11th Partnering with ACOs & IDNs Summit -

11th Partnering with ACOs & IDNs Summit
June 11–12, 2018
Boston, MA

Access Healthcare Through a Solution Driven Approach by Leveraging Internal and External Influences

Faculty – 11th Partnering with ACOs & IDNs Summit

Barrie Baker, M.D., MBA

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Dr. Baker has over 15 years’ experience in Medicaid Managed Care administration. As the Chief Medical Officer for the Public Plans Division of Tufts Health Plan, she is responsible for over 400,000 of Tufts’ Medicaid, Duals and Commercial Qualified Health Plan members. Prior to coming to Massachusetts, she also served as the medical director for Coventry’s Medicaid programs in Pennsylvania and Maryland, and as Senior Medical Director for Keystone Mercy Health Plan. Before joining the health insurance industry, Barrie spent seven years as a family physician in underserved areas.

Barrie earned her M.D. from the Medical College of Pennsylvania, an M.B.A. from Eastern University and a Bachelor of Architecture from Temple University. She is board certified in Family Practice. She has also presented numerous workshops & talks on Health Care Disparities and Cultural Diversity nationally over the past 20 years

Mike Barrett

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Mike is responsible for business development and oversees the company’s ACOs in the southeast region. In addition to the oversight of these ACOs, Mike is responsible for program growth and development. He has more than 25 years of experience in managed care payer and provider operations, holding executive positions at large hospital systems, managed Medicare physician groups and HMOs. Prior to joining the company, Mike assisted in the turnaround of a large globally capitated “at risk” IPA in greater New York City serving Medicare, Medicaid, Commercial and ACO populations. Mike earned his B.S. degree from Syracuse University. Mike is Co-Chairman of the National Association of ACOs (NAACOS) and was one of the original founders of the association.

Mary Blohm
Associate Director, Systems of Care, NOVARTIS PHARMACEUTICALS

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Mary Blohm has worked at Lilly for 12 years, nine of which have been in an Account Management role in Managed Healthcare Services. She started her career in sales more than 20 years ago and has worked for Coca-Cola, BMS and AstraZeneca. In the past nine years, Mary has been an AM in the WI and MN markets. She has covered the payers and WI Medicaid. For the past two years, Mary has been an AM in the IHS pilot in the Madison, WI territory. She has covered payers, Medicaid, hospitals and physician groups. She has three direct payer contracts that include Medicare Part D, commercial and Managed Medicaid for a regional PBM with three million lives, along with a local health plan contract. She also has a direct hospital contract with the University of WI health system. Mary enjoys spending time with her family and any outdoor activity.

Nicole Bradberry

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Nicole Bradberry is the Chief Executive Officer and Chairman of the Board of the Florida Association of ACOs (FLAACOs). FLAACOs is the premier professional organization for Accountable Care Organizations (ACOs) throughout Florida which provides education and collaboration in the fee for value healthcare space.

Most recently, as its CEO, Nicole led the successful transition of Captify Health to a specialty network benefits management solution prior to selling it to a large revenue cycle company, Continuum Health Alliance where she also served as their Chief Growth Officer. Ms. Bradberry leverages her strategic relationships and strong leadership, operations and technology background to develop innovative products and growth strategies for healthcare providers as they transition to value-based healthcare.

Prior to joining Captify Health, Ms. Bradberry, as President and Co-Founder of Citra Health Solutions, led the strategy and design behind the development of scalable population health tools and a professional service model that enabled physicians to successfully participate in value-based contracts such as ACOs.

Prior to Citra, she was a founding Executive and Chief Information Officer for Rise Health, where she led the design and implementation of a full primary care transformation suite of products, including proprietary technology and transformational business solutions. In this role, she led her team to win the prestigious U.S. Department of Health and Human Services health data award for IT innovation.

In addition, Ms. Bradberry spent 16 years leading operations and information technology programs for UnitedHealth Group and Cigna HealthCare. While there, she served as business lead for the technology transformation of the country’s largest dental and vision Services Company, led the national deployment of healthcare quality and affordability programs, and was responsible for the successful integration of many major health plans.

