 work was ensuring equitable access and improving outcomes for historically marginalized populations.
Before NCDHHS, Dr. Mallick worked closely with a range of healthcare stakeholders across the public and private sectors – including state Medicaid agencies, provider organizations, managed care organizations, and other payors – focusing on strategy, innovation, and data-driven change implementation. Her prior federal experience includes serving as a Senior Medical Advisor in the Office of the Administrator at CMS, where she focused on MACRA implementation, value-based payment in Medicare fee-for-service, clinician engagement, and clinician burden reduction.
Dr. Mallick continues to care for patients and brings that experience to her work at CMS. She earned her A.B. with honors from Harvard College, her M.D. from Stanford University School of Medicine, and completed internal medicine residency at Massachusetts General Hospital and Harvard Medical School.
Jean Moody-Williams, RN, MPP
Deputy Director, Center for Clinical Standards and Quality, Centers for Medicare & Medicaid Services
Jean D. Moody-Williams, RN, MPP, is the current Deputy Center Director for the Center for Clinical Standards and Quality (CCSQ) at the Centers for Medicare & Medicaid Services (CMS). She has served since 2008 under multiple administrations in the Senior Executive Service (SES) Corp. She currently is a part of a leadership team responsible for one of CMS’ Centers that has nearly 800 employees and a $3 billion annual budget. She is responsible for leading quality improvement, value based purchasing, and delivery system reform. She provides oversight to multiple kidney health activities including regulations for organ procurement and transplantation programs and learning networks, development of conditions of participation for dialysis facilities and healthcare systems, oversight of ESRD Networks for quality improvement and the ESRD Quality Incentive Program. She works to ensure better healthcare, healthier populations and smarter spending of healthcare dollars for more than 90 million Americans.
Susannah Bernheim, MD, MHS
Chief Quality Officer & Acting Chief Medical Officer, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services
Susannah Bernheim, MD, MHS, is Chief Quality Officer/Acting Chief Medical Officer for the CMS Innovation Center. She was previously an Associate Professor at Yale University School of Medicine and Senior Director of Quality Measurement at the Yale-New Haven Hospital Centers for Outcomes Research and Evaluation (CORE). She completed her undergraduate degrees at Yale University and her medical degree at the University of California, San Francisco (UCSF). Dr. Bernheim was a fellow in the Robert Wood Johnson Clinical Scholars program at Yale University, earning a Master’s degree in Health Sciences Research.
David M. White
Patient Advocate
David M. (Dave) White is a proofreader at an international law firm.
When I heard the words "your kidneys are no longer working" during an emergency room visit in 2009, I was not ready to accept the news. My first six months as a dialysis patient were challenging and scary. I was fortunate to have a loving family and support system that did not give up on me when I tried to give up on myself.
A care plan meeting in 2010 changed my attitude and my future. My dialysis care team worked with me to develop a plan of care that empowered me to reach my full potential as a person living with a serious illness. Most importantly, I was told that I had to own the plan for it to work. Thankfully, I listened, took charge of my health, and eventually thrived on dialysis before receiving a kidney transplant from a deceased donor in 2015.
I serve as an Expert Advisory Panelist with the Kidney Transplant Collaborative and recently accepted an invitation to join the National Committee for Quality Assurance’s Committee on Performance Measurement. I also serve or have served in leadership roles with the American Association of Kidney Patients, the Kidney Health Initiative, the Patient Advocate Foundation and the National Patient Advocate Foundation, PCORI, Quality Insights Renal Network 5, and the Veterans Transplantation Association, and was an inaugural member of the FDA Patient Engagement Collaborative, an advancement in the FDA's efforts to strengthen its relationship with patient communities.
I believe that the best way to eliminate disparities in health outcomes is to empower communities to take collective responsibility for their own well-being.
Carol Pugh
Caregiver
Carol is a retired clinical pharmacist with 15 years of faculty experience. She is the primary caregiver for her husband whose health has declined since being diagnosed with Parkinson’s Disease and dementia in 2021. Carol’s husband is in hospice at home.
Carol fell and broke her left hip the day after they moved into a new house in April 2022. This resulted in the need to call in 24/7 caregivers to care for her husband. Within 2 weeks, an infected stage 2 pressure ulcer led to his hospitalization where a series of medication issues, including withdrawal symptoms and inadequate pain management, unfolded. Carol faced resistance from healthcare providers as she advocated for her husband remotely from rehab. The struggle continued when a hospitalist decided on an abrupt discharge, which she successfully challenged. This journey underscores the challenges caregivers face in navigating a healthcare system that often falls short of providing the necessary support and understanding.
Carol’s account delves into critical issues such as medication management, quality of care concerns, and effective engagement with Patient Advocacy. The multifaceted perspective she brings, encompassing roles as a caregiver, patient advocate, and healthcare professional, offers a comprehensive view of the complexities within the healthcare system.
Laura Cooley, PhD
Editor-in-Chief, The Journal of Patient Experience
Dr. Laura Cooley holds a PhD in Health Communication and much of her careers as a leader of an academic nonprofit called The Academy of Communication in Healthcare. She is Editor-in-Chief at The Journal of Patient Experience (an academic research publication). She is also editor of a popular book “Communication Rx: Transforming Healthcare through Communication and Relationships” She speaks at national and international healthcare events and has published many articles on topics related to patient experience and communication.
Grab & Go stations will be conveniently located throughout the main convention floor (Floor 2).
Food Trucks will be stationed on Eutaw Street beneath the Skywalk.
Explore any of the amazing nearby restaurants
Anita Monteiro
Director, iQuality Improvement & Innovation Group Centers for Medicare & Medicaid Services
Anita Monteiro serves as the Director of the Quality Improvement & Innovation Group within the U.S. Centers for Medicare & Medicaid Services. Anita is passionate about and dedicated to her work, leading programs that improve the lives, health outcomes and the experience of care for the people that access healthcare services. The quality improvement work is accomplished by several teams of federal and contract staff across the U.S, as part of national programs that collectively serve as the primary driver for healthcare quality improvement for Medicare in the United States. Anita has previously served in leadership roles in CMS in the areas of Quality Measurement and Enforcement, and as a pediatric and neonatal ICU nurse, manager, and educator in both clinical and academic settings, and in several hospital administration roles in the private sector.
This is In Person Session.
Alzheimer’s Disease and Alzheimer’s Disease Related Dementias (AD/ADRD) affect as many as six million people in the United States, a number expected to more than double by 2060. AD/ADRD are debilitating conditions that impair memory, thought processes, and function, primarily among older adults. The chance of developing dementia is not equal—Black and Latino Americans are more likely to develop AD/ADRD, as are people with risk factors such as high blood pressure, diabetes, and depression.
AD/ADRD has physical, psychological, social, and economic impacts for the person, families and caregivers, communities, and the nation. Person-centered care is effective for people living with dementia when care goals are known and used to guide nonpharmacologic and pharmacological treatment. This session will address the importance of person-centered, patient-clinician decision making and identify ways to use the approach in dementia care planning broadly.
Adrienne Mims, MD, MPH, AGSF
Chief Medical Officer,Rainmakers Strategic Solutions
Adrienne Mims, MD MPH is the Chief Medical Officer at Rainmakers Strategic Solutions where she leads work in geriatrics, health equity, clinical quality measures, person and caregiver engagement, and quality improvement. She was a practicing geriatrician at JenCare Senior Medical Center and Kaiser Permanente in Georgia. Dr. Mims served as Chief Medical Officer at Alliant Health Solutions, a QIN-QIO. She is on the boards of the National Committee for Quality Assurance and the RRF Foundation for Aging and is vice chair of the Georgia Council on Aging. Dr. Mims is a member of the Georgia Alzheimer’s and Related Dementia Council. She currently chairs the HHS NAPA Advisory Council.
Shari Ling, MD (Moderator)
Deputy CMS Chief Medical Officer, Centers for Medicare & Medicaid Services
Shari Ling is the Deputy Chief Medical Officer for CMS. In this role she works to help achieve the Agency’s overall objectives to advance health equity, expand coverage, and improve health outcomes. Dr. Ling’s focus is on the achievement of health and well-being for beneficiaries, consumers, families, and caregivers through the delivery of high quality, person-centered care across all settings. Her expertise also contributes to excellence in CMS’s work on behavioral and mental health, acute and chronic pain, substance use disorders, nursing home quality, palliative care, long-term services and supports, and post-acute care.
Esther Oh, MD, PhD
Associate Professor of Medicine, Psychiatry and Behavioral Sciences and Pathology,Johns Hopkins University School of Medicine
Esther Oh is an associate professor of medicine, psychiatry and behavioral sciences and pathology at the Johns Hopkins (JH) University School of Medicine. She focuses on evaluation/management of memory disorders. She evaluates these in older adults with multiple chronic conditions. Dr. Oh also serves as associate director of the JH Memory and Alzheimer’s Treatment Center. She earned her MD from the Chicago Medical School and was a resident the University of Illinois at Chicago. She completed a fellowship in geriatric medicine and gerontology JH University School of Medicine and received her PhD from the JH Bloomberg School of Public Health.
Tonya Saffer, MPH
Director, Division of Healthcare Payment Models within the Patient Care Models Group, Center for Medicaid and CHIP Services, Centers for Medicare & Medicaid Services
Tonya leads a team working on health care delivery and payment innovations to support CMS beneficiaries with chronic conditions living in their homes and communities. Tonya has spent her career leveraging skills in policy, research, reimbursement, and economics to improve health and health care access for underserved populations and people living with chronic illness. Prior to joining CMS Tonya was the vice president of government affairs and market access for Outset Medical where she steered innovations in home dialysis technology to people with kidney failure. She previously served as the vice president of health policy for the National Kidney Foundation where she worked with health care professionals, insurers, federal and state agencies and legislators to leverage research and evidence and improve awareness, early identification, and treatment of kidney disease. Tonya also spent time on reimbursement and product commercialization strategies at Avalere Health. She began her career in health policy and reimbursement at a dialysis company where she developed alliances to champion changes to improve Medicare reimbursement for dialysis. Tonya holds a MPH degree from the George Washington University.
This is In Person Session
This session will explore findings from section 1115 Substance Use Disorder (SUD; (#17-003 RE: Strategies to Address the Opioid Epidemic) and Serious Mental Illness (SMI; #18-011 Opportunities to Design Innovative Service Delivery Systems for Adults with a Serious Mental Illness or Children with a Serious Emotional Disturbance) demonstrations. States conduct structured monitoring and rigorous evaluations of the demonstrations, and the Centers for Medicaid and CHIP Services (CMCS) conducts federal monitoring and evaluation of both demonstration opportunities to support identifying best practices and learning and diffusion. CMCS will share key findings and discuss how it uses findings. Based on data submitted to CMS through June 2022, between the baseline and Demonstration Year 3 and later, the demonstrations were associated with a 17.1 percent increase in the number of beneficiaries using SUD treatment services. For beneficiaries with opioid use disorder (OUD), the demonstrations were associated with an increase in the share of beneficiaries receiving medication assisted treatment (MAT). However, overdose death rates increased in 10 out of 14 states and the rate of ambulatory/preventive care use declined in 11 of 14 states. Presenters will discuss state activities to address findings, including but not limited to strategies to increase access to MAT. Lastly, Kentucky will share how their team uses the information to inform continuous process and quality improvement of the demonstration.
Sarah Sheets, MPhil
Research Analyst, State Demonstrations Group, Center for Medicaid and CHIP Services, Centers for Medicare and Medicaid Services
Sarah Sheets is a research analyst at the Division of Demonstration Monitoring and Evaluation at the State Demonstrations Group within the Centers for Medicaid and CHIP Services (CMCS). She came to CMCS after completing her Master’s degree in Politics at the University of Oxford, with an emphasis on research methods. At the State Demonstrations Group, she has worked with a diverse set of states with Medicaid Section 1115 Demonstrations, including many with SUD and SMI/SED demonstrations. She looks forward to continuing to assist states with their demonstration monitoring and evaluation activities as well as leveraging the data collected and sharing those findings to better inform future policymaking decisions.
Leslie Hoffman, M.Ed., LSSYB
Kentucky Cabinet for Health and Family Services,Department for Medicaid Services
Leslie Hoffmann has a Bachelor’s Degree in Psychology from Campbellsville University, Master’s in Education from Western Kentucky University and is completing a Doctorate in Business with a specialization in leadership/management from Campbellsville University. Leslie has over 25 years of experience leading behavioral health efforts and serving communities. Formerly as the Chief Behavioral Health Officer for DMS, Hoffmann oversaw Kentucky’s Section 1115 Demonstration, Mobile Crisis Planning Grant and Implementation, the Multisystemic Therapy Pilot and Certified Community Behavioral Health Clinic (CCBHC) Demonstration. Leslie continues to serve as Medicaid’s Champion for Racial and Health Disparities. Previous roles in Medicaid include Behavioral Health Director and Director for Community Alternatives where she spent years overseeing the Brain Injury Waiver Branch. Over her tenor, Leslie has served on Statewide Committees and received varies of awards for project approvals and implementation.
Danielle Daly, PhD, MS
State Demonstrations Group, Center for Medicaid and CHIP Services, Centers for Medicare and Medicaid Services
Dr. Danielle Daly is the Division Director for the Centers for Medicaid and CHIP Services (CMCS). She has a PhD in Health Policy and a Masters in Psychology with a focus on research. She is an expert in health services research and a leader in leveraging data to inform policy. She began her career conducting evaluations of Army mental health programs and systems, supporting process and quality improvement with a direct connection between evaluation findings and changes to programs and policies. She’s focused the last several years of her career on developing CMS’s capabilities to support monitoring and evaluation for Medicaid Section 1115 Demonstrations. Her team works diligently to provide technical assistance to states to conduct monitoring and evaluation activities to support answering policy questions that are key for federal leaders.
Angela Sparrow, MSW, CSW
Behavioral Health Supervisor, Kentucky Cabinet for Health and Family Services,Department for Medicaid Services
Angela Sparrow is a Certified Social Worker and graduate of Western Kentucky University with a Master’s in Social Work and nearly 15 years of experience in healthcare social and behavioral health services. She currently works as a Behavioral Health Supervisor for the Behavioral Health Initiative’s Team in the Commissioner’s Office as lead for substance use disorder (SUD) initiatives, including KY’s Section 1115 Demonstration for Medicaid. Previously Angela worked in DMS, Division of Community Alternatives as Transition Coordinator for the Money Follows the Person (MFP) Program. Sparrow has years of employment with the University of Kentucky as Program Coordinator with the Center for Health Services Research (CHSF) leading Project BOOST (Better Outcomes by Optimizing Safe Transitions) and lead for the UK HealthCare Length of Stay Team. She serves as a participant of several statewide committees, as well as member of the JEAP Initiative Provider and Payor Community Board.
This is In Person Session
The Indian Health Service (IHS) continues to support the expanded use of telehealth to provide patient care after the COVID-19 Public Health Emergency (PHE). This presentation will focus on an overview of the use of telehealth at the IHS and the support the Centers for Medicare & Medicaid Services (Centers for Medicare & Medicaid Services) provides. The presentation will include the accomplishments in expanding telehealth from April 2020 to the present. The various telehealth services available at the IHS will be discussed including Centers for Medicare & Medicaid Services’ support provided to rural and frontier areas. Issues in providing audio-only services will be discussed and aligned with services on the Medicare Telehealth Services List for CY 2024. Presenters will provide metrics describing the utilization of telehealth in IHS. Telehealth best practices will be discussed, and quantitative and qualitative results from IHS patient and IHS provider telehealth surveys will be addressed. Finally, patient outcomes utilizing telehealth services will be included and quality improvement options provided.
Susan Karol, MD
Chief Medical Officer, Division of Tribal Affairs, Centers for Medicare & Medicaid Services
Dr. Karol is the Chief Medical Officer for the Division of Tribal Affairs (DTA) in the Center of Medicaid and the Children’s Health Insurance Program (CMCS) at the Centers for Medicare and Medicaid Services (CMS). DTA serves as the point of contact on American Indian and Alaska Native (AI/AN) health policy and serves the CMS Tribal Technical Advisory Group (TTAG) regarding AI/AN issues for the agency. She is an enrolled member of the Tuscarora Indian Nation, the first American Indian woman General Surgeon and former National Chief Medical Officer for the Indian Health Service (2008-2017). Dr. Karol is a Captain in the United States Public Health Service deploying throughout the country to meet national healthcare needs such as hurricane recovery, border patrol health needs, migrant care, and COVID-19 missions. She graduated from Dartmouth College and the Medical College of Wisconsin prior to her general surgical training at the University of Massachusetts. She is a Diplomat of the American Board of Surgery (DABS), Fellow of the American College of Surgeons (FACS) and a member of the Association of American Indian Physicians. Dr. Karol is the Chairperson of the CMS American Indian and Alaska Native Employee Resource Group and is a member of the CMS Diversity, Inclusion and Equality Council. She is the Federal Co-Chairperson for the CMS Tribal Technical Advisory Group (TTAG) Health Equity, Data and Behavioral Health Subcommittees.
Susy Postal, DNP, RN-BC
Chief Informatics Officer, Indian Health Service
Susy Postal, DNP, RN-BC, (she/her) is the Chief Health Informatics Officer for the Indian Health Service (IHS), where her focus bridges information technology (IT) with health care to promote quality patient care and improved outcomes. She co- leads IHS’s telehealth expansion to meet the agency’s needs during and post COVID-19 public health emergency. Dr. Postal supports various national quality initiatives and the reporting needs for IHS. Dr. Postal leads the IHS’s National Quality Payment Program workgroup to support IHS quality reporting. Dr. Portal identifies quality measures reporting requirements, promotes the IHS’s health IT modernization efforts, and is the sponsor for both the IHS Quality Measure Advisory Board and the National Council of Informatics. Dr. Postal reviews federal policies and addresses areas of impact for IHS federal, tribal, and urban programs. She supports governmental efforts addressing data governance, social determinants of health, and the Long Term Impact of COVID including patient resources available. She serves on the U.S. Department of Health and Human Services (HHS) Long-Term Impact of COVID-19 and National Research Action Plan (NRAP) on Long COVID workgroups. Dr. Postal represents IHS on over 17 IHS workgroups and 26 national committees.
Chris Fore, PhD
Director, Indian Health Service Telebehavioral Health Center of Excellence
Chris Fore, Ph.D. is currently the Director of the Indian Health Service (IHS) TeleBehavioral Health Center of Excellence (TBHCE). He is a member of the Choctaw Nation of Oklahoma. He received his doctorate in child clinical psychology from Oklahoma State University. In 2009, he established the IHS TeleBehavioral Health Center of Excellence. The mandate of the Center is to explore the feasibility of telebehavioral health within IHS (regionally and nationally), improve access to care, develop models of care, and to address sustainability.
This is In Person Session
The purpose of the proposed panel is to describe the CMS Innovation Center’s approach to strengthening the focus on quality, outcomes, and experience within the Innovation Center’s alternative payment models. The resulting Quality Pathway emerged from the 2021 strategic refresh and includes development of a process to certify models for expansion based on quality improvement. The panel will introduce the pathway, describing how it elevates patient outcomes and experience of care within alternative payment models and emphasizes the translation of a model’s theory of action into measurable benefits for patients. The panel will discuss how this alignment of model design and quality strategy also drives new approaches to model evaluation, and how the Quality Pathway will be used to identify when a model may be eligible for expansion based on demonstrated quality improvement in alignment with CMMI’s statutory mandate. Having addressed the conceptual basis for the Pathway, the panel will share examples of models recently under development to demonstrate how the pathway will be used at the Center. This will include insight into design choices around measure selection, implementation decisions on data collection, and evaluation considerations on methodological approach. As part of discussing implementation of the pathway, the panel will identify a number of considerations entailed in executing this new approach to model quality strategies at the Center, such as those associated with novel measure development and rigorously evaluating the impact of models on patient outcome and experience.
Noemi Rudolph, MPH
Director, Research and Rapid Cycle Evaluation Group, Center for Medicare and Medicaid Innovation (CMMI)
Noemi Rudolph is the Director of the Research and Rapid-Cycle Evaluation Group (RREG) at the Center for Medicare & Medicaid Innovation (CMMI). In this role, Ms. Rudolph leads the team that conducts evaluations of Medicare and Medicaid payment and service delivery model tests and demonstrations and oversees research with policy relevance to CMS. Ms. Rudolph has a long background in evaluations and previously served as the Deputy Group Director and Division Director in RREG. Prior to becoming a manager at CMS, she worked on the evaluations of projects involving dual eligible beneficiaries, Medicare Advantage, and the Medicare prescription drug benefit. She joined the federal government as a Presidential Management Fellow working briefly in the U.S. House of Representatives Ways and Means Health Subcommittee, CMS’ San Francisco Regional Office, and a Medicare payment contractor. Ms. Rudolph has an M.P.H. in Community Health Sciences and a B.S. in Psychobiology, both from the University of California, Los Angeles.
Jacob Quinton, MD, MPH
Medical Officer, Center for Medicare and Medicaid Innovation (CMMI), Centers for Medicare & Medicaid Services
Dr. Jacob Quinton is a medical officer at the CMS Innovation Center (CMMI) where he has for the past three years worked on model design for primary care and condition-specific payment models as well as working on quality and equity issues across the CMMI model portfolio. Before joining CMMI he completed his internal medicine residency at Yale and the National Clinician Scholars Program at UCLA, during which time he was an NIH-funded health disparities researcher focused on high-need high-cost care in Medicaid as well as leading projects on the quality and equity implications of telemedicine use during the COVID-19 pandemic.
Susannah Bernheim, MD, MHS
Chief Quality Officer & Acting Chief Medical Officer, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services
Susannah Bernheim, MD, MHS, is Chief Quality Officer/Acting Chief Medical Officer for the CMS Innovation Center. She was previously an Associate Professor at Yale University School of Medicine and Senior Director of Quality Measurement at the Yale-New Haven Hospital Centers for Outcomes Research and Evaluation (CORE). She completed her undergraduate degrees at Yale University and her medical degree at the University of California, San Francisco (UCSF). Dr. Bernheim was a fellow in the Robert Wood Johnson Clinical Scholars program at Yale University, earning a Master’s degree in Health Sciences Research.
Assuring the transplantation of every kidney offer includes ensuring that those patients who are likely to soon receive an organ offer are prepared to accept. Froedtert Memorial Lutheran Hospital’s quality improvement activities highlighted a potential opportunity for refinement in this aspect of the pre-transplant process. Beginning in Spring 2023, the transplant team developed and executed an enhanced patient preparation called Top of the List to meet this need.
From the perspective of a long-time dialysis social worker and transplant recipient, Mr. Mace will bring his insights on supporting patients waiting for a transplant. He will also share his experience on how to build collaborative communication and standard processes between the dialysis facility and the transplant program to ensure patients are transplant ready.
Top of the List focuses on ensuring patients based upon the OPTN allocation sequence at the top of each blood type are “transplant ready.” Froedtert’s enhancements to the process included: weekly calls to the patient from the pre-transplant coordinator, immediate review of medical records including updates from dialysis units, weekly care team meetings with multi-disciplinary review, and weekly emails to the patients’ dialysis centers to ensure timely communication on pertinent patient issues or changes in status. While outcome data is still being collected, the process shows potential to increase organ offer acceptance and simplifying activities when the offer is made.
Mercedes Islas, BSN, RN
Froedtert Memorial Lutheran Hospital
Mercedes Islas began her nursing career in the Transplant ICU Charge Nurse prior to transitioning over to the Quality & Regulatory department of the Froedtert Transplant Program. She appreciates the impact of quality improvement in healthcare and is eager to develop her career within the healthcare quality profession.
Michael Mace, MSW, LICSW
Nephrology Social Worker,Fresenius Kidney Care
Michael Mace has been thriving with his kidney transplant for over 25 years, while serving as a renal social worker for 18 of them. Mr. Mace also volunteers with his local court and teaches classes to families to reduce domestic violence. He feels that it is an honor to serve his community and a privilege to inspire hope in the lives of people with ESRD.
This is In Person Session
The Mishawaka Indiana Home Therapy Team has operated on the premise that everyone deserves to attain their highest level of health and quality of life with improved dialysis treatment options. The Team aimed to cultivate a culture change and develop an effective strategy for delivering excellent kidney patient care.
A foundational component of the team’s strategy is based on Jean Watson’s Theory of Human Caring. In tandem with Watson's theory, the team integrated Lean Six Sigma principles into the framework.
This innovative process began in 2022 and incorporated elements into the new model, including group training, transforming traditional nursing roles, instilling an “owner versus renter” mentality, process improvement, and patient satisfaction through relationship-building practices. This foundation was designed to enhance the ability to deliver higher levels of care that improve the quality of life for every patient, every day.
During the group training implementation, clinical staff witnessed an exceptional phenomenon. Peer-to-peer relationships blossomed, spirits lifted, and the atmosphere in the room became magical. Patients were learning from each other and forming friendships that transcended the one-on-one training. Patients and caregivers began encouraging one another and forming their own support networks. The clinic’s dynamic was transformed because of it. Within the first 10 months, the number of trained patients surpassed the clinic's entire patient population from the previous year. This model of care is transformative and can lead to meaningful human connections that enhance the quality of care and improve a patient’s quality of life.
Tammy Carmean, MBA-HM, BSN, RN,
Fresenius Home Therapies Program Manager, Fresenius Kidney Care
Tammy Carmean has been a nurse leader for over thirty years in surgical, medical, renal, and urological care, including acute and outpatient dialysis facility management. She has been recognized for excellence in performance improvement, cultural change, patient satisfaction, and staff development.
Donna Ferguson, RN, BSN
RN Charge Nurse II, Fresenius Kidney Care
Donna Ferguson, working as a patient care technician while in nursing school, has dedicated her life to serving people with ESRD. As the Clinical Charge Nurse for Fresenius, she uses her servant leadership-style to expand access to home hemodialysis, peritoneal dialysis, and both living and deceased donor transplantation.
This is In Person Session
Four presenters, each a Partnership to Advance Tribal Health (PATH) team member supporting a different Indian Health Service (IHS) facility, will share their process, methods and goals for supporting a community in building a Community Health Assessments (CHA). Each presenter played a different role in the CHA process, illustrating how this work should be guided by each specific community or group and how trust, flexibility and responsiveness are keys to success in any initiative. Presenters will share their experiences, tools used, recommendations, challenges and successes for collaborating with a tribal community in building a CHA.
Linda Griskell, MHA (Moderator)
PATH Task Order Director, Comagine Health
Linda Griskell has enjoyed working in health care and quality improvement for over 25 years. She is the Task Order Director for the American Indian Alaska Native Healthcare Quality Initiative (AIANHQI) and has been with the Partnership for Advancing Tribal Health (PATH) team since November 2023. Since joining Comagine Health in 2015, Linda has worked as a director for the Quality Improvement Organization (QIO), Hospital Quality Improvement Contract (HQIC), and various other national and local quality improvement programs. Linda resides in southern Nevada and holds a master's degree in healthcare administration. She is a subject matter expert on care transitions, having engaged with a variety of urban and rural acute and post-acute care settings across the country.
Tasha Peltier, MPH, CPH
PATH Quality Improvement Advisor and Community Engagement Advocate, Quality Health Associates of North Dakota
Tasha Peltier is Hunkpapa Lakota and a citizen of the Standing Rock Nation. In 2016 she received a master's degree in public health with a specialization in American Indian Public Health from North Dakota State University. Through her schooling, work, and personal experiences, she has acknowledged a responsibility to uplift culturally centered approaches to achieving overall health, wellness, and community healing. Currently, she works for Quality Health Associates of North Dakota and serves as the National Community Engagement Advocate and a Quality Improvement Advisor for the Partnership to Advance Tribal Health (PATH) Project.
Carrie Howard, MA, CPHQ, CPPS
PATH Quality Improvement Advisor, Stratis Health
Carrie holds a Master of Arts in Health and Human Services Administration and certifications in healthcare quality (CPHQ) and patient safety (CPPS). She has many years of experience supporting leadership and improvement in rural settings. At Stratis Health, she leads rural health care improvement projects and the Partnership to Advance Tribal Health in Minnesota and across the nation. Carrie lives and works in rural northern Minnesota where she enjoys the woods and the waters.
Julia Drishinski, BSN, RN, CPHQ
PATH Quality Improvement Advisor, Mountain Pacific
Julia’s adage is to say, “yes!” first, as she aspires to assist professionals understand that healthcare quality and safety need not be complicated. She is a BSN prepared Registered Nurse and has worked in most healthcare operational lines over the last 30 years with an affinity for creating healthy work environments. She is a Certified Professional in Healthcare Quality, and has an extensive background in quality, risk management, safety, and infection Prevention. Julia resides in Montana and works for Mountain Pacific Quality Health as a Quality Improvement Advisor for PATH, the Partnership to Advance Tribal Health program.
This is In Person Session
Over the past two years, CMS has made significant strides in advancing oral health across all our programs. From 2020-2023, a CMS learning collaborative focused on advancing oral health prevention in primary care. Topically applied fluoride varnish effectively prevents dental caries in children and adolescents. Because young children under 5 are more likely to see a primary care provider (PCP) than a dental provider, PCPs are uniquely positioned to support oral health prevention by offering fluoride varnish as part of primary care visits and connecting beneficiaries to dental care. The session will open with an overview of the technical assistance CMS provides state Medicaid and CHIP agencies and their quality Improvement (QI) partners to advance oral health prevention in primary care for Medicaid and CHIP beneficiaries, featuring several state QI projects from the affinity group, highlighting their strategies, partnerships, and lessons learned.
In 2022, CMS conducted its first-ever oral-focused human-centered design research in four states, interviewing nearly 100 people (i.e., beneficiaries, providers, advocates, state administrators, etc.) to understand barriers to oral health care access for the Medicaid and dually eligible population to inform policy change. In this session, The CMS Chief Dental Officer, Dr. Chalmers, will present the findings from that engagement.
CMS also convened a Workgroup to gather stakeholder feedback from experts in the field to plan strategic priorities for the next phase of our Medicaid and CHIP Oral Health Initiative. The focus is to assess gaps related to oral health and access to care for Medicaid and CHIP beneficiaries and recommend strategic priorities for the next five years. The session will conclude the workgroup process and overview of the final report and recommendations.
Margo Rosenbach, PhD
Vice President and Director of Health Program Improvement, Mathematica
Margo Rosenbach is a vice president and director of health program improvement at Mathematica. She is an expert in analyzing program performance and outcomes related to access, utilization, quality, costs, and experience of care, with an emphasis on Medicaid and CHIP. She directs a contract for the Center for Medicaid and CHIP Services to provide technical assistance and analytic support to states on collecting, reporting, and using the Core Sets of health care quality measures to improve care and advance equity in Medicaid and CHIP. She has a Ph.D. in health policy from Brandeis University, Heller School for Social Policy and Management.
Andrew Snyder, MPA, (Moderator)
Senior Policy Advisor, Center for Medicaid and CHIP Services, Centers for Medicare & Medicaid Services
Andrew (Andy) Snyder is a senior policy advisor with the Center for Medicaid and CHIP Services, Division of Quality and Health Outcomes. He is the policy lead for the CMS Oral Health Initiative, which seeks to improve access to dental care for Medicaid beneficiaries. Before joining CMS in 2016, he worked on issues relating to the intersection of oral health and public programs in positions at the National Academy for State Health Policy, the Pew Children’s Dental Campaign, and the Wisconsin Medicaid program. He holds a master’s degree in public affairs from the University of Wisconsin-Madison.
Natalia Chalmers, DDS, MHSc, PhD
Chief Dental Officer, Office of the Administrator, Centers for Medicare & Medicaid Services
Dr. Chalmers is a board-certified pediatric dentist, oral health policy expert, and public health advocate who brings more than 20 years of clinical, research, industry, and regulatory experience to CMS in her role as Chief Dental Officer in the Office of the Administrator. Previously, Dr. Chalmers served as a Dental Officer at the US Food and Drug Administration. Dr. Chalmers has devoted her career to transforming scientific and health care data and information into actionable insights to address equity, improve care, and better inform policy and funding. Dr. Chalmers completed her Doctor of Dental Surgery degree at the Faculty of Dental Medicine of the Medical University of Sofia, a residency in pediatric dentistry at the University of Maryland School of Dentistry, and a Ph.D. in oral microbiology from the Graduate Partnerships Program of the University of Maryland School of Dentistry and the National Institute for Dental and Craniofacial Research at the National Institutes of Health, Post-doctoral Fellowship at the Forsyth Institute, and Clinical Research Fellowship at the National Institute for Dental and Craniofacial Research, National Institutes of Health. Dr. Chalmers holds a Master’s degree in Clinical Research from Duke Medical University and a Certificate in Drug Development and Regulatory Science from the University of California San Francisco School of Pharmacy. Her research has translated into action, improving oral care and advocating for the role health policy can play across the lifespan—particularly when it embraces dental well-being as a facet of care for the whole person.
