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5th Payer Partnership Forum -

5th Payer Partnership Forum
June 10 - 11, 2019
Boston, MA

Creating mutually beneficial partnerships through collaborative discussions centered on value-based payer engagement partnerships

Faculty – 5th Payer Partnership Forum

Sarika Aggarwal, M.D., MHCM

Christopher Anderoli, M.D.
Chief Transformational Officer and Chief of Surgical Services, ATRIUS HEALTH

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Dr. Chris Andreoli is Chief Transformation Officer and Chair, Surgical Specialties at Atrius Health, a non-profit healthcare leader delivering an effective system of connected care to 720,000 patients in eastern Massachusetts under a value-based care model. Dr. Andreoli is responsible for leading the development and execution of Atrius Health’s organizational transformation strategy toward achieving the organization’s vision of transforming care to improve lives. Dr. Andreoli maintains a clinical practice as a vitreo-retinal surgeon and is involved in clinical research and teaching with his academic appointment at Harvard Medical School. He received his medical degree from Boston University School of Medicine and his undergraduate degree from Boston University. He completed his clinical training at the Massachusetts Eye and Ear Infirmary.

Christopher Boone, Ph.D., FACHE, FHIMSS
Vice President, Global Medical Epidemiology & Big Data Analysis Lead, PFIZER WORLDWIDE MEDICAL & SAFETY

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Adjunct Professor, Health Informatics
University of Cincinnati

There are several words to describe Dr. Christopher Boone: health futurist, patient advocate, executive, professor, social scientist, and self-proclaimed “data hippie.” Boone is recognized as being a dynamic, innovative thought leader and a public voice on the power of health data and its ability to radically change the U.S. health care delivery system. Most recently, he was honored as a 2017 40 Under 40 Leader in Minority Health by the National Minority Quality Forum and Congressional Black Caucus.

Boone currently serves as the Vice President, Head of Real World Data & Analytics at Pfizer, an adjunct professor in the health informatics program at the University of Cincinnati, and a co-founder of a few start-up companies. Prior to Pfizer, he was a Vice President at Avalere Health and the Executive Director/CEO of the Health Data Consortium (HDC), a public-private partnership working to build a national movement on the use of open health data to transform the U.S. health care system.

Boone has held appointments on several prominent national committees, including the Executive Board of Directors for the Patient Advocate Foundation and the National Patient Advocate Foundation, the National Quality Forum’s (NQF) Interoperability Committee, the advisory group for Robert Wood Johnson Foundation’s Data Across Sector for Health (DASH) initiative, the Board of Directors for SHARE for Cures, the Federal Health IT Policy Committee, the advisory group for the American Society of Clinical Oncologists CancerLinQ initiative, and the National Committee on Vital and Health Statistics Working Group on HHS Data Access and Use.

Originally from Dallas, Texas, Dr. Boone earned a B.S. from the University of Tulsa, an M.S. from the University of Texas at Arlington, a Ph.D. from the University of Texas at Dallas, and two executive certificates from the Harvard Kennedy School. In addition, he is a certified healthcare executive and Fellow of the American College of Healthcare Executives.

Lili Brillstein

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Lili Brillstein is a nationally recognized thought leader in the advancement of Episodes of Care as a value-based approach for specialty care. She is the Director of Specialty Care Value Based Models for Horizon Blue Cross Blue Shield of New Jersey, and, under her leadership, has built the largest, most progressive and most collaborative program for commercially insured patients in the country.

Lili is responsible for the overall direction, strategy, design and oversight of the Horizon Episodes of Care/Bundled Payment Program. When Lili joined Horizon in January of 2013, the Episodes program was still in pilot and included only total hip and total knee replacement episodes. The program has grown to include additional orthopaedic episodes (including low back/laminectomy, shoulder replacement, knee arthroscopy), obstetrics and gynecology, GI (including an IBD episode with a fully integrated behavioral health component), cardiology, oncology, and substance use disorder.

