2020 Speakers

Formerly, Director of Medicare Advantage Operations, CMS

Michael S. Adelberg

Principal, Lead, Healthcare Strategy Practice, Faegre Baker Daniels Consulting
CareOregon

Keshia Bigler, MPH

Population Health Portfolio Manager
Tufts Health Plan

Jill K. Borrelli, LICSW

Vice President, Quality Management
Optima Health

Catherine Brisland, DO, MBA, FCCP

Medical Director
Centene

April Canetto

Director of Cultural Linguistics
Ochsner Health System

Dr. Kathy Jo Carstarphen

Medical Director
NCQA

Paul Cotton

Director of Federal Affairs
Cambridge Health Alliance

Dr. Lora Council

Senior Medical Director
Kaiser Permanente

Joe Crimando

Interim Director, Population Health
UCare

Gregory A. Hanley, FACHE, CPHQ

Vice President, Quality Management & Pharmacy
Geisinger

Allison Hess

Vice President, Innovation
Johns Hopkins HealthCare LLC

Tejaswita Karve, Ph.D.

Director, Medicare STARS Advantage MD Adminstration
Trusted Health Plans, Inc.

Jose Diaz Luna

VP of Pharmacy
Genesee Health Plan

Jim Milanowski

President/CEO
Horizon Blue Cross Blue Shield New Jersey

Steven R. Peskin, MD, MBA, FACP

Executive Medical Director Population Health & Transformation
Inland Empire Health Plan

Maria Pugo, DrPH, MPH

Health Services Evaluator, Health Services Research & Evaluation
Gateway Health Plan

Konark Rana

Director, Product Strategy and Development
NYU Langone Health

Harry Saag

CEO, Roster Health, Assistant Professor
UPMC Health Plan

Dan Swayze

Associate Vice President for Clinical Affairs and Community Support Services
Cigna-HealthSpring

Dr. Dirk Wales

Chief Medical Officer
Faegre Baker Daniels Consulting

Tricia Beckmann

Director
Speakers Biographies


Michael S. Adelberg

Principal, Lead, Healthcare Strategy Practice
Faegre Baker Daniels Consulting
Formerly, Director of Medicare Advantage Operations
CMS

Mike Adelberg leads the Healthcare Strategy Practice at Faegre Baker Daniels Consulting. He has 25 years progressive healthcare industry and government experience in Medicare, Medicaid and commercial health insurance. Mike spent fifteen years at the Centers for Medicare and Medicaid Services (CMS), including concurrently serving as the director of the Insurance Programs Group and the acting director of the Exchange Policy and Operations Group in the Center for Consumer Information and Insurance Oversight (CCIIO) where he oversaw most of the functions of the federally-run health insurance exchanges; serving as the Director of Medicare Advantage Operations, where he supervised the annual cycle for review and award of Medicare Advantage bids and contracts, developed CMS’s operational policy, and led the monitoring of Medicare Advantage contractors; and serving as the associate regional administrator for Medicare operations (Chicago Region) and the director of education and assistance programs. Mike gained private sector experience as vice president of product development and government affairs for the Universal American Corporation, a multi-state health insurer which operated Medicare Advantage and Medicaid health plans (subsequently acquired by Wellcare).

He has also led or co-led health policy studies published in Health Affairs and The American Journal of Managed Care. Mike speaks and publishes frequently on healthcare topics and has served on numerous advisory committees. He’s been quoted in the Washington Post, New York Times, Modern Healthcare, NPR, and other leading media. In his spare time, Mike is an author. He’s written three novels, a history book, several scholarly journal articles, and over sixty book reviews.