This is In Person Session
Emergency preparedness planning in nursing homes is crucial for safeguarding vulnerable populations, especially amid the challenges resulting from the pandemic. Staffing shortages limit the ability to focus on preparedness, with 77 percent of nursing homes facing challenges preparing for public health emergencies and natural disasters, according to a recent OIG report. To address this, Telligen developed an online assessment tool aligned with federal regulations and co-designed with nursing home partners to assist nursing homes in creating comprehensive emergency plans. This tool evaluates existing plans, procedures, and resources, focusing on evacuation plans, staff training, and essential resource availability and provides a comprehensive gap analysis for users to target their improvement efforts. Coordination with local emergency services for effective crisis collaboration is emphasized.
Upon completion, Telligen helps nursing homes identify and rectify gaps in their plans, enhancing their responsiveness to various emergencies. This session will highlight lessons learned from 368 completed assessments across a four-state region, showcase Telligen's collaboration with nursing home corporations to enhance testing, training plans, and system-level awareness for improvement, and offer best practices to foster a culture of readiness and resilience, ultimately ensuring the health and safety of residents and staff during crises.
Rejie Abraham, (Moderator)
Centers for Medicare & Medicaid Services, DCPH
Rejie Abraham is a Health Insurance Specialist who has worked at CMS for nearly 9 years. He is currently in CCSQ/iQIIG and has worked with practice transformation networks as well as QIN-QIOs. Before he was with the federal government, he was an analyst concentrating on healthcare workforce development and home and community-based services with the Maryland Department of Health. He was born and raised in Catonsville, MD and received a BA in political science and an MPP, with a focus on healthcare, at the University of Maryland, Baltimore County.
Brian Feist, BSN, RN
Senior Quality Improvement Facilitator, Subject Matter Expert for Emergency Preparedness, Telligen
Mr. Brian Feist is a dedicated healthcare professional with a rich and diverse career spanning 15 years. Prior to working for Telligen, Brian worked at a level 1 trauma center as a Trauma Coordinator for a level 1 trauma center orchestrating and optimizing trauma care protocols, ensuring the highest standards of patient care in critical situations. His expertise in trauma nursing was further demonstrated through his directorship and instruction of the Trauma Nursing Core Concepts, Advanced Trauma Life Support Coordinator, Stop the Bleed Instructor, Rural Trauma Team Development Course Instructor and Director, and Disaster Management Emergency Preparedness Coordinator. In these multifaceted roles, Mr. Feist contributed significantly to the education and preparedness of healthcare teams, emphasizing the importance of swift and effective responses to traumatic events and emergencies. His extensive experience reflects a commitment to excellence in emergency medical services, nursing, trauma coordination, and disaster management.
This is In Person Session
Patient safety events (PSEs) remain a persistent challenge in our healthcare system, and the Centers for Medicare & Medicaid Services (CMS) has adopted the goal of Zero Preventable Harm as part of its National Quality Strategy (NQS). This presentation will (1) discuss the prevalence of PSEs among Medicare beneficiaries, (2) analyze associated additional inpatient care and financial costs, and (3) provide insight to support CMS’ aim to promote the safest possible care for all. The Beneficiary and Family Centered Care National Coordinating Oversight and Review Center (BFCC NCORC) screens 4,000 Medicare medical records annually for PSEs, leading to follow-up actions by the BFCC-Quality Improvement Organizations (QIOs). NCORC analyzed additional days of hospitalization and payment associated with PSEs projected on a national level, by sample weighting, representing beneficiaries based on 4,000 Medicare discharges between October 2020 and December 2021. Over 5,000 PSEs were identified, and half of beneficiaries experienced at least one, with 6% being deemed preventable. PSEs were associated with nearly four additional days of inpatient care on average, totaling 32.5 million additional days nationally. This equates to $86 billion per year, or about one-tenth of all Medicare spending. Preventable PSEs cause about 5.7 million additional days of care, and over $15 billion in spending. Patient safety is the cornerstone of high-quality healthcare, yet PSEs happened in more than half of Medicare beneficiary hospitalizations, accounting for nearly 10% of all Medicare spending. These findings reinforce the urgent need for CMS’ quality agenda, and the goal of achieving zero preventable harm.
Li Chen, Ph.D
Health Research Lead, Avar Consulting
Dr. Li Chen is a seasoned Healthcare Research Lead with a ten-year track record spanning academia and industry. Dr. Chen's expertise encompasses health service research, biostatistics, epidemiology, clinical trials, and health economics. With a diverse international background, including consulting, academia, nursing, and pharmaceutical sectors, Dr. Chen's contributions are underscored by an impressive portfolio of over 45 academic publications and several funded research projects, with experience as a peer reviewer for esteemed journals and funding agencies. Her current role as the Healthcare Research Lead at Avar Consulting, Inc., has showcased her prowess in claim data analysis, patient safety, health equity, and health service research innovations.
Wendy Gary, MHA, (Moderator)
Chief Operating Officer, Avar Consulting; Executive Director, BFCC-QIO; Project Director, BFCC NCORC
Wendy Gary, M.H.A. has more than 30 years of experience providing quality and performance improvement expertise to health care organizations. She serves as the Chief Operating Officer for Avar Consulting, Inc., Executive Director of the BFCC-QIO, and Director of the BFCC NCORC. Ms. Gary holds an MHA, a Dual Bachelor’s Degree in Business and Health Science and Policy, and post-graduate certificates in Management Ethics and Aging.
Jacklyn Vollmer, MPH
Quality Improvement and Operations Support Specialist, Avar Consulting
Jacklyn Vollmer, MPH, is a Quality Improvement and Operations Support Specialist with comprehensive knowledge in biostatistics, data analytics, epidemiology, and public health. Before starting the Quality Improvement and Operations Support Specialist role within Avar Consulting, she worked as a data analyst, with her responsibilities including research and analysis for the Beneficiary and Family Centered Care National Coordinating Oversight and Review Center (BFCC-NCORC) program’s monitoring and evaluation reports, assisting in the production of NCORC program dashboards, and other research into special topics. Ms. Vollmer has a MPH with a concentration in epidemiology, a BPH, and a graduate certificate in biostatistics from the University of Kentucky. Her current responsibilities at Avar Consulting include initiating, analyzing, and revising of policies, plans, and procedures, assuring integrated and coordinated short-term to long-term planning on projects and tasks, identifying existing or potential problem areas within operations and recommending corrective action.
This session provides an overview of the Merit-based Incentive Payment System (MIPS) cost measure development process, measure methodologies (construction and attribution), cost measure scoring, and feedback reporting.
Cost measures are used to assess the overall cost related to providing and receiving medical care. Costs can include the direct costs of treatment, the total costs borne by a patient across all providers, follow-up care, outcomes after treatment, or some mixture of these. Cost measures are developed and maintained in iterative processes involving in-depth input from content experts and the public, such as Technical Expert Panels, Clinical Expert Workgroups, and persons and families with lived experience related to the cost measures. CMS uses Medicare administrative claims data to calculate cost measure performance, which means clinicians don’t have to submit any data for this performance category. MIPS eligible clinicians and groups who get scored on any of the cost measures will receive category and measure-level scoring information in their MIPS Performance Feedback Patient-Level Data Reports.
CMS will review an example of how a measure is developed, constructed, and scored. This will include defining an episode, identifying a clinician-patient relationship, determining the period of care, assigning costs of clinically related services, accounting for patient heterogeneity, calculating measure scores, and providing pertinent claims level feedback.
The session will provide insight on the methodologies CMS employs for developing and scoring cost measures, and how CMS is striving to improve the cost measures resources and data available to clinicians.
Allie Newsom, MPH
Senior Policy Lead, Acumen, LLC
Allie Newsom, MPH, is a policy researcher with nearly a decade of experience in healthcare policy and evaluation. Her work centers on assessing and enhancing the value of care provided to Medicare beneficiaries
. Ms. Newsom's contributions span numerous Centers for Medicare & Medicaid (CMS) contracts, including work on the development, maintenance, and implementation of cost measures for the Merit-Based Incentive Payment System (MIPS); an evaluation of an innovative payment model for Medicare Part D prescription drug plans; and public reporting of performance information on Doctors and Clinicians Care Compare. Ms. Newsom holds a Master of Public Health degree and a Bachelor of Science degree, both from the University of Maryland, College Park.
Christopher Reinartz, (Moderator)
Division Director, Information Systems Group, Center for Clinical Standards and Quality, Centers for Medicare & Medicaid Services
Chris has been with CMS since 2015, working on the technical implementation of the Quality Payment Program system. His team is responsible for maintaining the qpp.cms.gov website which provides clinicians with access to information to learn more about the Quality Payment Program and the means to submit measure date and obtain feedback on the scoring results. Prior to coming to CMS, Chris spent 10 years with General Dynamics IT as the lead system analyst on the CMS Part D Drug Data Processing System. Prior to that he worked for 16 years in claims operations at CareFirst Blue Cross Blue Shield.
Donta Henson, MS
Center for Clinical Standards and Quality, Centers for Medicare & Medicaid Services
Donta Henson, a 9-year Navy veteran, has excelled at CMS since 2014. Initially contributing to the Physician Fee Schedule, he swiftly advanced to become a Contracting Officer’s Representative (COR) in 2015. In 2022, Donta transitioned to CCSQ as the COR for the MIDS Patient Safety Physician-level Cost Measures and Patient Relationship Codes contract. Holding a master’s in health information technology and a B.A. in Health Administration & Policy from the University of Maryland, Baltimore County, he seamlessly blends military discipline with healthcare expertise, ensuring the success of critical contracts at CMS.
Shirley Fung, MPH, MSMR,
MIPS Scoring, Data & Analytics, and Operations Lead, Center for Clinical Standards and Quality, Centers for Medicare & Medicaid Services
Shirley joins the Division of Electronic and Clinical Quality from CMMI/the Division of Model Learning System, where she was responsible for the design, development, and implementation of the Enhancing Oncology Model (EOM) through leading a team of contractors and collaborating with multiple cross-functional groups within CMS. Prior to CMMI, Shirley was with the Office of Communication where she led research to inform the development, implementation, and evaluation of outreach campaigns designed to operationalize the Health Insurance Marketplace provisions in the American Rescue Plan Act. She previously worked at Pfizer, PPD/Evidera, and Johns Hopkins Medicine Neurosurgery, where she led de novo development of fit-for-purpose PRO measures and oversaw qualitative and quantitative research to generate credible evidence to support FDA label claims and CDC recommendations. She has an MPH with double concentration in Health Outcomes Research and Global Health and an MSMR in Marketing Research. She is currently a doctoral candidate in Health Sciences.
Steven Szeliga, MS,
QPP Chief Product Owner, ICF International, Inc.
The Chief Product Owner for Quality Payment Program and work closely with CMS Leadership to evaluate implementation options for proposed policies.
In response to the President’s executive order to advance racial equity and support for underserved communities, the Department of Health and Human Services (HHS) established an equity action plan. In alignment with this plan, Beneficiary and Family-Centered Care Quality Improvement Organizations (BFCC-QIOs) are working to identify and address barriers to equitable access and utilization of beneficiary protection, support, and advocacy services.
BFCC-QIOs offer case review services for beneficiaries who think they may be entitled to additional Medicare-covered services, or who think the quality of care they received does not meet clinical standards. Using BFCC-QIO program data, we assessed the degree to which case review services are being utilized by beneficiaries of different races and ethnicities.
Disparities in case review utilization are evident among Hispanic and Asian beneficiaries and these disparities may further contribute to existing health outcome inequalities. The concern is that these beneficiaries are still experiencing premature healthcare service termination or other quality of care issues such as gaps between government and other health providers, but are not exercising their right to review and possibly resolve these issues through BFCC-QIO program services.
BFCC-QIOs are carefully analyzing the approach and implementation strategies for their work. Seeking input from experts, stakeholders and Medicare beneficiaries, BFCC-QIOs are identifying strategies to improve access and awareness and reduce disparities in use of BFCC-QIO case review services that may contribute to poor health outcomes.
Scott Fortin, MBA
Sr. Director Communications and Outreach,Kepro
Scott Fortin, MBA, has over 20 years of experience in the healthcare industry, with 10 of those specific to the Quality Improvement Organization (QIO) community. He is a solutions-oriented marketing and stakeholder relations professional skilled in managing relationships and strategic communications. He understands methodology to develop and implement unique relational strategies in high profile environments. Scott is also well versed in collaborating with key partners and stakeholders to deliver communications and outreach solutions that support program objectives, ensuring effective and strategic messaging. Scott graduated from Olivet Nazarene University with a Master of Business Administration.
Carmen Villegas, RN, BSN, BCPA
Immediate Advocacy Manager,Livanta
Carmen Villegas, RN, BSN, BCPA, is the Quality Triage/Immediate Advocacy Review Manager for Livanta, a Beneficiary and Family Centered Care, Quality Improvement Organization. Ms. Villegas is a registered nurse and a Board Certified Patient Advocate (BCPA). She has been with Livanta since 2015. Ms. Villegas has 25 years of experience in various clinical settings, and her extensive knowledge of patient advocacy and focus on individualized patient care is why she provides exceptional service. Fluent in both Spanish and English, Ms. Villegas is able to connect with Spanish-speaking patients and their families, which allows her to provide culturally competent care.
Stephanie Fry, BA, CPXP
Associate Vice President, Westat
Ms. Stephanie Fry is a survey methodologist and mixed methods researcher who leads health services and policy research. She has supported the QIO program and evaluation work for more than 15 years and is currently serving as the BFCC NCORC Deputy Director. Ms. Fry is also a Senior Study Director at Westat where her work focuses on design and implementation of healthcare program evaluations, including the collection and reporting of stakeholder, beneficiary, provider, and payer perspectives.
The 2024 National Impact Assessment aggregates retrospective data from 26 CMS quality and value-based incentive programs to characterize quality and efficiency impacts associated with the use of measures. The session will focus on summarizing key findings from these comprehensive analyses that provide important insights regarding effects of the COVID-19 pandemic during the period of analysis. We will describe national measure performance trend data pre-COVID-19 (2016–2019) compared with results in the initial years of the COVID-19 public health emergency (PHE)— 2020 and 2021— and describe patient impact and costs avoided when performance for select measures improved. Data also will be presented on how the CMS measure portfolio is evolving to reduce measurement burden and address CMS quality priorities. Lessons learned from the COVID-19 PHE and proposed actions to improve the resilience of quality measurement and the health care system will be discussed. Finally, underscoring equity as a primary objective of the CMS National Quality Strategy, the session will explore patterns of disparities in quality measure scores and offer insight into underlying drivers of disparities identified through focus groups in underserved communities.
Robert Ziemba, PhD
Statistician, HSAG
Robert Ziemba is a statistician at HSAG with more than 7 years of experience in the analysis of CMS quality measures. Dr. Ziemba was the lead statistician for the 2021 and 2024 National Impact Assessment of the Centers for Medicare & Medicaid Services (CMS) Quality Measures Report. He oversees development and implementation of data analysis and presentation. Dr. Ziemba also contributes analytic support for several CMS projects in the area of quality measurement and program implementation. Dr. Ziemba has a PhD in Biology from Arizona State University and a Master of Public Health degree from the University of South Florida.
Kyle Campbell, PharmD
Project Director,HSAG
Kyle Campbell has over 25 years of combined research, pharmacy, quality improvement, and measure development experience. His experience includes developing and maintaining quality measures for use in CMS programs, advising on national policy related to measure development, designing and implementing quality improvement interventions, and overseeing research related to medication safety. At HSAG, he oversees projects related to measure development, health care policy and evaluation, and medication safety, including the CMS Measure & Instrument Development and Support (MIDS) National Impact Assessment of CMS Quality and Efficiency Measures contract. Dr. Campbell has a Doctor of Pharmacy degree from the University of Florida.
Kendra Hanley, MS, BA
Impact Assessment Team Lead,HSAG
Kendra Hanley is a nationally recognized expert with over 15 years’ experience in the development, specification, and evaluation of quality measures, with emphasis on electronic clinical quality measures. Ms. Hanley is the HSAG team lead for the 2024 National Impact Assessment of the CMS Quality Measures Report. She oversees research, methodologic, and analytic activities, including data acquisition and analysis. Previously, she led a team responsible for the CMS Quality Measure Development Plan, mandated by the Medicare Access and CHIP Reauthorization Act of 2015. Ms. Hanley has a Master of Science degree in Health Systems Management from Rush University in Chicago.
Million Hearts® prioritized strategies for building healthy communities and optimizing care through a committed focus on specific populations experiencing inequities. This session describes how Million Hearts 2027 is addressing health equity with a review of communication assets and opportunities for engagement, an exploration of health equity-related issues for widespread use of self-measured blood pressure monitoring and cardiac rehabilitation, and an overview of new and future opportunities to reduce cardiovascular maternal health disparities.
Haley Stolp
Policy and Partnership Strategist, Centers for Disease Control Disease Control and Prevention
Haley Stolp, MPH is the Policy and Partnership Strategist for Million Hearts® in the Division for Heart Disease and Stroke Prevention at the Centers for Disease Control and Prevention (CDC).
Laurence Sperling, MD, FACC, FAHA, FACP, FASPC
Executive Director, Million Hearts Initiative, Centers for Disease Control and Prevention
Laurence S. Sperling, M.D., FACC, FAHA, FACP, MASPC is the Founder and was the Director of The Heart Disease Prevention Center at Emory (1997-2019). He is currently the Katz Professor in Preventive Cardiology at the Emory University School of Medicine, and Professor of Global Health in the Rollins School of Public Health. Dr. Sperling is the Executive Director of Million Hearts for the Division of Heart Disease and Stroke Prevention at the Centers for Disease Control and Prevention and the Center for Medicare and Medicaid Services. He served as the President of the American Society for Preventive Cardiology from 2014-2016, served on the writing committee of 2018 the ACC/ AHA Guideline on the Management on Blood Cholesterol, and serves as Associate Editor for the American Journal of Preventive Cardiology, and the Chair of the World Heart Federation writing group on the Roadmap for Cardiovascular Disease Prevention among People Living with Diabetes. He has been an investigator in a number of important clinical trials and has authored over 350 manuscripts, abstracts, and book chapters.
Taylor Streeter, MPH
Health Scientist, ASRT, Inc.
Taylor Streeter is a health scientist from ASRT Inc. in the Division for Heart Disease and Stroke Prevention at the Centers for Disease Control and Prevention. As a member of the Million Hearts® science team, she supports the evaluation, translation, and implementation of evidence-based strategies for cardiovascular disease prevention. Taylor also supports Million Hearts® work in maternal health which focuses on preventing and managing hypertensive disorders of pregnancy. She received her MPH from Emory University, Rollins School of Public Health and has a background in evaluation, data visualization, minority health, and maternal and child health.
This session will bring together experts in the field of Behavioral and Physical Health Integration from CMS’s Center for Medicare & Medicaid Innovation (CMMI), the Agency for Healthcare Research and Quality (AHRQ), and the Office of the National Coordinator for Health Information Technology (ONC) to discuss innovations and lessons learned. The speakers will share what they are doing in their specific areas and engage in discussion around 5 key elements of integration: 1) team based care, 2) workforce training, education and culture, 3) community and individual needs, 4) payment and 5) infrastructure, IT and data sharing.
Elisabeth Kato, MD, MRP
Medical Officer, Agency for Healthcare Research and Quality
Elisabeth Uphoff Kato, MD, MRP, is a medical officer at the Agency for Healthcare Research and Quality in the Center for Evidence and Practice Improvement, where she coordinates AHRQ activities related to Substance Use Disorders and serves as Acting Deputy Director for the Center. She previously served as medical officer in both the Evidence-based Practice Center Program and the US Preventive Services Task Force at AHRQ. Prior to joining the federal government she worked as a Senior Medical Research Analyst with Hayes Inc. Before turning to medicine, Dr. Kato worked on international development projects in Nepal, Thailand, and Cambodia. Dr. Kato received medical training at the University of Maryland and has Master’s and Bachelor’s degrees from Cornell University.
Shari Ling, MD (Moderator)
Deputy CMS Chief Medical Officer, Centers for Medicare & Medicaid Services
Shari Ling is the Deputy Chief Medical Officer for CMS. In this role she works to help achieve the Agency’s overall objectives to advance health equity, expand coverage, and improve health outcomes. Dr. Ling’s focus is on the achievement of health and well-being for beneficiaries, consumers, families, and caregivers through the delivery of high quality, person-centered care across all settings. Her expertise also contributes to excellence in CMS’s work on behavioral and mental health, acute and chronic pain, substance use disorders, nursing home quality, palliative care, long-term services and supports, and post-acute care.
Michael Wittie
Public Health Analyst, Office of Policy,Office of the National Coordinator for Health Information Technology
Michael Wittie is a public health analyst in the ONC Office of Policy's Federal and State, Tribal, Local and Territorial Division. His portfolio includes the policy coordination for USCDI, public health, clinical decision support, and behavioral health care transformation. He also serves as co-chair of the HHS Behavioral Health Coordination Council Integration Subcommittee’s Technology Enabled Solutions Work Group. Michael holds a bachelor’s degree in neuroscience and psychology from Oberlin College and an MPH in epidemiology from Emory University.
Rebecca VanAmburg
Social Science Research Analyst, Center for Medicare and Medicaid Innovation, Centers For Medicare & Medicaid Services
Acting Deputy Division Director, Division of Population Health Incentives and Infrastructure (DPHII), which houses InCK, AHC and work stream with SDOH. Formerly, the Acting Deputy Division Director of the Division of Health Innovation and Integration, which houses IBH, MOM and ViT.
Karran Phillips, MD, MSc
Deputy Director, Center for Substance Abuse Treatment, SAMSHA
Karran Phillips, MD, MSc is the Deputy Director for the Center for Substance Abuse Treatment (CSAT). She comes to CSAT after 15 years at the National Institute on Drug Abuse, National Institutes of Health (NIDA, NIH) where she served as a clinical investigator, Medical Director of the Archway Outpatient Treatment Clinic, and the NIDA Clinical Director. As Clinical Director she coordinated, supported, and supervised the development, implementation and conduct of intramural clinical research activities and provided the infrastructure needed to promote top quality clinical research and to ensure research participant safety and confidentiality. Her clinical research focuses on the use of mobile health technologies to improve access and quality care for individuals with substance use disorder and hepatitis C and HIV. Her current clinical work includes providing low threshold buprenorphine treatment to individuals with SUD from a mobile van outside the Baltimore Mens' Detention Center.
This is In Person Session
This session will inform and engage participants in the development of Project PIVOT (Patients Involved in developing Outcomes Together), a patient-driven research initiative to identify and prioritize Patient Reported Experiences (PREs) and Patient-Reported Outcomes (PROs) that matter most to them on the issues of patient safety, diagnosis safety and health equity.
Purpose: There is heightened national awareness, including at the White House, across CMS and other DHHS agencies, and among researchers about improving patient experiences and outcomes by addressing embedded patient safety, diagnostic and health equity challenges. In the past, improvement work has incorporated traditional tools such as clinical outcome measures and satisfaction scores. There has been limited incorporation of PREs and PROs prioritized by patient/consumer community. Project PIVOT will provide an opportunity for a range of diverse patients/families, and communities, especially those who experience marginalization, to come together with measure development experts to identify and prioritize PREs and PROs that matter most to them.
Evaluation: The ultimate goal of Project PIVOT is to identify existing validated patient reported measures of patient safety and discrimination/bias and facilitate the creation of new validated measures where none exist to ensure more meaningful measurement and future research.
Outcomes:
Suz Schrandt, JD
Founder, CEO and Chief Patient Advocate, ExPPect
Suz Schrandt is a patient and patient engagement engineer with a health and disability law and policy background. She is the Founder and CEO of ExPPect, a patient engagement “do-tank” which focuses on driving greater partnership with patient experts and leaders across the healthcare ecosystem. Schrandt previously served as the Director of Patient Engagement at the Arthritis Foundation, where she led the Foundation's Patient Engagement strategy, and as the Deputy Director of Patient Engagement for the Patient-Centered Outcomes Research Institute. While at PCORI, she helped to create and implement several key patient engagement initiatives and tools including the Patient and Family Engagement Rubric. Before joining PCORI, Schrandt served as the Health Reform Team Leader for the Kansas Health Institute, where she educated the state's policymakers, providers, and consumers about implementation of the Affordable Care Act and other key health legislation. Schrandt’s passion for patient engagement began in large part from her own experience, having been diagnosed with polyarticular juvenile idiopathic arthritis as a teenager. She has undergone multiple joint replacement and other orthopedic surgeries and has logged over thirty years of first-hand experience with the healthcare system. She is a daughter, granddaughter, sister, aunt, niece, and friend of many people with rheumatologic diseases and has seen first-hand their determination, and the power that their knowledge and voice can have. Schrandt is one of nine voting members on the FDA’s inaugural Patient Engagement Advisory Committee, is the Chairperson for the International Society of Pharmacoeconomics and Outcomes Research (ISPOR) Global Patient Council.
Martin Hatlie, JD
Founding Member, Patients for Patient Safety US
Marty Hatlie is a patient safety advocate with a strong interest in the roles patients and family members play as co-creators of patient safety and health equity solutions. He currently serves as President & CEO for Project Patient Care, a Chicago-based nonprofit dedicated to using the voice of the patient to improve patient safety and outcomes disparities. In 2021 he co-founded Patients for Patient Safety US, the US branch of the World Health Organization’s (WHO) Patients for Patient Safety network. He also is a principal of the Healthcare Patient Partnership Institute, which work with hospitals and health systems to engage patients as advisors in improvement work.
Early in his career Hatlie was a litigator focused on civil rights, medical liability defense and alternative dispute resolution. In the 1980s/90s he was a lobbyist for the American Medical Association and lead strategist for its tort reform campaigns. He coordinated the AMA’s launch of the National Patient Safety Foundation in 1997 and served as its founding Executive Director from 1997—99. He has since been active in U. S. federal health system transformation work as a consultant on multiple research and demonstration projects funded by the Centers for Medicare and Medicaid Services, the Agency for Healthcare Research and Quality, and the Patient Centered Outcomes Research Institute. He currently serves on the CMS-supported Pre-Rulemaking Measure Review Hospital Committee, the National Steering Committee overseeing implementation of Safer Together: The National Action Plan to Advance Patient Safety, and WHO’s Patients for Patient Safety Programme Advisory Council.
This is In Person Session
Recognizing the scope and complexity of health system challenges can be overwhelming. Committing to improving quality in healthcare can be exciting but daunting. What does a successful path forward look like? As the PHE taught us, it’s the basics: consistent processes, quality monitoring and most importantly, staff engagement, that are at the heart of routine or extraordinary medical responses. This session will discuss how to focus on the basic systems and foundation necessary to build any quality intervention, both organizationally and personally. This session is focused on the power of personal purpose in shaping the path forward, and our collective responsibility in making and sustaining improvements.
Anita Monteiro
Director, iQuality Improvement & Innovation Group Centers for Medicare & Medicaid Services
Anita Monteiro serves as the Director of the Quality Improvement & Innovation Group within the U.S. Centers for Medicare & Medicaid Services. Anita is passionate about and dedicated to her work, leading programs that improve the lives, health outcomes and the experience of care for the people that access healthcare services. The quality improvement work is accomplished by several teams of federal and contract staff across the U.S, as part of national programs that collectively serve as the primary driver for healthcare quality improvement for Medicare in the United States. Anita has previously served in leadership roles in CMS in the areas of Quality Measurement and Enforcement, and as a pediatric and neonatal ICU nurse, manager, and educator in both clinical and academic settings, and in several hospital administration roles in the private sector.
Joshua Cartwright, DHA, MHL, CPHQ, FACHDM
Associate Principal – HRCChartis
Joshua Cartwright is an Associate Principal with Chartis partnering with the clinical transformation team focused on compliance and high reliability. Dr. Cartwright has over 15+ years of experience as a seasoned professional dedicated to healthcare organizational excellence, with quality and patient safety as his guiding compass.
Dr. Cartwright has advocated to advance quality programs and patient safety on the national stages with large academic organizations, not-for-profits and with professional organizations like the Institute for Healthcare Improvement (IHI) and the National Association of Healthcare Quality. He has developed large award-winning pilots that have won state and federal accolades and continues to advance his research through authored works focused on care delivery, community engagement and proactive screening for social drivers of health.
Before joining Chartis, Dr. Cartwright was privileged to lead quality and patient safety at a Johns Hopkins Medicine entity and held a leadership role with the prestigious Johns Hopkins Health System Armstrong Institute for Patient Safety and Quality. Prior to this he led quality reporting and performance measurement with Presbyterian Health System in New Mexico and served as a lead consultant with TMF Health Quality Institute QIN-QIO during the CMS 11th Scope of Work. Joshua started his early quality career in transplant and cardiovascular and thoracic surgery with Southwest Transplant Alliance and UT Southwestern Medical Center in Dallas, Texas.
Dr. Cartwright is an alum of the Medical University of South Carolina, where he completed his Doctor of Health Administration. He holds a Master of Healthcare Leadership from Brown University and a Bachelor of Science in Business Administration and Management from Texas A&M University-Commerce. His academic career also includes an Associate of Science in Biology from Dallas College. In addition to his professional responsibilities, Dr. Cartwright is an active member of the Malcolm Baldrige Quality Award National Examiner Board and a Fellow of the American College of Health Data Management.
David Wright, MPA
Director, Quality Safety & Oversight Group, Centers for Medicare & Medicaid Services
David Wright serves as the Director of the Quality, Safety & Oversight Group within the U.S. Centers for Medicare & Medicaid Services. He loves his job and the role he plays in quality of care assurance for everyone accessing health care in the United States. This work is accomplished through the Group’s role in issuing policy and compliance guidance to over 8,400 dedicated health and safety surveyors at the State and Federal levels who perform quality of care inspections of more than 400,000 providers that participate in the Medicare or Medicaid programs, or who provide laboratory services under the Clinical Laboratory Improvement Amendments (CLIA). David joined CMS in June 1993 through the Presidential Management Internship program and has been with the Agency for over 30 years, twenty-three of which were in CMS’ Dallas Location.
Tom Evans, MD, FAAFP
President & CEO, Iowa Healthcare Collaborative
Tom Evans, MD, is President and CEO of the Iowa Healthcare Collaborative (IHC). Dr. Evans received bachelor and master’s degrees from Drake University, a medical degree from the University of Iowa, and completed a family medicine residency at Broadlawns Medical Center in Des Moines. He practiced family medicine for 13 years before serving as chief medical officer for the Iowa Health System. In 2005, he founded the Iowa Healthcare Collaborative to focus on sustainable healthcare transformation in Iowa and the nation. Dr. Evans has served as president of both the Iowa Medical Society and the Iowa Academy of Family Physicians. He has also served on the delegations for the American Medical Association (AMA) and the American Academy of Family Physicians (AAFP). He has served on the boards of the National Patient Safety Foundation and Bethel University in St. Paul, Minnesota. Dr. Evans is a faculty member with the Institute for Healthcare Improvement and teaches courses in both strategy and healthcare improvement at the University of Iowa College of Public Health.
This is In Person Session
This session will focus on the Equity in Postpartum Care Challenge prize competition, which rewards innovative strategies to improve postpartum care for Black or African American and American Indian or Alaska Native (AI/AN) beneficiaries enrolled in Medicaid or Children’s Health Insurance Program (CHIP). The competition emphasizes follow-up care form conditions associated with morbidity and mortality in the later postpartum period, including diabetes, postpartum depression and/or postpartum anxiety, hypertension, and substance use disorders (SUD). Two winners will speak about their winning projects and how they succeeded in scaling and spreading their ideas to improve equity in postpartum care.
Kristen Zycherman, RN, BSN
Quality Improvement Technical Director,Division of Quality and Health Outcomes, Children and Adult Health Program Group, Center for Medicaid & CHIP Services
Kristen Zycherman, RN, BSN is the Quality Improvement Technical Director and lead for the Maternal and Infant Health Initiative in the Centers for Medicare and Medicaid Services (CMS) Division of Quality & Health Outcomes, in Center for Medicaid & CHIP Services (CMCS) Children and Adults Health Program Group (CAHPG). She is a subject matter expert in maternal and infant health. Within CMS, she previously worked in the Medicare-Medicaid Coordination Office supporting the coordination of coverage and care for dually eligible beneficiaries as well as in the Division of Medical Review and Education. Prior to CMS, she was a labor and delivery registered nurse at Howard County General Hospital. She completed her Bachelor of Science in nursing at Johns Hopkins School of Nursing during which time she participated in their Birth Companions Doula Program. She also completed a Bachelor of Arts in sociology from the University of Maryland College Park with a concentration in social stratification.