Lili is a passionate advocate of Episodes of Care/Bundled Payments as a strategy to successfully migrate from fee for service to quality- & value-based models that rewards providers for excellent outcomes and patient experience, while reducing the overall cost of healthcare. One of the hallmarks of her perspective is the criticality of beginning with models that do not include a risk transfer to providers until all of the stakeholders have worked together in a retrospective, no risk model and achieved success. The goal is cultivate true partnerships aligned around the patient and improve their experiences and outcomes, and ultimately reduce unnecessary care and waste.

Lili is a guest lecturer on episodes of care/bundled payments at the Harvard Business School working with Michael Porter and team, and has co-authored several peer-reviewed articles on the subject of Episodes. In addition, Lili has served as an Advisor to CMS on bundled payments, and is on the Advisory Boards of the US Women’s Health Alliance and the Quality Cancer Care Alliance; both national coalitions focused on advancing value-based care to improve quality and cost of care delivery. She is also an Adjunct Associate Professor at The Rutgers School of Pharmacy, and a member of the Board of Directors for the NJ Coalition to End Domestic Violence.

Lili’s expertise at cultivating functionally collaborative relationships between payers and providers across the full continuum of health care has allowed not only the pillars of the triple aim to be achieved, but the spirit of the relationships to shift from one of the adversaries to one of the collaborators.

Anita Burrell

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Anita Burrell is a dynamic, passionate and infectiously enthusiastic consultant focused on improving patient outcomes through pharmaceutical innovation. She is also an adjunct assistant professor at Rutgers University and a regular speaker in the industry on health economics, market access, and mHealth.

Anita has 23 years of leadership experience in the pharmaceutical industry in a wide variety of roles and geographies. As the Global Project Lead for Aubagio, the oral MS therapy from Genzyme, she was able to bring Aubagio to market over eight months ahead of schedule becoming the second oral therapy to market in the USA and EU. Aubagio is the fastest growing MS product in the US and the #1 product in the Genzyme/Sanofi portfolio with revenue of €1.3B in 2016.

As a consultant, Anita has helped companies to:

  • Understand market dynamics and payer behavior in diabetes and MS
  • Design big data platforms to deliver value in terms of regional sales variations
  • Develop predictive models to inform HTA submissions
  • Understand the implications of digital health and possibilities to use behavioral economics
  • Anita holds a BA (Hons) in Economics from the University of Stirling, an M.A. in Economics from Dalhousie University, Nova Scotia, Canada, and a Masters in Business Administration from Kingston University, Surrey UK. She speaks French at an advanced level.

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Denise Cabrera
Previously Vice President Clinical Account Management, CIGNA PHARMACY MANAGEMENT

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Denise brings over 25 years of experience in the managed healthcare and Pharmacy Benefit Manager (PBM) industry. She is a licensed pharmacist, earning her degree from The Ohio State University. Throughout her career in managed care she has had an op-portunity to view the healthcare landscape from multiple stakeholder perspectives includ-ing patient, prescriber, employer, payer and manufacturer. Beginning her career at Medco, counseling patients with chronic conditions, afforded her a clear understanding of the patent’s journey which has been the cornerstone for her career pathing.

Through expanded leadership roles Denise has become a versatile, results oriented, health care professional entrusted with numerous strategic responsibilities including clin-ical program development, trend control, proposals, pricing, contract negotiation and data analytics review. Managing highly functioning teams, in support of a large commercial portfolio, has given her a clear line of sight into what drives employer concerns and benefit decisions.

As Vice President of Clinical Account Management at Cigna Denise was responsible for the regional commercial business. Strong organizational agility was vital as she and her team collaborated with medical and behavior specialists, within the organization, to en-sure a holistic approach to account management.