Ms. Bradberry holds a bachelor’s degree in Statistics from the University of Florida. She is a former Board of Director for Diabetes America, is a member of the Women Business Leaders of the US Health Care Industry Foundation, prior Board member of the Boys and Girls Club of NE Florida, prior Co-Chair of the ambulatory committee for Central/North Florida HIMSS, Dean’s Council member for University of North Florida and member of the Junior League. She has been recognized for her personal and professional achievements many times, recently as the nation’s Outstanding Midmarket IT Leader of the Year and one of the Business Journal’s “Women of Influence.” She is often found on the speaker faculty for healthcare conferences focused on ACOs, Population Health and Value-Based Care. She is passionate about changing healthcare and enabling physicians to provide high quality, cost-effective and consumer-focused care.

Donna Brezinski

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Dr. Donna Brezinski is the CEO and Founder of Little Sparrows Technologies. A neonatologist and instructor in pediatrics at Harvard Medical School, she has a 20+ year career in pediatrics and newborn medicine, assuming numerous leadership roles in clinical medicine and health care policy. She is the inventor of the Bili-Hut™, the first portable, high-intensity neonatal phototherapy device that can operate for prolonged intervals on a battery. She founded Little Sparrows Technologies to realize the commercialization of this device so as to provide universal accessibility to effective jaundice treatment. Under her leadership, Little Sparrows Technologies has received numerous honors and awards, including a Saving Lives at Birth grant sponsored in part by the Bill & Melinda Gates Foundation/USAID, Phase I and II SBIR awards from the National Institutes of Health, and a seed grant from the Philadelphia Pediatric Device Consortium funded by the FDA, among others. Dr. Brezinski received her undergraduate degree in Biochemistry from Boston College, graduating as valedictorian. She received her medical degree and general pediatrics training at Yale University and her subspecialty training in newborn medicine at Harvard Medical School.

Dan Brooks
Senior Vice President, Strategic Partnerships, HEALTHEC

Fred Brownfield
Director, Pharma Innovative Contracting, HUMANA

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Today, as the owner of FB Innovations, LLC, Fred provides consultative services for Pharmaceutical Manufacturers, PBMs and other Payors around formulary access, rebate and value-based contracting strategies.

As a 31-year veteran of Humana Inc., Fred has spent most of his career pioneering efforts in developing and managing Humana’s P&T and formulary process. Additionally, he built and led Humana’s Trade team where he negotiated Medicare and Commercial rebate contracts. Most recently, he designed, developed and implemented value-based contracts across multiple disease states. Throughout his career, he successfully cultivated genuine, loyal and strong relationships within the industry.

Fred earned a B.S. in Pharmacy from Ferris State University in 1977. He is a Registered Pharmacist in the states of Michigan and Kentucky and is a member of the Academy of Managed Care Pharmacy (AMCP) and Pharmaceutical Care Management Association (PCMA).

Sarah Johnson Conway, M.D.


Assistant Professor of Medicine, Division of General Internal Medicine, JOHNS HOPKINS UNIVERSITY SCHOOL OF MEDICINE

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Dr. Sarah Johnson Conway is an assistant professor of medicine at the Johns Hopkins University School of Medicine. Her areas of clinical expertise include internal medicine and hospital medicine.

Dr. Conway serves as the Medical Director of the Johns Hopkins Hospital Infusion Center. She also serves as the Associate Medical Director of the Johns Hopkins Medicine Alliance for Patients (or JMAP). Her research interests include quality improvement, care coordination, transitions of care, and accountable care.

Dr. Conway received her undergraduate degree in Economics from Harvard University. She earned her M.D. from the Perelman School of Medicine at the University of Pennsylvania. She completed her residency in internal medicine at Johns Hopkins University School of Medicine. Following residency, she served as the Department of Medicine’s inaugural Health Systems Management Fellow.

Michelle Copenhaver
Regional Vice President Value-Based Collaborations SE Region, AETNA

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Michelle Copenhaver is the Regional Vice President of Aetna’s Southeast Territories. She has 30 years of experience in the healthcare industry, both in the clinical realm as a Registered Nurse and as a Healthcare Executive in the payer space. Currently, she leads a team that manages multiple ACO and other value-based model commercial and Medicare Advantage collaborations throughout the southeast region, including contracting, relationship engagement, operations and day-to-day management excellence, strategic expansion, the establishment of win-wins for provider partnership relationship, continuous improvement, growth, and sustainability.

Bob Delise

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Bob Delise is Founder and President of Artisan Healthcare Consulting. He has provided strategic and tactical insights for healthcare product companies since the early 1990s; during his career, he has advised more than 100 biotechnology, pharmaceutical, and medical device brands worldwide.

