Institute Agenda


Print-friendly Agenda
Day One Tuesday August 25
Day Two Wednesday August 26
Day Three Thursday August 27
8:00 am - 4:00 pm

The OPEN MINDS Care Innovation Summit: Solving The Problem Of Access For Consumers With Complex Care Needs

Executive Summit

Connecting consumers with complex support needs to effective, innovative treatment programs is an ongoing challenge. Despite the strong demand for behavioral health services, limited options and long waits are often the norm. The summit will kick off with an overview of the trends driving new innovation in the health and human service market and a review of OPEN MINDS strategic framework for designing and launching sustainable treatment programs. The day will feature case study presentations on cutting-edge new clinical programs – including their design, keys to successful implementation and programs to ensure the right complex consumer has access to the right support at the right time. The summit will conclude with a round table discussion on the strategic challenges to innovation for specialty provider organizations and health plans.

Paul M. Duck

Senior Associate, OPEN MINDS

Paul M. Duck brings over 40 years of experience in leadership and management focusing on managed care, health information technology organizations, strategy, business development, and market expansion, and customer experience optimization to the OPEN MINDS team.

Prior to joining OPEN MINDS, Mr. Duck served as the Vice President, Strategy & Development at Beacon Health Options. In this role, Mr. Duck led the organization’s strategy and business development efforts – responsible for a 30% increase in net revenue and initiated over $1 billion in revenue generation. Mr. Duck was active in national behavioral health initiatives as an executive of Beacon Health Options, including participating as a speaker at national and state association meetings.

Before joining Beacon Health Options, Mr. Duck was the Vice President of Business Development at Netsmart Technologies. During his tenure, Mr. Duck was responsible for business planning, including, the oversight of strategic activities including acquisitions, development, and execution of strategic initiatives, and positioning, and sales of large strategic customers. He also led the rollout of the company’s benchmarking and data analytics product suite.

Prior to Netsmart, Mr. Duck served as the Chief Executive Officer for Coastal Orthopedics and Pain Management, a large group practice with five clinic locations and two ambulatory surgical centers. As the organization’s chief executive officer, Mr. Duck was responsible for significant positive changes in leadership and corporate culture, financial and operational performance, compliance, and governance. Mr. Duck improved net collections by over $1 million per month and grew the practice through negotiating better contract rates with payers. He also implemented an organizational rebranding initiative and launched a new marketing campaign.

Prior to Coastal Orthopedics and Pain Management, Mr. Duck served as the President and Chief Executive Officer for Florida Radiology Imaging, one of the largest outpatient diagnostic imaging service companies serving the greater Orlando market. During his tenure, Mr. Duck led the construction of three new, full modality, diagnostic imaging locations. Mr. Duck revolutionized the company’s culture by creating a highly attractive and functional work environment.

Mr. Duck earned his Bachelor of Arts in Business Management from Case Western Reserve University. He earned his Associate of Arts in Electronic Engineering Technology from the Electronic Technology Institute. Mr. Duck received an award by Inc Magazine for leading Florida Radiology Imaging as one of America’s fastest-growing companies. Mr. Duck recently served as a contributing author to the book The New Health Age: The Future of Health Care in America.

×

Vicky Couillard

Executive Director, Vail Place

Vicky Couillard has worked in the mental health field for over 30 years, the last eight as the Executive Director of Vail Place, a Twin Cities community resource center for people with serious mental illnesses. With a degree in Organizational Behavior and Communications and a passion for teaming, Vicky has led the agency’s innovative approach to supporting people with complex needs and addressing the social determinants of health in a collaborative person- and partner-centered manner.

Vicky has developed a reputation for vision and strategic planning that have resulted in Vail’s organic and exponential growth. Under her leadership, Vail’s foundational Clubhouse Programs, based on the internationally acclaimed evidence-based model, advanced to national prominence and Vail is now leading a coalition to expand Clubhouse Programs throughout Minnesota.

In addition, Vicky’s entrepreneurial spirit has helped Vail expand its programming far beyond its two highly respected Clubhouse Programs. She has done this first by developing an internal team of passionate and dedicated professionals; and second by attracting local healthcare experts to serve on a committee whose express goal has been expanding the effectiveness, reach and impact of Vail’s unique programming. This partnership has created a strong model of data-driven care and performance management, analysis and reporting.

