- April 14, 2016
- Posted by: Health Care Payment Learning & Action Network
- Categories: Blog, LAN Update
The CMS Alliance to Modernize Healthcare (CAMH) is now soliciting candidates for a new work group focused on primary care. This group of experts who will collaboratively develop recommendations on the critical components for primary care payment in category 3 or 4 alternative payment models (APMs) and make practical recommendations for accelerating adoption of these models, including steps to support implementation. The initial work group deliverable will be a white paper that includes actionable recommendations within a 12-24 month time frame. One of the initial tasks will be to refine the work group’s charge, ensure a manageable scope, and develop a plan that focuses on recommendations that can be road tested in the near term. This work group will not set or make policy, nor make formal recommendations to the Centers for Medicare & Medicaid Services (CMS).
The LAN is designed to enable participants to work together to achieve alignment across sectors and stakeholder groups. We are interested in candidates who fill one or several of the criteria below:
- Physicians, nurses, and other health care professionals currently practicing in internal medicine, family practice, pediatrics, or geriatrics
- Medical professionals with specialties, expertise, or experience integrating with primary care
- Expertise in the newer models of care and current/planned innovations in the field, including telemedicine and retail clinics
- Experience working with multiple stakeholders of different perspectives on complex health system issues
- Experience in methodological approaches, including benchmarking, risk adjustment, quality measures, etc
- Experience with designing, implementing, or evaluating different types of primary care payment models
- Experience in bringing any of the following perspectives to the discussion of payment models and reform:
- Small/rural physician practices
- Patients or consumers
- Purchasers, including state purchasers and private employers
- Behavioral health integration professionals
- Minority or safety net organizations
- Medicaid
- Health plans, including those focused on multi-payer alignment
This work group will consist of approximately 15 core members and is expected to work at a swift pace. Members will be expected to participate, at a minimum, in bi-weekly conference calls and one full-day meeting in the Washington, D.C. area. There is no reimbursement available for travel expenses.
If you believe you have the time and qualifications and would like to be considered to serve as a core member of this work group, or if you would like to refer a colleague, we welcome you to submit a nomination. Due to limited resources, we are not able to send individual notes to those not selected. We welcome your nominations or referrals through Monday, May 2.
Purchasers
Enabling Organizations | 
Policy Makers
Community Organizations
Emily DuHamel Brower, M.B.A., is senior vice president of clinical integration and physician services for Trinity Health. Emphasizing clinical integration and payment model transformation, Ms. Brower provides strategic direction related to the evolving accountable healthcare environment with strong results. Her team is currently accountable for $10.4B of medical expense for 1.6M lives in Medicare Accountable Care Organizations (ACOs), Medicare Advantage, and Medicaid and Commercial Alternative Payment Models.
Mr. James Sinkoff is the Deputy Executive Officer and Chief Financial Officer for Sun River Health (formerly known as Hudson River HealthCare), and the Chief Executive Officer of Solutions 4 Community Health (S4CH); an MSO serving FQHCs and private physician practices.
Victor is the Chief Medical Officer for TennCare, Tennessee’s Medicaid Agency. At TennCare, Victor leads the medical office to ensure quality and effective delivery of medical, pharmacy, and dental services to its members. He also leads TennCare’s opioid epidemic strategy, social determinants of health, and practice transformation initiatives across the agency. Prior to joining TennCare, Victor worked at Evolent Health supporting value-based population health care delivery. In 2013, Victor served as a White House Fellow to the Secretary of Health and Human Services. Victor completed his Internal Medicine Residency at Emory University still practices clinically as an internist in the Veteran’s Affairs Health System.
Dr. Brandon G. Wilson, DrPH, MHA (he, him, his) joined Community Catalyst as the Director of the Center for Consumer Engagement in Health Innovation, where he leads the Center in bringing the community’s experience to the forefront of health systems transformation and health reform efforts, in order to deliver better care, better value and better health for every community, particularly vulnerable and historically underserved populations. The Center works directly with community advocates around the country to increase the skills and power they have to establish an effective voice at all levels of the health care system. The Center collaborates with innovative health plans, hospitals and providers to incorporate communities and their lived experience into the design of systems of care. The Center also works with state and federal policymakers to spur change that makes the health system more responsive to communities. And it provides consulting services to health plans, provider groups and other health care organizations to help them create meaningful structures for engagement with their communities.
Tamara Ward is the SVP of Insurance Business Operations at Oscar Health, where she leads the National Network Contracting Strategy and Market Expansion & Readiness. Prior to Oscar she served as VP of Managed Care & Network Operations at TriHealth in Southwest Ohio. With over 15 years of progressive health care experience, she has been instrumental driving collaborative payer provider strategies, improving insurance operations, and building high value networks through her various roles with UHC and other large provider health systems. Her breadth and depth of experience and interest-based approach has allowed her to have success solving some of the most complex issues our industry faces today. Tam is passionate about driving change for marginalized communities, developing Oscar’s Culturally Competent Care Program- reducing healthcare disparities and improving access for the underserved population. Tamara holds a B.A. from the University of Cincinnati’s and M.B.A from Miami University.
Dr. Peter Walsh joined the Colorado Department of Health Care Policy and Financing as the Chief Medical Officer on December 1, 2020. Prior to joining HCPF, Dr. Walsh served as a Hospital Field Representative/Surveyor at the Joint Commission, headquartered in Oakbrook Terrace, Illinois.