Adi Hirshberg, MD
Director of Obstetrical Services, Clinical Associate Professor, Maternal Fetal Medicine, Hospital of the University of Pennsylvania, Penn Medicine
Adi Hirshberg is an Associate Professor of Clinical Obstetrics and Gynecology at the University of Pennsylvania Perelman School of Medicine. She completed her OB/GYN residency and Maternal Fetal Medicine fellowship at the Hospital of the University of Pennsylvania. She serves as the Director of Obstetrical Services at the Hospital of the University of Pennsylvania and physician lead of the Obstetrics Quality Improvement committee at Penn. Her areas of expertise include hypertensive disorders of pregnancy, quality improvement, severe maternal morbidity, and labor and delivery. She also co- developed Heart Safe Motherhood, an evidence-based remote blood pressure monitoring program for postpartum hypertension used throughout Penn Medicine.
Lindsay Standeven, MD
Assistant Professor of Psychiatry and Behavioral Sciences and Clinical Education Director, The Johns Hopkins Reproductive Mental Health Center
Linsday Standeven is an Assistant Professor of Psychiatry at Johns Hopkins and the Clinical and Education Director of Johns Hopkins Reproductive Mental Health Center. After completing her residency in Psychiatry, Dr. Standeven completed a two-year fellowship in reproductive psychiatry. She is the director of resident training in women's mental health and serves on the educational board of the National Curriculum on Reproductive Psychiatry (NCRP). Her research focuses on the role of neurosteroid changes in pregnancy and PMADs. She has also received NIH funding to study the role of neurosteroids and the psychiatric symptoms of women with Polycystic Ovary Syndrome.
This is In Person Session
This session will provide information about the statutory and regulatory quality requirements associated with HCBS waiver programs. The session will outline the quality assurances states must provide, including obligations for quality monitoring and improvement. It will also provide details about the Center for Medicaid and CHIP Services quality oversight including health and welfare site visits in states.
George Failla, Esq.
Director, Medicaid & CHIP Operations Group, Division of Home and Community Based Services Operations and Oversight, Center for Medicaid and CHIP Services, Centers for Medicare & Medicaid Services
George P. Failla, Jr. has been with the Centers for Medicare & Medicaid Services (CMS) since May 2015, and currently serves as the Director of the Division of HCBS Operations and Oversight with leadership responsibility for three professional managers, three technical directors and twenty-five HCBS Analysts and an administrative Specialist. DHCBSO addresses operational aspects and oversight of Medicaid programs advancing home and community-based services as an alternative to institutional placement and the division has purview over 1915(c) waivers and 1915(i), 1915(j) and 1915(k) State Plan Amendments as well as 1115 Demonstration Waivers across the country. Prior to his work in DHCBSO, he served Deputy Director in the Division of Long Term Services and Supports (DLTSS) from July 2016 to May 2021 with policy development and oversight in HCBS and certain institutional long term services and supports. He is a sought-after national voice on key topics and has delivered training sessions in CMS platforms and national Conferences in a variety of topic areas related to HCBS. Prior to work at CMS, he served as Deputy Secretary (and Acting Secretary) in the Maryland Department of Disabilities (MDOD) where he directed the development, implementation and communication of MDOD’s policy initiatives and served as the Department’s primary liaison to the Office of the Governor, Maryland General Assembly, and Executive Agencies of the State.
Susan Cummins
Technical Director, Medicaid & CHIP Operations Group, Division of Home and Community Based Services Operations and Oversight, Center for Medicaid and CHIP Services, Centers for Medicare & Medicaid Services
Susie Cummins has been a public servant for 36 years. After working for the State of Idaho for 22 years, her tenure began with the Centers for Medicaid and CHIP Services (CMCS) in 2010. She was hired by the Seattle Regional Office Medicaid Division to help states implement health insurance exchanges as required by the Affordable Care Act. For the last 7 years, Susie has been in her current position as a Technical Director within the CMCS Medicaid & CHIP Operations Group’s Division of Home and Community Based Services (HCBS) Operations and Oversight. She provides technical assistance to federal and state staff with a particular focus on oversight and quality of the nation’s 327 HCBS programs.
This is In Person Session
This session will focus on efforts from CMS and NIH/NHLBI to improve access, quality, and the experience of health care for individuals with Sickle Cell Disease (SCD). In 2023, CMS released a new CMS Action Plan for SCD. The Action Plan is based on listening sessions and lessons from the field as CMS is continuously gathering information on what barriers exist for individuals and providers. CMS will highlight some activities in the SCD Action Plan that address the challenges specific to CMS programs which are designed to improve health outcomes and reduce health disparities for individuals with SCD. In addition, this session will address current NIH/NHLBI efforts that are underway to advance our research and knowledge of SCD to help improve the lives of those living with this disease. Lastly, you will hear from a representative from the Maryland Sickle Cell Disease Association and her experience with SCD.
Teanika Hoffman, MA
CHW, Sickle Cell Coalition of Maryland
Shondelle Wilson-Frederick, PhD, NHLBI
Chief Engagement Officer, National Heart, Lung and Blood Institute (NHLBI) National Institutes of Health (NIH)
Shondelle Wilson-Frederick, Ph.D. serves as the Chief Engagement Officer for the National Heart, Lung, and Blood Institute (NHLBI) at the National Institutes of Health. She works across the Institute to create an engagement strategy for effectively connecting with multiple partners to advance health equity across heart, lung, blood, and sleep research and related public health initiatives. Prior to joining NHLBI, Dr. Wilson-Frederick spent over 10 years at the U.S. Department of Health and Human Services (HHS) serving as a subject matter expert for sickle cell disease (SCD), overseeing strategic engagement activities and leading national health disparities and chronic disease initiatives that supported the White House and HHS strategic priorities. Dr. Wilson-Frederick holds a Ph.D. in Bacteriology from the University of Wisconsin-Madison, and postdoctoral training in Cancer Epidemiology from the Johns Hopkins Bloomberg School of Public Health.
Melissa Majerol
Cell and Gene Therapy Access Model Co-Lead, Center for Medicare and Medicaid Innovation (CMMI)
Melissa Majerol is a Co-Lead of the Cell and Gene Therapy Access (CGT) Model at the Centers for Medicare and Medicaid Services’ (CMS) Innovation Center. In her role, Melissa helps guide the policy development and manage the day-to-day operations of the Model. Before joining the CGT Model, Melissa’s work focused on health equity and implicit bias, Medicaid policy, and health care access for uninsured populations. Melissa holds a Master of Public Health degree from the Harvard T.H. Chan School of Public Health.
Jessica Lee, MD, MSHP
Acting Chief Medical Director, Center for Medicaid and CHIP Services, Centers for Medicare & Medicaid Services
Jessica Lee, MD, MSHP is the acting Chief Medical Officer for Center for Medicaid and CHIP Services, where she leads the center’s clinical strategy and portfolio in health-related social needs. Dr. Lee was previously the medical officer in the Division of Quality and Health Outcomes at CMCS, where she led initiatives in quality measures and quality improvement. Dr. Lee has deep expertise in clinical medicine and quality, and a background in health policy at the health system, state, and federal levels, including projects at Denver Health. She has served as a senior health policy analyst at the Government Accountability Office, focusing on payment policy and community benefits provided by nonprofit hospitals. She has conducted grant-funded research focused on the intersection of health care delivery systems and population health. Dr. Lee continues to care for patients as a practicing pulmonologist at the University of Pennsylvania and ICU physician at the Corporal Michael J. Crescenz VA Medical Center in Philadelphia.
This is In Person Session
As CMS seeks to align quality measures through the Universal Foundation, there remain important measurement gaps. The CMS Innovation Center strategically chooses to develop new measures when tied to the overarching goal of a model. We will describe the context, importance and development of new measures for Center for Medicare and Medicaid Innovation (CMMI) alternative payment models.
CMMI will discuss considerations for new measure development in newly announced CMMI models, as well as the approach and rationale for new measure development in current models. This session will also highlight novel measures under the Integrated Care for Kids (InCK) and Emergency Triage, Treat, and Transport (ET3) model and the Guiding an Improved Dementia Experience model to highlight this work:
InCK: There is evidence that interventions aimed at reducing rates of youth out of home placement (OOHP) have the potential to both improve children’s health outcomes and reduce their rates of avoidable health care utilization. This session will provide an overview of the novel OOHP measure developed for the InCK Model. This measure reports the rate of new OOHP episodes per 1,000 attributed beneficiaries in a set geographic area.
ET3: The ET3 Model tested an innovative new approach to paying for emergency ground ambulance services in Medicare. In order to better assess the efficacy of triage interventions, CMMI developed the Post-Triage Emergency Department (ED) Visit measure that assessed the rate at which patients return to the ED within three days of an intervention.
Participants will learn how the CMS Innovation Center evaluates opportunities to develop new quality measures and the details of recently developed measures.
Alexis Lilly, MBA
Deputy Director, Center for Medicare and Medicaid Innovation (CMMI), Centers for Medicare & Medicaid Services
Alexis has supported the work of ET3 first as model lead and now as the Deputy Director for the Division of Health Care Delivery. Prior to joining CMMI in 2019, Alexis oversaw programmatic and financial obligations of grants and cooperative agreements at a Baltimore-area FQHC and Johns Hopkins.
Chadwick Morgan, MPH
Integrated Care for Kids Center for Medicare and Medicaid Innovation (CMMI) Centers for Medicare & Medicaid Services
Chadwick Morgan, MPH, is the Co-Model Lead for the Integrated Care for Kids Model at the Center for Medicare and Medicaid Innovation (CMMI). He previously served as the Contracting Officer’s Representation on the contract that developed the novel Out-of-home placement measure as well as the Quality Lead for the Value in Opioid Use Disorder Treatment Demonstration. Prior to CMMI, Chad was a Health Care Analyst at the National Committee for Quality Assurance and a Fellow in the Centers for Disease Control and Prevention’s Public Health Associate Program. He earned his BS and MPH from the University at Albany.
Emily Creveling, MSW
Integrated Care for Kids Model Co-Lead, Center for Medicare and Medicaid Innovation (CMMI), Centers for Medicare & Medicaid Services
Emily Creveling is the CMS Integrated Care for Kids Model Co-Lead. Prior to joining CMMI in 2023, she worked for the National Academy for State Health Policy and managed Virginia’s maternal and child health Medicaid programs, specializing in managed care operations.
Jacob Quinton, MD, MPH
Medical Officer, Center for Medicare and Medicaid Innovation (CMMI), Centers for Medicare & Medicaid Services
Dr. Jacob Quinton is a medical officer at the CMS Innovation Center (CMMI) where he has for the past three years worked on model design for primary care and condition-specific payment models as well as working on quality and equity issues across the CMMI model portfolio. Before joining CMMI he completed his internal medicine residency at Yale and the National Clinician Scholars Program at UCLA, during which time he was an NIH-funded health disparities researcher focused on high-need high-cost care in Medicaid as well as leading projects on the quality and equity implications of telemedicine use during the COVID-19 pandemic.
Marvin Nichols, MHA
ET3 Model Lead, Center for Medicare and Medicaid Innovation (CMMI), Centers for Medicare & Medicaid Services
Marvin Nichols, Model Lead of the ET3 Model, has been with CMS since 2021. Marvin previously worked for a quality improvement organization in WV that focused on population health management and the efficient use of health information technology to support patient-centered care.
This is In Person Session
A critical part of advancing reform and addressing provider burden in the health care system is creating meaningful alignment among payers. Over the last year, both Center for Medicare and Medicaid Innovation (CMMI) and the Learning and Action Networks (LAN) have announced new models and initiatives meant to generate directional alignment that balances the need for multi-payer alignment goals with payer flexibility. This session describes how these efforts work together to generate this alignment at both the national and local levels.
Emphasizing both collaborative and individual efforts, CMMI and the LAN will highlight key initiatives and milestones generating meaningful multi-payer alignment across the healthcare market. In both instances, these efforts adopt the principles of directional alignment, where alignment does not require identical arrangements or programs, but looks to create collaboration and alignment around core areas, such as quality measurement, and create closer alignment over time.
Participants will learn how CMMI and the LAN are working together and with a wide range of partners to advance alignment in key areas of delivery system reform.
Sonya Streeter, MPP, MPH
Associate Vice President, Westat
Sonya Streeter has 20 years of experience in health services research, focusing on value-based payment, accountable care, coordinated care for older adults, and health equity. She has held leadership roles in technical assistance, collaborative learning, evaluation, and monitoring projects. Ms. Streeter is currently project director for the CMS End-Stage Renal Disease Quality Incentive Program (ESRD QIP) Monitoring and Evaluation contract. Previously, she worked on multiple Center for Medicare and Medicaid Innovation (CMMI) kidney care initiatives, including serving as senior advisor for the learning system for the Kidney Care Choices Model and project director for the learning system for the Comprehensive ESRD Care Model. Ms. Streeter has a master's degree in public policy and master’s degree in Public Health from the University of California, Berkeley. Chiao Wen Lan is a Social Scientist for the End-Stage Renal Disease National Coordinating Center (ESRD NCC). She conducts research and supports clinical, technical, and analytic efforts focused on advancing health equity. She supports CMS in identifying unmet health-related social needs affecting the kidney care community, developing strategic approaches for the use and analysis of healthcare data, and targeting interventions and innovative solutions to advance kidney care nationwide. Previously, she served as the co-investigator for a National Institute of Health (NIH) grant and led the epidemiological assessment to examine the impacts of neonatal opioid withdrawal syndrome in tribal communities. She also evaluated COVID-19 impacts and supported a Centers for Disease Control and Prevention project to prevent suicide, intimate partner violence, and adverse childhood effects. She has been involved in multiple NIH-funded randomized controlled intervention trials aimed at ameliorating the impacts of substance misuse and HIV/AIDS on patients and families around the world, especially in resource-limited settings. A certified public health professional, she holds a doctorate in Community Health Sciences from the UCLA Fielding School of Public Health and a Master of Public Health from Brown University.
Chiao Wen Lan, PhD, MPH, CPH
Social Scientist, End Stage Renal Disease National Coordinating Center (ESRD NCC)
Chiao Wen Lan has conducted research globally, including a National Institute of Health grant, to support clinical and analytic efforts to advance health equity. As the ESRD National Coordinating Center’s Social Scientist, she analyzes ESRD trends, identifies opportunities to address inequities, and drives change in the ESRD community.
In the aftermath of the COVID-19 pandemic, hospitals struggled with low performance in healthcare-associated infections (HAIs). Hospitals were overwhelmed and frustrated with their performance as a result of competing priorities due to COVID-19 and resultant staff turnover. Health care professionals, specifically infection preventionists (IPs) struggled during and after the pandemic.
In 2023, TMF launched a series of topic-specific affinity discussion groups to address lagging performance by its supported hospitals on specific patient safety measures. Each affinity group met monthly for three months and focused on one specific topic. We started with topics that hospitals struggled to improve, such as sepsis and pressure injuries. We provided short on-demand videos, tools and resources, and access to a subject matter expert for each group. The theme of Cultivate Your Patient Safety Environment was used across all affinity group topics.
The Alliant Hospital Quality Improvement Contractor (HQIC) applied a peer-to-peer strategy through hospital networking and one-on-one customized calls to reduce HAIs as well as improve reporting of National Healthcare Safety Network (NHSN) data. As a result of a networking call, one hospital was able to learn from a high performing hospital to significantly decrease pressure injuries. An Infection Preventionist and subject matter expert worked one-on-one with hospitals that had newly hired IPs or staff new to the role. Together, they identified gaps and implemented interventions that led to change and improvement in HAIs. Coaching packages which included best-practice interventions and links to relevant resources and professional websites were shared with hospitals. The data were monitored over time until target goals were achieved.
Donna Cohen, BSN, RN, CCM
Director Quality Programs,Alliant Health Solutions
Donna Cohen serves as Director Quality Programs at Alliant Health Solutions. Her career began more than 3 decades ago and consists of experience in a variety of clinical settings. She is a Registered Nurse and a Certified Case Manager. She has experience in inpatient hospital settings, physician practice management and Managed Care. Before joining Alliant, she was a Practice Director with a large physician practice group and with the implementation of EPIC, led the clinical informatics team. She currently leads the hospital quality improvement team and serves as a subject matter expert for the QIO work in Chronic Disease Management.
Rose Langdon, BSN, MBA, CPHQ, FNAHQ
Lead Educator, TMF Health Quality Institute
Rose Langdon, RN, BSN, MBA, CPHQ, FNAHQ, is a healthcare quality improvement consultant with TMF Health Quality Institute. She is an instructor for the Texas Rural Hospital Quality Improvement Training Program, which prepares participants for certification as Certified Professionals in Healthcare Quality (CPHQ). Ms. Langdon also supports the Hospital Quality Improvement Contractor initiative where she provides technical assistance to small, rural and critical access hospitals, and hospitals serving vulnerable and underserved populations, across six states and three U.S. territories.
While with TMF, Ms. Langdon has also served as the national curriculum lead for the Comprehensive Primary Care initiative, and the training and education lead for the Quality Payment Program-Small, Underserved and Rural Support contract.
Ms. Langdon is a registered nurse with over 30 years of experience in health care, and she has achieved a Six Sigma Lean Black Belt in Healthcare. Her work has been published in the Journal of Continuing Education in the Health Professions. Ms. Langdon has served as director-at-large on the National Association of Healthcare Quality board of directors and has served on multiple task teams with this organization. She has also served on the board of the Michigan Association for Healthcare Quality.
Karen Holtz, MS, MT(ASCP), CPHQ
HQIC Education Lead, Alliant Health Solutions
As the Alliant HQIC Education Lead, Karen works closely with partners, subject matter experts, and hospitals to develop content for Learning and Action Network (LAN) educational events, patient-safety coaching packages, and the monthly HQIC newsletter.
In addition, Karen is responsible for writing success stories that are shared in blogs and newsletters. Karen earned a Master of Science degree in Healthcare Management from the University of Pittsburgh and a Bachelor of Science degree in Medical Technology from Slippery Rock University of Pennsylvania. She is a Certified Professional in Healthcare Quality (CPHQ) and a member of the North Carolina Association of Healthcare Quality.
Ann Werner, MSW, CPHQ
Director,TMF Health Quality Institute
Ann Werner, MSW, CPHQ, is a director with TMF Health Quality Institute. She leads the Hospital Quality Improvement Contractor initiative. Under this contract with the Centers for Medicare & Medicaid Services, TMF’s healthcare quality improvement consultants provide technical assistance to small, rural and critical access hospitals, and hospitals serving vulnerable and underserved populations, across six states and three U.S. territories. Ms. Werner also leads the Texas Rural Hospital Quality Improvement Training Program project team. This program prepares participants for certification as Certified Professionals in Healthcare Quality as they work on quality improvement projects within their organization. Ms. Werner holds a master’s degree in social work from the University of Houston. She has worked in leadership positions in the areas of quality improvement and patient experience for over 25 years in a variety of health care settings.
This is In Person Session
Hospital Quality Improvement Contractor (HQIC) use a variety of data sources to inform their ability to provide customized technical assistance. As early adopters and promoters of the Centers for Disease Control and Prevention (CDC) Hospital Sepsis Program Core Elements, Health Quality Innovators (HQI) leveraged this framework to identify hospital program needs and designed a flexible core of technical assistance to meet hospitals at various levels of sepsis program implementation. Health Quality Innovators (HQI) analyzed the NHSN 2022 Patient Safety Component—Annual Hospital Survey, specifically responses under the Sepsis Management and Practices section. Questions in the annual survey are closely tied to the CDC’s Hospital Sepsis Program Core Elements, however, Health Quality Innovators (HQI) was already using this framework with HQIC hospitals prior to the official launch of the program in August 2023. Health Quality Innovators (HQI) used the survey results to inform technical assistance planning and one-on-one coaching. IPRO also created a sepsis gap assessment to obtain an in-depth understanding of the hospitals’ needs. This gap assessment was then used to inform education needs and content for inclusion in a sepsis affinity group. In addition, IHC created and utilized low performer reports to identify the hospitals and specific components in the greatest need for technical assistance and sepsis education. All three Hospital Quality Improvement Contractors (HQICs) use Medicare FFS Administrative Claims data and site visits to measure improvement in sepsis mortality. Approximately 669 hospitals enrolled in either the Health Quality Innovators (HQI), IPRO or IHC, Hospital Quality Improvement Contractor provider engaged in a variety of interventions to reduce sepsis mortality over three years of the Hospital Quality Improvement Contractor project. These interventions included change pathways, affinity groups, action plans, office hours, educational events, podcasts, site visits and survivor stories. Several initiatives were expanded to include collaboration with additional Hospital Quality Improvement Contractors. During this session, we will highlight both Hospital Quality Improvement Contractor wide interventions as well as specific case studies describing specific systems, processes, and strategies that attributed to improvements in sepsis care and reduced mortality.
Virginia Brooks (Moderator) MHA, CPHQ, FACHE
Vice President, Health Quality Innovators
Virginia Brooks, Vice President, leads Health Quality Innovators’ (HQI) work with hospitals as a CMS-funded Health Quality Improvement Contractor (HQIC). She directs HQI’s Maryland Perinatal Neonatal Quality Collaborative that engages Maryland’s hospitals to improve health outcomes for women and newborns. She headed HQI’s Practice Transformation Network (PTN), which supported more than 1,400 primary care practitioners as they transformed clinical and business processes to achieve improved care and reduced cost. Virginia holds a Master’s in Health Administration from Virginia Commonwealth University. She is a Certified Professional in Healthcare Quality (CPHQ) and a Fellow in the American College of Healthcare Executives.
Rebecca Boll, MSPH, CPHQ
Senior Director, IPRO
Rebecca Boll is a health services director with over 25 years of experience. Ms. Boll has led multi-site projects in hospital quality improvement, primary care, end-of-life care, value-based purchasing, and infant development. Currently, as a Senior Director in IPRO’s Healthcare Quality Improvement Department, Ms. Boll oversees the CMS Hospital Quality Improvement Contractor (HQIC) program providing focused technical support to participating rural, critical access, and acute care hospitals serving vulnerable populations across a 12-state region. Ms. Boll holds a Master of Science in Public Health from the University of Colorado Health Sciences Center and is a Certified Professional in Healthcare Quality.
Charisse Coulombe, MS, MBA, CPHQ, CPPS
Director, Hospital Quality Initiatives, Iowa Healthcare Collaborative (IHC)
Charisse Coulombe is a Director for the Hospital Quality Initiatives Department at Iowa Healthcare Collaborative (IHC). Coulombe provides oversight of the IHC hospital focused federal and state projects, leads the delivery of programs and activities as well as engages states and hospitals for sustainable healthcare transformation. Coulombe holds over twenty years of experience in healthcare and has accomplished the successful completion of state and federal programs including having led one of the Centers for Medicare and Medicaid Services Hospital Engagement Networks and one of the CMS Hospital Improvement Innovation Networks. Coulombe holds a Master in Business Administration from the University of Phoenix, Master of Science in Biology from Western Illinois University and is a Certified Professional in Healthcare Quality/CPHQ and Certified Professional in Patient Safety/CPPS.
Kendra Cooper, MSN-HCQ, RN, CPHQ
Consulting Manager,Health Quality Innovators
Kendra Cooper serves as a Consulting Manger with Health Quality Innovators where she serves as a content expert in quality improvement, clinical outcomes measurement, regulatory quality reporting, and project management. Previously, she served as the Director of Clinical Engagement at PeraHealth, Inc. in Charlotte, NC and as System Director of Quality Outcomes at Riverside Health System, in Newport News, Virginia. Kendra received her Bachelor of Science in Nursing from Ohio State University and her Master of Science in Nursing from George Washington University. She is a Certified Professional for Healthcare Quality (CPHQ) and Six Sigma Green Belt.
CarlaLisa Rovere-Kistner LCSW, CPHQ, CCM
Quality Improvement Specialist, IPRO
On October 4, 2024, I will celebrate my 50th anniversary in the field of healthcare. While the majority of that career has leading in Social Work and Case Management, I have worked across the continuum. The last decade has been spent sifting from the bedside to quality, patient safety and patient experience. From supporting patients and families in life changing moments to mentoring cultures and their leaders in transformation, it has been an exhilarating and humbling privilege.
In May 2023, the Independent Evaluation Contractor (IEC) hosted a roundtable discussion with representatives from all 12 Quality Innovation Network – Quality Improvement Organizations (QIN-QIO) contractors; the discussion aimed to understand how contractors define, measure, and report attributable impact within individual healthcare environments. Findings from the 2023 closed-door session and subsequent follow-up data were analyzed. Insights pertaining to alignment of success definitions informed the development of CMS resources to support contractors’ use of success stories to support assessment of attributable impact.
The goal of this IEC presentation is to share progress toward adequately identifying and reporting success stories in quality improvement that suggest that provider impacts may be attributable to the contractors’ support.. The IEC will present analyses from QIN-QIO-furnished qualitative data related to identified cases of observed healthcare improvement collected during the NQIIC 12th SOW, November 2019 through November 2023. Findings include QIN-QIO feedback on challenges in capturing their own success and opportunities for improving the definition of success. The IEC will discuss lessons learned and next steps to help QIN-QIOs improve the process of identifying and communicating evidence of attributable impact.
McCall Glover, MPH
Data Scientist, Booz Allen Hamilton
McCall Glover is a Behavioral Scientist with specialized skills in evaluation and data analytics. She works with Booz Allen Hamilton as a qualitative researcher and evaluator for the IEC. She earned an MPH from the Rollins School of Public Health at Emory University, and previously completed the CDC Evaluation Fellowship at CDC's Division of Violence Prevention. McCall is a champion of mixed methods approaches, and she primarily focuses on qualitative data collection and analysis.
This is In Person Session
More than one fifth of American adults live with chronic pain, with about seven percent experiencing “high impact” pain. In US military veterans, chronic pain is even more common, with nine percent suffering from severe pain. Pain is a debilitating condition that negatively affects quality of life and work and is closely associated with depression, dementia, suicidality, and substance use. Pain also disproportionally impacts people who are racial and ethnic minorities, bisexual, divorced/separated, living with a disability, and have chronic conditions like arthritis and kidney disease. Nearly 80 percent of people with Medicare report chronic pain that interferes with function. Pain causes disability and social isolation, and is an ongoing burden for individuals, families, friends, caregivers, and health systems. Advancing pain care across all groups, ages, and settings is a public health imperative. Addressing pain effectively is one of the four goals of CMS’s Behavioral Health Strategy, prompting new monthly payment codes to help people with Medicare more easily access holistic care in an ongoing clinical relationship. The Department of Veterans Affairs (VA) has a long history of developing successful solutions for pain management. Its Stepped Care Model of Pain Management is one example and there is new work in pain measurement that offers potential to better tailor care. The person-centered and team-based approaches employed by the VA can serve as a model for other health systems seeking feasible, effective pain care that improves lives.
Paige Mathew, PharmD, BCPS, BCGP
Pain Management and Opioid Stewardship Clinical Pharmacy br/>Program Manager, Department of Veterans Affairs
Dr. Paige Mathew, PharmD, BCPS, BCGP oversees pain management and opioid safety programs for Veterans across Washington DC, Maryland, and West Virginia in her role as Pain Management, Opioid Safety, and PDMP (PMOP) Program Manager in the Veterans Affairs Healthcare System. She completed her Doctor of Pharmacy degree from the University of Washington in Seattle, and her pharmacy postgraduate residency at the Carl T Hayden Veterans’ Administration Medical Center in Phoenix. She is dual Board-Certified in both Pharmacotherapy and Geriatric Pharmacy. Her areas of interest include expanding access for substance use disorder treatment, decreasing disparities in access to care for people living in rural areas, and raising awareness on safe prescribing and risk mitigation.
Scott Lawrence, DC, CHCQM, FABQAURP
Senior Advisor, CMS Quality Improvement and Innovation Group
Scott Lawrence, in his long career at CMS, has been integral to annual development of the CMS Medicare Physician Fee Schedule. He helped finalize new chronic pain management and treatment codes into the 2023 Physician Fee Schedule. In addition to his extensive policy experience, Dr. Lawrence is a practicing chiropractor
Tara McMullen, PhD, MPH
Associate Director Opioid Safety, Veterans Health Administration
Tara McMullen is a gerontologist with specialized experience across the field of aging. Her interests focus on quality in post-acute and community settings, policy and aging issues, and the long-term services and supports workforce. Previous to her service at the VA, she worked at CMS as a technical advisor in quality measurement and was a Presidential Management Fellow at the VA for its National Opioid Initiative. Tara has published many peer-reviewed papers and book chapters on older adult policy and quality issues.
This is In Person Session
The road to becoming a High Reliability Organization (HRO) can be long and complex. The Minnesota Hospital Association (MHA) saw the desire from Minnesota hospitals and health systems to begin their HRO journeys and, using their unique process to tackle quality improvement, developed a strategic process for implementing and rolling out an HRO program. MHA created a road map for their members to use to successfully implement their own HRO program from getting started, all the way through advanced HRO implementation. MHA’s Director of Quality and Safety, John Sellner, PharmD, RPh, will present on MHA’s strategic process to tackling quality and the implementation and rollout of the High Reliability Road Map. Roderick Baker, Winona Health Minnesota will review Winona Health’s utilization of the Road Map in their HRO journey and provide recommendations to participants on how to utilize HRO resources to inform learnings and make improvements along the way.
John Sellner, PharmD
Association Director of Quality and Safety, Minnesota Hospital
John Sellner has been a vital clinical leader to MHA with an extensive background in healthcare operations and continuous quality improvement. John earned his doctorate in pharmacy from the University of Minnesota and has practiced as a pharmacist over the last 10 years. During this time, John has developed skills in interdisciplinary collaboration, team development, data/analytics, and program management. John leads a team of quality and safety specialists at the Minnesota Hospital Association where in partnership with hospitals and health systems, they collaborate and facilitate quality and safety committees, care delivery initiatives, and manage adverse health events across the state.
Roderick Baker
Associate Vice President of Development, Winona Health
Roderick Baker is Winona Health’s Associate Vice President of Development. Rod began his journey with Winona Health in 2016 and values developing people throughout the organization. His responsibilities include the Winona Health Foundation, human resources, learning and development, and switchboard. Rod’s career has spanned electronics manufacturing, higher education, government and consulting. Rod graduated from Purdue University with a BS in Electrical Engineering and a BA in Political Science and completed his MA in International Relations from Johns Hopkins University. He served as a Peace Corps Volunteer for two years in Bolivia and has self-published a career guidebook for young adults. He values community service and has served as a board member for local non-profits.
This is In Person Session
This session will provide an overview of the CMS Framework for Advancing Health Care in Rural, Tribal, and Geographically Isolated Communities and how it supports CMS’s overall efforts to advance health equity, expand access to quality, affordable health coverage, and improve health outcomes for all Americans. The Framework’s six priorities were identified through lessons learned and feedback from those living and working in rural, Tribal, and geographically isolated communities. CMS’s approach to operationalizing this Framework over the next five years will be informed by ongoing public engagement, as appropriate, and CMS will continue to monitor trends in health and health care that uniquely impact rural, tribal, and geographically isolated areas.
Kitichia Weeks, MA
Health Insurance Specialist/Account Manager, Division of Health Plans Operations, Centers for Medicare & Medicaid Services
Kitichia Weekes is a native of the US Virgin Islands.She began her CMS career approximately 16 years ago in the New York Regional Office’s Division of Medicare Health Plan Operations (now the Div. of Health Plan Operations) as a Special Assistant to the Associate Regional Administrator at the time and a Medicare Advantage Drug Plan (MAPD) Account Manager. She later transferred to the Atlanta Regional Office where she served in the capacity of an MAPD Caseworker and Account Manager and subsequently in her current role as a Health Insurance Marketplace Account Manager. Before working with CMS, she served as the US Virgin Islands’ State Health Insurance Assistance Program (SHIP) Director for approximately four years. She is very passionate about helping and advocating for others, especially underserved populations.
Thomas Bane, PhD, LMSW
Special Assistant to the Regional Administrator, OPOLE, Centers for Medicare & Medicaid Services
Thomas Bane, PhD, LMSW is trained as a social worker and qualitative researcher. He began his federal career with the Centers for Medicare & Medicaid Services (CMS) as a Presidential Management Fellow, and he currently is the Special Assistant to the Regional Administrator in New York. He currently serves as the co-chair of the Pacific and Caribbean Territories Subcommittee of the CMS Rural Health Council. Dr. Bane was the health sector chief for recovery efforts in the USVI after Hurricanes Irma and Maria, and he remains the HHS liaison to FEMA for long-term recovery efforts in the territory. In addition to his hurricane response deployment with the Administration for Strategic Preparedness and Response, Dr. Bane has completed detail assignments with the Pacific Island Health Offices Association in Guam and the CMS Office of Minority Health.