Bob founded Artisan on the basis of outstanding client service — a philosophy he feels makes the difference between a good consulting firm and an exceptional one. Artisan helps leading oncology, immunology and rare disease companies act decisively through strategic and analytic insights. Artisan’s consulting services range from sales data analytics to innovative partnering approaches with strategic customers, to new product development and differentiation.

Sanjay Doddamani, M.D.

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Dr. Sanjay Doddamani is the Chief Medical Officer of the Geisinger-led Keystone ACO, and a senior director in population health at Geisinger Health System. In this capacity, he works with executive leadership to accelerate improvement of performance metrics across the system working closely with the service line medical directors, platform leaders and operational leadership to improve integration of population health initiatives. He is also the systemwide chief of the Advanced Cardiac Disease – Heart Failure program for Geisinger Health System. His background as a heart failure cardiologist has kept him interested in chronic disease management aspects of heart failure. Additionally, he oversees the LVAD program for mechanical circulatory (heart pump) support. Dr. Doddamani is board certified in Internal Medicine and Cardiology, as well as in heart failure and cardiac transplant. He has served on numerous panels and committees, as well as delivered lectures, both nationally and abroad, related to heart health and disease.

Mark Fisher
Senior Manager, Organized Customer Group Commercial Excellence, SANOFI

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Mark brings more than 25 years of pharmaceutical experience to bear in his current role as the National Director- Key Account Lead for Joint Health at Sanofi. Prior to joining Sanofi, Mark was with GSK where he held roles of increasing responsibility in sales (retail and institutional), analytics, sales training, sales leadership, market development, brand professional marketing and key account management across a wide range of therapeutic areas. Mark has a passion for the overlap between healthcare reform, IDNs, the Triple Aim and the therapeutic value proposition in his current and past roles.

Mark currently lives in New Hampshire with his wife of 26 years and their dog, Holly.

Jesse Fishman
Health Outcomes Lead, Medical Affairs Professional, UCB

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Jesse Fishman currently leads the U.S. medical affairs organization Scientific & Real World Data Alliances Department at UCB by providing strategic development and oversight of scientific and database partnerships in their neurology patient value unit (NPVU). Our division of the NPVU seeks to communicate about the clinical and economic solutions that will serve patients with severe disease.

Jesse has 10 years of industry experience working in various roles in clinical development and medical affairs. Jesse has been responsible for developing evidence generation strategies, for medical affairs strategic planning, and for ensuring US payer customer needs are aligned with health outcomes research and communication plans. He has supported 7 new product launches for fortune 500 pharmaceutical companies such as Pfizer and Amgen by communicating about a product’s unique value proposition and supporting market access positions across various therapeutic areas that include oncology, neurology, and rare diseases.

His research and numerous publications focus on topics such as health outcomes, health policy and literacy, and ways to improve communication between patients and healthcare providers. Jesse holds a chemistry degree from Arizona State University and a Doctor of Pharmacy from the University of Arizona. He also completed a pediatric residency at Children’s Healthcare of Atlanta and practiced as a critical care pharmacist prior to entering the pharmaceutical industry.

Alan Gilbert

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Alan Gilbert is a mission-driven growth serial entrepreneur with “up through the ranks” experience in the healthcare industry. He is viewed as a thought leader in the areas of accountable care solutions and collaborative care, and is a frequent contributor to professional online journals as well as a sought-after speaker at industry conferences. He possesses a clear understanding of the current healthcare landscape, and has conceived and implemented strategies that resulted in new markets, new clients and increased revenue. Alan benefits from having a well-developed network of long-standing relationships at the executive level, with access and credibility to be viewed as their trusted advisor. Alan is focused on the achievement of systematically better health outcomes at lower costs through a TEAM-based approach to care management. Alan is currently the Chief Growth Officer and Co-Founder of TEAM of Care Solutions, LLC, focusing on Technology Enabled Active Management of Care (TEAM). Previous to TEAM of Care Solutions, LLC, Alan was the Co-Founder of AxSys Health, the U.S. operations of a U.K.-based Collaborative Care Technology Care Company called AxSys Technology.

