- July 6, 2015
- Posted by: Health Care Payment Learning & Action Network
- Category: LAN Update
Sam Nussbaum, MD, Executive Vice President, Clinical Health Policy and Chief Medical Officer at Anthem, Inc., has been appointed to head the Alternative Payment Model (APM) Definitions and Progress Tracking Work Group.
The Work Group is charged with recommending a set of APM terms and concepts to serve as a foundation for the LAN’s work going forward. These terms must be easily understood but also specific enough to be operationally meaningful. In addition, the group will propose an approach for measuring APM adoption across the U.S. health care system that includes clarity on what should be measured as well as a set of categories that enable meaningful reporting. The LAN will measure progress toward APM adoption following the Work Group’s recommendations. The Work Group will be composed of approximately 15 individuals with a variety of pertinent expertise. It will work intensively and is expected to wrap up its task at the end of four months.
An advocate of models that improve quality, safety and affordability, Nussbaum has championed payment reform and measurement initiatives for more than a decade. Under his leadership, the Work Group will embark on its herculean task quickly and efficiently. Nussbaum brings broad knowledge of the health ecosystem from his experience in clinical research and teaching, working on the provider side in a health system, and executive leadership of a major payer, though he will leave his organizational hat at the door when convening the Work Group. He was selected as Chair for his demonstrated ability to bring together the range of perspectives that must inform an approach for measuring progress in APMs. Nussbaum is a member of the LAN Guiding Committee (GC) and will ensure that the strategy and momentum established by the GC continues through the efforts of this first Work Group. The Work Group membership, recruited through applications and referrals from LAN participants, will be announced soon.
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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.