Keshia Bigler, MPH

Population Health Portfolio Manager
CareOregon

Keshia Bigler is the Population Health Manager for the Columbia Pacific CCO in Oregon. She has extensive experience working in health research doing primary research focused on health disparities and working in the Kaiser Permanente Evidence-based Practice Center (EPC) conducting systematic reviews and meta-analyses to inform clinical guidelines for the USPSTF, APA, and CDC Community Guide. She worked with the Oregon Health Authority to refine the state cervical and breast cancer screening program and co-chairs the Pacific Northwest Community Paramedicine and Mobile Integrated Health Coalition. She has served on state steering committees that informed the state Health Information Technology (HIT) strategy. She has a strong passion for health equity and ensuring all people have equitable access to high quality healthcare regardless of socioeconomic status. Keshia received her MPH from OHSU with a focus in Primary Care and Health Disparities, and completed her Bachelor of Science in Community Health and Human Biology. As a native Oregonian, she enjoys spending time outdoors with her dog, live music, traveling, and cheering on local sports teams - Rip City!

Jill K. Borrelli, LICSW

Vice President, Quality Management
Tufts Health Plan

Catherine Brisland, DO, MBA, FCCP

Medical Director
Optima Health

Dr. Catherine Brisland is a Medical Director for Optima Health with expertise in government programs, specifically, Virginia Medicaid Long Term services and Supports (MLTSS). In this role, Dr. Brisland draws from her solid clinical foundation as she works to interface with providers and utilization management to provide high quality and financial management within the framework of the MLTSS Model of Care. Dr. Brisland earned her Doctor of Osteopathic Medicine from Kansas City University of Medicine and Biosciences in 1994 and her Master of Business Administration from Virginia Commonwealth University in 2017. She finished her Internal Medicine and Pulmonary Medicine training at Scott and White Hospital (Texas A&M University) in 1998 and completed her Critical Care Fellowship at the Mayo Clinic in Rochester, Minnesota in 2001. She is board certified in Critical Care Medicine and Internal Medicine and continues to practice medicine as a hospitalist.

April Canetto

Director of Cultural Linguistics
Centene

April Canetto is the Manager of Cultural and Linguistic Services at Health Net. April has a graduate degree in Social Work, with an emphasis in Macro practice. April has 10 years' experience in systems design, program development and the application of the social determinants of health toward improving outcomes. April has designed and led community mobilization efforts to improve social conditions for vulnerable populations with expertise in the field of health disparities, school readiness and poverty reduction.

Her skills include the development of comprehensive systems change strategies targeted at the community, neighborhood and institutional level to improve family and individual outcomes. April leads health disparity reduction efforts across Health Net and has been successful in integrating departments toward collective action. April developed a health disparity reduction model, improved the collection of race, ethnicity and language data and has successfully led the organization in decreasing disparities in targeted HEDIS measures. Through her leadership, Health Net has been recognized as a leader in health disparity reduction and received the Disparity Leadership Program Best Overall Project Award and the Innovation in Addressing Health Equity Award from the National Business Group on Health.

Dr. Kathy Jo Carstarphen

Medical Director
Ochsner Health System

Dr Carstarphen is originally from Selma, Alabama and attended Washington University in St Louis with a double major in Biology and African-American Studies. She obtained her medical and public health degrees at the University of Alabama at Birmingham, then completed residency in Internal Medicine at Tulane Hospital in New Orleans.

She has a special interest in complex medical management of vulnerable populations. She created and directs the MedVantage Clinic at Ochsner Health System in New Orleans, Louisiana which integrates primary care with addressing social determinants of health for high-risk patients.

Paul Cotton

Director of Federal Affairs
NCQA

Paul Cotton is the National Committee for Quality Assurance Director of Federal Affairs. He works with Congress, the Administration and other stakeholders to improve health care quality. Previously he was a lobbyist for AARP on Medicare, Medicaid, CHIP, health reform, health IT and quality improvement issues. He has also worked at the Center for Medicare & Medicaid Services as Hearings & Policy Presentation Director in the Office of Legislation, and as a journalist for publications including the Journal of the American Medical Association.