Ashby Wolfe, MD, MPP, MPH
Regional Chief Medical Officer, Center for Clinical Standards and Quality, Centers for Medicare & Medicaid Services
Dr. Ashby Wolfe is a board-certified family physician and serves as Regional Chief Medical Officer for the Centers for Medicare & Medicaid Services (CMS) offices in Seattle and San Francisco. Dr. Wolfe has served as a CMS Regional Chief Medical Officer since 2015, focusing on the implementation of Medicare and Medicaid policy across the Western United States. She also continues to support the implementation of multiple CMS quality reporting programs including the Quality Payment Program, as co-lead of the QPP Clinician Champions project.
Susan Karol, MD
Chief Medical Officer, Division of Tribal Affairs, Centers for Medicare & Medicaid Services
Dr. Karol is the Chief Medical Officer for the Division of Tribal Affairs (DTA) in the Center of Medicaid and the Children’s Health Insurance Program (CMCS) at the Centers for Medicare and Medicaid Services (CMS). DTA serves as the point of contact on American Indian and Alaska Native (AI/AN) health policy and serves the CMS Tribal Technical Advisory Group (TTAG) regarding AI/AN issues for the agency. She is an enrolled member of the Tuscarora Indian Nation, the first American Indian woman General Surgeon and former National Chief Medical Officer for the Indian Health Service (2008-2017). Dr. Karol is a Captain in the United States Public Health Service deploying throughout the country to meet national healthcare needs such as hurricane recovery, border patrol health needs, migrant care, and COVID-19 missions. She graduated from Dartmouth College and the Medical College of Wisconsin prior to her general surgical training at the University of Massachusetts. She is a Diplomat of the American Board of Surgery (DABS), Fellow of the American College of Surgeons (FACS) and a member of the Association of American Indian Physicians. Dr. Karol is the Chairperson of the CMS American Indian and Alaska Native Employee Resource Group and is a member of the CMS Diversity, Inclusion and Equality Council. She is the Federal Co-Chairperson for the CMS Tribal Technical Advisory Group (TTAG) Health Equity, Data and Behavioral Health Subcommittees.
Over the past two years, CMS has made significant strides in advancing oral health across all our programs. From 2020-2023, a CMS learning collaborative focused on advancing oral health prevention in primary care. Topically applied fluoride varnish effectively prevents dental caries in children and adolescents. Because young children under 5 are more likely to see a primary care provider (PCP) than a dental provider, PCPs are uniquely positioned to support oral health prevention by offering fluoride varnish as part of primary care visits and connecting beneficiaries to dental care. The session will open with an overview of the technical assistance CMS provides state Medicaid and CHIP agencies and their quality Improvement (QI) partners to advance oral health prevention in primary care for Medicaid and CHIP beneficiaries, featuring several state QI projects from the affinity group, highlighting their strategies, partnerships, and lessons learned.
In 2022, CMS conducted its first-ever oral-focused human-centered design research in four states, interviewing nearly 100 people (i.e., beneficiaries, providers, advocates, state administrators, etc.) to understand barriers to oral health care access for the Medicaid and dually eligible population to inform policy change. In this session, The CMS Chief Dental Officer, Dr. Chalmers, will present the findings from that engagement.
CMS also convened a Workgroup to gather stakeholder feedback from experts in the field to plan strategic priorities for the next phase of our Medicaid and CHIP Oral Health Initiative. The focus is to assess gaps related to oral health and access to care for Medicaid and CHIP beneficiaries and recommend strategic priorities for the next five years. The session will conclude the workgroup process and overview of the final report and recommendations.
Margo Rosenbach, PhD
Vice President and Director of Health Program Improvement, Mathematica
Margo Rosenbach is a vice president and director of health program improvement at Mathematica. She is an expert in analyzing program performance and outcomes related to access, utilization, quality, costs, and experience of care, with an emphasis on Medicaid and CHIP. She directs a contract for the Center for Medicaid and CHIP Services to provide technical assistance and analytic support to states on collecting, reporting, and using the Core Sets of health care quality measures to improve care and advance equity in Medicaid and CHIP. She has a Ph.D. in health policy from Brandeis University, Heller School for Social Policy and Management.
Andrew Snyder, MPA, (Moderator)
Senior Policy Advisor, Center for Medicaid and CHIP Services, Centers for Medicare & Medicaid Services
Andrew (Andy) Snyder is a senior policy advisor with the Center for Medicaid and CHIP Services, Division of Quality and Health Outcomes. He is the policy lead for the CMS Oral Health Initiative, which seeks to improve access to dental care for Medicaid beneficiaries. Before joining CMS in 2016, he worked on issues relating to the intersection of oral health and public programs in positions at the National Academy for State Health Policy, the Pew Children’s Dental Campaign, and the Wisconsin Medicaid program. He holds a master’s degree in public affairs from the University of Wisconsin-Madison.
During this patient-centered roundtable session, attendees will learn from kidney dialysis/transplant patients, the NKF, ESRD Networks, QIN-QIOs, TAQIL, and experts as they explore the complete kidney transplant journey.
From the five CKD stages to dialysis treatment options, and the transplant process, the expert panel will highlight gaps throughout the transplant care continuum and identify potential solutions, including strategies to reduce inequities experienced by underserved communities.
To address these identified gaps, speakers will review available partnership opportunities, new programs being tested in select communities, critical resources accessible to healthcare professionals, as well as the vital need to improve patient education that is culturally and linguistically appropriate throughout the kidney care system.
Victoria Cash MBA, BSN, RN, CPHQ
Executive Director,IPRO ESRD Network of the Ohio River Valley
Victoria Cash is the Executive Director for IPRO ESRD Network 9 and the Quality Improvement lead for the 13 states that are part of the IPRO ESRD Network program. She began her career as a nephrology nurse advancing to ESRD leadership positions in both the inpatient and outpatient settings, supporting ESRD programs for all modalities across state and national boundaries.
Ivory Harding, MS
Director, Quality and Regulatory Affairs, National Kidney Foundation
Ivory Harding has deep experience in healthcare quality measure and research development, currently serving as the Director of Quality and Regulatory Affairs at the National Kidney Foundation (NKF). Her focus is to drive strategies in the evolution of NKF’s healthcare quality agenda, including measure development and maintenance.
Matthew Cooper MD
Chief of Transplantation, Director of the Solid Organ Transplant Line and Professor of Surgery at the Medical College of Wisconsin, Medical College of Wisconsin
Matthew Cooper, MD is recognized as a national clinical leader for transplantation through his many roles. These include Past President of UNOS and the Organ Procurement Transplant Network, Board of Directors for the National Kidney Foundation, and Chair of the American Transplant Congress. Dr. Cooper is currently Mark B. Adams Chair in Transplant Surgery Chief at Froedtert Memorial Lutheran Hospital.
Sherri Morgan-Johnson RN, BSN, MHSA, FAC-COR III
Nurse Consultant, Centers for Medicare & Medicaid Services
Sherri Morgan-Johnson is a Nurse Consultant with CCSQ, IQIIG, DKH at CMS. She is the COR for the TAQIL contract and serves as CCSQ DEI Ambassador and trainer to spread the CMS DEI Strategy. As a PO, COR, and member of the Transforming Clinical Practice team, she provides expert guidance in QI.
Sumeska Thavarajah, MD
Medical Director, Fresenius Kidney Care
Sumeska Thavarajah, MD, is a medical director at Fresenius and an Assistant Professor of Medicine at the Johns Hopkins University School of Medicine. She serves as Chair of the National Kidney Foundation of Maryland’s Medical Advisory Board and received the Linda Cameron Award for Patient Services in 2015.
Charles Rice, CPhT, MTM, BBM
ETCLC National Faculty, Patient and Family Representative
Charles stays active in the kidney community, lending his experience to several organizations, including Minnesota Kidney Specialist, Midwest Kidney Network, the ESRD National Coordinating Center, the National Kidney Foundation, the American Kidney Fund, and the American Association of Kidney Patients. With a background in Pharmacy and Business Management, Charles has a particular focus on transplant medications and is involved with UNOS and Pharma-Innovate4Outcomes
This is In Person Session
Drug overdose deaths in the United States, driven by illicit fentanyl and other opioids, remain at historically high levels – with more than 107,000 lives lost in the past year, and millions more struggle with opioid and other substance use disorders. The opioid crisis reaches every corner of our country, from alleyways to nursing homes, and requires an immediate call to action. Federal partners, local governments, healthcare institutions, and communities are working together to provide viable solutions to combating the opioid crisis.
There is a nationwide need for education on medications for opioid use disorder (MOUD) to increase the number of practitioners eligible to manage and/or prescribe appropriate medications. Medicare providers are uniquely positioned to create the gold standard of opioid use disorder treatment by screening, diagnosing, and treating Medicare patients for opioid use disorder as routine healthcare. They can also exhibit positive attitudes to reduce stigmas associated with opioid use disorder.
This session will consist of a panel discussion where, IPRO, the Quality Innovation Network-Quality Improvement Organization (QIN-QIO) will describe the state of the opioid crisis from a nursing home perspective and discuss how to improve patient safety in vulnerable populations. The Substance Abuse and Mental Health Services Administration (SAMHSA) will provide regulatory updates on opioid prescribing, the stigma of opioid addiction, and discuss key elements of Opioid Treatment Programs (OTPs). Finally, the Health Resources and Services Administration (HRSA), Federal Office of Rural Health Policy (FORHP), will share opioid-related resources and funding opportunities to engage partners in rural communities.
This session will take a closer look at what the current state of clinical quality is in the US and the opportunities for AI to improve it, if implemented responsibly and effectively. CHAI is a community of health systems, public and private organizations, and expert practitioners of AI and data science, who have come together to harmonize standards and reporting for health AI and educate end-users on how to evaluate these technologies before adoption.
Brian Anderson, MD
CEO Coalition for Health AI, Inc.
Dr. Brian Anderson is the Chief Executive Officer of the Coalition for Health AI (CHAI), a non-profit coalition he co-founded in 2021. CHAI is focused on developing a set of consensus-driven guidelines and best practices for Responsible AI in Health, as well as supporting the ability to independently test and validate AI for safety and effectiveness. Prior to leading CHAI, Dr. Anderson was the Chief Digital Health Physician at MITRE, where he led research and development efforts across major strategic initiatives in digital health alongside industry partners and the U. S. Government. He was responsible for leading much of MITRE’s work during the COVID-19 pandemic, working closely with the White House COVID Task Force, as well as Operation Warp Speed. He also led MITRE’s largest R&D effort in Oncology, focusing on the initial development of mCODE and the use of AI in more efficient and inclusive clinical trial design. Dr. Anderson is an internationally recognized author and expert in digital health, and is regularly engaged as a speaker on digital health innovation, health standards development, clinical decision support systems, and interoperability. Prior to MITRE, Anderson led the Informatics and Network Medicine Division at athenahealth. He has also served on several national, and international, health information technology committees in partnership with the Office of the National Coordinator (ONC), the National Institutes of Health (NIH) and the Organization for Economic Cooperation and Development (OECD).
Jean Moody-Williams, RN, MPP
Deputy Director, Center for Clinical Standards and Quality, Centers for Medicare & Medicaid Services
Jean D. Moody-Williams, RN, MPP, is the current Deputy Center Director for the Center for Clinical Standards and Quality (CCSQ) at the Centers for Medicare & Medicaid Services (CMS). She has served since 2008 under multiple administrations in the Senior Executive Service (SES) Corp. She currently is a part of a leadership team responsible for one of CMS’ Centers that has nearly 800 employees and a $3 billion annual budget. She is responsible for leading quality improvement, value based purchasing, and delivery system reform. She provides oversight to multiple kidney health activities including regulations for organ procurement and transplantation programs and learning networks, development of conditions of participation for dialysis facilities and healthcare systems, oversight of ESRD Networks for quality improvement and the ESRD Quality Incentive Program. She works to ensure better healthcare, healthier populations and smarter spending of healthcare dollars for more than 90 million Americans.
The Gallery Walk will showcase Poster presentations. This engaging event provides attendees with the opportunity to explore a diverse array of poster presentations, each highlighting innovative research, best practices, and case studies in the field of quality management. Attendees will have the chance to interact with poster presenters, fostering meaningful discussions, networking, and knowledge exchange.
In 2022, the Centers for Medicare & Medicaid Services (CMS) launched the CMS National Quality Strategy (NQS), a plan aimed at improving the quality and safety of health care for everyone, with a special focus on those from underserved and under-resourced communities. The CMS NQS builds on CMS’ efforts to improve health care quality for individuals across their lifespan and continuum of care by using all the Agency’s levers, including value-based payment programs and models; health and safety standards (including conditions for coverage and conditions of participation); survey and certification programs; quality measurement and public reporting; and quality improvement technical assistance. Join us to learn more about the recent publication, Quality in Motion: Acting on the CMS National Quality Strategy, and current CMS actions and accomplishments regarding equity and engagement, outcomes and alignment, safety and resiliency, and interoperability and scientific advancement.
Michelle Schreiber, MD
Deputy Director, Quality & Value, Centers for Medicare & Medicaid Services
Dr. Schreiber is currently the Deputy Director of the Center for Clinical Standards and Quality at CMS, and the Director of the Quality Measurement and Value-Based Incentives Group. Dr. Schreiber is a general internal medicine physician with over 25 years of health care experience. Prior to coming to CMS she was the Senior Vice President and Chief Quality Officer of Henry Ford Health System (HFHS) in Detroit, Michigan. Earlier roles at HFHS included the Division Head of General Internal Medicine, and the SVP of Clinical Transformation and IT Integration, where she was the clinical lead of the systemwide Epic implementation. The Epic implementation and use earned HFHS a Davies Award in 2018. She has also held senior leadership roles at the Detroit Medical Center, where she was the Chief Quality Officer, and with Trinity Health System where she was the national system Chief Medical Officer, and acting interim Chief Medical Information Officer.
While at CMS Dr. Schreiber has led many quality initiatives, including MIPS transformation to value pathways, the modernization of the Hospital Stars program, as well as advancing digital quality measurement systems. She is on the boards of ACCME (continuing medical education), Leapfrog, and a member of HITACH (the national health information advisory committee) among others. Prior to joining CMS she also participated in numerous state and national quality committees including the Board of Directors for the Michigan Hospital Association Keystone Center and the Patient Safety Organization, the Board of Directors of MPRO (Michigan Peer Review Organization – the Michigan QIO), the National Quality Forum Patient Safety Metrics Committee, and the National Quality Partners.
Susannah Bernheim, MD, MHS
Chief Quality Officer & Acting Chief Medical Officer, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services
Susannah Bernheim, MD, MHS, is Chief Quality Officer/Acting Chief Medical Officer for the CMS Innovation Center. She was previously an Associate Professor at Yale University School of Medicine and Senior Director of Quality Measurement at the Yale-New Haven Hospital Centers for Outcomes Research and Evaluation (CORE). She completed her undergraduate degrees at Yale University and her medical degree at the University of California, San Francisco (UCSF). Dr. Bernheim was a fellow in the Robert Wood Johnson Clinical Scholars program at Yale University, earning a Master’s degree in Health Sciences Research.
Martin Hatlie, JD
Founding Member, Patients for Patient Safety US
Marty Hatlie is a patient safety advocate with a strong interest in the roles patients and family members play as co-creators of patient safety and health equity solutions. He currently serves as President & CEO for Project Patient Care, a Chicago-based nonprofit dedicated to using the voice of the patient to improve patient safety and outcomes disparities. In 2021 he co-founded Patients for Patient Safety US, the US branch of the World Health Organization’s (WHO) Patients for Patient Safety network. He also is a principal of the Healthcare Patient Partnership Institute, which work with hospitals and health systems to engage patients as advisors in improvement work.
Early in his career Hatlie was a litigator focused on civil rights, medical liability defense and alternative dispute resolution. In the 1980s/90s he was a lobbyist for the American Medical Association and lead strategist for its tort reform campaigns. He coordinated the AMA’s launch of the National Patient Safety Foundation in 1997 and served as its founding Executive Director from 1997—99. He has since been active in U. S. federal health system transformation work as a consultant on multiple research and demonstration projects funded by the Centers for Medicare and Medicaid Services, the Agency for Healthcare Research and Quality, and the Patient Centered Outcomes Research Institute. He currently serves on the CMS-supported Pre-Rulemaking Measure Review Hospital Committee, the National Steering Committee overseeing implementation of Safer Together: The National Action Plan to Advance Patient Safety, and WHO’s Patients for Patient Safety Programme Advisory Council.
Jessica Lee, MD, MSHP
Acting Chief Medical Director, Center for Medicaid and CHIP Services, Centers for Medicare & Medicaid Services
Jessica Lee, MD, MSHP is the acting Chief Medical Officer for Center for Medicaid and CHIP Services, where she leads the center’s clinical strategy and portfolio in health-related social needs. Dr. Lee was previously the medical officer in the Division of Quality and Health Outcomes at CMCS, where she led initiatives in quality measures and quality improvement. Dr. Lee has deep expertise in clinical medicine and quality, and a background in health policy at the health system, state, and federal levels, including projects at Denver Health. She has served as a senior health policy analyst at the Government Accountability Office, focusing on payment policy and community benefits provided by nonprofit hospitals. She has conducted grant-funded research focused on the intersection of health care delivery systems and population health. Dr. Lee continues to care for patients as a practicing pulmonologist at the University of Pennsylvania and ICU physician at the Corporal Michael J. Crescenz VA Medical Center in Philadelphia.
This Mini Plenary will highlight expert clinicians’ and system leaders’ approaches to healthcare delivery and quality improvement for many of the most complex patients for whom American systems care – community members with comorbid substance use disorder, mental illness, and chronic pain. Patients with this complex triad often experience unmet healthcare needs and substantially worse health and social outcomes - reflecting not only clinical complexity but also significant challenges in accessing and paying for services, variations in quality of care, and entrenched system failures to address health related social needs. Leaders with deep clinical expertise and experience working in systems to improve care for people with substance use disorders, mental illness, and chronic pain will discuss their methods to tackle challenging clinical and social scenarios, recommending practical resources and that they and their systems use to integrate approaches to quality improvement, care delivery, and social determinants of health. Master Class experts will represent federal (SAMHSA Center for Substance Abuse and Treatment (invited)), clinical academic (the University of Alabama Birmingham and Department of Veterans Affairs (invited)), and state (New York Office of Addiction Services and Supports (invited)) systems, offering diverse vantage points and practical approaches and tools to address the needs of patients with this complex triad of conditions.
Benjamin Springgate, MD, MPH, FACP
Professor of Medicine and Public Health, Louisiana State University Health-New Orleans
Benjamin Springgate MD, MPH is a Professor of Medicine and Health Policy at LSU Health-New Orleans, and a Fellow in CMS’ Center for Clinical Standards and Quality. As LSU Health’s Chief of Community and Population Medicine and Vice-Chair of Medicine, Dr. Springgate has served as Chief Health Officer and senior clinical advisor for state and local agencies, has worked as a health policy fellow in the U.S. Senate, and leads an active clinical, educational, research, and administrative portfolio focused on improving health and quality of care for populations affected by behavioral health conditions, COVID-19, addiction, incarceration, and climate change.
Chinazo Cunningham
Commissioner,New York State Office of Addiction Services and Supports
Dr. Chinazo Cunningham is Commissioner of the New York State Office of Addiction Services and Supports, where she oversees one of the nation’s largest system of substance use and addiction services. She is a physician, trained in internal medicine and addiction medicine, and has spent over 25 years providing care, developing programs, and conducting research with people who use drugs. For decades, she has collaborated with community-based harm reduction organizations and led one of the first programs in the US to integrate addiction treatment into primary care. Her work has focused on improving access to care, utilization of health care services, and health outcomes. Dr. Cunningham has authored over 150 peer-reviewed manuscripts and has been the principal investigator on numerous federally-funded grants. In addition to serving on and chairing several national advisory committees and guideline committees, she has trained hundreds of physicians and has been recognized by local and national awards.
Karran Phillips, MD, MSc
Deputy Director, Center for Substance Abuse Treatment, SAMSHA
Karran Phillips, MD, MSc is the Deputy Director for the Center for Substance Abuse Treatment (CSAT). She comes to CSAT after 15 years at the National Institute on Drug Abuse, National Institutes of Health (NIDA, NIH) where she served as a clinical investigator, Medical Director of the Archway Outpatient Treatment Clinic, and the NIDA Clinical Director. As Clinical Director she coordinated, supported, and supervised the development, implementation and conduct of intramural clinical research activities and provided the infrastructure needed to promote top quality clinical research and to ensure research participant safety and confidentiality. Her clinical research focuses on the use of mobile health technologies to improve access and quality care for individuals with substance use disorder and hepatitis C and HIV. Her current clinical work includes providing low threshold buprenorphine treatment to individuals with SUD from a mobile van outside the Baltimore Mens' Detention Center.
Stefan Kertesz, MD, MSc
Professor, University of Alabama at Birmingham Heersink School of Medicine and the Birmingham Alabama Health Care System Homeless PACT
Stefan G. Kertesz, MD, MSc is a Professor of Medicine at the Heersink School of Medicine of the University of Alabama at Birmingham. He is board-certified in internal medicine and addiction medicine.
Since 1996, Dr. Kertesz has focused his clinical work and research on enhancing health care delivery for populations at high risk of receiving poor care in mainstream health care systems. He began his career as a primary care doctor for homeless individuals at the Boston Health Care for the Homeless program. Dr. Kertesz has led federally-funded health services research since 2002.
At present, he leads the only federally funded study to directly examine suicides that occur after prescription opioids are reduced in chronic pain, a concern highlighted in 2019 by both the Food and Drug Administration and the Centers for Disease Control and Prevention, based in part on research and reporting by Dr. Kertesz. The ongoing research study combines both survivor interviews and record review of suicides that have occurred after prescription opioid reduction, and is accessible at https://go.uab.edu/csi
Dr. Kertesz's writing and commentary have been featured in the New York Times, Washington Post, NPR, Kaiser Health News, STATNews and the New England Journal of Medicine.
Jonathan Blum
Principal Deputy Administrator & Chief Operating Officer, Office of the Administrator, Centers for Medicare & Medicaid Services
Jonathan (Jon) Blum currently serves as the Principal Deputy Administrator and Chief Operating Officer at the Centers for Medicare & Medicaid Services (CMS). In this dual role, Jon oversees CMS’s program policy planning and implementation and day-to-day operations of the entire agency. CMS’s programs provide health coverage to more than 147 million individuals, spending more than $1 trillion in annual benefits with an annual operating budget of more than $6 billion.
This is Jon’s second time serving in a senior leadership position at CMS. He previously served as the Deputy Administrator and Director of the Center of Medicare from 2009 – 2014, leading the agency’s Medicare payment and delivery reform strategies and the policy and program management of the Medicare program.
Jon has more than 25 years of public- and private-sector experience working in health care policy and administration. In addition to his positions at CMS, he has worked as a strategy and management consultant, an Executive Vice President for Medical Affairs at CareFirst BlueCross BlueShield, professional staff at the Senate Finance Committee, and a program analyst at the Office of Budget and Management.
Prior to joining CMS, Jon served on several nonprofit boards with missions to improve access and equity to health care and health coverage, including Mary's Center, a Federally Qualified Health Center; the Primary Care Coalition of Montgomery County; and the Medicare Rights Center.
Jon earned a Master of Public Policy from the Kennedy School of Government at Harvard University and a Bachelor of Arts from the University of Pennsylvania.
Anita Monteiro
Director, iQuality Improvement & Innovation Group Centers for Medicare & Medicaid Services
Anita Monteiro serves as the Director of the Quality Improvement & Innovation Group within the U.S. Centers for Medicare & Medicaid Services. Anita is passionate about and dedicated to her work, leading programs that improve the lives, health outcomes and the experience of care for the people that access healthcare services. The quality improvement work is accomplished by several teams of federal and contract staff across the U.S, as part of national programs that collectively serve as the primary driver for healthcare quality improvement for Medicare in the United States. Anita has previously served in leadership roles in CMS in the areas of Quality Measurement and Enforcement, and as a pediatric and neonatal ICU nurse, manager, and educator in both clinical and academic settings, and in several hospital administration roles in the private sector.
Dora Hughes, MD, MPH
Acting Chief Medical Officer & Acting Director, Center for Clinical Standards and Quality, Centers for Medicare & Medicaid Services
Dora Hughes, M.D., M.P.H., is Chief Medical Officer at the CMS Innovation Center at the Centers for Medicare & Medicaid Services. She leads the Center’s work on health equity, provides clinical input on models, liaises with stakeholder groups, and directs CMMI’s clinician community.
Previously, Dr. Hughes served as an Associate Research Professor of Health Policy & Management at George Washington University, where her work focused on the intersection of clinical and community health, health equity, healthcare quality and workforce. Prior to this role, Dr. Hughes was a Senior Policy Advisor at Sidley Austin, where she advised on regulatory and legislative matters in the life science industry. Additionally, Dr. Hughes served as the Counselor for Science & Public Health at the U.S. Department of Health & Human Services in the Obama Administration, helping to implement the Affordable Care Act and providing guidance to the Public Health Service Act authorized agencies and Food and Drug Administration. Dr. Hughes began her career in health policy as Senior Program Officer at the Commonwealth Fund, and subsequently was Deputy Director for the HELP Committee for the late Senator Edward M. Kennedy and Health Policy Advisor to former Senator Barack Obama. Dr. Hughes received a B.S. from Washington University, M.D. from Vanderbilt and M.P.H. from Harvard. She completed an internal medicine residency at Brigham & Women’s Hospital.
David Wright, MPA
Director, Quality Safety & Oversight Group, Centers for Medicare & Medicaid Services
David Wright serves as the Director of the Quality, Safety & Oversight Group within the U.S. Centers for Medicare & Medicaid Services. He loves his job and the role he plays in quality of care assurance for everyone accessing health care in the United States. This work is accomplished through the Group’s role in issuing policy and compliance guidance to over 8,400 dedicated health and safety surveyors at the State and Federal levels who perform quality of care inspections of more than 400,000 providers that participate in the Medicare or Medicaid programs, or who provide laboratory services under the Clinical Laboratory Improvement Amendments (CLIA). David joined CMS in June 1993 through the Presidential Management Internship program and has been with the Agency for over 30 years, twenty-three of which were in CMS’ Dallas Location.
Tamara Syrek Jensen
Director, Coverage and Analysis Group
Tamara Syrek Jensen has over 25 years of experience at the Centers for Medicare & Medicaid Services (CMS). Currently serving as the Director of the Coverage and Analysis Group (CAG), she oversees a team of experts, ensuring that Medicare beneficiaries have access to technologies that demonstrate improvements in health outcomes. Her responsibilities include formulating and driving policies that guide the Medicare coverage of a range of clinical items and services. Tamara was the 2022 CMS Executive of the Year. Outside the realm of healthcare policy, she enjoys participating in a variety of athletic activities to keep up with her husband, kids, and their family dog.
Karen Tritz
Centers for Medicare & Medicaid Services
Director of the Survey & Operations Group
Karen Tritz is the Director of the Survey & Operations Group, in the Center for Clinical Standards and Quality at CMS. The Survey & Operations Group oversees the health, safety and quality of care provided by over 64,000 organizations including hospitals, dialysis facilities, nursing homes, home health agencies, hospices, ambulatory surgery centers and other settings. She began that position in July 2020. Between 2006 and 2020, Karen held various positions within CMS’ Quality Safety and Oversight Group and has led efforts to develop quality and safety standards for a variety of settings. She has previously worked for the Congressional Research Service providing assistance to Members of Congress and their staff, and the State of Wisconsin, Medicaid program leading healthcare and employment options for individuals with disabilities. She is a native of Wisconsin and completed her undergraduate there and her Masters of Social Work from Washington University in St. Louis, Missouri.
Michelle Schreiber, MD
Deputy Director, Quality & Value, Centers for Medicare & Medicaid Services
Dr. Schreiber is currently the Deputy Director of the Center for Clinical Standards and Quality at CMS, and the Director of the Quality Measurement and Value-Based Incentives Group. Dr. Schreiber is a general internal medicine physician with over 25 years of health care experience. Prior to coming to CMS she was the Senior Vice President and Chief Quality Officer of Henry Ford Health System (HFHS) in Detroit, Michigan. Earlier roles at HFHS included the Division Head of General Internal Medicine, and the SVP of Clinical Transformation and IT Integration, where she was the clinical lead of the systemwide Epic implementation. The Epic implementation and use earned HFHS a Davies Award in 2018. She has also held senior leadership roles at the Detroit Medical Center, where she was the Chief Quality Officer, and with Trinity Health System where she was the national system Chief Medical Officer, and acting interim Chief Medical Information Officer.
While at CMS Dr. Schreiber has led many quality initiatives, including MIPS transformation to value pathways, the modernization of the Hospital Stars program, as well as advancing digital quality measurement systems. She is on the boards of ACCME (continuing medical education), Leapfrog, and a member of HITACH (the national health information advisory committee) among others. Prior to joining CMS she also participated in numerous state and national quality committees including the Board of Directors for the Michigan Hospital Association Keystone Center and the Patient Safety Organization, the Board of Directors of MPRO (Michigan Peer Review Organization – the Michigan QIO), the National Quality Forum Patient Safety Metrics Committee, and the National Quality Partners.
Lisa Parker
Centers for Medicare & Medicaid Services
Director of the Clinical Standard Group
Lisa Parker is the Director of the Clinical Standards Group, which is responsible for establishing health and safety regulations for Medicare and Medicaid participating health care providers and suppliers, generally known as Conditions of Participation (CoPs). While the regulations vary by provider type, in general CoPs typically address facility governance and administration, patient rights, care planning, quality assessment and performance improvement, services provided, and emergency preparedness. Lisa has over 30 years of experience in the development of Medicare regulations. She has led many regulatory efforts to ensure the health and safety of patients across the health care system including the Emergency Preparedness Conditions of Participation and most recently several emergency regulations published during the COVID 19 public health emergency, as well as regulations to reduce burden and increase flexibility for providers.
Mark Plaugher
Centers for Medicare & Medicaid Services
Acting Director of the Information System Group (ISG)
Mark Plaugher is the Acting Director of the Information System Group (ISG), supporting CMS’ Center for Clinical Standards and Quality. ISG has overall responsibility for delivering and maintaining technology to support CMS quality programs. Mark brings over 25 years of IT experience in large-scale enterprise environments. He has spent the last two decades in direct support of CMS in both the private sector and as a CMS employee. In the private sector, he held multiple leadership roles. Mark also managed the delivery of IT services for the University of Maryland’s School of Medicine, Departments of Genetics and Pediatrics.
Jennifer Dubbs
Director, Business Operations Group
Center for Clinical Standards and Quality
Centers for Medicare and Medicaid Services
Jennifer Dubbs is the Director of the Business Operations Group supporting budget, acquisition and administrative operations for the Center for Clinical Standards and Quality. Jennifer brings over 30 years of experience in strategic planning, project management, budget and financial management, and acquisition management. Jennifer is a change leader that is results driven that is motivated by eliminating waste, creating efficiency, and developing and leading high performing teams. She holds a degree in Economics from the University of Maryland and a Master of Administrative Science, Information Technology, from The Johns Hopkins University.
The Centers for Medicare & Medicaid Services (CMS) is committed to improving performance on key patient safety metrics through the application of CMS levers such as quality measurement, payment, health and safety standards, and quality improvement support. This session is a conversation with CMS Senior Leadership and Federal partners to renew our collective commitment to patient safety. We will be discussing progress that has been made, as well as challenges faced, since the 2023 CMS Quality Conference. Additionally, the panel will speak to a call to action for our healthcare community so that together we can achieve our patient safety goals.
Michelle Schreiber, MD
Deputy Director, Quality & Value, Centers for Medicare & Medicaid Services
Dr. Schreiber is currently the Deputy Director of the Center for Clinical Standards and Quality at CMS, and the Director of the Quality Measurement and Value-Based Incentives Group. Dr. Schreiber is a general internal medicine physician with over 25 years of health care experience. Prior to coming to CMS she was the Senior Vice President and Chief Quality Officer of Henry Ford Health System (HFHS) in Detroit, Michigan. Earlier roles at HFHS included the Division Head of General Internal Medicine, and the SVP of Clinical Transformation and IT Integration, where she was the clinical lead of the systemwide Epic implementation. The Epic implementation and use earned HFHS a Davies Award in 2018. She has also held senior leadership roles at the Detroit Medical Center, where she was the Chief Quality Officer, and with Trinity Health System where she was the national system Chief Medical Officer, and acting interim Chief Medical Information Officer.
While at CMS Dr. Schreiber has led many quality initiatives, including MIPS transformation to value pathways, the modernization of the Hospital Stars program, as well as advancing digital quality measurement systems. She is on the boards of ACCME (continuing medical education), Leapfrog, and a member of HITACH (the national health information advisory committee) among others. Prior to joining CMS she also participated in numerous state and national quality committees including the Board of Directors for the Michigan Hospital Association Keystone Center and the Patient Safety Organization, the Board of Directors of MPRO (Michigan Peer Review Organization – the Michigan QIO), the National Quality Forum Patient Safety Metrics Committee, and the National Quality Partners.