Jonathan Harding, M.D.
Senior Medical Director, Senior Products Division, TUFTS HEALTH PLANS

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Dr. Harding is currently the Senior Medical Director for Senior Products, overseeing Quality, Utilization, Pharmacy, Medical Trend, and Network relationships for a population of over 125,000 Medicare and Retiree members at Tufts Health Plan in Massachusetts. Previously, he was Vice President for Health Services at Touchstone Health Partnership, a Medicare IPA/PSO in New York. Prior to that he was Chief Medical Officer of the Fallon Clinic in Worcester, MA, a multi-specialty globally capitated group practice with over 300 practitioners, and held several different positions at FHP in California, a multi-faceted healthcare company with HMO, medical group, and hospital businesses. He also continues his role as a physician reviewer for the National Committee on Quality Assurance (NCQA), reviewing Health Plans, Disease Management companies, Special Needs Plans, and Medical practices. He is a Certified Content Expert in Patient-Centered Medical Home. He brings over 25 years of experience in medical management.

Dr. Harding received his bachelor’s degree and his degree in medicine from Boston University and he is board certified in internal medicine and geriatric medicine. He also has been certified by the ABMM and ABQAURP, and is a Fellow of the American College of Physician Executives. Dr. Harding has previously taught Internal Medicine at the University of California, Irvine, School of Medicine; the University of Massachusetts Medical School in Worcester and in Uganda and South Africa.

Michael Kaminsky
Director, Value-Based Care Strategy, AETNA

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Michael Kaminsky is currently the Director of Value-Based Care Strategy for the Texas market with Aetna. He oversees ~30 Commercial and Medicare value-based partnerships in the state encompassing ~450,000 members. Previously, he was a Senior Manager in the Joint Venture Strategy and Business Development group, forming advanced partnerships with health systems, including the Texas Health + Aetna joint venture in Dallas-Fort Worth. Prior to Aetna, Michael worked at The Boston Consulting Group (BCG). He graduated from Brandeis University with a Bachelor’s degree in Health: Science, Society, and Policy.

Christopher Lisanti
Managing Partner, THE EXEQUOR GROUP

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Chris is the founder and managing partner of the Exequor Group, and since opening its doors in 2012, has led his team of experts into numerous new collaborations in the life sciences and healthcare industries. In a career spanning more than 20 years, Chris supported successful pharmaceutical and biotech product launches. He continues as a trusted adviser, guiding numerous companies in enhancing and implementing their go-to-market strategies. He deftly navigates through today’s increasingly complex healthcare labyrinth, now driven by the Affordable Care Act and new healthcare stakeholders. Through advanced analytics, detailed customer input, real-world experience and proven methodologies, Chris delivers actionable results for a range of clients in the life sciences industry. As such, he is a national thought leader on the implications of healthcare reform in the pharmaceutical industry and how manufacturers can take advantage of newly uncovered commercial opportunities.

His evolutionary approach has delivered positive top- and bottom-line impact and secured a lengthy dossier of satisfied clients and long-term friends. He also brings a wealth of knowledge from the consumer, high-tech and information technology sectors.

Chris combines a distinguished corporate background with a fresh and fierce can-do philosophy that only a boutique firm can offer. He is passionate about delivering new and creative solutions to meet the ever-changing demands of today’s healthcare landscape. With infectious energy, market savvy and ingenuity, Chris Lisanti brings knowledge, leadership and vision to a complex and vital healthcare industry.

John Marchica

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John Marchica is a faculty associate in the W.P. Carey School of Business and the graduate College of Health Solutions at Arizona State University. He is leading ongoing, in-depth research initiatives on Accountable Care Organizations, Integrated Health Systems, and value-based care. John is also the founder and CEO of Darwin Research Group, a healthcare market analytics firm specializing in health care delivery systems.

John began his career at SRG as a health systems analyst, followed by a successful stretch in general management at Abbott Laboratories. He’s a two-time healthcare entrepreneur, and his first company, FaxWatch, was listed twice on the Inc. 500 list of fastest-growing American companies. John is the author of The Accountable Organization and has advised senior management on strategy and organizational change for more than a decade.

John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He serves as an active member of the American College of Healthcare Executives and is an advisor to the Global Council on Alzheimer’s Disease.

Brian McGarry
Market President, AETNA

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Brian is the President of National Accounts in Pennsylvania, Delaware, New Jersey, Virginia, Maryland, West Virginia and DC. He has oversight for Sales and Service associated with some of Aetna’s largest prospects and customers within Aetna’s large employer business. He has all P+L accountability for all lines of coverage and products. Before being promoted to President in 2003, Brian was the Vice President Sales and Service of Mid-Atlantic National Accounts.

Brian joined Aetna in March of 1996 as the Eastern U.S. Sales Director in Corporate Health Administrators – a wholly owned subsidiary of Aetna. In that role, he was responsible
for directing a sales team focused on the sale of mid and large sized self?insured employee benefit programs throughout the East Coast. Later that year, Brian’s role was expanded to include all of the US. In 2000, he joined National Accounts in Philadelphia as Director of Sales and Service.