Denise’s passion to influence quality of care and affordability in healthcare translates well as she leverages her PBM experience and principles of leadership, built upon collabo-ration, and simplifying complex challenges, to help employers achieve their strategic im-peratives.

Aria Cohen
National Account Director, SOBI – NORTH AMERICA

Francisco Curbera
Director of Innovation, Blockchain, Healthcare and Life Sciences, IBM

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Francisco Curbera is Director of Innovation for Blockchain in Healthcare and Life Sciences at IBM, where he leads the development of blockchain based solutions for the healthcare and life sciences industries. Prior to that he directed technology and research programs for IBM Watson Health and worked for the IBM Research division leading research in distributed computed infrastructure, business process management, and health informatics. He holds a B.S. in Physics from Universidad Complutense in Madrid, Spain, and a Ph.D. in Computer Science from Columbia University.

Jeffrey Gold
SVP and Special Counsel, Managed Care and Insurance, HEALTH ASSOCIATION OF NEW YORK STATE

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Jeffrey Gold is Senior Vice President and Special Counsel of the Managed Care and Insurance division at HANYS, the Healthcare Association of New York State. Mr. Gold works with the payor community, state and federal regulators, and New York State government to address provider issues and has drafted, negotiated, and helped secure major packages of managed care reform legislation that impact external appeals, administrative denials, claims processing and payor practices. He has designed HANYS’ highly regarded Strategies, Weapons, and Tactics programs (SWAT) and coaches hospitals on denials management and contract negotiation strategies.

Prior to his arrival at HANYS, in 2000, Mr. Gold was Special Counsel for Health Care to the New York State Attorney General. Mr. Gold served four Attorneys General in New York and was the founding Bureau Chief of New York’s Health Care Bureau in 1997. Mr. Gold joined the Attorney General’s office in 1987 and developed his managed care background as a result of overseeing units of the Attorney General’s office at Helen Hayes Hospital in West Haverstraw, New York, Roswell Park Cancer Institute in Buffalo, and the three State University of New York medical centers in Brooklyn, Syracuse, and Stony Brook. Before 1987, he worked at two private law firms in New York City, with a focus on civil litigation.

Mr. Gold has a B.A. from the University of Pennsylvania (1975) and a J.D. from Brooklyn Law School (1979). He is a frequent lecturer at Bar Associations meetings, Health Care Conferences, and HFMA events and has published several articles.

Lance Hill

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As Chief Executive Officer of Within3, Lance Hill brings his own brand of energy, leadership and vision to the company.

With the belief that deeper engagement among healthcare professionals results in improved healthcare and better patient outcomes, Lance strategizes with global healthcare decision makers on how to integrate digital collaboration solutions into their businesses as an effective new channel of communication.

Prior to joining Within3, Lance served as the Vice President and General Manager of the worldwide Service Oriented Architecture business unit for the webMethods Corporation, an international leader in enterprise software. With annual revenues exceeding $200 million, webMethods was acquired in 2007 by German giant, Software AG, for $546 million.

Recruited directly from the University of Toledo by tech giant IBM, Lance led the design and implementation of global telecommunication networks for Fortune 500 businesses and major healthcare organizations, as well as consulted and lectured on worldwide technology strategies. He also developed training, methodology and best practices for Global Services consultants. Lance subsequently joined a top 10 U.S. financial services firm where he served as the Vice President of Enterprise Engineering and founded its Fusion Technology Group, dedicated to accelerating corporate adoption of new technologies and business processes.

A veteran in the technology industry, Lance dedicates himself to work he strongly believes in — improving healthcare by providing an easy-to-use, always accessible, digital collaboration solution for healthcare professionals and industry leaders to connect, communicate and collaborate.