Dora Hughes, MD, MPH
Acting Chief Medical Officer & Acting Director, Center for Clinical Standards and Quality, Centers for Medicare & Medicaid Services
Dora Hughes, M.D., M.P.H., is Chief Medical Officer at the CMS Innovation Center at the Centers for Medicare & Medicaid Services. She leads the Center’s work on health equity, provides clinical input on models, liaises with stakeholder groups, and directs CMMI’s clinician community.
Previously, Dr. Hughes served as an Associate Research Professor of Health Policy & Management at George Washington University, where her work focused on the intersection of clinical and community health, health equity, healthcare quality and workforce. Prior to this role, Dr. Hughes was a Senior Policy Advisor at Sidley Austin, where she advised on regulatory and legislative matters in the life science industry. Additionally, Dr. Hughes served as the Counselor for Science & Public Health at the U.S. Department of Health & Human Services in the Obama Administration, helping to implement the Affordable Care Act and providing guidance to the Public Health Service Act authorized agencies and Food and Drug Administration. Dr. Hughes began her career in health policy as Senior Program Officer at the Commonwealth Fund, and subsequently was Deputy Director for the HELP Committee for the late Senator Edward M. Kennedy and Health Policy Advisor to former Senator Barack Obama. Dr. Hughes received a B.S. from Washington University, M.D. from Vanderbilt and M.P.H. from Harvard. She completed an internal medicine residency at Brigham & Women’s Hospital.
Arjun Srinivasan, MD
Deputy Director
Program Improvement in the Division of Healthcare Quality Promotion at the Centers for Disease Control and Prevention (CDC)
Arjun Srinivasan, MD, is the Deputy Director for Program Improvement in the Division of Healthcare Quality Promotion at the Centers for Disease Control and Prevention (CDC) and a Captain in the United States Public Health Service. He is board certified in infectious diseases. Before coming to CDC, he was an Assistant Professor of Medicine in the Infectious Diseases Division at the Johns Hopkins School of Medicine, where he was the founding director of the Johns Hopkins Antibiotic Management Program and the associate hospital epidemiologist. His primary responsibilities include oversight and coordination of efforts to eliminate healthcare-associated infections and reduce antimicrobial resistance. His research and investigative areas of concentration have included outbreak investigations, infection control, multi-drug resistant gram-negative pathogens, and now focus on hospital antibiotic stewardship. Dr. Srinivasan has published more than 100 articles in peer-reviewed journals on his research in healthcare epidemiology, infection control, antibiotic use, and antimicrobial resistance.
Craig A. Umscheid, M.D., MS
Director, Center for Quality Improvement and Patient Safety (CQuIPS)Agency for Healthcare Research and Quality (AHRQ)Department of Health and Human Services
Craig A. Umscheid, MD, MS, is an internist and clinical epidemiologist who serves as the Director of the Center for Quality Improvement and Patient Safety (CQuIPS) at the Agency for Healthcare Research and Quality (AHRQ) in the U.S. Department of Health and Human Services. CQuIPS is one of three research centers at AHRQ, includes divisions of patient safety, patient safety organizations, healthcare associated infections, healthcare data and analysis, and quality improvement and measurement, and supports the safety and quality of healthcare through research, practice improvement, and data analysis and measurement. Prior to AHRQ, Dr. Umscheid was an Associate Professor and Chief Quality and Innovation Officer at the University of Chicago. He began his career at the University of Pennsylvania, where he became an Associate Professor, Vice Chair of Quality and Safety for the Department of Medicine, and co-founder and Director of Penn’s Center for Evidence-based Practice. His career has been dedicated to disseminating and implementing research evidence into clinical practice to support patient care quality and safety. His work has been supported by AHRQ, PCORI, CDC and NIH, and described in over 125 peer-reviewed publications. Dr. Umscheid volunteers as a hospitalist at Georgetown, where he is an Adjunct Professor.
Natalia Chalmers, DDS, MHSc, PhD
Chief Dental Officer, Office of the Administrator, Centers for Medicare & Medicaid Services
Dr. Chalmers is a board-certified pediatric dentist, oral health policy expert, and public health advocate who brings more than 20 years of clinical, research, industry, and regulatory experience to CMS in her role as Chief Dental Officer in the Office of the Administrator. Previously, Dr. Chalmers served as a Dental Officer at the US Food and Drug Administration. Dr. Chalmers has devoted her career to transforming scientific and health care data and information into actionable insights to address equity, improve care, and better inform policy and funding. Dr. Chalmers completed her Doctor of Dental Surgery degree at the Faculty of Dental Medicine of the Medical University of Sofia, a residency in pediatric dentistry at the University of Maryland School of Dentistry, and a Ph.D. in oral microbiology from the Graduate Partnerships Program of the University of Maryland School of Dentistry and the National Institute for Dental and Craniofacial Research at the National Institutes of Health, Post-doctoral Fellowship at the Forsyth Institute, and Clinical Research Fellowship at the National Institute for Dental and Craniofacial Research, National Institutes of Health. Dr. Chalmers holds a Master’s degree in Clinical Research from Duke Medical University and a Certificate in Drug Development and Regulatory Science from the University of California San Francisco School of Pharmacy. Her research has translated into action, improving oral care and advocating for the role health policy can play across the lifespan—particularly when it embraces dental well-being as a facet of care for the whole person.
Christi A. Grimm
Inspector General, Office of Inspector General, Department of Health and Human Services
The Honorable Christi A. Grimm was sworn in as the sixth Inspector General of the U.S. Department of Health and Human Services (HHS) on February 22, 2022, following her nomination by the President and confirmation by the U.S. Senate. As Inspector General, she leads an independent and objective organization of 1,600 auditors, evaluators, investigators, data analysts, attorneys, and management professionals who protect the integrity of HHS programs and the health and welfare of the people they serve. The Office of Inspector General (OIG) oversees more than 100 programs administered by HHS agencies, including the Centers for Medicare & Medicaid Services, Administration for Children and Families, Centers for Disease Control and Prevention, Food and Drug Administration, and National Institutes of Health. Collectively, taxpayers devote more than $2 trillion a year to these programs.
Ms. Grimm brings two decades of leadership in overseeing health and human services programs. She is a leading expert in program integrity issues related to HHS programs, with particular emphasis on health and safety in care provided in home and community-based settings, in hospitals and nursing homes, and in facilities serving unaccompanied children under HHS’s Office of Refugee Resettlement. Ms. Grimm began her career with OIG as an evaluator and conducted groundbreaking work to improve quality and safety in hospitals, stop unqualified providers from enrolling in Medicare and Medicaid, and improve the process for appealing Medicare payment decisions.
Grab & Go stations will be conveniently located throughout the main convention floor (Floor 2).
Food Trucks will be stationed on Eutaw Street beneath the Skywalk.
Explore any of the amazing nearby restaurants
A critical part of advancing reform and addressing provider burden in the health care system is creating meaningful alignment among payers. Over the last year, both Center for Medicare and Medicaid Innovation (CMMI) and the Learning and Action Networks (LAN) have announced new models and initiatives meant to generate directional alignment that balances the need for multi-payer alignment goals with payer flexibility. This session describes how these efforts work together to generate this alignment at both the national and local levels.
Emphasizing both collaborative and individual efforts, CMMI and the LAN will highlight key initiatives and milestones generating meaningful multi-payer alignment across the healthcare market. In both instances, these efforts adopt the principles of directional alignment, where alignment does not require identical arrangements or programs, but looks to create collaboration and alignment around core areas, such as quality measurement, and create closer alignment over time.
Participants will learn how CMMI and the LAN are working together and with a wide range of partners to advance alignment in key areas of delivery system reform.
Kate Davidson LCSW
CMMI, Centers for Medicare & Medicaid Services, Director of the Learning and Diffusion Group (LDG)
Kate Davidson, LCSW is the Director of the Learning and Diffusion Group (LDG) at the Center for Medicare and Medicaid Innovation (CMMI), within the Centers for Medicare & Medicaid Services (CMS). In this role, Ms. Davidson leads CMMI’s team focused on accelerating healthcare system transformation by leveraging improvement science within and across models, as well as leading the multi-payer alignment strategy for the Center through the Healthcare Payment Learning and Action Network (HCP-LAN). Prior to joining CMS, Ms. Davidson led Policy and Practice Improvement efforts at the National Council for Mental Wellbeing, where she managed payment reform, quality improvement, and workforce development initiatives in mental health and addiction prevention, treatment, and recovery organizations and provided training and technical assistance to human services organizations, counties and states. Ms. Davidson began her career in healthcare as a social worker researching, testing and scaling interventions in primary care, behavioral health and community-based settings. Ms. Davidson has an MSW from Fordham University and a BA from Loyola College in Maryland.
Mark McClellan M.D., PhD
Director, Margolis Center for Health Policy at Duke University
Mark McClellan, M.D., Ph.D., is director of the Duke-Margolis Institute for Health Policy and Robert J. Margolis professor of business, medicine, and policy at Duke University. He is a physician-economist who focuses on quality and value in health care, including payment reform, real-world evidence, and more effective drug and device innovation. Dr. McClellan is at the center of the nation’s efforts to combat the pandemic and the author of a roadmap that details the steps needed for a comprehensive COVID-19 response and safe reopening of our country. He is former administrator of the Centers for Medicare & Medicaid Services and former commissioner of the U.S. Food and Drug Administration, where he developed and implemented major reforms in health policy.
Dr. McClellan is an independent director on the boards of Johnson & Johnson, Cigna, Alignment Healthcare, and PrognomIQ. He co-chairs the Guiding Committee for the Health Care Payment Learning & Action Network and serves as an advisor for Arsenal Capital Group, Blackstone Life Sciences, and MITRE
Dr. Helen Burstin MD, MPH, MACP
CEO, Council of Medical Specialty Services
Helen Burstin, MD, MPH, MACP is the Chief Executive Officer of the Council of Medical Specialty Societies (CMSS), a coalition of more than 50 specialty societies representing more than 800,000 physicians. As the national organization of specialty societies, CMSS advances the expertise and collective voice of medical specialty societies in support of physicians and the patients they serve. Representing every specialty, from primary care to surgery, CMSS addresses critical issues across specialties through shared learning and innovation, convening, collaboration, and collective action.
Dr. Burstin formerly served as Chief Scientific Officer of The National Quality Forum (NQF). Prior to joining NQF, she was the Director of the Center for Primary Care, Prevention, and Clinical Partnerships at the Agency for Healthcare Research and Quality (AHRQ). Prior to joining AHRQ, Dr. Burstin was an Assistant Professor at Harvard Medical School and served as Director of Quality Measurement at Brigham and Women’s Hospital. She is the author of more than 100 articles and book chapters on quality, safety, equity, and measurement. She is a member of the National Academy of Medicine. Dr. Burstin currently serves on the board of the Society to Improve Diagnosis in Medicine. A graduate of the State University of New York at Upstate College of Medicine and the Harvard School of Public Health, Dr. Burstin completed her residency training in primary care internal medicine at Boston City Hospital and fellowship in General Internal Medicine and Health Services Research at Brigham and Women's Hospital and Harvard Medical School. She is a Clinical Professor of Medicine at George Washington University School of Medicine and Health Sciences.
This session will explore recently released CMS guidance on health-related social needs (HRSN) and how states are implementing housing and nutritional supports to improve the quality of care and health outcomes. In November 2023, CMS issued an Informational Bulletin on how states can address health-related social needs (HRSN) in Medicaid and the Children’s Health Insurance Program (CHIP), and framework of services and supports considered allowable under specific authorities, including section 1115 demonstrations. CMS has approved 1115 demonstrations for HRSN services in states including Arizona and Washington. Presenters from these state Medicaid programs will describe how they have implemented housing and nutritional supports, integrating with existing social and housing services, as well as how they are measuring associated changes in health care utilization and quality, and health outcomes.
Jessica Lee, MD, MSHP
Acting Chief Medical Director, Center for Medicaid and CHIP Services, Centers for Medicare & Medicaid Services
Jessica Lee, MD, MSHP is the acting Chief Medical Officer for Center for Medicaid and CHIP Services, where she leads the center’s clinical strategy and portfolio in health-related social needs. Dr. Lee was previously the medical officer in the Division of Quality and Health Outcomes at CMCS, where she led initiatives in quality measures and quality improvement. Dr. Lee has deep expertise in clinical medicine and quality, and a background in health policy at the health system, state, and federal levels, including projects at Denver Health. She has served as a senior health policy analyst at the Government Accountability Office, focusing on payment policy and community benefits provided by nonprofit hospitals. She has conducted grant-funded research focused on the intersection of health care delivery systems and population health. Dr. Lee continues to care for patients as a practicing pulmonologist at the University of Pennsylvania and ICU physician at the Corporal Michael J. Crescenz VA Medical Center in Philadelphia.
Christopher Chen, MD, MBA, FACP
Medical Director, Medicaid Washington State Health Care Authority
Dr. Christopher Chen, MD, MBA, is a Medical Director for Medicaid and Clinical Informatics at the WA State Health Care Authority. Dr. Chen is dedicated to serving the underserved and believes in the HCA’s mission to use innovative polices and purchasing strategies to improve health and address disparities. He helps guide clinical policy and strategy at the agency, and supports initiatives in health information technology, telehealth, quality, and health equity. He obtained his medical degree from the University of Pennsylvania School of Medicine, his business degree from The Wharton School, and completed his residency in internal medicine – primary care at the University of Washington. He is board certified in internal medicine and clinical informatics.
Ruben Soliz, MPH
Federal Relations Lead and Health Policy Advisor
Arizona Health Care Cost Containment System
Ruben Soliz is the Federal Relations Lead and Health Policy Advisor for Arizona’s State Medicaid Program, the Arizona Health Care Cost Containment System (AHCCCS). With over 15 years of experience in health and human services, he has championed health equity through community engagement and health policy. Specific policy objectives that he has advanced include improving access to health care, ending homelessness, youth development and addressing the HIV/AIDS epidemic in Africa. He is a 2018 graduate of the Master of Public Health Program at the University of Arizona and a 2023 graduate of the Center for Health Care Strategies Equity Changemakers Institute.
With more than 70% of Medicaid and Children's Health Insurance Program (CHIP) beneficiaries enrolled in managed care, states can have a significant impact on improving health services delivery and outcomes for their Medicaid and CHIP beneficiaries by working with their managed care plans (MCPs) on quality improvement (QI) initiatives. State staff from Texas Health and Human Services developed an approach to coordinating MCP QI efforts around a common state aim statement. Each MCP chose and implemented an improvement project to complement the state aim, and the state created a structure to enhance peer learning and impact. Participants will hear from a state speaker about their approach and from a participating MCP that ran its own supportive QI project. This session will also review resources developed by Centers for Medicare & Medicaid Services to help state Medicaid and CHIP staff and their MCP QI partners implement a similar approach.
Emily Stauffer Rocha, MBA, MSN, RN, NE-BC, CHCQM,
Director of Clinical Innovation,Texas Health and Human Services Commission
Emily Stauffer Rocha, RN is the Director of Clinical Innovation at Texas Medicaid. She leads programs focused on the care of women and children, palliative care, quality improvement, and preventive care. Her background is in pediatric critical care, emergency nursing, and hospital leadership.
Crystal O'Reilly BSN, RN
AVP, Quality and Care Management Affairs, Cook Children's Health Plan
Crystal O’Reilly is a Registered Nurse with 20 years’ experience in Pediatrics, Quality Improvement, and nursing leadership. Crystal has practiced at six major pediatric healthcare delivery systems, primarily in Pediatric Hematology/Oncology and Stem Cell Transplant. Her current role is in executive nursing leadership at Cook Children’s Health Plan, a community-based Medicaid and CHIP plan based in Fort Worth, Texas. Crystal’s responsibilities include oversight of all Member-facing clinical programs, including Quality, Care Management, Service Coordination, Outreach, Transition Services, and a clinical telephone hotline. Crystal has co-authored a number of articles, including those with a special focus on healthcare quality outcomes and health disparities in children with Diabetes Mellitus. Crystal’s professional interests include improving healthcare outcomes, particularly preventive healthcare services, and reducing health disparities among children and pregnant women receiving government assistance for healthcare coverage.
Susan Ruiz, BA
EPSDT/Children’s Health Subject Matter Expert, Division of Quality and Health Outcomes, Children and Adult Health Program Group, Center for Medicaid & CHIP Services
Susan Ruiz has worked on Medicaid and children’s health issues for more than 25 years. From early beginnings in state eligibility policy, through many years spent reviewing school-based services, administrative claims submissions, and hundreds of Medicaid State Plan Amendments, Susan has done a little bit of everything. She has designed and implemented program reviews throughout the country looking at dental services, well-child visits, grievances & appeals, and EPSDT. Susan has been with the CMCS Division of Quality & Health Outcomes since 2016 and leads the work on the Child Core Set and EPSDT.
The panel presentation will provide an update to the Medicare Value-Based Care Strategy. The presentation will specifically focus on progress along the three objectives of the Strategy—Alignment, Growth and Equity—as well as future priorities and vision.
Michelle Schreiber, MD
Deputy Director, Quality & Value, Centers for Medicare & Medicaid Services
Dr. Schreiber is currently the Deputy Director of the Center for Clinical Standards and Quality at CMS, and the Director of the Quality Measurement and Value-Based Incentives Group. Dr. Schreiber is a general internal medicine physician with over 25 years of health care experience. Prior to coming to CMS she was the Senior Vice President and Chief Quality Officer of Henry Ford Health System (HFHS) in Detroit, Michigan. Earlier roles at HFHS included the Division Head of General Internal Medicine, and the SVP of Clinical Transformation and IT Integration, where she was the clinical lead of the systemwide Epic implementation. The Epic implementation and use earned HFHS a Davies Award in 2018. She has also held senior leadership roles at the Detroit Medical Center, where she was the Chief Quality Officer, and with Trinity Health System where she was the national system Chief Medical Officer, and acting interim Chief Medical Information Officer.
While at CMS Dr. Schreiber has led many quality initiatives, including MIPS transformation to value pathways, the modernization of the Hospital Stars program, as well as advancing digital quality measurement systems. She is on the boards of ACCME (continuing medical education), Leapfrog, and a member of HITACH (the national health information advisory committee) among others. Prior to joining CMS she also participated in numerous state and national quality committees including the Board of Directors for the Michigan Hospital Association Keystone Center and the Patient Safety Organization, the Board of Directors of MPRO (Michigan Peer Review Organization – the Michigan QIO), the National Quality Forum Patient Safety Metrics Committee, and the National Quality Partners.
Purva Rawal, PhD
Chief Strategy Officer at the CMS Innovation Center
Centers for Medicare and Medicaid Services
As part of the Senior Leadership team, Purva provides guidance and leadership on the execution of the Innovation Center’s strategy.
Prior to her current role, she spent a decade in policy and business strategy consulting and policy research focused leading projects on value-based payment and health system transformation. She was also an adjunct assistant professor at Georgetown University. In 2016, she published a book, The Affordable Care Act: Examining the Facts and has published book chapter, blogs, and papers on value-based care. Previously, Dr. Rawal served as professional staff on the Senate Budget Committee during the passage of the Affordable Care Act and as the health and social policy advisor to Sen. Joseph Lieberman (I-CT). She began her health policy career as a Christine Mirzayan Science and Technology Fellow at the National Academy of Sciences and as a Congressional Fellow for the Society for Research on Child Development and the American Association for the Advancement of Science. Dr. Rawal received her B.A. and Ph.D. from Northwestern University.
John Pilotte
Director of the Performance-based Payment Policy Group (P3)
Center for Medicare at the Centers for Medicare & Medicaid Services
John manages policy development and operations for the Medicare Shared Savings Program, Medicare’s national Accountable Care Organization program with nearly 500 ACOs and 10.9 million Medicare beneficiaries, oversees policy, compliance, and enforcement of new hospital price transparency regulations, and supports policy development and operations of value based payment programs, models and initiatives. Prior to P3, John served as the Director of the Division of Payment Policy Demonstrations managing the development and implementation of the Physician Group Practice Demonstrations and care coordination demonstrations. Prior to joining CMS, John was a health care consultant for PricewaterhouseCoopers and worked on the government relations staff at the National Association of Children’s Hospitals and Related Institutions. John has a master’s in health policy and management from the Johns Hopkins University and a Bachelor of Science from Indiana University’s School of Public and Environmental Affairs.
Sophia Sugumar (Moderator) MSHM
Program Policy Lead,Division of Electronic and Clinical Quality, Centers for Medicare & Medicaid Services
Health disparities continue to persist among patients with End Stage Renal Disease (ESRD). Marginalized racial and ethnic minority and low socioeconomic populations have a disproportionate burden of involuntary discharges (IVDs) and other disparities, such as lack of access to transplantation and higher unplanned hospital readmissions. Structural competency for equitable kidney care is an approach in which healthcare professionals recognize and respond to health and illness as the downstream effects of broad social, political, and economic factors. It serves as an equity framework for overcoming disparities and bias in healthcare. Applying this approach in kidney care can play a significant role in reducing health disparities and advancing health equity. The ESRD National Coordinating Center (NCC) developed a three-module structural competency training for kidney professionals to address health inequities. The training provides specific, evidence-based interventions and strategies to address the structural drivers of kidney care inequities, including IVDs.
Keith Norris MD
Distinguished Professor of Medicine, UCLA Division of General Internal Medicine and Health Services Research
Dr. Keith Norris is an internationally recognized clinician scientist and health policy leader who has been instrumental in shaping national health policy and clinical practice guidelines for chronic kidney disease (CKD). A board-certified nephrologist, in 1995, he was invited to join the inaugural National Kidney Foundation Kidney Disease Outcomes Quality Initiative and was a member of the subsequent Medicare ESRD continuous Performance Measures workgroup. He presently serves as a member of the Forum of ESRD Networks Medical Advisory Board. He also co-directs the Center for Kidney Disease Research, Education and Hope (CURE-CKD), a Providence St. Joseph Health/UCLA partnership, using electronic health record data to examine outcomes and quality of care for over 3.7 million patients with CKD and/or at risk for CKD (hypertension, diabetes, pre-diabetes). He has made major contributions to diversity, equity, and inclusion while addressing disparities in contemporary society. He serves as Executive Vice Chair for the UCLA Department of Medicine for Equity, Diversity and Inclusion. He is also a member of the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) Advisory Council and the National Academy of Medicine.
Ken Teasley
Patient Facility Representative br/>NCC Legacy PSME
CAB, Harlem Wellness Center- MT. Sinai
Ken is a passionate advocate for kidney care patients based on his inspirational journey. He was the first recipient of a kidney transplant in the state of New York upon the HIV Organ Procurement Equity legislation being passed in 2013. Ken has a long history of community involvement including his work as a Patient Advisor on the Medical Review Board and ESRD Network Patient Facility Representative, a transplant and organ donation volunteer for LiveOnNY, and a member of Transplant Recipients International Organization as well as a volunteer for the National Kidney Foundation.
This presentation will examine the implications of historical prescribing practices on patients receiving Chronic Opioid Therapy (COT) and assess the subsequent changes in prescribing patterns, patient access, and associated risks. This presentation will feature a panel from the Compass Program, including an addiction medicine physician, a pharmacist, a nurse, and a family medicine physician participant. The panel will discuss several of the core pillars of the Compass Program and how they are being implemented within the participant cohort to change clinical practice and improve patient outcomes. They will discuss resources to support opioid-sparing management of acute pain to reduce opioid exposure, utilizing nonopioid pharmacologic agents and nonpharmacologic therapies. For patients maintained on chronic opioid therapy (COT), the panel will discuss risk management strategies to increase patient safety including rotation to safer agents, providing naloxone, using patient-specific tapering strategies, and minimizing co-prescribing of other sedating agents. Lastly, the panel will discuss the critical need for primary care providers and family medicine physicians to help reduce overdose mortality trends by offering treatment of OUD with buprenorphine products, supported by resources, 1-on-1 coaching, and education from the Compass Program.
Jen Brockman, MHA, BSN, RN, CPPS,
Chief Clinical Program Officer & OPSS Project Director,Iowa Healthcare Collaborative
As the Chief Clinical Program Officer for the Iowa Healthcare Collaborative, Jen Brockman leads an organizational structure that supports quality improvement, patient safety, change management, data analytics and achievement of strategic directives. Ms. Brockman has extensive experience designing and executing small and large scale clinical and population health strategies, leading multi-state programs to improve clinical quality and drive transformation and developing statewide alignment strategies and national provider networks. Ms. Brockman has demonstrated expertise in strategic planning and process implementation, project management, continuous quality improvement (QI), risk management, patient safety and infection prevention, provider engagement, and quality reporting. Ms. Brockman has more than twenty years of clinical nursing experience in a variety of healthcare settings including acute and long-term care, quality management and infection prevention. She received a Bachelor of Science and Nursing Degree from the University of Iowa and Master’s in Healthcare Administration Degree from Walden University. Ms. Brockman oversees IHC operations and serves as the organizational administrative leader, responsible for resource allocation decisions, staff role assignments, external partner coordination, and coordination of partner subcontractors through scope of work development and oversight. Through past professional and educational experiences, Ms. Brockman has built skills in quality improvement, project management, organizational development, strategic communication, healthcare transformation, integrated delivery networks, and systems thinking.
Don Stader, MD, FACEP
OPSS Medical Director & Addiction Medicine Specialist, Stader Opioid Consultants
Don Stader, MD FACEP is a board certified emergency and addiction medicine physician, who works at Lincoln Health in Colorado. He is the Medical Director of the Compass Opioid Stewardship Program, a nationwide initiative to improve pain control, prescribing habits, addiction treatment and opioid stewardship for primary care clinicians. Don is also the founder of The Naloxone Project and former chair of the Colorado Naloxone Project. He is the founder and past chair of Colorado ACEP's Opioid Task Force, the Editor-in-Chief of COACEP's 2017 Opioid Prescribing & Treatment Guidelines and the CO's CURE’s guidelines on pain control and opioid stewardship. Don served for over 2 years as the Senior Pain Management & Opioid Policy Physician Adviser for the Colorado Hospital Association and serves on multiple national and local committees addressing the opioid epidemic in Colorado and across the nation, he is the current chair of ACEP’s Pain & Addiction Management Section.
Laurie Fisher, MD
Family Medicine Physician & OPSS Cohort, Town Plaza Family Practice
Laurie D Fisher, MD, is a board-certified family medicine physician with Town Plaza Family Practice in Prairie Village, KS. She has been in practice for more than 25 years. She practices the full scope of family medicine including newborn and obstetrical care and has been one of the most productive family medicine doctors throughout HCA (Healthcare Corporation of America) for over 20 years. Dr. Fisher received her medical degree from the University of South Dakota School of Medicine and completed her residency at Truman Medical Center East in Kansas City, MO. During her residency, she received both the George Hedgepath Award for UMKC Outstanding Resident and the Outstanding Family Practice Resident Award. She serves in various leadership roles at HCA Midwest Health, including the Physician Advisory Board, Menorah Medical Center facility lead, and was also previously a member of the Menorah Medical Center Board of Directors. Dr. Fisher is a member of the American Academy of Family Physicians and the Kansas Academy of Family Physicians.
Rachael Duncan, PharmD, BCPS, BCCCP
OPSS Coach, Stader Opioid Consultants
Rachael is a pharmacist and consultant for the Colorado-based consulting firm Stader Opioid Consultants. She has spent the past decade focused on policy, advocacy, and educational work surrounding opioid stewardship and substance use disorder treatment at both the state and national level. Rachael is a clinician coach for the Compass Opioid Stewardship Program, a nationwide program that supports providers in caring for patients on chronic opioid therapy or with a substance use disorder. She is the Associate Director of The Naloxone Project (TNP), a nonprofit aimed at making hospitals into naloxone distribution sites. Through TNP, she is Program Director of the MOMs (Maternal Overdose Matters) Initiative, which targets birthing hospitals as naloxone distribution sites for at-risk perinatal patients and families. She is also Program Director of MOMs+, a quality improvement program aimed at helping birthing hospitals build addiction treatment infrastructure for perinatal patients. Her clinical practice is in hospital-based pharmacy.
In response to the President’s executive order to advance racial equity and support for underserved communities, the Department of Health and Human Services (HHS) established an equity action plan. In alignment with this plan, Beneficiary and Family-Centered Care Quality Improvement Organizations (BFCC-QIOs) are working to identify and address barriers to equitable access and utilization of beneficiary protection, support, and advocacy services.
BFCC-QIOs offer case review services for beneficiaries who think they may be entitled to additional Medicare-covered services, or who think the quality of care they received does not meet clinical standards. Using BFCC-QIO program data, we assessed the degree to which case review services are being utilized by beneficiaries of different races and ethnicities.
Disparities in case review utilization are evident among Hispanic and Asian beneficiaries and these disparities may further contribute to existing health outcome inequalities. The concern is that these beneficiaries are still experiencing premature healthcare service termination or other quality of care issues such as gaps between government and other health providers, but are not exercising their right to review and possibly resolve these issues through BFCC-QIO program services.
BFCC-QIOs are carefully analyzing the approach and implementation strategies for their work. Seeking input from experts, stakeholders and Medicare beneficiaries, BFCC-QIOs are identifying strategies to improve access and awareness and reduce disparities in use of BFCC-QIO case review services that may contribute to poor health outcomes.
Scott Fortin, MBA
Sr. Director Communications and Outreach,Kepro
Scott Fortin, MBA, has over 20 years of experience in the healthcare industry, with 10 of those specific to the Quality Improvement Organization (QIO) community. He is a solutions-oriented marketing and stakeholder relations professional skilled in managing relationships and strategic communications. He understands methodology to develop and implement unique relational strategies in high profile environments. Scott is also well versed in collaborating with key partners and stakeholders to deliver communications and outreach solutions that support program objectives, ensuring effective and strategic messaging. Scott graduated from Olivet Nazarene University with a Master of Business Administration.
Carmen Villegas, RN, BSN, BCPA
Immediate Advocacy Manager,Livanta
Carmen Villegas, RN, BSN, BCPA, is the Quality Triage/Immediate Advocacy Review Manager for Livanta, a Beneficiary and Family Centered Care, Quality Improvement Organization. Ms. Villegas is a registered nurse and a Board Certified Patient Advocate (BCPA). She has been with Livanta since 2015. Ms. Villegas has 25 years of experience in various clinical settings, and her extensive knowledge of patient advocacy and focus on individualized patient care is why she provides exceptional service. Fluent in both Spanish and English, Ms. Villegas is able to connect with Spanish-speaking patients and their families, which allows her to provide culturally competent care.
Stephanie Fry, BA, CPXP
Associate Vice President, Westat
Ms. Stephanie Fry is a survey methodologist and mixed methods researcher who leads health services and policy research. She has supported the QIO program and evaluation work for more than 15 years and is currently serving as the BFCC NCORC Deputy Director. Ms. Fry is also a Senior Study Director at Westat where her work focuses on design and implementation of healthcare program evaluations, including the collection and reporting of stakeholder, beneficiary, provider, and payer perspectives.
Over the past two years, CMS has made significant strides in advancing oral health across all our programs. CMS has developed a set of cross-cutting initiatives that engage teams across our organization to drive the goals highlighted by the strategic pillars and enhance focus on critical components of our work. These initiatives are high-level, multi-year priorities for CMS that bring our centers and offices together to leverage their expertise and strengthen collaboration. The CMS Chief Dental Officer will describe the launch and work under the Oral Health Cross-Cutting Initiative. Access to oral health services promotes health and wellness and allows beneficiaries and consumers to achieve the best health possible. States have the flexibility to determine what dental benefits are provided to adult Medicaid enrollees. While most states offer at least emergency dental services for adults, less than half of the states currently provide comprehensive dental care. There are no minimum requirements for adult dental coverage. More than 1 in 4 (26%) adults in the United States have untreated tooth decay. Over the last ten years, dental pain has been a top reason for opioid prescribing upon discharge from the ED, thereby contributing to the overdose crisis. There is a bi-directional link between oral health and substance use disorder. This session will focus on the outcomes of two studies that analyzed Medicaid enrollment and claims data. These studies examine oral health needs, disparities, and access to dental services for Medicaid adults with substance use disorders, as well as the impact of the COVID-19 public health emergency, state coverage policies, and socio-demographic factors on adults' access to dental services.
Jessica Maksut PhD
Technical Director, Office of Minority Health; Centers for Medicare & Medicaid Services
Dr. Jessica Maksut is a social and behavioral health scientist with a PhD in human development from the University of Connecticut and postdoctoral training in epidemiology from the Johns Hopkins Bloomberg School of Public Health. Her work centers health and health care equity with attention to underserved groups such as individuals with disabilities and those residing in rural, Tribal, and geographically isolated areas. Dr. Maksut joined the CMS Office of Minority Health in 2020 and works as a Health Insurance Specialist and Technical Advisor in the Data Analytics and Research Group.