Dr. Lora Council

Senior Medical Director
Cambridge Health Alliance

Lora Council, MD, MPH is a practicing family physician and the Senior Medical Director for Primary Care at Cambridge Health Alliance, a safety-net health system in Massachusetts that excels in care for vulnerable populations. She was previously the Senior Vice President of the Primary Care Service Line for Dartmouth-Hitchcock. She received her medical degree from the University of Massachusetts Medical School and her MPH at the Dartmouth Institute for Health Policy and Clinical Practice. She completed the NH Dartmouth Family Medicine Residency and the Leadership Preventive Medicine Residency at Dartmouth-Hitchcock. She has worked at the Center for Medical Home Improvement and as a medical director for quality and safety. She continues to follow her QuEST (Quality & Safety, Experience, Sustainability, and Teamwork) to improve primary care for patients, families, and teams.

Joe Crimando

Interim Director, Population Health
Kaiser Permanente

Gregory A. Hanley, FACHE, CPHQ

Vice President, Quality Management & Pharmacy
UCare

Greg is the Vice President of Quality Management & Pharmacy for UCare. UCare serves over 400,000 members in Minnesota and Wisconsin. Greg provides oversight and direction for the CMS Star Ratings improvement program, HEDIS, CAHPS, HOS, QRS, QIS, NCQA Accreditation, member complaints, appeals, and grievance process, practitioner credentialing, and Pharmacy. UCare has had an Excellent NCQA Accreditation rating since 2014 and has a 4.5 Star Medicare Advantage plan.

Prior to joining UCare, Greg was the Midwest Regional Director of Quality Improvement at Coventry Health Care in Kansas City, MO. As such, he oversaw Coventry’s credentialing, NCQA Accreditation, CAHPS and quality of care, as well as its quality Committees and all quality improvement projects.

Greg retired from the Army in 2005 after a 21-year career as a Medical Service Corps Officer and in Psychological Operations. Greg is board certified by the American College of Healthcare Executives (ACHE) as a Fellow (FACHE) in health care management and a Certified Professional in Healthcare Quality (CPHQ). He earned a Bachelor of Arts degree from St. Cloud State University and a Master of Business Administration from Portland State University.

Allison Hess

Vice President, Innovation
Geisinger

Allison Hess is the Associate Vice President of Health and Wellness Programs for Geisinger. In this role, she is responsible for the oversight of health and wellness programs for commercial, Medicare and Medicaid populations, community based programming and programming for the Geisinger employee population. Ms. Hess earned her bachelor of science in Health Education with a concentration in Psychology from Bloomsburg University and is currently pursuing her MBA. She is a Certified Wellness Practitioner (CWP) and has additional certifications in the wellness and health education field.
Ms. Hess has worked for over 15 years in the specialty of community health and worksite wellness. Her most recent work involves community based strategies impacting food insecurity and focusing on social determinants of health and the impact on condition management.

Tejaswita Karve, Ph.D.

Director, Medicare STARS Advantage MD Adminstration
Johns Hopkins HealthCare LLC

Tejaswita Karve, Ph.D. is an accomplished healthcare executive with an expertise in Population Health Management and Quality Ratings Programs, specifically, Medicare Star Ratings. With background in biomedical research, she earned her Doctoral degree in Biomedical Sciences from Georgetown University, Washington, D.C., where her work focused on the identification of prognostic biomarkers for cancer with potential for commercialization.

Her healthcare experience spans across industries from Health Analytics Consulting (at Accenture, LLC), to PBM (at CVS Health) and several Integrated Delivery Systems such as Presbyterian Healthcare Services, UPMC Health Plan and currently at Johns Hopkins HealthCare, LLC. Tejaswita’ s primary focus has been developing data-driven strategies, reporting and analytics capabilities and driving execution efforts to consistently deliver impactful results. Most recently, these approaches have successfully resulted in achieving 4.5 Stars performance on 2 of 3 contracts accounting for 75% of all Medicare lives at the UPMC Health Plan. She is passionate about promoting advocacy positions supporting whole person care models geared towards understanding and integrating social determinants of health in care delivery and achieving desired outcomes.