Sachin Kamal-Bahl
Vice President and Innovation Center Head, Global Health & Value, PFIZER

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Sachin Kamal-Bahl is currently Vice President and Head of the Global Health and Value Innovation Center at Pfizer Inc. — a newly created organization under Dr Kamal-Bahl’s leadership — that develops and integrates innovative approaches based on well-considered risks and strong technical underpinnings to address the access, pricing or valuation of challenges and opportunities. Dr Kamal-Bahl oversees the group’s strategic efforts aimed to a) help the organization recognize the strategic implications of environmental issues impacting valuation of and access to Pfizer therapies; b) develop and test prototypes and consider systematically embedding them within internal processes of the organization in order to better position Pfizer to demonstrate value and gain market access for assets at launch; c) develop, execute and evaluate innovative experimental approaches in order to address access, pricing or valuation challenges for Pfizer assets being raised by payers and; d) spearhead efforts with strong technical underpinnings to develop and/or support Pfizer’s approach to access, value and shape external practices over time.

Dr. Kamal-Bahl previously was the Executive Director and Global HTA Strategy Head at Merck & Co., Inc., where he provided strategic guidance to senior leadership on aspects related to HTA and its evolving landscape and was responsible for the development of Merck’s positions on key HTA topics. His group was also responsible for translating and executing HTA concepts across all of Merck’s franchises and geographies/regions.

Prior to this role, Dr. Kamal-Bahl was the Global Access Team Leader for the Diabetes and Obesity Franchise in the Global Market Access division at Merck & Co., Inc. In this key strategic role he led a companywide global cross-functional team that was responsible for developing an integrated market access strategy that includes pricing, reimbursement, health economics and outcomes research, health technology assessment, and payer and stakeholder engagement strategies to optimize profitability and market access and coordinate the implementation of this strategy for the entire portfolio of products under the Diabetes and Obesity Franchise.

In other previous roles within the company, Dr. Kamal-Bahl has worked in the Global Strategic Pricing area where he was a Global Strategic Pricing Leader responsible for developing the pricing strategies for all products under the diabetes and obesity franchise. In the past he has also led the development of health economics, outcomes research, market access and reimbursement strategies supporting the cardiovascular and metabolic franchises in leveraging the value proposition for cardiovascular, diabetes and obesity products within the US Outcomes Research & Management and Global Outcomes Research departments at Merck & Co., Inc.

Dr. Kamal-Bahl is a clinically trained pharmacist who obtained a Ph.D. in pharmaceutical health services research at the University of Maryland, Baltimore, MD. He currently also holds positions as Adjunct Senior Fellow at the Leonard Davis Institute of Health Economics at the University of Pennsylvania and as Adjunct Assistant Professor at the University of Maryland School of Pharmacy.

Dr. Kamal-Bahl is actively involved with several professional organizations such as AcademyHealth, American Heart Association, American Diabetes Association and International Society for Pharmacoeconomics and Outcomes Research. He has also published in several journals such as American Journal of Cardiology, American Heart Journal, Archives of Internal Medicine, Archives of Pediatrics and Adolescent Medicine, Diabetes Care, Endocrine Practice, Health Affairs, International Journal of Obesity, Journal of the American Geriatrics Society, Obesity, and Preventing Chronic Disease.

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.

Thomas Koenig
Executive Director, Biosimilars Market Access, BOEHRINGER INGELHEIM PHARMACEUTICALS

Roy McConnell
Executive Director Accountable Care/Payor Risk Strategies, DEACONESS HEALTH SYSTEM

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Roy joined Deaconess Hospital in 2015 as Director of Payor Risk Strategies to focus on all value/risk-based arrangements. He brought with him over 25 years of Payor/TPA experience. In 2016, he took over responsibilities for management and expansion of the OneCare Network. In 2017, he was appointed Executive Director of Deaconess Care Integration (DCI) and Director of Accountable Care. The ACO serves over 35,000 beneficiaries in the Evansville Indiana area. DCI was #2 in shared savings for all Next Generation Models in 2017. He currently serves in all these roles.