Carla Shoff PhD,
Senior Advisor to the Chief Dental Officer, Office of the Administrator; Centers for Medicare & Medicaid Services
Dr. Carla Shoff is the Senior Advisor to the Chief Dental Officer in the Office of the Administrator at the Centers for Medicare & Medicaid Services (CMS). Before this role, Dr. Shoff was a Social Science Research Analyst in the Office of Enterprise Data and Analytics at CMS for 9 years. She began her career as a Research Associate at the Population Research Institute at Penn State University (PSU). Dr. Shoff holds a dual-title Ph.D. in Rural Sociology and Demography and a graduate certificate in Survey Methodology from PSU, where she focused her studies on health disparities, quantitative research methods, and statistics. Dr. Shoff has devoted her career to using data to identify disparities in population health, health-related behaviors, and access to health care, which can be used to inform policy and advance health equity. She has a robust research portfolio of over 30 publications in peer-reviewed journals.
Lorel Burns DDS, MS
Assistant Professor, NYU College of Dentistry
Dr. Lorel Burns is a clinician-investigator and assistant professor at New York University (NYU) College of Dentistry. She is a Diplomate of the American Board of Endodontics. Dr. Burns’ research interests include endodontic treatment outcomes, access to dental care, clinician decision-making, and dental education. Her research has been funded by the National Institutes of Health (NIH)/ National Institute of Dental and Craniofacial Research (NIDCR), the Robert Wood Johnson Foundation (RWJF), and the American Dental Education Association, ADEAGies Foundation. Dr. Burns is the 2023-2024 Center for Medicare & Medicaid Services (CMS) Oral Health Policy Fellow.
The Customer Focused Research Group (CFRG) within the Office of Burden Reduction and Health Informatics (OBRHI) will present on their Behavioral Health and Oral Health Human-Centered Design Customer Engagements. Human-Centered Design (HCD) is the process CMS uses to understand the people for which they write policies; and create programs and services. CFRG will share the qualitative research aimed at understanding how to ensure equitable access to oral health care without stigma. Each respective engagement revealed many insights in addition to an opportunity to co-create illustrations with external customers to highlight and raise the customers’ voice in supporting those suffering with substance use disorders.
Morgan Taylor
Lead Human Center Design Specialist, Office of Burden Reduction & Health Informatics (OBRHI)
Morgan is an experienced human-centered design leader with 8 years at the Centers for Medicare and Medicaid Services (CMS). Morgan currently manages multiple human-centered design engagements, leading cross-agency qualitative research efforts supporting the Administration’s priorities and is a Technical Advisor for the Customer Focused Research Group (CFRG), within the Office of Burden Reduction & Health Informatics (OBRHI). Morgan ensures the CFRG team leverages human-centered design methodologies to elevate the voices of all CMS stakeholders. Prior to joining CFRG, Morgan spent 2.5 years in the Office of the Administrator directly supporting the Principal Deputy Administrator for Operations and Policy.
The 2024 National Impact Assessment aggregates retrospective data from 26 CMS quality and value-based incentive programs to characterize quality and efficiency impacts associated with the use of measures. The session will focus on summarizing key findings from these comprehensive analyses that provide important insights regarding effects of the COVID-19 pandemic during the period of analysis. We will describe national measure performance trend data pre-COVID-19 (2016–2019) compared with results in the initial years of the COVID-19 public health emergency (PHE)— 2020 and 2021— and describe patient impact and costs avoided when performance for select measures improved. Data also will be presented on how the CMS measure portfolio is evolving to reduce measurement burden and address CMS quality priorities. Lessons learned from the COVID-19 PHE and proposed actions to improve the resilience of quality measurement and the health care system will be discussed. Finally, underscoring equity as a primary objective of the CMS National Quality Strategy, the session will explore patterns of disparities in quality measure scores and offer insight into underlying drivers of disparities identified through focus groups in underserved communities.
Robert Ziemba, PhD
Statistician, HSAG
Robert Ziemba is a statistician at HSAG with more than 7 years of experience in the analysis of CMS quality measures. Dr. Ziemba was the lead statistician for the 2021 and 2024 National Impact Assessment of the Centers for Medicare & Medicaid Services (CMS) Quality Measures Report. He oversees development and implementation of data analysis and presentation. Dr. Ziemba also contributes analytic support for several CMS projects in the area of quality measurement and program implementation. Dr. Ziemba has a PhD in Biology from Arizona State University and a Master of Public Health degree from the University of South Florida.
Kyle Campbell, PharmD
Project Director,HSAG
Kyle Campbell has over 25 years of combined research, pharmacy, quality improvement, and measure development experience. His experience includes developing and maintaining quality measures for use in CMS programs, advising on national policy related to measure development, designing and implementing quality improvement interventions, and overseeing research related to medication safety. At HSAG, he oversees projects related to measure development, health care policy and evaluation, and medication safety, including the CMS Measure & Instrument Development and Support (MIDS) National Impact Assessment of CMS Quality and Efficiency Measures contract. Dr. Campbell has a Doctor of Pharmacy degree from the University of Florida.
Kendra Hanley, MS, BA
Impact Assessment Team Lead,HSAG
Kendra Hanley is a nationally recognized expert with over 15 years’ experience in the development, specification, and evaluation of quality measures, with emphasis on electronic clinical quality measures. Ms. Hanley is the HSAG team lead for the 2024 National Impact Assessment of the CMS Quality Measures Report. She oversees research, methodologic, and analytic activities, including data acquisition and analysis. Previously, she led a team responsible for the CMS Quality Measure Development Plan, mandated by the Medicare Access and CHIP Reauthorization Act of 2015. Ms. Hanley has a Master of Science degree in Health Systems Management from Rush University in Chicago.
Approximately 68 million people in the United States speak a language other than English at home, and of those, 8.2% speak English less than very well. Individuals with limited English proficiency (LEP) do not speak English as their preferred language and have a limited ability to read, write, speak, or understand English. A lack of meaningful language access can lead to inequitable access to health and human services. Research indicates that adverse events affect patients with LEP more frequently, are often caused by communication problems, and are more likely to result in serious harm compared to those that affect English-speaking patients. Providing language access decreases barriers to equal access to health and human services. During this session, you will hear from three leaders working to ensure language access. They will share insights from the federal perspective with a focus on policy and communications, as well as from one large health system and their 20-year experience with language services.
Maria Moreno MPH
Program Manager Sutter Health
Maria has been at Sutter Health for twenty years, primarily focusing on developing and executing patient and community-centered health equity activities to close health disparities, ensuring alignment with strategic priorities, forming and maintaining clinical and non-clinical partnerships and programs across the organization. In these two decades at Sutter, Maria has led dozens of large projects and programs strategically planning, designing goals and objectives with milestones, and evaluating impact of each. Maria has focused on using evidence based, data-driven methods to understand root causes to respond with key tactics to close health equity gaps, address key performance indicators, while developing interventions. Maria attributes her success to her high level of attention to detail and diligence to ensure the intersection with clinical improvement, quality, and patient-centeredness with a commitment to better serve historically marginalized communities.
Genevieve Babecki
Language Access Coordinator, HHS/Office of Civil Rights
Genevieve Babecki is the Language Access Coordinator for the U.S. Department of Health and Human Services, where she serves in the Office for Civil Rights as a senior policy expert establishing language access compliance policies and processes for the Department. Prior to joining the Office for Civil Rights, she was the City of Alexandria, Virginia's first Language Access Coordinator and worked on language access initiatives across the Virginia state court system. Genevieve is a nationally certified medical interpreter who previously assisted Spanish-speaking patients and families at University of Maryland Capital Region Medical Center, as well as Children's National Hospital Emergency Medicine and Trauma Center. While French is Genevieve's first language, she is also fluent in English and Spanish.
Lina Rashid
Senior Policy Advisor, Centers for Medicare and Medicaid Service/Center for Consumer Information and Insurance Oversight
Lina Rashid currently serves as the Senior Policy Advisor for the Deputy Director of the Center for Consumer Information and Insurance Oversight (CCIIO) where she assists with expanding Americans’ access to health coverage through the Affordable Care Act (ACA). She has supported implementation of the ACA in a variety of roles across government while working with advocates, tribes, stakeholders, and states. In that role she leads technical assistance efforts for the Section 1332 State Innovation Waiver Program. She was the Acting Director of the Division for Consumer Advocacy and Assister Support in the Consumer Support Group, and was also a State Officer at CCIIO. As an External Outreach Specialist for the HHS Regional Director’s Office in Chicago she focused on policy and outreach related issues in Region V (IL, IN, MI, MN, WI). Before joining HHS, she served in Congress as a Legislative Assistant for Rep. Betty McCollum from Minnesota where she played an important role in the passage of the ACA, formation of the Quality Care Coalition, and served as an adviser for global health, labor, housing, and Appropriations, Oversight, and Budget Committee work. Lina also served as a Legislative Assistance for Rep. Joe Sestak from Pennsylvania where she focused on healthcare issues. Lina received a B.S. in Psychology from the University of Pittsburgh and a Master’s Degree in Health Management from Duquesne University.
Anita Pinder
Director, Centers for Medicare & Medicaid Services/Office of Equal Opportunity & Civil Rights
Anita Pinder is the Chief Diversity Officer and Director of the Office of Equal Opportunity and Civil Rights at the Centers for Medicare & Medicaid Services (CMS). She provides agency-wide leadership on issues related to equal employment opportunity, reasonable accommodation, prevention of workplace harassment, and civil rights. She leads the agency’s Diversity, Equity and Inclusion priority aimed at creating and sustaining a workplace where differences are pursued and embraced, processes and systems are impartial and fair, and individuals experience a sense of satisfaction and belonging. She is involved in formulating policy and guidance that supports CMS in achieving its strategic objectives in service to the American public.
The purpose of the proposed panel is to describe the Centers for Medicare & Medicaid Services Innovation Center’s approach to strengthening the focus on quality, outcomes, and experience within the Innovation Center’s alternative payment models. The resulting Quality Pathway emerged from the 2021 strategic refresh and includes development of a process to certify models for expansion based on quality improvement. The panel will introduce the pathway, describing how it elevates patient outcomes and experience of care within alternative payment models and emphasizes the translation of a model’s theory of action into measurable benefits for patients. The panel will discuss how this alignment of model design and quality strategy also drives new approaches to model evaluation, and how the Quality Pathway will be used to identify when a model may be eligible for expansion based on demonstrated quality improvement in alignment with CMMI’s statutory mandate.
Having addressed the conceptual basis for the Pathway, the panel will share examples of models recently under development to demonstrate how the pathway will be used at the Center. This will include insight into design choices around measure selection, implementation decisions on data collection, and evaluation considerations on methodological approach. As part of discussing implementation of the pathway, the panel will identify a number of considerations entailed in executing this new approach to model quality strategies at the Center, such as those associated with novel measure development and rigorously evaluating the impact of models on patient outcome and experience.
Susannah Bernheim, MD, MHS
Chief Quality Officer & Acting Chief Medical Officer, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services
Susannah Bernheim, MD, MHS, is Chief Quality Officer/Acting Chief Medical Officer for the CMS Innovation Center. She was previously an Associate Professor at Yale University School of Medicine and Senior Director of Quality Measurement at the Yale-New Haven Hospital Centers for Outcomes Research and Evaluation (CORE). She completed her undergraduate degrees at Yale University and her medical degree at the University of California, San Francisco (UCSF). Dr. Bernheim was a fellow in the Robert Wood Johnson Clinical Scholars program at Yale University, earning a Master’s degree in Health Sciences Research.
Noemi Rudolph, MPH
Director, Research and Rapid Cycle Evaluation Group, Center for Medicare and Medicaid Innovation (CMMI)
Noemi Rudolph is the Director of the Research and Rapid-Cycle Evaluation Group (RREG) at the Center for Medicare & Medicaid Innovation (CMMI). In this role, Ms. Rudolph leads the team that conducts evaluations of Medicare and Medicaid payment and service delivery model tests and demonstrations and oversees research with policy relevance to CMS. Ms. Rudolph has a long background in evaluations and previously served as the Deputy Group Director and Division Director in RREG. Prior to becoming a manager at CMS, she worked on the evaluations of projects involving dual eligible beneficiaries, Medicare Advantage, and the Medicare prescription drug benefit. She joined the federal government as a Presidential Management Fellow working briefly in the U.S. House of Representatives Ways and Means Health Subcommittee, CMS’ San Francisco Regional Office, and a Medicare payment contractor. Ms. Rudolph has an M.P.H. in Community Health Sciences and a B.S. in Psychobiology, both from the University of California, Los Angeles.
Jacob Quinton, MD, MPH
Medical Officer, Center for Medicare and Medicaid Innovation (CMMI), Centers for Medicare & Medicaid Services
Dr. Jacob Quinton is a medical officer at the CMS Innovation Center (CMMI) where he has for the past three years worked on model design for primary care and condition-specific payment models as well as working on quality and equity issues across the CMMI model portfolio. Before joining CMMI he completed his internal medicine residency at Yale and the National Clinician Scholars Program at UCLA, during which time he was an NIH-funded health disparities researcher focused on high-need high-cost care in Medicaid as well as leading projects on the quality and equity implications of telemedicine use during the COVID-19 pandemic.
Oral health is a crucial component of overall well-being. States are mandated to provide dental care for children under Medicaid and the Children's Health Insurance Program (CHIP). However, a 2023 report revealed that only 46% of Medicaid-insured children and teens had a dental check-up in 2018. The COVID-19 pandemic further hindered access to dental services, with a 20% reduction in treatments for children. This decrease in access to preventive and necessary dental care has led to a higher reliance on emergency services and the need for antibiotics to treat advanced dental issues and their complications. The pandemic also necessitated a shift towards less invasive treatments, like silver diamine fluoride (SDF). Healthcare systems aiming to enhance patient experience often encounter significant obstacles, indicating the necessity to modify behaviors and practices throughout various organizational levels and sectors. However, they can also benefit from applying well-established principles and methods for quality improvement (QI).
This session will delve into the findings from three joint studies analyzing enrollment and claims data from the Transformed Medicaid Statistical Information System (T-MSIS). These studies aim to understand how Medicaid-enrolled children used oral health services during 2019, 2020, and 2021. The data reveals patterns over time and highlights significant variations based on geography and demographics. Notably, there has been no substantial change in the rates and duration of antibiotic prescriptions for dental issues. Nevertheless, there is a marked increase in the use of silver diamine fluoride and a growing number of emergency department visits for non-traumatic dental problems, especially among children with special healthcare needs. These trends highlight numerous opportunities for quality improvement efforts at various levels and areas within the dental care system.
Meagan Khau, MHA (Moderator)
Director, Data and Policy Analytics Group, Office of Minority Health,Centers for Medicare & Medicaid Services
Meagan Khau is the Director of the Data Analytics & Research Group (DARG) at the at the Centers for Medicare & Medicaid Services’ Office of Minority Health (CMS OMH). DARG conducts research and analyses to identify areas disparities to improve quality of care and access to care for the underserved populations, and implements initiatives and data analyses to improve data collection and reporting of race and ethnicity, primary language, disability, and other characteristics associated with health disparities. Prior to joining CMS OMH, Meagan was the Deputy Director of the Division of Pharmacy in the Center for the Medicaid and CHIP Services, managing the operations of the Medicaid Drug Rebate Program, supporting system developments, ensuring program compliance, and implementing new policies and regulations. Meagan received her Master of Health Administration from the University of Southern California and B.A. in Sociology from the University of California, Irvine.
Kimia Imani, MS
DDS/PhD Student, University of Washington School of Dentistry
Kimia Imani is a second-year, dual-degree DDS and PhD student at the University of Washington School of Dentistry. She earned her undergraduate degrees (Biochemistry and Psychology) and master’s degree (Health Services) at the UW as well. Kimia’s research focuses on low-income children and adolescents' oral health disparities, the impact of special health care needs on dental care use, and most recently veterans' unmet dental care needs. Kimia draws on knowledge from the social and dental sciences, aiming to eliminate inequalities and improve oral health for vulnerable populations.
Kaylie Magidson, DDS
Pediatric Postdoctorate Student, New York University College of Dentistry
Dr. Magidson received her BSc Honors with Distinction from Western University in 2017, and is a graduate of the Schulich School of Medicine and Dentistry in London, Ontario. Dr. Magidson is the recipient of numerous academic awards, including being the Gold Medal recipient for both her undergraduate and dental degrees. During dental school, Dr. Magidson served as Alpha Omega chapter president and was involved in various programs where she worked with children of all ages, including those with special healthcare needs. Her passion for children's oral healthcare led her to the post-graduate program at NYU College of Dentistry. She is currently in her second year of the program and serves as the pediatric dentistry representative on the Graduate Council on Ethics and Professionalism Committee. Dr. Magidson is a member of the American Academy of Pediatric Dentistry, Canadian Society for Disability & Oral Health and Women in Dentistry. While Dr. Magidson has greatly enjoyed living in NYC, she looks forward to returning home to promote oral health and improve access to care for children in Calgary.
Beau Meyer, DDS, MPH
Associate Professor, The Ohio State University College of Dentistry
Dr. Meyer is an Associate Professor at The Ohio State University College of Dentistry and Nationwide Children’s Hospital, and an Associate Medical Director with Partners For Kids. He completed dental school at The Ohio State University College of Dentistry, and his residency training in pediatric dentistry and master’s degree in health policy and management from the University of North Carolina at Chapel Hill. He is an active member of the American Academy of Pediatric Dentistry, serving as an Expert Consultant for their Pediatric Dental Medicaid and CHIP Advisory Committee and Chair for their Council on Pre-doctoral Education.
The Indian Health Service (IHS) continues to support the expanded use of telehealth to provide patient care after the COVID-19 Public Health Emergency (PHE). This presentation will focus on an overview of the use of telehealth at the IHS and the support the Centers for Medicare & Medicaid Services (CMS) provides. The presentation will include the accomplishments in expanding telehealth from April 2020 to the present. The various telehealth services available at the IHS will be discussed including CMS’s support provided to rural and frontier areas. Issues in providing audio-only services will be discussed and aligned with services on the Medicare Telehealth Services List for CY 2024. Presenters will provide metrics describing the utilization of telehealth in IHS. Telehealth best practices will be discussed, and quantitative and qualitative results from IHS patient and IHS provider telehealth surveys will be addressed. Finally, patient outcomes utilizing telehealth services will be included and quality improvement options provided.
Susan Karol, MD
Chief Medical Officer, Division of Tribal Affairs, Centers for Medicare & Medicaid Services
Dr. Karol is the Chief Medical Officer for the Division of Tribal Affairs (DTA) in the Center of Medicaid and the Children’s Health Insurance Program (CMCS) at the Centers for Medicare and Medicaid Services (CMS). DTA serves as the point of contact on American Indian and Alaska Native (AI/AN) health policy and serves the CMS Tribal Technical Advisory Group (TTAG) regarding AI/AN issues for the agency. She is an enrolled member of the Tuscarora Indian Nation, the first American Indian woman General Surgeon and former National Chief Medical Officer for the Indian Health Service (2008-2017). Dr. Karol is a Captain in the United States Public Health Service deploying throughout the country to meet national healthcare needs such as hurricane recovery, border patrol health needs, migrant care, and COVID-19 missions. She graduated from Dartmouth College and the Medical College of Wisconsin prior to her general surgical training at the University of Massachusetts. She is a Diplomat of the American Board of Surgery (DABS), Fellow of the American College of Surgeons (FACS) and a member of the Association of American Indian Physicians. Dr. Karol is the Chairperson of the CMS American Indian and Alaska Native Employee Resource Group and is a member of the CMS Diversity, Inclusion and Equality Council. She is the Federal Co-Chairperson for the CMS Tribal Technical Advisory Group (TTAG) Health Equity, Data and Behavioral Health Subcommittees.
Susy Postal, DNP, RN-BC
Chief Informatics Officer, Indian Health Service
Susy Postal, DNP, RN-BC, (she/her) is the Chief Health Informatics Officer for the Indian Health Service (IHS), where her focus bridges information technology (IT) with health care to promote quality patient care and improved outcomes. She co- leads IHS’s telehealth expansion to meet the agency’s needs during and post COVID-19 public health emergency. Dr. Postal supports various national quality initiatives and the reporting needs for IHS. Dr. Postal leads the IHS’s National Quality Payment Program workgroup to support IHS quality reporting. Dr. Portal identifies quality measures reporting requirements, promotes the IHS’s health IT modernization efforts, and is the sponsor for both the IHS Quality Measure Advisory Board and the National Council of Informatics. Dr. Postal reviews federal policies and addresses areas of impact for IHS federal, tribal, and urban programs. She supports governmental efforts addressing data governance, social determinants of health, and the Long Term Impact of COVID including patient resources available. She serves on the U.S. Department of Health and Human Services (HHS) Long-Term Impact of COVID-19 and National Research Action Plan (NRAP) on Long COVID workgroups. Dr. Postal represents IHS on over 17 IHS workgroups and 26 national committees.
Chris Fore, PhD
Director, Indian Health Service Telebehavioral Health Center of Excellence
Chris Fore, Ph.D. is currently the Director of the Indian Health Service (IHS) TeleBehavioral Health Center of Excellence (TBHCE). He is a member of the Choctaw Nation of Oklahoma. He received his doctorate in child clinical psychology from Oklahoma State University. In 2009, he established the IHS TeleBehavioral Health Center of Excellence. The mandate of the Center is to explore the feasibility of telebehavioral health within IHS (regionally and nationally), improve access to care, develop models of care, and to address sustainability.
There is no denying that that there is much work to be done to improve the transplantation system as there are over 100, 000 patients waiting for organ transplants, as of October 2023.
In September 2023, a federal collaborative, led by the Centers for Medicare & Medicaid Services (CMS) and the Health Resources and Services Administration (HRSA), called the Organ Transplantation Affinity Group (OTAG), launched with a goal of strengthening accountability, equity, and performance to improve access to organ donation, procurement, and transplantation for patients, donors, families and caregivers, and providers.
Join this listening session to learn about and provide feedback on OTAG’s mission to strengthen federal oversight and support of the organ transplantation system.
Jean Moody-Williams, RN, MPP
Deputy Director, Center for Clinical Standards and Quality, Centers for Medicare & Medicaid Services
Jean D. Moody-Williams, RN, MPP, is the current Deputy Center Director for the Center for Clinical Standards and Quality (CCSQ) at the Centers for Medicare & Medicaid Services (CMS). She has served since 2008 under multiple administrations in the Senior Executive Service (SES) Corp. She currently is a part of a leadership team responsible for one of CMS’ Centers that has nearly 800 employees and a $3 billion annual budget. She is responsible for leading quality improvement, value based purchasing, and delivery system reform. She provides oversight to multiple kidney health activities including regulations for organ procurement and transplantation programs and learning networks, development of conditions of participation for dialysis facilities and healthcare systems, oversight of ESRD Networks for quality improvement and the ESRD Quality Incentive Program. She works to ensure better healthcare, healthier populations and smarter spending of healthcare dollars for more than 90 million Americans.
Suma Nair, PhD, MS, RD
Associate Administrator, Health Services Bureau, Health Resources and Services Administration
Suma Nair PhD, MS, RD is the Associate Administrator for the Health Systems Bureau in the Health Resources and Services Administration.
As the Associate Administrator, Dr. Nair leads a portfolio of unique programs that improve access to care and strengthen public health and health care systems by increasing access to organ and blood stem cell donation and transplantation, including leading efforts to modernize the Organ Procurement and Transplantation Network; facilitating vaccine and countermeasure injury compensation; ensuring access to free or low cost health care at Hill-Burton obligated facilities; and providing health care to individuals with Hansen’s disease (leprosy), as well as educating health care professionals and conducting research on Hansen’s disease diagnosis and treatment.
Previously, Dr. Nair led the Office of Quality Improvement in HRSA’s Bureau of Primary Health Care, which supports more than 1,400 health centers operating more than 13,000 service delivery sites, including community health centers, migrant health centers, health care for the homeless centers, and public housing primary care centers. In this role, Dr. Nair led programs related to clinical and operational quality improvement, patient safety and risk management, primary care innovation, data reporting, and program evaluation. Dr. Nair led national health center clinical quality and performance improvement strategies/initiatives, including risk management and patient safety activities, ambulatory care accreditation, patient centered medical home recognition, and integration of behavioral health and oral health care within primary care. Dr. Nair led the development and implementation of the Health Center COVID-19 Vaccine, Testing Supply, Therapeutics and Mask Programs directly allocating these critical resources to health centers to advance health equity in medically underserved communities. Dr. Nair was recognized as a finalist for the Service to America Medal by the Partnership for Public Service in 2022.
Prior to joining the Bureau of Primary Health Care, Dr. Nair worked on program evaluation and performance improvement programs impacting more than 80 different grant programs across HRSA. She earned a Bachelor of Arts degree in Nutrition and a Master of Science degree in Public Health Nutrition from Case Western Reserve University, and a Doctor of Philosophy degree in Health Services Administration from the University of Maryland, College Park.
Learn about the Age-Friendly Health Systems movement and how it leads to improved outcomes for older adults and health system resilience. Presenters will share actionable opportunities, implementation successes and programs for specific settings.
Terry Fulmer, PhD, RN, FAAN
President, The John A. Hartford Foundation
Dr. Fulmer is an expert in geriatrics and a former academic leader. She serves as the chief strategist for a national foundation dedicated to improving the care of older adults and her vision catalyzed the Age-Friendly Health Systems movement.
Leslie Pelton, MPA
Vice President, Institute for Healthcare Improvement
The Healthcare and Public Health (HPH) sector continues to experience increasingly sophisticated cyberattacks that exploit complex hospital infrastructures, underfunded cybersecurity functions, and numerous vulnerable legacy medical devices. These cyberattacks against the sector are growing both in numbers and severity. ASPR, in its Sector Risk Management Agency (SRMA) role and with active involvement from stakeholders across the Department of Health and Human Services (HHS), proactively confronts these growing cyber threats and strengthens the HPH sector’s cybersecurity posture. In December, HHS published a roadmap outlining how the department will level up to this challenge to make our healthcare system more resilient and prepared for cyber threats. In January, aligned with the first pillar in this new roadmap, HHS—through ASPR—published HPH Cybersecurity Performance Goals to further help healthcare organizations implement these high-impact cybersecurity practices.
Brian Mazanec, PhD
Deputy Director, Office of Preparedness, Department of Health and Human Services
"In Brian’s role as Deputy Director of the Office of Preparedness, he helps lead the office responsible for all aspects of preparation for events such as disease outbreaks, natural disasters, cyber attacks, and intentional attacks with chemical, biological, radiological, or nuclear (CBRN) weapons. This work is closely coordinated with other offices within ASPR, as well as other related components within HHS, other U.S. government departments and agencies, and international allies and partners. Brian’s responsibilities include oversight and management of the following component offices: Security and Intelligence; Information Management, Data and Analytics; Critical Infrastructure Protection; Health Care Readiness; Medical Reserve Corps; Planning and Exercises; Continuity; and the Secretary’s Operations Center.
Prior to joining ASPR, Brian served at the U.S. Government Accountability Office (GAO), where he was the senior executive responsible for leading the agency’s Strategic Warfare and Intelligence portfolio."
Data-driven quality improvement is the foundation of healthcare transformation. The ability to visualize the end goals, outcomes and results, strategically leverage healthcare data, then design a quality improvement process/intervention to deliver outcomes is what separates the highly effective quality improvement professionals from those that are not. This session focuses on the practices and interventions quality improvement professionals can use on a daily basis to help them relate the small decisions to the bigger picture and ensure that what’s produced eventually will be valuable.
Anita Monteiro
Director, iQuality Improvement & Innovation Group Centers for Medicare & Medicaid Services
Anita Monteiro serves as the Director of the Quality Improvement & Innovation Group within the U.S. Centers for Medicare & Medicaid Services. Anita is passionate about and dedicated to her work, leading programs that improve the lives, health outcomes and the experience of care for the people that access healthcare services. The quality improvement work is accomplished by several teams of federal and contract staff across the U.S, as part of national programs that collectively serve as the primary driver for healthcare quality improvement for Medicare in the United States. Anita has previously served in leadership roles in CMS in the areas of Quality Measurement and Enforcement, and as a pediatric and neonatal ICU nurse, manager, and educator in both clinical and academic settings, and in several hospital administration roles in the private sector.
Timmy T. Nelson
Patient Advocate/Outreach Advisor, UPS (retired)/Network 4, Quality Insights,Chester County Community Foundation
July 21, 2017, Timmy Nelson was fortunate to undergo a life altering major surgery. After 3.5 years of home based, self-administered peritoneal dialysis (PD), he became the recipient of a fully functioning kidney.
Timmy was diagnosed with End Stage Renal Disease (ESRD) in January of 2013 and began peritoneal dialysis in December of that year. This modality of treatment enabled him to continue his frequent air travel and remain effective in performing his assigned work-related duties.
Timmy retired from UPS in March of 2015 after 38 years of service.
Timmy began his ESRD outreach by developing a PD Patient Support Group at his dialysis facility. The focus of this West Chester based group was addressing and lessening the concerns of patients, caregivers, along with perspective PD patients.
Post retirement, Timmy developed a working relationship with Quality Insights Renal Network 4. He attends the monthly quality improvement conference calls and is a member of the Network 4 Medical Review Board (MRB).
Timmy is a Board Member (Secretary/Treasurer) for Quality Insights – WV.
Timmy meets with dialysis patients to share his dialysis/transplant journey. He is an ambassador and Governing Board Member for Gift of Life -Philadelphia.
Serving as a patient resource, his goal is to assist with education, transitions to home dialysis modalities, and preparation for patients to be acceptable candidates for the kidney transplant waitlist.
Sven T. Berg, MD, MPH
Chief Executive Officer, Quality Insights
Dr. Sven T. Berg serves as the Chief Executive Officer of Quality Insights, a health care quality improvement organization. His role encompasses overseeing federal, state, and commercial projects that aim to enhance health care quality and assurance. Quality Insights operates as a CHANGE AGENT, inspiring transformation in health and healthcare behaviors; a CONNECTOR, building a community focused on optimal health systems; and a DECISION PARTNER, transforming data into insights for informed decision-making.
Before joining Quality Insights, Dr. Berg was the Chief of Clinical Services at Wilford Hall Medical Center, located at Lackland AFB, Texas. There, he oversaw over a million outpatient and 25,000 inpatient encounters annually. His notable achievements include merging two major medical center staffs, initiating a physician engagement program that increased productivity by 15% in the first year, and chartering 12 lean events to enhance healthcare efficiency, quality, and patient safety.
Earlier, as Chief of Clinical Services for a Medical Operations Group, Dr. Berg set professional standards for over 400 physicians, focusing on process improvement and patient safety. He coauthored a $65 million, five-year diabetes prevention and treatment plan, leading to the establishment of a diabetes center of excellence.
Dr. Berg holds an MD from Cornell University Medical College and a Masters in Public Health from the Uniformed Services University of the Health Sciences. He completed a Pediatrics residency at Wilford Hall USAF Medical Center and a Pediatric Hematology-Oncology fellowship at St. Jude Children’s Research Hospital. He is a Fellow of the American Academy of Pediatrics.
Oral health is a crucial component of overall well-being. States are mandated to provide dental care for children under Medicaid and the Children's Health Insurance Program (CHIP). However, a 2023 report revealed that only 46% of Medicaid-insured children and teens had a dental check-up in 2018. The COVID-19 pandemic further hindered access to dental services, with a 20% reduction in treatments for children. This decrease in access to preventive and necessary dental care has led to a higher reliance on emergency services and the need for antibiotics to treat advanced dental issues and their complications. The pandemic also necessitated a shift towards less invasive treatments, like silver diamine fluoride (SDF). Healthcare systems aiming to enhance patient experience often encounter significant obstacles, indicating the necessity to modify behaviors and practices throughout various organizational levels and sectors. However, they can also benefit from applying well-established principles and methods for quality improvement (QI).
This session will delve into the findings from three joint studies analyzing enrollment and claims data from the Transformed Medicaid Statistical Information System (T-MSIS). These studies aim to understand how Medicaid-enrolled children used oral health services during 2019, 2020, and 2021. The data reveals patterns over time and highlights significant variations based on geography and demographics. Notably, there has been no substantial change in the rates and duration of antibiotic prescriptions for dental issues. Nevertheless, there is a marked increase in the use of silver diamine fluoride and a growing number of emergency department visits for non-traumatic dental problems, especially among children with special healthcare needs. These trends highlight numerous opportunities for quality improvement efforts at various levels and areas within the dental care system.