Jose Diaz Luna

VP of Pharmacy
Trusted Health Plans, Inc.

Jim Milanowski

President/CEO
Genesee Health Plan

Jim Milanowski has over 22 years experience in the management of mental health, substance abuse, behavioral health managed care and medical care coverage programs. Mr. Milanowski currently serves as the President and Chief Executive Officer of the Genesee Health Plan (GHP), administering a community based indigent health care plan. The health plan has covered over 70,000 Genesee County residents since 2001. Since the start of enrollment into Affordable Care Act in 2013, GHP has conducted outreach and enrollment sessions with over 15,000 Genesee County residents. The health plan received the 2015 Pinnacle Award from the Michigan Association of Health Plans for this effort.

As a strong advocate, his expertise includes working to reduce racial disparities, uncompensated care, and the impact of chronic disease. During his leadership, Genesee Health Plan has received the national quality award from URAC for Best Practices in Patient Empowerment and Protection, the Greater Flint Labor Council's Community Partnership Award and the Robert M. Pestronk Excellence in Public Health Award. He is a founding member of the Health Net Collaborative, and a member of the Greater Flint Health Coalition Access, Dental and Medical Group Visit Committees. He is the Treasurer of the Michigan Association of County Health Plans and is on the Board of Directors for the Genesee Community Health Center.

Mr. Milanowski received his Bachelor of Arts degree in Psychology from Spring Arbor University and his Master's of Science degree in Clinical Psychology from Eastern Michigan University. He is a limited-licensed psychologist in the state of Michigan, and has extensive counseling experience with adult, child, and adolescent populations.

Steven R. Peskin, MD, MBA, FACP

Executive Medical Director Population Health & Transformation
Horizon Blue Cross Blue Shield New Jersey

Steven R. Peskin, MD is the Executive Medical Director Population Health at Horizon Blue Cross Blue Shield of New Jersey. His expertise encompasses physician leadership, medical delivery management, performance improvement in health care, contracting; applications in technology include mobile/social media, clinical/scientific communications for health care professional and consumer audiences.

Dr. Peskin is the former Executive Vice President and Chief Medical Officer for MediMedia USA, CEO of Pharmaceutical Research Plus, President/COO of Nelson Managed Solutions and has worked in multiple executive positions in health plans at PacifiCare Health Systems, CIGNA Healthcare, and John Hancock. Dr. Peskin has authored industry and scientific articles, book chapters and spoken at various conferences and events about physician leadership, the medical home, mobile health and social media.

Dr. Peskin is an Associate Clinical Professor in the Department of Medicine at Rutgers Robert Wood Johnson Medical School. He is a clinical preceptor at The Eric B, Chandler Clinic for interns and residents in Internal Medicine. Dr. Peskin assists with the Population Health and business of medicine training for the Rutgers RWJ Internal Medicine physicians in training.

Dr. Peskin is a Diplomat of the American Board of Internal Medicine and a Fellow of the American College of Physicians, serves as Governor for the Southern Region of the ACP in New Jersey, Board of Trustees for Friends of the National Library of Medicine, editorial advisory boards of The Journal of Population Health Management and Managed Care and is a Senior Scholar in the School of Population Health at Thomas Jefferson University. His community service includes the Boards of the Greater Donnelley Neighborhood Initiative and Young Audiences of New Jersey.

Dr. Peskin received a bachelor’s degree from The University of North Carolina Chapel Hill and a medical degree from Emory University School of Medicine. He completed residency at Saint Elizabeth’s Medical Center in Boston and holds an MBA from the Sloan School of Management at Massachusetts Institute of Technology.