Prior to joining Aetna, Brian spent 12 years at Prudential Healthcare in a variety of progressively responsible Sales and Sales Management positions throughout Southeastern United
States. Immediately prior to joining Aetna, he was the Director of Marketing for Prudential in Virginia.

Over the years, Brian has participated on a number of charitable and business-related boards in the Greater Philadelphia area. He is an immediate past board member of the American Heart Association, a member of their Executive Leadership Team for the Heart Ball, and a past Chairman of the Philadelphia Heart Walk — the largest single fundraising event for the AHA. Brian is a past Board member of the Greater Philadelphia Economy League — a private/public partnership advancing business in the Area. Brian is a frequent speaker on a variety of healthcare and business topics such as the business case for wellness and employee engagement.

Brian graduated from the University of Scranton with a B.S. in Business Management and Marketing.

John Minichiello

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John is the Executive Director of Integra Community Care Network in Rhode Island. Integra is an accountable care organization (ACO) with more than 120,000 total covered Medicare, Medicaid, and Commercial ACO lives. John leads the ACO and is focused on establishing a culture of health while leading performance improvement efforts within various population health initiatives, particularly spearheading efforts in the areas of complex care management, quality improvement, post-acute care management, shared decision making and social determinants of health. With over twenty years of experience working within care systems reimbursed by global payment and other value-based payment models, John has held leadership and management positions in several ACOs, integrated care delivery networks, and health plans.

Steven Peskin, M.D., MBA, FACP
Executive Medical Director, Population Health, HORIZON BLUE CROSS BLUE SHIELD OF NEW JERSEY

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

Dr. Peskin is the former Executive Vice President and Chief Medical Officer for MediMedia USA, CEO of Pharmaceutical Research Plus, and President/COO of Nelson Managed Solutions. He 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 as well as book chapters, and has spoken at various conferences and events about physician leadership, the medical home, mobile health and social media.

Dr. Peskin continues to work at the Rutgers Robert Wood Johnson School of Medicine as a clinical preceptor and instructor at the Eric B. Chandler Clinic and assists in the business of medicine curriculum. He is Course Director for Internal Medicine Grand Rounds at The University Medical Center in Princeton. He has held faculty appointments in medicine at several universities across the country and is currently an Associate Clinical Professor of Medicine Rutgers Robert Wood Johnson School of Medicine.

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, is on the 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.

Matt Portch
Vice President, Managed Markets, SUNOVION PHARMACEUTICALS

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Matt is currently the Vice President of Managed Markets for Sunovion Pharmaceuticals Inc. Matt is responsible for leading the Account Management, Trade, Contracting and MM Marketing Teams at Sunovion.

Prior to this position, Matt was Vice President of Commercial Model Innovation at Pfizer. He and his team were responsible for evolving Pfizer’s Business Model to meet the rapidly evolving needs of Health Care Providers and Organizations in the US. This includes the development of evolved Customer Solutions to meet the changing needs of Customers; Health Information Technology insights to adapt to an HIT-enabled marketplace and new delivery models that are more relevant in meeting Customer needs.

Prior to his current role at Sunovion Matt also served as Vice President, Managed Markets for Pfizer. Previous experience included a number of positions in Sales Leadership, Account Management Leadership, Marketing Leadership and Operations with Pfizer, Pharmacia and Bristol-Myers Squibb.

Michael Ruiz
Vice President, Provider Relations, UCARE

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As UCare’s Vice President of Provider Relations and Contracting, Michael Ruiz leads complex negotiations with providers and develops innovative Medicare and commercial value-based contracting arrangements. He also manages teams and processes to support improved operations and performance at UCare.

Ruiz was most recently Vice President, Medicare Market Performance at UnitedHealthcare in Minnetonka, Minn. His responsibilities included overseeing value-based contracting analysis for incentive programs, addressing gaps in Medicare Star Ratings and improving medical cost performance for health plan members.

He previously held positions as Senior Director, Accountable Care Strategy at UnitedHealthcare; Senior Provider Contract Manager with Blue Cross Blue Shield of Minnesota in Eagan, Minn.; Project Manager with Medical Management, Inc., of Portland, Ore.; and Hospital Director with Banfield Pet Hospitals in the Twin Cities area.