Meagan Khau, MHA (Moderator)
Director, Data and Policy Analytics Group, Office of Minority Health,Centers for Medicare & Medicaid Services
Meagan Khau is the Director of the Data Analytics & Research Group (DARG) at the at the Centers for Medicare & Medicaid Services’ Office of Minority Health (CMS OMH). DARG conducts research and analyses to identify areas disparities to improve quality of care and access to care for the underserved populations, and implements initiatives and data analyses to improve data collection and reporting of race and ethnicity, primary language, disability, and other characteristics associated with health disparities. Prior to joining CMS OMH, Meagan was the Deputy Director of the Division of Pharmacy in the Center for the Medicaid and CHIP Services, managing the operations of the Medicaid Drug Rebate Program, supporting system developments, ensuring program compliance, and implementing new policies and regulations. Meagan received her Master of Health Administration from the University of Southern California and B.A. in Sociology from the University of California, Irvine.
Kimia Imani, MS
DDS/PhD Student, University of Washington School of Dentistry
Kimia Imani is a second-year, dual-degree DDS and PhD student at the University of Washington School of Dentistry. She earned her undergraduate degrees (Biochemistry and Psychology) and master’s degree (Health Services) at the UW as well. Kimia’s research focuses on low-income children and adolescents' oral health disparities, the impact of special health care needs on dental care use, and most recently veterans' unmet dental care needs. Kimia draws on knowledge from the social and dental sciences, aiming to eliminate inequalities and improve oral health for vulnerable populations.
Kaylie Magidson, DDS
Pediatric Postdoctorate Student, New York University College of Dentistry
Dr. Magidson received her BSc Honors with Distinction from Western University in 2017, and is a graduate of the Schulich School of Medicine and Dentistry in London, Ontario. Dr. Magidson is the recipient of numerous academic awards, including being the Gold Medal recipient for both her undergraduate and dental degrees. During dental school, Dr. Magidson served as Alpha Omega chapter president and was involved in various programs where she worked with children of all ages, including those with special healthcare needs. Her passion for children's oral healthcare led her to the post-graduate program at NYU College of Dentistry. She is currently in her second year of the program and serves as the pediatric dentistry representative on the Graduate Council on Ethics and Professionalism Committee. Dr. Magidson is a member of the American Academy of Pediatric Dentistry, Canadian Society for Disability & Oral Health and Women in Dentistry. While Dr. Magidson has greatly enjoyed living in NYC, she looks forward to returning home to promote oral health and improve access to care for children in Calgary.
Beau Meyer, DDS, MPH
Associate Professor, The Ohio State University College of Dentistry
Dr. Meyer is an Associate Professor at The Ohio State University College of Dentistry and Nationwide Children’s Hospital, and an Associate Medical Director with Partners For Kids. He completed dental school at The Ohio State University College of Dentistry, and his residency training in pediatric dentistry and master’s degree in health policy and management from the University of North Carolina at Chapel Hill. He is an active member of the American Academy of Pediatric Dentistry, serving as an Expert Consultant for their Pediatric Dental Medicaid and CHIP Advisory Committee and Chair for their Council on Pre-doctoral Education.
Drug overdose deaths in the United States, driven by illicit fentanyl and other opioids, remain at historically high levels – with more than 107,000 lives lost in the past year, and millions more struggle with opioid and other substance use disorders. The opioid crisis reaches every corner of our country, from alleyways to nursing homes, and requires an immediate call to action. Federal partners, local governments, healthcare institutions, and communities are working together to provide viable solutions to combating the opioid crisis.
There is a nationwide need for education on medications for opioid use disorder (MOUD) to increase the number of practitioners eligible to manage and/or prescribe appropriate medications. Medicare providers are uniquely positioned to create the gold standard of opioid use disorder treatment by screening, diagnosing, and treating Medicare patients for opioid use disorder as routine healthcare. They can also exhibit positive attitudes to reduce stigmas associated with opioid use disorder.
This session will consist of a panel discussion where, IPRO, the Quality Innovation Network-Quality Improvement Organization (QIN-QIO) will describe the state of the opioid crisis from a nursing home perspective and discuss how to improve patient safety in vulnerable populations. The Substance Abuse and Mental Health Services Administration (SAMHSA) will provide regulatory updates on opioid prescribing, the stigma of opioid addiction, and discuss key elements of Opioid Treatment Programs (OTPs). Finally, the Health Resources and Services Administration (HRSA), Federal Office of Rural Health Policy (FORHP), will share opioid-related resources and funding opportunities to engage partners in rural communities.
Robert Accetta, RPh, BCGP, FASCP
Senior Pharmacist, IPRO QIN_QIO
Robert C. Accetta is a Senior Pharmacist in IPRO’s Healthcare Quality Improvement department. He has more than 35 years of experience and insight in all aspects of post-acute, long-term, and assisted living pharmacy service, facility oversight, project development, and implementation skills. He has experience with Quality Assurance and the CMS State Operations Manual, Appendix PP, Nursing Homes, strategies for tapering psychotropic medications including validation of diagnoses for use of Antipsychotics, and Gradual Dose Reductions (GDRs). Prior to joining IPRO, Mr. Accetta created a consulting business, advising facilities, long term care pharmacies, pharma, and associations on topics related to health care, survey preparedness, pharmacy consulting, and education. He is a Fellow and member of the Board of Directors, of the American Society of Consultant Pharmacists (ASCP).
Megan Meacham, MPH
Director, Rural Strategic Initiatives Division, Health Resources and Services Administration (HRSA)
Megan is Director of the Rural Strategic Initiatives (RSI) Division within HRSA’s Federal Office of Rural Health Policy (FORHP), where she leads the team that manages a number of high-priority rural health grant programs, including the Rural Communities Opioid Response Program (RCORP). Prior to becoming Director of RSI, she served as a Senior Advisor in FORHP where she worked on a variety of rural program and policy issue areas, and was a key member involved in the creation of the RCORP Initiative. She has also worked as a Project Officer in FORHP’s Hospital State Division where she coordinated a national quality improvement initiative and managed a number of state-based grant programs.
Wanda Pamphile, PharmD, MPH
Senior Health Insurance Specialist, Centers for Medicare & Medicaid Services
CDR Wanda Pamphile joined the Centers for Medicare & Medicaid Services (CMS), Office of Program Operations and Local Engagement (OPOLE) in June 2023, and serves as the Provider Outreach Specialist and Rural Health Coordinator in Region 2 (New York). Upon graduating from Temple University School of Pharmacy, she became a Commissioned Corps officer with the United States Public Health Service (USPHS).
CDR Pamphile has held numerous leadership positions during her 20 years of service as an officer. Prior to joining OPOLE, she worked at the Food and Drug Administration (FDA), the Bureau of Prisons (BOP), and most recently the Health Resources and Services Administration (HRSA).
In addition to earning her doctorate in pharmacy, CDR Pamphile holds a Bachelor of Science in Biology from Howard University, and a Master of Public Health degree from The George Washington University Milken Institute School of Public Health.
Karran Phillips, MD, MSc
Deputy Director, Center for Substance Abuse Treatment, SAMSHA
Karran Phillips, MD, MSc is the Deputy Director for the Center for Substance Abuse Treatment (CSAT). She comes to CSAT after 15 years at the National Institute on Drug Abuse, National Institutes of Health (NIDA, NIH) where she served as a clinical investigator, Medical Director of the Archway Outpatient Treatment Clinic, and the NIDA Clinical Director. As Clinical Director she coordinated, supported, and supervised the development, implementation and conduct of intramural clinical research activities and provided the infrastructure needed to promote top quality clinical research and to ensure research participant safety and confidentiality. Her clinical research focuses on the use of mobile health technologies to improve access and quality care for individuals with substance use disorder and hepatitis C and HIV. Her current clinical work includes providing low threshold buprenorphine treatment to individuals with SUD from a mobile van outside the Baltimore Mens' Detention Center.
It is a focus of the Biden-Harris Administration to make it easier for states to support schools in providing critical health care services, especially mental health services, for millions of students across the nation. The Bipartisan Safer Communities Act helped pave the way for the Medicaid guidance Delivering Services in School-Based Settings: A Comprehensive Guide to Medicaid Services and Administrative Claiming announced in May 2023 as a significant overhaul of school Medicaid billing. The new guidance is designed to streamline the process of school-based billing and increase students’ access to healthcare at school. This session provides an overview of the flexibilities provided in the guide, including allowing state Medicaid agencies to change the way that services are paid for in schools, as well as which providers can bill for services in schools. This session will highlight intra-state coordination between a State Medicaid Agency and Local Educational Agency (LEA) to leverage school-based services to improve behavioral health service delivery to children in Medicaid and CHIP and how they are measuring the improvements (e.g., increasing claiming and delivery of behavioral health services). This session will highlight how states can ease the administrative burden for schools so that more services can be paid for by Medicaid/CHIP—bringing more money into the schools for health services—and by extension allowing for more services.
Kate Ginnis MSW, MPH
CMCS Senior Advisor for Youth CoverageCenters for Medicare and Medicaid ServiceMedicare & Medicaid Services
Kate Ginnis, MSW, MPH is the Senior Policy Advisor for Youth in the Office of the Center Director at CMCS/CMS where she is focused on ensuring that the specific needs of children, youth, and their families are considered throughout policy development and implementation. Prior to joining CMS, Kate was the Senior Director of Parent, Child, and Family Policy and Programs at MassHealth, Massachusetts’ Medicaid and CHIP program. She previously held both clinical and policy advocacy leadership roles in behavioral health at Boston Children’s Hospital. Kate’s policy perspective is informed by over a decade providing treatment, teaching, and doing clinical research with children, adolescents, and families with behavioral health needs in a pediatric Emergency Department, as well as through being a parent to two young adults.
Kate Yager MA
Director of Medicaid Chicago Public Schools
She serves as the Director of Medicaid for Chicago Public Schools (CPS), one of the nation's largest school districts. Kate has more than 20 years of experience in public policy across various disciplines at the state and local levels in Illinois, New York, and Tennessee. Currently, Kate oversees all Medicaid programming at CPS, including service capture and claiming, compliance and quality assurance, and federal and state policy and advocacy efforts. Previously, Kate served as the Deputy Chief of Policy in the Office of Mayor Rahm Emanuel, State Policy Director for Healthy Schools Campaign, and Director of Economic Research for the Tennessee Technology Development Corporation. Kate has a Master of Arts degree in Economics from the University of Missouri - Kansas City and a Bachelor of Arts degree in Economics from Binghamton University. Kate currently serves on the National Alliance for Medicaid in Education (NAME) board of directors and is an active member of the governmental affairs committee.
Sergio Obregón M.Ed.
Bureau Chief for Medical Eligibility and Special Programs, Division of Eligibility
Illinois Department of Healthcare and Family Services
Sergio Obregón has over 17 years of experience working in the Medicaid landscape with most of his time spent designing, building, and implementing Medicaid programming that directly impacts schools and communities in urban areas. A strategic Social Services Director with a proven track record of accelerating and maintaining enrollment into public safety net programs, developing/implementing master data management solutions, building strong inter-agency relationships, and creating focused marketing programs, Sergio has worked to create opportunity for some of the most vulnerable communities in Chicago and now the State of Illinois as the Bureau Chief for Medical Eligibility and Special Programs within the Division of Eligibility at the Illinois Department of Healthcare and Family Services. Using the three-pillar approach of Enroll, Engage and Utilize, which he first put into practice at the Chicago Public Schools, Sergio now works across the agency to ensure all communities have access to the right care, at the right place and at the right time.
The HIV viral suppression measure included in CMS’ Adult Core Set (HVL-AD) offers a unique opportunity to promote inter-program, intra-state collaboration to share data and develop joint and/or complementary policies to drive high-impact, sustainable improvement for Medicaid beneficiaries living with HIV. NASTAD was funded by the Health Resources and Services Administration (HRSA) HIV/AIDS Bureau (HAB) to support building the capacity to calculate and report the HVL-AD measure to CMS, through the implementation of a quality improvement collaborative. Calculation of the HVL-AD measure uniquely utilizes multiple data sources in addition to claims data, including clinical and laboratory data received by public health programs. Panelists for this session will discuss how the use of multiple data sources across both Medicaid and public health programs, served as the catalyst for inter-agency collaboration, in which they will focus on recent experiences initiating HVL-AD reporting and use the data from a participating state in the collaborative. Panelists will highlight the process of inter-agency engagement, their team accomplishments and lessons learned particularly highlighting collaboration strategies. The session will offer insights into what it takes to create the conditions for both enabling collaboration as well as how that collaboration has led to the strategic use of the data plan engagement strategies that will support the improvement of health outcomes for Medicaid beneficiaries living with HIV.
Bashirat Olayanju, MPH,
Director, Health System NASTADs Integration
Bashirat Olayanju, MPH, serves as the Director of Health Systems Integration at the National Alliance of State and Territorial AIDS Directors (NASTAD), an organization devoted to advancing the health and dignity of people living with and impacted by HIV/AIDS, viral hepatitis, and intersecting epidemics by strengthening governmental public health and leveraging community partnerships. Bashirat spearheads multiple projects funded by the Health Resources and Services Administration, including a Special Projects of National Significance (SPNS) project dedicated to enhancing reporting of the HIV Viral Load Suppression Measure to CMS. Additionally, she leads coordination efforts for the Ending the HIV Epidemic (EHE) Systems Coordination Provider Cooperative Agreement. Bashirat has over 12 years of invaluable experience overseeing Ryan White’s care programming across Chicagoland and surrounding areas while working with the AIDS Foundation of Chicago. She also managed Ryan White’s quality improvement initiatives for Part A and B programming and operations, skillfully onboarding new stakeholders and guiding community engagement initiatives. She earned her MPH from DePaul University and a B.A. from the University of Wisconsin in La Crosse.
Marlene Matosky MPH, RN,
Chief - Clinical and Quality Branch Health Resources and Services Administration
Marlene Matosky joined the Health Resources and Services Administration’s HIV/AIDS Bureau in 2011. Marlene is the chief of the Clinical and Quality Branch in the Division of Policy and Data. Marlene leads projects related to clinical quality management, HIV/AIDS Bureau performance measures, Centers for Medicare and Medicaid quality payment programs and Medicaid Adult Core Set, stigma reduction, leadership training for people with HIV, and Special Projects of National Significance for rapid start, housing, telehealth, and aging. Prior to serving with the federal government, Marlene has spent over 20 years implementing HIV public health grants and serving as a registered nurse at the bedside. She is also a Lean Sigma Green Belt.
Parker James, MPP,
Policy Analyst The Hilltop Institute
Parker James is a policy analyst at The Hilltop Institute. He conducts data and policy analysis; prepares specification forms, memos, charts, tables, and reports; and reviews literature and Medicaid data to inform policy decisions. He contributes to various projects, such as the annual Maryland Medicaid HealthChoice evaluation, Maryland Medicaid’s Maternal Opioid Misuse Model, and the Maryland Medicaid-HIV Initiative to improve HIV viral load suppression rates. Parker graduated from the University of Maryland, Baltimore County (UMBC) with an MPP (Master of Public Policy) and a concentration in health policy. He also obtained a BA in health administration and policy from UMBC.
Increasing alignment and coordination across CMS quality programs and initiatives focuses our attention on high priority clinical areas and amplifies the impact of CMS actions. The CMS National Quality Strategy serves as a guide for collaboration as we concentrate our efforts to advance health equity, address maternal morbidity and mortality, streamline the CMS quality measurement portfolio, and improve the delivery of safe care. Join us to hear the current activities and accomplishments of programs across CMS as we work to get closer to the high-quality, safe, equitable, and resilient health care system envisioned for all individuals.
Jessica Lee, MD, MSHP
Acting Chief Medical Director, Center for Medicaid and CHIP Services, Centers for Medicare & Medicaid Services
Jessica Lee, MD, MSHP is the acting Chief Medical Officer for Center for Medicaid and CHIP Services, where she leads the center’s clinical strategy and portfolio in health-related social needs. Dr. Lee was previously the medical officer in the Division of Quality and Health Outcomes at CMCS, where she led initiatives in quality measures and quality improvement. Dr. Lee has deep expertise in clinical medicine and quality, and a background in health policy at the health system, state, and federal levels, including projects at Denver Health. She has served as a senior health policy analyst at the Government Accountability Office, focusing on payment policy and community benefits provided by nonprofit hospitals. She has conducted grant-funded research focused on the intersection of health care delivery systems and population health. Dr. Lee continues to care for patients as a practicing pulmonologist at the University of Pennsylvania and ICU physician at the Corporal Michael J. Crescenz VA Medical Center in Philadelphia.
Douglas Jacobs, MD, MPH
Chief Transformation Office Center for Medicaid and CHIP Services; Centers for Medicare & Medicaid Services
Dr. Jacobs is the Chief Transformation Officer in the Center for Medicare at the Center for Medicare and Medicaid Services (CMS). In this role, he helps to lead center-wide efforts to move the health care system towards value-based care, advance health equity, and promote delivery system transformation. Medicare is the nation's largest payer, responsible for more than 1 in 5 health care dollars spent in the US and responsible for covering more than 63 million Americans. Prior to this role, he was the Chief Medical Officer and first Chief Innovation Officer for the Pennsylvania Department of Human Services (DHS), where he helped oversee the state’s Medicaid program. Dr. Jacobs is a board-certified Internal Medicine Physician and has continued seeing patients throughout the pandemic. Dr. Jacobs was chosen by Governor Tom Wolf to help lead the Whole-Person Health Reform package in Pennsylvania. Under his leadership, the Department of Human Services created Pennsylvania's first equity incentive program in Medicaid and also led the creation of a new program to incorporate community-based organizations to address the social determinants of health. When the COVID-19 pandemic began, he helped lead the Department's response to the pandemic. He helped start a successful program that paired academic medical centers with long-term care facilities that was funded for $175 million by the state legislature. When the first COVID-19 vaccinations were approved under emergency use authorization, he helped lead the phased roll-out of vaccine distribution and implementation of vaccination programs for the most underserved Pennsylvanians. Dr. Jacobs has written and published articles in the New England Journal of Medicine, Journal of the American Medical Association, American Journal for Public Health, Health Affairs Blog, Washington Post, and New York Times. His most widely-cited academic work is a study that identified ways insurance companies were systematically discriminating against patients with chronic conditions, coining the term “adverse tiering” to describe their practice of taking all drugs to treat certain conditions like HIV and making them prohibitively expensive. He graduated magna cum laude from Brown University and with distinction from UCSF’s School of Medicine. He has worked in several health policy offices in government, including ASPE at HHS, the National Academy of Medicine, and the Senate HELP Committee. He was previously selected as one of Forbes 30 under 30 in Healthcare.
Susannah Bernheim, MD, MHS
Chief Quality Officer & Acting Chief Medical Officer, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services
Susannah Bernheim, MD, MHS, is Chief Quality Officer/Acting Chief Medical Officer for the CMS Innovation Center. She was previously an Associate Professor at Yale University School of Medicine and Senior Director of Quality Measurement at the Yale-New Haven Hospital Centers for Outcomes Research and Evaluation (CORE). She completed her undergraduate degrees at Yale University and her medical degree at the University of California, San Francisco (UCSF). Dr. Bernheim was a fellow in the Robert Wood Johnson Clinical Scholars program at Yale University, earning a Master’s degree in Health Sciences Research.
Michelle Schreiber, MD
Deputy Director, Quality & Value, Centers for Medicare & Medicaid Services
Dr. Schreiber is currently the Deputy Director of the Center for Clinical Standards and Quality at CMS, and the Director of the Quality Measurement and Value-Based Incentives Group. Dr. Schreiber is a general internal medicine physician with over 25 years of health care experience. Prior to coming to CMS she was the Senior Vice President and Chief Quality Officer of Henry Ford Health System (HFHS) in Detroit, Michigan. Earlier roles at HFHS included the Division Head of General Internal Medicine, and the SVP of Clinical Transformation and IT Integration, where she was the clinical lead of the systemwide Epic implementation. The Epic implementation and use earned HFHS a Davies Award in 2018. She has also held senior leadership roles at the Detroit Medical Center, where she was the Chief Quality Officer, and with Trinity Health System where she was the national system Chief Medical Officer, and acting interim Chief Medical Information Officer.
While at CMS Dr. Schreiber has led many quality initiatives, including MIPS transformation to value pathways, the modernization of the Hospital Stars program, as well as advancing digital quality measurement systems. She is on the boards of ACCME (continuing medical education), Leapfrog, and a member of HITACH (the national health information advisory committee) among others. Prior to joining CMS she also participated in numerous state and national quality committees including the Board of Directors for the Michigan Hospital Association Keystone Center and the Patient Safety Organization, the Board of Directors of MPRO (Michigan Peer Review Organization – the Michigan QIO), the National Quality Forum Patient Safety Metrics Committee, and the National Quality Partners.
Million Hearts® prioritized strategies for building healthy communities and optimizing care through a committed focus on specific populations experiencing inequities. This session describes how Million Hearts 2027 is addressing health equity with a review of communication assets and opportunities for engagement, an exploration of health equity-related issues for widespread use of self-measured blood pressure monitoring and cardiac rehabilitation, and an overview of new and future opportunities to reduce cardiovascular maternal health disparities.
Haley Stolp
Policy and Partnership Strategist, Centers for Disease Control Disease Control and Prevention
Haley Stolp, MPH is the Policy and Partnership Strategist for Million Hearts® in the Division for Heart Disease and Stroke Prevention at the Centers for Disease Control and Prevention (CDC).
Laurence Sperling, MD, FACC, FAHA, FACP, FASPC
Executive Director, Million Hearts Initiative, Centers for Disease Control and Prevention
Laurence S. Sperling, M.D., FACC, FAHA, FACP, MASPC is the Founder and was the Director of The Heart Disease Prevention Center at Emory (1997-2019). He is currently the Katz Professor in Preventive Cardiology at the Emory University School of Medicine, and Professor of Global Health in the Rollins School of Public Health. Dr. Sperling is the Executive Director of Million Hearts for the Division of Heart Disease and Stroke Prevention at the Centers for Disease Control and Prevention and the Center for Medicare and Medicaid Services. He served as the President of the American Society for Preventive Cardiology from 2014-2016, served on the writing committee of 2018 the ACC/ AHA Guideline on the Management on Blood Cholesterol, and serves as Associate Editor for the American Journal of Preventive Cardiology, and the Chair of the World Heart Federation writing group on the Roadmap for Cardiovascular Disease Prevention among People Living with Diabetes. He has been an investigator in a number of important clinical trials and has authored over 350 manuscripts, abstracts, and book chapters.
Taylor Streeter, MPH
Health Scientist, ASRT, Inc.
Taylor Streeter is a health scientist from ASRT Inc. in the Division for Heart Disease and Stroke Prevention at the Centers for Disease Control and Prevention. As a member of the Million Hearts® science team, she supports the evaluation, translation, and implementation of evidence-based strategies for cardiovascular disease prevention. Taylor also supports Million Hearts® work in maternal health which focuses on preventing and managing hypertensive disorders of pregnancy. She received her MPH from Emory University, Rollins School of Public Health and has a background in evaluation, data visualization, minority health, and maternal and child health.
During this patient-centered roundtable session, attendees will learn from kidney dialysis/transplant patients, the NKF, ESRD Networks, QIN-QIOs, TAQIL, and experts as they explore the complete kidney transplant journey.
From the five CKD stages to dialysis treatment options, and the transplant process, the expert panel will highlight gaps throughout the transplant care continuum and identify potential solutions, including strategies to reduce inequities experienced by underserved communities.
To address these identified gaps, speakers will review available partnership opportunities, new programs being tested in select communities, critical resources accessible to healthcare professionals, as well as the vital need to improve patient education that is culturally and linguistically appropriate throughout the kidney care system.
Victoria Cash MBA, BSN, RN, CPHQ
Executive Director,IPRO ESRD Network of the Ohio River Valley
Victoria Cash is the Executive Director for IPRO ESRD Network 9 and the Quality Improvement lead for the 13 states that are part of the IPRO ESRD Network program. She began her career as a nephrology nurse advancing to ESRD leadership positions in both the inpatient and outpatient settings, supporting ESRD programs for all modalities across state and national boundaries.
Ivory Harding, MS
Director, Quality and Regulatory Affairs, National Kidney Foundation
Ivory Harding has deep experience in healthcare quality measure and research development, currently serving as the Director of Quality and Regulatory Affairs at the National Kidney Foundation (NKF). Her focus is to drive strategies in the evolution of NKF’s healthcare quality agenda, including measure development and maintenance.
Matthew Cooper MD
Chief of Transplantation, Director of the Solid Organ Transplant Line and Professor of Surgery at the Medical College of Wisconsin, Medical College of Wisconsin
Matthew Cooper, MD is recognized as a national clinical leader for transplantation through his many roles. These include Past President of UNOS and the Organ Procurement Transplant Network, Board of Directors for the National Kidney Foundation, and Chair of the American Transplant Congress. Dr. Cooper is currently Mark B. Adams Chair in Transplant Surgery Chief at Froedtert Memorial Lutheran Hospital.
Patrick Gee Ph.D
Founder, iAdvocate
Patrick Gee, Ph.D., is a relentless advocate for change. Sharing his lived experience with stakeholders across the country, his goal is to create access to a better quality of life, equitable care, and effective treatments for those battling diabetes, kidney disease, heart disease, hypertension, and health disparities. He is an active leader in many organizations, including the American Society of Nephrology (ASN) from whom he received the ASN President’s Medal in 2022.
Sherri Morgan-Johnson RN, BSN, MHSA, FAC-COR III
Nurse Consultant, Centers for Medicare & Medicaid Services
Sherri Morgan-Johnson is a Nurse Consultant with CCSQ, IQIIG, DKH at CMS. She is the COR for the TAQIL contract and serves as CCSQ DEI Ambassador and trainer to spread the CMS DEI Strategy. As a PO, COR, and member of the Transforming Clinical Practice team, she provides expert guidance in QI.
Sumeska Thavarajah, MD
Medical Director, Fresenius Kidney Care
Sumeska Thavarajah, MD, is a medical director at Fresenius and an Assistant Professor of Medicine at the Johns Hopkins University School of Medicine. She serves as Chair of the National Kidney Foundation of Maryland’s Medical Advisory Board and received the Linda Cameron Award for Patient Services in 2015.
IPRO and Alliant Health Solutions deployed multiple assessments and conducted technical assistance to understand the current health equity needs of Hospital Quality Improvement Contractors (HQIC) supported hospitals. The responses revealed that hospitals are most concerned about and need support for preparing for the new CMS health equity reporting requirements. In response, IPRO and Alliant Health Solutions developed multiprong approaches to support hospital health equity implementation, including Learning and Action Networks (LAN) with subject matters experts, affinity groups, one-on-one technical assistance, SDOH resources, discharge tools, a dynamic six-step model for hospital health equity implementation, and a bite-sized learning video series on health literacy, cultural and linguistically appropriate standards (CLAS). Additionally, Alliant Health Solutions worked with a hospital in Georgia, which prompted dedicated monthly health equity office hours co-led by the Alliant Health Solutions health equity lead and a representative from the Georgia hospital.
In addition, the HANYS and Convergence HQIC teams will describe organizational approaches to addressing and advancing health equity. HANYS will describe their experience developing and administering a health equity gap analysis assessment and how hospitals have used the tool, identified gaps, and taken action by addressing & implementing practice recommendations across all 7 assessment categories. The Convergence HQIC team will describe the approach to equity that focuses on building reliable, culturally sensitive processes for implementing a Social Drivers of Health (SDOH) screening program in hospitals across a variety of settings.
Laura Benzel, MS, BS, CCSGB,
Project Director, Health Equity Lead, IPRO
Laura is a Project Director at Qlarant and supports the IPRO Quality Innovation Network – Quality Improvement Organization (QIN-QIO), a Centers for Medicare & Medicaid Services program, as a health equity subject matter expert across 11 states (NY, NJ, OH, MD, DE, and the 6 New England states) and the District of Columbia. Since 2016, Laura has served as an advisor, consultant and subcontractor to NORC @University of Chicago for a national healthcare disparities quality improvement initiative for the CMS Office of Minority Health. Laura holds a Masters of Science in Health Systems Management and is Six Sigma Green Belt Certified.
Natalie Graves MPH,
Director, Research & Implementation, Convergence Health Consulting
Natalie Graves is Director of Research and Implementation at Convergence Health Consulting where she leads HQIC programming related to social drivers of health. Natalie has a decade of experience leading programs to transform health care by leveraging quality improvement strategies and peer-to-peer learning. She has collaborated with CMS, hospitals, accountable care organizations, state Medicaid agencies, and patient and family advocates to translate ambitious goals into concrete action plans for improvement. Her areas of expertise include social drivers of health, value-based care, payment reform, and quality improvement. Natalie holds a Master’s in Public Health from the University of Michigan.
Nicole Ford MBA, CPHQ,
Project Manager, Healthcare Association of New York State
Nicole Ford is a Project Manager for HANYS and the Eastern Quality Improvement Collaborative (EQIC) and brings more than 10 years of program management experience to her role leading health equity, quality improvement and patient safety initiatives. Ms. Ford works with hospitals and health systems to achieve measurable outcomes and develops programming to build organizational capacity to eliminate health disparities and advance health equity. She holds a Master of Business Administration in healthcare administration from Excelsior College and is a certified professional in healthcare quality.
Rosa Abraha MPH,
Health Equity Lead, Alliant Health Solutions
Rosa Abraha serves as the Health Equity Lead for Alliant Health Solutions, in which she leads cross-company vision, strategy and intervention planning for health disparities reduction in hospitals, nursing homes and communities for the CMS HQIC and QIN-QIO contracts and other state-based contracts. Prior to Alliant, Ms. Abraha served as a Public Health Advisor in the Centers for Disease Control and Prevention (CDC), Center for Preparedness and Response (CPR), where she led the Center’s first health equity portfolio and managed complex cross-cutting strategic planning, legislative and partnership related projects. Ms. Abraha also deployed to the COVID-19 Response as the Chief Advisor to CDC’s first Chief Health Equity Officer, as well supporting COVID-19 related congressional briefings and vaccine policy efforts. Ms. Abraha has previously deployed in the international Ebola Response supporting leading government affairs and policy efforts. Ms. Abraha was chosen to represent CDC at the 2019 National Governors Association Conference and served as the Healthy People 2030 CDC Lead for the Emergency Preparedness Workgroup. Prior to CDC, Ms. Abraha’s career involved managing behavioral and community health and health communication projects at premier public health agencies, including the National Academies of Science, Engineering and Medicine, the Food and Drug Administration (FDA), and the National Institutes of Health (NIH). Ms. Abraha has a Master of Public Health in Health Policy and Management from Emory University.
Attend this presentation to hear about the work Quality Insights and TMF Health Quality Institute, two Quality Innovation Network-Quality Improvement Organizations, have done around hospital readmissions.
The first part of this session will focus on how standardization of communication can reduce or prevent unnecessary hospital readmissions across the continuum of care. Since 2019, the TMF Quality Innovation Network-Quality Improvement Organization healthcare quality improvement specialists, along with health care providers and partners in the community of El Paso, Texas, identified poor communication among the health care providers in the community that resulted in high readmission rates. To combat these rates, the community developed a Nurse-to-Nurse Report to standardize communication among the health care providers in the community that treat the same patients being readmitted.
The second part of this session will compare parametric and nonparametric cost estimates for hospital readmissions. Using Medicare claims data from Pennsylvania and West Virginia spanning 2017-2022, we estimate how much more, on average, Medicare beneficiaries with selected index diagnoses cost when readmitted within 30 days, compared to those not readmitted, after controlling for demographics and comorbidities. This estimation is accomplished via a robust machine learning variable importance framework. This approach avoids the assumptions associated with parametric methods, and thus enhances accurate valuation."""
Stephanie Hursey, MSN, MHA, CCM (Moderator),
Contract Officer Representative, Centers for Medicare & Medicaid Services, DCPH
Stephanie Hursey, RN, a Health Insurance Specialist, has been with the Centers for Medicare and Medicaid Services (CMS), in Baltimore, MD for eight years. Ms. Hursey is a contract officer representative and the subject matter expert for care coordination within the Division of Community and Population Health (DCPH) and the Integrated Quality Improvement and Innovation Group (IQIIG) for the 12th SOW. Ms. Hursey holds a Bachelor’s Degree from Salisbury State University, Master’s of Science in Nursing, and Master’s of Science in Healthcare Administration from the University of Phoenix. In Ms. Hursey’s spare time, she enjoys teaching Sunday school, deep sea fishing, playing and teaching pickleball.
Vanessa Andow, CPHQ, CPPS, FACHE,
Project Director, TMF Health Quality Institute
Vanessa Andow, CPHQ, CPPS, FACHE, is a project director with TMF Health Quality Institute. She leads the Partnership for Community Health task team, which is part of the Quality Innovation Network-Quality Improvement Organization contract with the Centers for Medicare & Medicaid Services. Ms. Andow and her team of quality improvement consultants work with health care providers across care settings to decrease opioid adverse events, reduce adverse drug events, improve chronic disease self-management and improve transitions of care. Ms. Andow holds a master’s degree in business administration with a focus on health care administration from Texas A&M University at Corpus Christi and is a Fellow of the American College of Healthcare Executives.