Vail is now at the forefront of innovative, data-driven ways to deliver mental health recovery that have resulted in sustainable and scalable “go-to market strategies” around person-centered and whole-person solutions for healthcare systems and managed care organizations. Vicky is dedicated not only to Vail’s continued innovation and growth, but to finding opportunities to help spread what Vail has learned to the broader healthcare community.

×

Shelly Zuzek, MSW, LICSW

Director of Integrated Care, Vail Place

Shelly Zuzek is the Director of Integrated Care at Vail Place – located in the Twin Cities metro area in Minnesota – a non-profit that provides a continuum of services and programs for people living with mental illnesses, substance use disorders and chronic health conditions. The focus of Vail’s programming is addressing the social determinants of health through direct services and strategic collaborations.

Shelly is charged with developing those collaborations, a job that merits adding “innovation” to her title. Shelly has built partnerships with healthcare providers, including two unique multi-tiered care models with a national HMO and a local healthcare provider. She has had remarkable success by leveraging her 30+ years of direct service and clinical oversight to envision and develop new care models that help manage the SDOH and overall population health for people on Medicaid.

Shelly was the grant manager and coordinator for a State Innovation Model (SIM) grant awarded to Vail in 2015 to develop an Accountable Community for Health in partnership with North Memorial Health in Robbinsdale, MN. Shelly led the initiative which brought dramatic early results through Rapid Access to Case Management services – resulting in a 77% reduction in unnecessary rehospitalizations. In just a few years the partnership evolved into the Vail Connect model, which expanded services, reach, and impact. Vail Connect’s integrated care approach and rapid access to services has significantly reduced emergency department visits and inpatient psychiatric unit readmission rates, resulting in lowered healthcare costs. Additionally, under Shelly’s leadership, Vail has entered into a contract with HealthPartners in Bloomington, MN to implement Vail’s Results Focused Model as a pilot to test an assertive outreach and integrated care approach to providing wrap-around services with individuals experiencing serious behavioral health and medical challenges and high utilization of healthcare dollars.

×

9:00 am - 10:30 am

Moving To Value In California County Health & Human Services

Invitation Only

The interest in demonstrating value is widespread in the U.S health and human service system. Both government funders and employers are pushing for better measures of outcomes and performance across the service system.

In California, the Department of Health Care Services (DHCS) is moving towards improving quality outcomes and delivery system transformation through value-based initiatives and modernization of systems payment reform across the Medi-Cal program. The question for County administrators is how to design a service delivery system and contracting that maximizes value for both stakeholders and consumers. To learn more about best practices in county value-based contracting, join OPEN MINDS senior associates Richard Louis and Ken Anderson for this session on how to design a value-based service system, how to assess provider organization readiness for VBR participation, and development of county infrastructure for managing value based contracts.

Ken Anderson

Senior Associate, OPEN MINDS

Kenneth J. Anderson brings to the OPEN MINDS team over 40 years of experience in leadership and management, focusing on Medicaid and Medicare programs operated by states, counties, and health plans. Prior to joining OPEN MINDS, Mr. Anderson served as the Vice President of Public Sector Business Development of Optum. In this role, Mr. Anderson was responsible for Medicaid and Medicare business development activities with states, counties, and health plans. Mr. Anderson worked with a variety of Optum services including, behavioral health management, person-centered care management, and medical-behavioral integration. He was also accountable for developing customer relationships, solution design, proposal development, and implementation processes.

In addition to those business development roles, Mr. Anderson was also was involved with internal planning regarding the impact of Medicaid expansion. He had an active role with analysis of market approaches for serving people with I/DD conditions, people with criminal justice involvement, and housing programs. Mr. Anderson was recognized as Optum’s “Top Producer” three times with an average annual sales of over $100M.

Mr. Anderson has also served as the Vice President of Public Sector Quality Improvement & Implementations at OptumHealth, Public Sector. In this role, Mr. Anderson led the public sector managed care program implementations and quality initiatives. He ensured the coordination of services between stakeholders, as well as managing programs to meet customer expectations. Mr. Anderson also served as the Vice President, Public Sector for United Behavioral Health’s operations in Washington State. He was responsible for managing the Project Directors for United’s contracts in King County (Seattle), Clark County (Vancouver), and Spokane County including, budget development, customer relations, and program management.