Ruiz earned a Bachelor of Arts degree from the University of Minnesota. He is a member of the Health Care Financial Management Association. Ruiz and his family live in St. Paul, Minn., where he coaches the Mendota Heights Athletic Association Football, Highland Hoops Basketball League, and Hi-Mac Baseball League, and is president of the Friends of the Oxford Pool.

Marie Sanchirico
Director, Medical Managed Care, SANOFI GENZYME

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Marie Sanchirico. Ph.D. is a value and access medical professional and Ph.D. immunologist currently working as a national Medical Managed Care Director at Sanofi Genzyme in complex specialty drug care division. Prior to joining Sanofi medical affairs, Marie was an associate professor at UMASS Medical School and Instructor of Medicine at Harvard Medical School. Marie received her bachelor’s degree in biochemistry at Ithaca College, her Ph.D. from UMASS, Amherst, and specialty trained in immunology as an NIH postdoctoral fellow and Instructor of medicine at Harvard Medical school/Dana Farber Cancer Institute. Marie has three daughters (ages 15, 13 and 9) and is a dedicated hot yogi and outdoor enthusiast.

John Sears, Ph.D., MBA
Health Care Quality and Commercial Strategy Director, JOHNSON & JOHNSON

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John Sears is currently a Director of Health Care Quality Strategy with Johnson & Johnson Health Care Systems. In his current role, John develops internal commercial strategies that support pipeline, inline and above-brand workstreams by bridging any gaps between Janssen’s capabilities and the evolving US healthcare system. John has previous experience with global marketing, sales operations, medical affairs and business consulting working across the majority of therapeutic areas within Janssen.

Anthony Vespa

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Mr. Vespa is a certified public accountant and attorney with experience in the areas of real estate, manufacturing, banking, corporate finance, healthcare and tax. He received his B.A. from Hillsdale College and his J.D. from the University of Detroit School of Law.

Mr. Vespa serves as the Executive Director of Southeast Michigan Accountable Care (SEMAC) since its inception. His efforts were instrumental in the initial formation of SEMAC and its initiatives with Centers for Medicare and Medicaid.

Pritpal Virdee
Senior Vice President and Chief Operating Officer, Senior Health Services, BLUE CROSS BLUE SHIELD MICHIGAN

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Pritpal is the Senior Vice President and Chief Operating officer for Senior Health Services at Blue Shield of Michigan. Pritpal oversees a broad portfolio of responsibilities to support BCBSM’s Medicare programs within the State of Michigan with the goal of strengthening BCBSM’s market positioning and constituent relationships while achieving positive business results. Responsibilities include Operations, Compliance, Part D, Billing and Recoveries, Project and Data Management, Provider Initiatives and Network Development and Innovation

At Anthem, Pritpal served as Plan President for Indiana, Missouri, and Kentucky for all Medicare lines of business. He was responsible for the P&L and creating provider collaborative relationships.

As CEO of Smart Insurance, Pritpal was responsible for the launch of SmartDRx a National PDP as well as other Senior related products

As Divisional Vice President at Walgreens Pritpal’ was responsible for running all Government Programs as well as managing the start and growth of the 340B business and the starting Walgreens Medicare business (Smart Insurance)

Prior to Walgreens, Pritpal worked for Express Scripts and held a number of senior positions in the Product Management team with responsibility for e-prescribing, Specialty Pharmaceuticals, Consumer Directed Healthcare, Medicare.
As Vice President, Medicare and COO of the Express Scripts Insurance Company, Pritpal was responsible for the execution of Express Scripts’ Medicare strategy and day-to-day management for the insurance company. Most recently Pritpal was the Vice President and General Manager of the Workers Compensation PBM.

Prior to Express Scripts, Virdee co-founded and served as Executive Vice President of Medihub.com, an innovative provider of electronic-procurement solutions to the non-hospital sector of the healthcare industry. He also co-founded one of the country’s first e-Prescribing companies- RxEase. From 1993 to 2000, he was President and COO of the publicly held home infusion and specialty pharmacy Infu-tech, Inc. For the multi-billion-dollar medical products company, Fresenius A.G., he headed Fresenius Pharma U.S.A., serving as President of that corporate subsidiary from 1990 to 1993, and for five years prior to that he served as General Manager of the Fresenius U.K. Pharma Division.

A native of the U.K., Virdee also worked for the pharmaceutical company G.D. Searle. Pritpal holds a Bachelor of Science degree in chemical engineering from the Southbank University of London.

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