Sadiq Bouda Abdulai, PhD
Senior Data Analyst, Quality Insights
Sadiq Bouda Abdulai, PhD conducts advanced statistical analyses and builds web-based data analytics tools to support quality improvement efforts at Quality Insights. Before coming to Quality Insights, he conducted research and data analytics at the New Jersey Innovation Institute Healthcare Delivery Systems iLab. He holds a PhD in Data Science from the New Jersey Institute of Technology. His research interests include causal inference, machine learning and natural language processing with a focus on health care quality improvement.
Jill Manna BA, PMP.
Quality Improvement Specialist, TMF Health Quality Institute
Jill Manna, BA, PMP, Director of Analytic Resources is the Director of Analytic Resources. Ms. Manna provides analytic supervision and guidance for the Quality Insights analytic team. She possesses expertise in managing, analyzing and reporting health care data. In addition, she has a broad knowledge of various data sources, including inpatient, outpatient, pharmacy and ancillary. Prior to her 20-year tenure at Quality Insights, Ms. Manna served as a Health Data Analyst Supervisor, for KePRO in Harrisburg, PA, where she managed data analysts and provided data analysis, reporting and support for disease management studies. At Aetna US Healthcare (USQA) in Blue Bell, PA, she served as a Business Systems Delivery Specialist providing statistical reporting and analysis of various managed care data. At Keystone Health Plan Central in Camp Hill, PA, she provided statistical analysis of managed care as a Research Associate in Research and Analysis and as a Senior Product Implementation Coordinator for Actuarial Services. She earned a BA in Mathematics from Bloomsburg University and a Project Management Professional Certification from the Project Management Institute (PMI).
Grace Bolanos Sewell, MA, CCLS, CPHQ
Quality Improvement Specialist, TMF Health Quality Institute
Grace Bolanos Sewell, MA, CCLS, CPHQ, Master STEPPS Trainer, is a healthcare quality improvement specialist with TMF Health Quality Institute. She currently works with hospitals, home health agencies, long-term acute care hospitals, physician practices and other health care providers to facilitate community coalitions for certain regions in Texas as part of the Quality Innovation Network-Quality Improvement Organization contract TMF holds with the Centers for Medicare & Medicaid Services (CMS). The community coalitions Ms. Bolanos Sewell helps to facilitate focus on reducing avoidable readmissions, strengthening coordination of care, improving immunization rates and chronic disease self-management, reducing adverse drug events and opioid misuse while improving access to behavioral health care. Ms. Bolanos Sewell has also worked at TMF on contracts with CMS focused on increasing screening for depression and alcohol use disorder in primary care practices, hospitals and inpatient psychiatric facilities (IPFs). She has also worked with these facilities to help them implement quality improvement solutions to reduce the 30-day readmission rate and increase follow-up care for discharged IPF patients. Ms. Bolanos Sewell has more than 20 years of experience focused on health care quality improvement and working in the behavioral health care field with children, adolescents and their families. She has a master’s degree in forensic psychology from the University of North Dakota.
Rapidly advancing technology, access to data, and secure ways to communicate with an increasingly tech-savvy cross-section of the American population has changed how we think about protecting Medicare beneficiaries and the Medicare Trust Fund. Beneficiary and Family-Centered Care Quality Improvement Organizations (BFCC-QIOs) are adopting strategies to improve access and efficiency while reducing burden for all parties.
In their scope of improving the effectiveness, efficiency, economy and quality of services provided to Medicare beneficiaries, BFCC-QIOs review case documentation, medical records, and/or Medicare claims for more than 400,000 records annually. BFCC-QIOs also produce detailed documentation for providers and Medicare beneficiaries to summarize findings for beneficiary-initiated quality of care reviews. Continuously looking to improve quality, BFCC-QIOs identified ways to streamline processes, resulting in improved outcomes and beneficiary- and family-centered services.
To support providers, BFCC-QIOs are implementing cutting edge technologies such as artificial intelligence and machine learning to create efficiencies in case review and documentation processes; these have resulted in reduced burden, improved patient-safety and improved standardization. To support beneficiaries, BFCC-QIOs utilize these tools to ensure appropriate implementation of plain language in documentation intended for beneficiaries and families. Finally, to support the Medicare Trust fund, BFCC-QIOs developed approaches to streamline records review and more efficiently use physician review time for identification of cases that are likely to be misaligned with CMS policies.
While technology cannot replace the need for human review, input, and interactions, BFCC-QIOs have identified ways to maximize efficiencies and use administrative, clinician, and beneficiary time when it is most valuable.
Wendy Gary, MHA, (Moderator)
Chief Operating Officer, Avar Consulting; Executive Director, BFCC-QIO; Project Director, BFCC NCORC
Wendy Gary, M.H.A. has more than 30 years of experience providing quality and performance improvement expertise to health care organizations. She serves as the Chief Operating Officer for Avar Consulting, Inc., Executive Director of the BFCC-QIO, and Director of the BFCC NCORC. Ms. Gary holds an MHA, a Dual Bachelor’s Degree in Business and Health Science and Policy, and post-graduate certificates in Management Ethics and Aging.
Josh Dominick, MPA,
Director, Business Intelligence Kepro
Josh Dominick, MPA, has two decades of experience in the healthcare sector, where he champions the integration of data analytics and healthcare to foster transformative change. As the Director of Business Intelligence at Acentra Health, he spearheads initiatives aimed at leveraging data to enhance member care and drive organizational change. With a keen awareness of industry dynamics and emerging technologies, Josh endeavors to elevate quality of care and outcomes for patients throughout the healthcare ecosystem. His commitment to driving meaningful change underscores a dedication to advancing healthcare through informed decision-making and strategic technology innovation. Josh graduated with an undergraduate degree from the Pennsylvania State University and a master’s degree in public administration from Shippensburg University.
Jed Shakarji,
Data Analyst II, Avar Consulting
Mr. Shakarji is a Data Analyst with experience in data analytics, modeling, and machine learning. Before starting as a Data Analyst at Avar Consulting Inc., he worked as a Domestic Guest Researcher at the National Institute of Standards and Technology, where he researched various machine-learning methodologies. At Avar, he analyzes healthcare quality data by developing multiple software tools and researching, developing, and implementing machine learning models.
Brian Salzer, MS, PMP
Data Science Team Lead, Avar Consulting
Mr. Brian Salzer is the Healthcare Data Science Team Lead at Avar Consulting, Inc. He has a diverse background in health data science, machine learning, statistical analysis, and data visualization using statistical programming languages, including but not limited to R, Python, and SAS. Before working with healthcare data, Mr. Salzer was a Data Engineer in the Federal Reserve Board of Governors Division of Monetary Affairs where he managed complex, high-volume, high-frequency financial data collection.
Over the past two years, CMS has made significant strides in advancing oral health across all our programs. CMS has developed a set of cross-cutting initiatives that engage teams across our organization to drive the goals highlighted by the strategic pillars and enhance focus on critical components of our work. These initiatives are high-level, multi-year priorities for CMS that bring our centers and offices together to leverage their expertise and strengthen collaboration. The CMS Chief Dental Officer will describe the launch and work under the Oral Health Cross-Cutting Initiative. Access to oral health services promotes health and wellness and allows beneficiaries and consumers to achieve the best health possible. States have the flexibility to determine what dental benefits are provided to adult Medicaid enrollees. While most states offer at least emergency dental services for adults, less than half of the states currently provide comprehensive dental care. There are no minimum requirements for adult dental coverage. More than 1 in 4 (26%) adults in the United States have untreated tooth decay. Over the last ten years, dental pain has been a top reason for opioid prescribing upon discharge from the ED, thereby contributing to the overdose crisis. There is a bi-directional link between oral health and substance use disorder. This session will focus on the outcomes of two studies that analyzed Medicaid enrollment and claims data. These studies examine oral health needs, disparities, and access to dental services for Medicaid adults with substance use disorders, as well as the impact of the COVID-19 public health emergency, state coverage policies, and socio-demographic factors on adults' access to dental services.
Jessica Maksut PhD
Technical Director, Office of Minority Health; Centers for Medicare & Medicaid Services
Dr. Jessica Maksut is a social and behavioral health scientist with a PhD in human development from the University of Connecticut and postdoctoral training in epidemiology from the Johns Hopkins Bloomberg School of Public Health. Her work centers health and health care equity with attention to underserved groups such as individuals with disabilities and those residing in rural, Tribal, and geographically isolated areas. Dr. Maksut joined the CMS Office of Minority Health in 2020 and works as a Health Insurance Specialist and Technical Advisor in the Data Analytics and Research Group.
Carla Shoff PhD,
Senior Advisor to the Chief Dental Officer, Office of the Administrator; Centers for Medicare & Medicaid Services
Dr. Carla Shoff is the Senior Advisor to the Chief Dental Officer in the Office of the Administrator at the Centers for Medicare & Medicaid Services (CMS). Before this role, Dr. Shoff was a Social Science Research Analyst in the Office of Enterprise Data and Analytics at CMS for 9 years. She began her career as a Research Associate at the Population Research Institute at Penn State University (PSU). Dr. Shoff holds a dual-title Ph.D. in Rural Sociology and Demography and a graduate certificate in Survey Methodology from PSU, where she focused her studies on health disparities, quantitative research methods, and statistics. Dr. Shoff has devoted her career to using data to identify disparities in population health, health-related behaviors, and access to health care, which can be used to inform policy and advance health equity. She has a robust research portfolio of over 30 publications in peer-reviewed journals.
Lorel Burns DDS, MS
Assistant Professor, NYU College of Dentistry
Dr. Lorel Burns is a clinician-investigator and assistant professor at New York University (NYU) College of Dentistry. She is a Diplomate of the American Board of Endodontics. Dr. Burns’ research interests include endodontic treatment outcomes, access to dental care, clinician decision-making, and dental education. Her research has been funded by the National Institutes of Health (NIH)/ National Institute of Dental and Craniofacial Research (NIDCR), the Robert Wood Johnson Foundation (RWJF), and the American Dental Education Association, ADEAGies Foundation. Dr. Burns is the 2023-2024 Center for Medicare & Medicaid Services (CMS) Oral Health Policy Fellow.
Natalia Chalmers, DDS, MHSc, PhD
Chief Dental Officer, Office of the Administrator, Centers for Medicare & Medicaid Services
Dr. Chalmers is a board-certified pediatric dentist, oral health policy expert, and public health advocate who brings more than 20 years of clinical, research, industry, and regulatory experience to CMS in her role as Chief Dental Officer in the Office of the Administrator. Previously, Dr. Chalmers served as a Dental Officer at the US Food and Drug Administration. Dr. Chalmers has devoted her career to transforming scientific and health care data and information into actionable insights to address equity, improve care, and better inform policy and funding. Dr. Chalmers completed her Doctor of Dental Surgery degree at the Faculty of Dental Medicine of the Medical University of Sofia, a residency in pediatric dentistry at the University of Maryland School of Dentistry, and a Ph.D. in oral microbiology from the Graduate Partnerships Program of the University of Maryland School of Dentistry and the National Institute for Dental and Craniofacial Research at the National Institutes of Health, Post-doctoral Fellowship at the Forsyth Institute, and Clinical Research Fellowship at the National Institute for Dental and Craniofacial Research, National Institutes of Health. Dr. Chalmers holds a Master’s degree in Clinical Research from Duke Medical University and a Certificate in Drug Development and Regulatory Science from the University of California San Francisco School of Pharmacy. Her research has translated into action, improving oral care and advocating for the role health policy can play across the lifespan—particularly when it embraces dental well-being as a facet of care for the whole person.
The True Cost of Patient Safety Events and Pursuing the Goal of Zero Harm
Patient safety events (PSEs) remain a persistent challenge in our healthcare system, and the Centers for Medicare & Medicaid Services (Centers for Medicare & Medicaid Services) has adopted the goal of Zero Preventable Harm as part of its National Quality Strategy (NQS). This presentation will (1) discuss the prevalence of PSEs among Medicare beneficiaries, (2) analyze associated additional inpatient care and financial costs, and (3) provide insight to support Centers for Medicare & Medicaid Services’ aim to promote the safest possible care for all. The Beneficiary and Family Centered Care National Coordinating Oversight and Review Center (BFCC NCORC) screens 4,000 Medicare medical records annually for PSEs, leading to follow-up actions by the BFCC-Quality Improvement Organizations (QIOs). NCORC analyzed additional days of hospitalization and payment associated with PSEs projected on a national level, by sample weighting, representing beneficiaries based on 4,000 Medicare discharges between October 2020 and December 2021. Over 5,000 PSEs were identified, and half of beneficiaries experienced at least one, with 6% being deemed preventable. PSEs were associated with nearly four additional days of inpatient care on average, totaling 32.5 million additional days nationally. This equates to $86 billion per year, or about one-tenth of all Medicare spending. Preventable PSEs cause about 5.7 million additional days of care, and over $15 billion in spending. Patient safety is the cornerstone of high-quality healthcare, yet PSEs happened in more than half of Medicare beneficiary hospitalizations, accounting for nearly 10% of all Medicare spending. These findings reinforce the urgent need for Centers for Medicare & Medicaid Services’ quality agenda, and the goal of achieving zero preventable harm.
Li Chen, Ph.D
Health Research Lead, Avar Consulting
Dr. Li Chen is a seasoned Healthcare Research Lead with a ten-year track record spanning academia and industry. Dr. Chen's expertise encompasses health service research, biostatistics, epidemiology, clinical trials, and health economics. With a diverse international background, including consulting, academia, nursing, and pharmaceutical sectors, Dr. Chen's contributions are underscored by an impressive portfolio of over 45 academic publications and several funded research projects, with experience as a peer reviewer for esteemed journals and funding agencies. Her current role as the Healthcare Research Lead at Avar Consulting, Inc., has showcased her prowess in claim data analysis, patient safety, health equity, and health service research innovations.
Jacklyn Vollmer, MPH
Quality Improvement and Operations Support Specialist, Avar Consulting
Jacklyn Vollmer, MPH, is a Quality Improvement and Operations Support Specialist with comprehensive knowledge in biostatistics, data analytics, epidemiology, and public health. Before starting the Quality Improvement and Operations Support Specialist role within Avar Consulting, she worked as a data analyst, with her responsibilities including research and analysis for the Beneficiary and Family Centered Care National Coordinating Oversight and Review Center (BFCC-NCORC) program’s monitoring and evaluation reports, assisting in the production of NCORC program dashboards, and other research into special topics. Ms. Vollmer has a MPH with a concentration in epidemiology, a BPH, and a graduate certificate in biostatistics from the University of Kentucky. Her current responsibilities at Avar Consulting include initiating, analyzing, and revising of policies, plans, and procedures, assuring integrated and coordinated short-term to long-term planning on projects and tasks, identifying existing or potential problem areas within operations and recommending corrective action.
This session will explore the broader definition of harm beyond physical safety, and the importance of addressing inequities to achieve zero harm. Dr. Gandhi will share strategies and tactics to show how leading organizations are innovating and transforming a culture and leveraging high reliability to build engaged, resilient care teams that deliver safe, high-quality care and the optimal patient experience.
Tejal Gandhi, MD, MPH, CPPS
Chief Safety and Transformation Officer, Press Ganey
Tejal Gandhi, MD, MPH, CPPS, is the Chief Safety and Transformation Officer at Press Ganey. In this role, Dr. Gandhi is responsible for advancing the Zero Harm movement, improving patient and workforce safety, and developing innovative health care transformation strategies.
Jean Moody-Williams, RN, MPP
Deputy Director, Center for Clinical Standards and Quality, Centers for Medicare & Medicaid Services
Jean D. Moody-Williams, RN, MPP, is the current Deputy Center Director for the Center for Clinical Standards and Quality (CCSQ) at the Centers for Medicare & Medicaid Services (CMS). She has served since 2008 under multiple administrations in the Senior Executive Service (SES) Corp. She currently is a part of a leadership team responsible for one of CMS’ Centers that has nearly 800 employees and a $3 billion annual budget. She is responsible for leading quality improvement, value based purchasing, and delivery system reform. She provides oversight to multiple kidney health activities including regulations for organ procurement and transplantation programs and learning networks, development of conditions of participation for dialysis facilities and healthcare systems, oversight of ESRD Networks for quality improvement and the ESRD Quality Incentive Program. She works to ensure better healthcare, healthier populations and smarter spending of healthcare dollars for more than 90 million Americans.
Jean Moody-Williams, RN, MPP
Deputy Director, Center for Clinical Standards and Quality, Centers for Medicare & Medicaid Services
Jean D. Moody-Williams, RN, MPP, is the current Deputy Center Director for the Center for Clinical Standards and Quality (CCSQ) at the Centers for Medicare & Medicaid Services (CMS). She has served since 2008 under multiple administrations in the Senior Executive Service (SES) Corp. She currently is a part of a leadership team responsible for one of CMS’ Centers that has nearly 800 employees and a $3 billion annual budget. She is responsible for leading quality improvement, value based purchasing, and delivery system reform. She provides oversight to multiple kidney health activities including regulations for organ procurement and transplantation programs and learning networks, development of conditions of participation for dialysis facilities and healthcare systems, oversight of ESRD Networks for quality improvement and the ESRD Quality Incentive Program. She works to ensure better healthcare, healthier populations and smarter spending of healthcare dollars for more than 90 million Americans.
As the newest Medical Officer to join CMS, Dr. Lenise Cummings-Vaughn will share her insights and lessons learned as a Hub leader for the AHRQ ECHO National Nursing Home COVID Action Network and the themes that emerge including balancing patient needs for socialization with infection control, resource management, staffing stabilization, burn out, and education on best practices and quality assessment and improvement.
Lenise Cummings-Vaughn, MD, CMD
Medical Officer, Center for Clinical Standards and Quality, Centers for Medicare & Medicaid Services
Lenise Cummings-Vaughn, MD, CMD joined CMS in February 2024 as a Medical Officer in CCSQ. She has provided care for older adults in the outpatient, inpatient and long-term care settings, most recently as an Associate Professor of Medicine in the Division of Geriatrics and Nutritional Sciences, at Washington University in Saint Louis, associate medical director for an all dementia nursing facility, and clinician in the Memory and Aging Project at the Knight Alzheimer’s Disease Research Center.
This session will demonstrate how one of the committees that is part of the Moving Forward Coalition assembled residents, care partners, advocates, and researchers to develop a step-by-step Resident Council Guide for nursing home residents, staff, and community members. We will describe how the guide is currently being piloted and tested in 4 nursing homes and what we hope to learn from this pilot. We will discuss the importance of a resource guide and its use to assist nursing homes to implement, sustain, and continually enhance an effective, person-centered Resident Council.
Anna Fisher, CADDCT, CDP, CMDCP, CDSGF, QCP
Education Consultant/Nurse, Hillcrest Health Services
Dr. Anna Fisher serves as a Hillcrest Health Services quality, dementia, emergency preparedness, and regulatory education expert for diverse business lines that include assisted living, memory support, adult day services, in-patient rehabilitation, outpatient therapy, home health care, private duty, telehealth, hospice, and skilled nursing care. Dr. Fisher is also an adjunct professor in the College of Arts and Sciences at Bellevue University and teaches in the Masters-Health Administration Program. She continues to serve as a Clinical Practice Committee member, Emergency Preparedness Committee member, and Quality Award Senior Examiner for the American Health Care Association (AHCA) and National Center of Assisted Living (NCAL). Dr. Fisher is Chair of the Omaha-Metropolitan Healthcare Coalition (OMHCC) Non-Hospital Healthcare Workgroup and appointed as a working group member of the National Advisory Committee on Seniors and Disasters (NACSD).
Mairead Painter, BSW
Long Term Care Ombudsman, State of Connecticut
Mairead Painter is a dedicated advocate and leader in the field of long-term care, currently serving as the Connecticut State Long Term Care Ombudsman. In addition to her role as Ombudsman, Mairead holds key positions, including Co-Chair of the Coalition for Elder Justice in Connecticut, Co-Chair of the Connecticut Medicaid Long Term Services & Supports Rebalancing Initiatives Steering Committee, and 1st Vice President of the National Association of State Ombudsman.
A proud alumna of the University of Saint Joseph in West Hartford, CT, Mairead's journey in the realm of social work and advocacy has been both diverse and impactful. Before assuming her current role, she brought her expertise to various positions, including Social Worker in long-term care facilities, Child Protective Service Social Worker, Regional Ombudsman, and Program Manager within the Community Options, Strategic Planning Unit.
As the State Ombudsman, Mairead passionately champions the rights, quality of life, and person-centered care for residents in skilled long-term care nursing facilities, residential care homes, and assisted living/managed residential communities. Her responsibilities extend to overseeing the Program's advocacy initiatives, where she identifies critical issues and works towards developing policies, regulations, and legislation aimed at enhancing the quality of life for those receiving long-term services and support.
Ms. Painter is deeply committed to the principles of person-centered care and informed choice throughout the continuum of care. Actively engaged in stakeholder workgroups, legislative task forces/committees, and the National Association of State Ombudsman (NASOP), she brings her extensive background and experience to bear on shaping Connecticut's long-term care landscape.
In her unwavering dedication to improving the lives of individuals in long-term care, Mairead Painter is a steadfast advocate, shaping policies and driving positive change across the state.
The NET program enriches the lives of NH residents by recruiting community partners to actively engage in activities that bring value to residents. The NET program evaluates the impact and feasibility of the community taking an active role to improve resident experiences and quality of life.
Patricia Gagliano, MD
Task Order 1 Lead and Vice President, IPRO’s Healthcare Quality Improvement Department
Dr. Patricia Gagliano is a physician and member of IPRO’s leadership team. In her role as Vice President of IPRO’s Healthcare Quality Improvement department, she is responsible for leading efforts to drive greater connectivity and coordination to transform healthcare delivery for consumers.
Melanie Ronda, MSN, RN, LTC-CIP, CPHQ
Task 3 Lead, Infection Preventionist and a Director in IPRO’s Healthcare Quality Improvement Department,IPRO QIN-QIO
Melanie Ronda has worked in various healthcare settings over the last 30 years. She has experience as an Infection Preventionist in Acute Care and Long-Term Care and a former Director of Nursing in Long Term Care. Melanie serves as the Task 1 Nursing Home Lead for NY, NJ and OH and the Task 3 Lead.
Jennifer Wieckowski, MSG
Senior Executive Director, Health Services Advisory Group
Jennifer Wieckowski is the Senior Executive Director for Health Services Advisory Group (HSAG). She has 19 years of experience working in healthcare quality improvement with community providers including hospitals, nursing homes, home health agencies, and community-based organizations.
Part 1: Since April 2020, Quality Improvement Organizations have received Targeted Response Quality Improvement Initiative (TRQII) referrals from CMS for nursing homes identified as needing assistance with infection control, COVID hot spots, and low vaccination rates. Great Plains QIN operationalizes a multi-faceted best practice approach to facilitate engagement and action leveraging all encounters with nursing homes to improve infection control practices and vaccination uptake.
Part 2: This session will focus on applying high reliability concepts to team members and throughout quality projects to increase nursing home participation in targeted response quality improvement initiatives."
Nicole Haas, MPH, CPH, CPHQ
Quality Improvement Initiative Manager, Alliant Health Solutions
Nicole has been with Alliant Health Solutions since 2020. She manages the teams that work with facilities on reducing COVID-19 outbreaks, improving infection prevention and control processes, and increasing COVID-19 vaccination rates.
Dee Kaser, RN, CDCES
Quality Improvement Advisor, Great Plains
Ms. Kaser has been employed with Great Plains QIN since 2014. With over 38 years’ experience as a registered nurse with special interest in chronic disease management, quality improvement, and immunization. Ms. Kaser currently serves as a subject matter expert in the areas of chronic disease management, immunization, smoking cessation, and quality improvement initiatives.
Stephanie Meduna, RN, BSN
Quality Improvement Advisor, Great Plains
Ms. Meduna has 29+ years’ experience as a registered nurse; infection prevention and control and quality improvement in long-term care settings are her special interests. Ms. Meduna has been employed with Great Plains QIN since 2022 and serves as a subject matter expert for infection prevention and control, COVID-19 bundles, COVID-19 infection and vaccine TRQII’s efforts and QSEP.
Grab & Go stations will be conveniently located throughout the main convention floor (Floor 2).
Food Trucks will be stationed on Eutaw Street beneath the Skywalk.
Explore any of the amazing nearby restaurants
This presentation will feature insights from the San Francisco Department of Public Health's Chief Quality Officer, HSAG representatives and CMS, offering a comprehensive understanding of the recertification journey of San Francisco's Laguna Honda Hospital and Rehabilitation Center (LHH), the 2nd largest public run skilled nursing facility in the United States. Attendees will gain valuable insights into the strategies employed for successful culture change and sustainability, providing a compelling narrative of resilience, collaboration, and innovation in addressing healthcare challenges.
Barb Averyt, MHA
Senior Executive Director, Health Services Advisory Group
Barb Averyt is the Senior Executive Director for Health Services Advisory Group (HSAG). She has over 45 years of experience working in healthcare quality improvement with community providers including hospitals, nursing homes, home health agencies, and community-based organizations.
Troy S. Williams, MSN, RN, CPHQ, CPHRM
Laguna Honda CMS Recertification Co-Incident Commander, Chief Quality Officer, San Francisco Health Network, San Francisco Department of Public Health
Troy Williams is the CQO for San Francisco Health Network. As an RN, he has 29 years of healthcare experience, including leadership roles in nursing, risk management and quality. He served 7 years as CQO at Zuckerberg San Francisco General Hospital & Trauma Center before his selection as SFHN CQO.
Keith Chartier, DrPH, MPH
Executive Director, Health Services Advisory Group
Dr. Keith Chartier is the Executive Director for Health Services Advisory Group (HSAG). He has 20 years of experience working in healthcare quality improvement with community providers including hospitals, nursing homes, physician offices, and end stage renal disease providers.
Jim Bossemeyer
Acting Director, Division of SF/Seattle Survey & Enforcement
Centers for Medicare & Medicaid Services
Jim Bossenmeyer is the Acting Director, Division of SF/Seattle Survey & Enforcement , Survey & Operations Group. In this role, Jim provides direction and guidance to State Survey Agencies in implementation of survey and operations program policies. Jim’s has been with CMS since 1992 in a variety operational and policy positions in CMS’ Office of Intormation Technology, Center for Medicare, and Center for Program Integrity. A New Orleans naïve, Jim holds a Bachelor of Science in Economics from the University of New Orleans and his Master of Business Administration from the University of Baltimore.
Part 1 – Mountain Pacific Project Firstline team co-created an interactive, team and skills-based activity that provided innovative learning for health care professionals. The Escape Room is a “fun and effective way to learn,” while improving the team culture. Part 2 - Comagine Health QIN-QIO designed and implemented a two-part model to evaluate participant and facility level learning collaborative outcomes over time for single cohorts and across cohorts to access impact and growth. Strategies for learning collaborative evaluation, highlighting an example focused on a Hypertension SMBP learning collaborative will be shared.
Crystal Morse, MS HSA, CSW, CCM
Senior Account Manager, Mountain Pacific Quality Health
Crystal Morse joined Mountain Pacific in October 2017. Crystal started working with the Centers for Disease Control and Prevention (CDC) Project Firstline infection prevention and control program since its announcement and launch in October 2020 and was promoted to Mountain Pacific’s Project Firstline senior account manager in 2022. Crystal works with state and local partners to promote effective infection prevention and control efforts to reduce infectious disease across health care settings and within our communities.
Laura Myerchin Sklaroff, MA, EdD
Director, Systemwide Quality Improvement Evaluation, Comagine Health
Laura Myerchin Sklaroff has nearly two decades experience conducting healthcare focused evaluation work in public, private, and government settings. She serves as the Director for Systemwide Quality Improvement Evaluation at Comagine Health. Dr. Sklaroff holds a Master’s Degree in Applied Psychology and Evaluation from Claremont Graduate University and a Doctorate in Education with emphasis on Organizational Leadership from Northeastern University. Her research and evaluation interests focus on trauma informed care, telehealth, and long COVID.
Callie Perkins, BSN
Wyoming Account Manager, Mountain Pacific Quality Health
Callie Perkins is a registered nurse with more than 20 years of experience working in health care. Callie joined Mountain Pacific as the Wyoming Account Manager in September 2022. She supports initiatives to prevent COVID-19 and other infections in health care settings and to provide education, assistance, and other training to health care professionals across Wyoming.
Ann Jensen, MPH, CPH
Healthcare Data Analyst, Comagine Health
Ann Jensen has been a science and health data researcher for nearly seven years. She earned her Masters of Public Health degree in Epidemiology from the Oregon Health and Sciences University – Portland State University School of Public Health in June 2021. She is also certified in public health. In her current role as a Healthcare Data Analyst at Comagine Health, she provides analytic support on multiple quality improvement contracts.
During this unprecedented SNF employee shortage, employee retention is paramount. Forest Hill of DC’s efforts led to a front-page story in the NTY, an AHCA Program of the Year, and the District of Columbia’s first CNA apprenticeship program.
Tina Sandri, MHSA, LNHA, QCP, RYT-200
Chief Executive Officer, Forest Hills of DC
Tina Sandri is passionate about quality, the workforce, and resilience. She trained AITs, taught graduate school in LTC administration, and advisory board member of Vision Centre. Ms. Sandri was presented the McKnight’s Hall of Honor award in 2023. She is part of the Moving Forward Steering Committee member and practicing QCP.
Eimee Casal, Division of Nursing Homes, Colleen Frey, Division of Community and Population Health, and Shequila Purnell-Saunders, Division of Chronic and Post Acute Care of the Center for Clinical Standards and Quality at the Centers for Medicare and Medicaid Services will discuss several recent and forthcoming initiatives impacting nursing home providers, residents, and families."
Colleen Frey
Director, Division of Community and Population Health, Centers for Medicare & Medicaid Services
Colleen Frey is currently serving at the U.S. Centers for Medicare & Medicaid Services as the Director responsible for the CMS Quality Improvement Program, focused on Nursing Homes and Communities. Colleen leads a team of twenty-five outstanding clinical, communication, data, and specialized contract individuals, who drive the CMS program providing technical assistance to 15,000 nursing homes and over 500 community partner programs. In addition, the team focuses on Health Equity, delivering specialized assistance to over 11,000 areas where health inequities exist.
Prior to joining CMS, Colleen worked in the private sector at a healthcare system that provided care to vulnerable populations. She got her start working as a Registered Nurse in an infectious disease unit, caring for individuals who were HIV+ and others with serious, life-threatening infections. Other specialties include pulmonary rehabilitation, informatics, and quality and patient safety. Her last position in the private sector was serving as Administrative Director, overseeing quality, patient safety, regulatory, emergency management, and infection control programs. Colleen holds a Bachelor’s Degree in Nursing from Oakland University, and a Master’s Degree in Nursing, Business and Health Systems, Informatics Concentration, from the University of Michigan.
Eimee Casal, BSN, RN, LNHA
Quality and Safety Branch Manager, Division of Nursing Home, Centers for Medicare & Medicaid Services
Eimee is a Registered Nurse and a Licensed Nursing Home Administrator. Since joining CMS in 2019, Eimee has focused on policy and guidance related to abuse, infection control, admission, transfer, and discharge, nursing services, and COVID-19 issues, for example, visitation, infection control practices, testing, and vaccines. Before working at CMS, she worked as a clinical nurse in long-term care and hospital settings for 10 years and then became a Director of Nursing in a long-term care facility, as well as a Regional Nurse Consultant, for over 6 years.
Shequila Purnell-Saunders
Director, Division for Chronic and Post Acute Care, Centers for Medicare & Medicaid Services
Shequila Purnell-Saunders leads CMS’s post-acute care quality measurement programs. Her passion is cultivating community to produce quality outcomes, ensure quality care, and develop meaningful, quality measurement in support of our nation’s most vulnerable citizens and their families who care for them.
Jean Moody-Williams, RN, MPP
Deputy Director, Center for Clinical Standards and Quality, Centers for Medicare & Medicaid Services
Jean D. Moody-Williams, RN, MPP, is the current Deputy Center Director for the Center for Clinical Standards and Quality (CCSQ) at the Centers for Medicare & Medicaid Services (CMS). She has served since 2008 under multiple administrations in the Senior Executive Service (SES) Corp. She currently is a part of a leadership team responsible for one of CMS’ Centers that has nearly 800 employees and a $3 billion annual budget. She is responsible for leading quality improvement, value based purchasing, and delivery system reform. She provides oversight to multiple kidney health activities including regulations for organ procurement and transplantation programs and learning networks, development of conditions of participation for dialysis facilities and healthcare systems, oversight of ESRD Networks for quality improvement and the ESRD Quality Incentive Program. She works to ensure better healthcare, healthier populations and smarter spending of healthcare dollars for more than 90 million Americans.
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