Maria Pugo, DrPH, MPH

Health Services Evaluator, Health Services Research & Evaluation
Inland Empire Health Plan

Dr. Maria Pugo is an accomplished public health professional with extensive involvement across several sectors in healthcare administration. As a lead for numerous access-to-healthcare initiatives, Dr. Pugo has been an integral part in the collaborative efforts in bridging the gap of health equity across the region. At Inland Empire Health Plan (IEHP), a not-for-profit Medi-Cal and Medicare health plan and one of the fastest-growing health plans in the nation, Dr. Pugo provides leadership in research and evaluation. Alongside a team of healthcare data analysts and doctoral fellows, she delivers analytical and programmatic support to the organization. Originally from Los Angeles, Dr. Pugo’s educational career has provided her residence across California – San Bernardino, San Diego, and San Francisco exposing her to the diversity of public health and adding to her appreciation of resource-based collaborative efforts and research focused on disease prevention. She has a Doctoral Degree in Public Health with a focus on Healthcare Policy and Leadership from Loma Linda University.

Konark Rana

Director, Product Strategy and Development
Gateway Health Plan

Konark is healthcare executive with 15 plus years of experience in healthcare strategy, creating clinical, member centric solutions which helps organizations to increase revenue, decrease costs and improving operational effectiveness by addressing people, processes and technology across every aspect of the healthcare payer lifecycle.

Currently as a Director of Product Strategy and Development within Gateway Healthplan he focuses on strategizing, designing and implementing innovative and transformative programs that support Gateway’s members throughout their journey to self reliance while positioning Gateway to be at forefront in the industry. He and his team contributes to support growth, value based payments, clinical and quality (HEDIS, Stars) programs and outcomes.

Harry Saag

CEO, Roster Health, Assistant Professor
NYU Langone Health

Dr. Harry Saag is a Hospitalist at NYU Langone Health and serves as the Medical Director for Network Integration and Ambulatory Quality across NYULH’s 200 sites consisting of an Academic-based Faculty Group Practice as well as a Network of Federally Qualified Health Centers working to improve quality, reduce costs, and increase patient and staff satisfaction. In this role, he helps design ambulatory quality metrics for the enterprise as well as assists in strategizing how NYULH will optimize its performance in a hybrid value-based and fee-for service environment. Specifically, he serves as one of the clinical leads partnering with operational teams focused on population health management, quality, care coordination, and data analytics.

He was born and raised in Birmingham, Alabama, and received an Economics Degree from The University of Georgia. He then returned to his native Alabama where he received his medical degree from The University of Alabama – Birmingham before moving to New York where he completed his residency training in internal medicine at NYU School of Medicine and subsequently served as a Chief Resident.

He is passionate about population health management and value-based contracts, where incentives are aligned between payer, provider, and patient as well as using data to inform decisions with the goal of keeping patients healthy, happy, and at home. His work has been published in JAMA, JAMA Internal Medicine, and the Journal of General Internal Medicine among others.

Dan Swayze

Associate Vice President for Clinical Affairs and Community Support Services
UPMC Health Plan

Dr. Dirk Wales

Chief Medical Officer
Cigna-HealthSpring

Tricia Beckmann

Director
Faegre Baker Daniels Consulting

Tricia Beckmann, JD, Director at Faegre (FAY-GREE) Baker Consulting, helps clients throughout the health care industry, particularly health plans, navigate state and federal regulatory issues. She applies a pragmatic approach to health policy and reform and helps plans navigate both policy and business opportunities and challenges as the Medicare and Medicaid programs continue to evolve. She spent four years with the Centers for Medicare and Medicaid Services (CMS), where she reported directly to agency leadership responsible for the health insurance Marketplaces and private insurance market reforms that are at the center of the Affordable Care Act (ACA). Prior to joining Faegre, Tricia served as an in-house attorney for a population health company that supports hospital and physician organizations in their adoption of value-based care and population health management. Tricia also has prior in-house government relations experience working for a not-for-profit managed care health plan in California.