Denise Meade
Director of Product Management, IBM WATSON HEALTH

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Denise Meade, Director of Product Management at IBM Watson Health, oversees the development of new offerings using real-world evidence for access, value, and commercial needs. In addition, she chairs the Innovation Council on Value-Based Purchasing and manages strategic collaborations for new product incubations. Prior to joining IBM Watson Health, Denise held management roles in healthcare consulting, life sciences product development, and technology growth planning.

Jamie Partridge
Director, Global Scientific Affairs, ABBOTT

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Jamie Partridge, Director, Global Scientific Affairs at Abbott Nutrition leads a team focusing on Scientific External Engagement, Health Economics and Outcomes Research, Public Health and Policy. Jamie joined Abbott Nutrition in 2012 and established its HEOR group which focuses on initiatives in the area of therapeutic nutrition to demonstrate nutrition intervention and process-improvement as a cost-effective way of improving health outcomes. Jamie came to Abbott Nutrition from Abbott Vascular’s HEOR team, where she supported ABSORB™ Bioresorbable Scaffolds, XIENCE Drug-Eluding Stents, and the MitraClip Mitral Valve Repair System. Prior to working in industry, Jamie was a researcher in the Center for Health Outcomes, Policy and Evaluation Studies in the College of Public Health at the Ohio State University and served as a faculty member at a variety of universities including the Ohio State University, University of Saskatchewan, St. John’s University, Georgia Southern University and the University of Montana.

Jamie has a B.A. in Economics from the University of Illinois, an M.B.A in Finance and Operations Management from Indiana University’s Kelley School of Business, and a Ph.D. in Agricultural Economics from the University of Saskatchewan.

John C. Robicsek
Assistant Vice President, Strategy, Business, and Program Development, ATRIUM HEALTH

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Throughout his twenty+ year career in healthcare, John Robicsek has had the good fortune to be charged to define, design and execute unique programs recognized as “best in class” for ambulatory patient and provider practice medication experience and outcomes. Having spent almost equal time working for a pharmaceutical manufacture AND now at a large regionally integrated health system, John brings a unique perspective in understanding the challenges faced in connecting patients, providers, manufactures, payers, plan sponsors, and others, in creating a patient-centric, processing and clinical care team model that produces superior, demonstrable results in patient care. Since 2011, he has focused all his efforts in building and representing a uniquely designed integrated specialty care pharmacy model, from its inception to what it is today, at Atrium Health.

Michael Ruiz
Vice President, Business Development, WAYFORTH HEALTH

Marie Sanchirico
Medical Managed Care Director, 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.

Lou Savant
Director, Market Access, OSIRIS THERAPEUTICS, INC.

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Lou Savant is Director of Market Access and Reimbursement at Osiris Therapeutics, Inc. Lou is responsible for developing market access strategies and partnerships with payers and employer groups. He leads a nationwide team of Regional Account Managers and oversees Osiris’s on-site reimbursement services department. Lou brings over 25 years of pharmaceutical and biotechnology industry experience in multiple areas including clinical research, HEOR, business development, sales management, marketing and market access. Prior to joining Osiris, Lou was with TAP Pharmaceuticals and Takeda Pharmaceuticals. Lou began his career as an exercise physiologist in cardiac rehabilitation and developed corporate health and wellness programs. He holds a B.S. degree in Nutrition and Exercise Science from Penn State University.

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.

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

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Pritpal S.Virdee, Senior Vice President and Chief Operating Officer- Senior Health Services leads the operational areas across all product lines, fostering a strong matrix partnership across key operational functions within BCBSM. Pritpal recently came from Anthem, where he held the position of Health Plan President, Medicare – Indiana, Kentucky and Missouri holding profit and loss responsibility for all Medicare products within the regions. He previously served in leadership roles at Walgreens and Express Scripts. Pritpal earned a Bachelor’s degree in Chemical Engineering from Southbank University in London, and a Diploma in Marketing from the Institute of Marketing in the United Kingdom.

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