Before working with United Health Group and Optum, Mr. Anderson was the Managed Care Administrator for California’s Solano County. In that role, he was responsible for the management of the capitated Medicaid mental health system, two primary care clinics, a dental clinic, family planning and perinatal services, and public health funds for indigent individuals. He led a department-wide initiative to integrate service delivery across these funding streams.

Mr. Anderson earned his Master of Arts in Psychology from Chapman College in Orange, California. He earned his Bachelor of Arts in Math from Colorado College in Colorado Springs, Colorado.

×

Richard Louis, III

Senior Associate, OPEN MINDS

Richard Louis, III, brings extensive experience in public and for-profit behavioral healthcare administration and business development to the OPEN MINDS team. Mr. Louis was formerly the Executive Director of Strategic Development and Planning, Pacific Region, for Providence Service Corporation.

Prior to OPEN MINDS, Mr. Louis served as the Assistant Director of the San Bernardino County Department of Behavioral Health, the 4th largest county behavioral health system in California, where he was responsible for day-to-day operations of a system serving over 50,000 unduplicated consumers annually through 31 county-operated facilities and 60 contract provider organizations.

Prior to his work with San Bernardino County, Mr. Louis was the Vice President of Government Operations for College Health Enterprises. In this role, he pioneered the development of public sector partnerships, contracts, and community mental health system joint ventures in California by creating some of the first inpatient psychiatric hospital-based, outpatient, day treatment, and institutional specialty treatment programs for county, state, and federal government agencies including L.A. County Department of Mental Health, L.A. County Probation Department, California Youth Authority, California Department of Developmental Disabilities, California Department of Corrections & Rehabilitation, and U.S. Immigration Customs Enforcement/Homeland Security.

Mr. Louis has served in a number of leadership roles with several organizations in the community including: the California Hospital Association – Center for Behavioral Health, Advisory Board, and SCAN Health Plan – Advisory Board; the Board of Directors of the Forensic Mental Health Association of California, College Hospitals, and the Intercommunity Child Guidance Center of Whittier; and testified on behalf of the National Association of Psychiatric Healthcare Systems before President Bush’s New Freedom Commission on Mental Health. Mr. Louis is currently a volunteer police officer with the City of Monterey Park Police Department in East Los Angeles serving since 1987 and currently holds the rank of Captain. Mr. Louis was recently appointed to the City of Claremont Police Commission in Los Angeles County.

He is a graduate of Whittier College and of the Police Academy of Rio Hondo College.

×

9:00 am - 12:00 pm

The New CFO Challenge: An OPEN MINDS Seminar On Becoming Your Organization’s Strategic Leader In A Changing Market

Executive Seminar

Managing for profitability as your organization moves through value based transformation is the new key to long term sustainability. Success with value-based reimbursements that reward outcomes instead of inputs require changes to traditional care team and operational aspects of health care delivery. It changes the role of the CFO from steward of operations to a builder of a stronger more modern care delivery system. How is the c-suite responding to these new demands to ensure ongoing success within the complex care realm?

In this seminar, Ray Wolfe, Senior Associate, OPEN MINDS, will address the changing roles of the finance department & staff reorganization.The following topics will be the focus of this seminar:

  • Unit pricing / episode bundling
  • Value based contract negotiation
  • Flexible budgeting
  • Determining financial risk tolerances
  • Evaluation of market opportunities – from risk adverse to catalyst for growth

Ray Wolfe, JD

Senior Associate, OPEN MINDS

Raymond “Ray” Wolfe, J.D. brings over 40 years of experience in the health and human services sector to the OPEN MINDS team. Mr. Wolfe currently serves as a Senior Associate, a position in which he utilizes his expertise to successfully lead varying projects for OPEN MINDS. His areas of expertise include managed care and value-based reimbursement models, financial analysis and management, mergers and acquisitions, CCBHC certification, integrated care, performance improvement, and strategic planning.

Before joining OPEN MINDS, Mr. Wolfe served in a 22-year tenure with Pittsburgh Mercy Health System in Pittsburgh, Pennsylvania. Most recently, Mr. Wolfe served as the organization’s Chief Operating Officer (COO), where he was responsible for oversight of all system operations, strategic planning, and performance management. Under his direction Pittsburgh Mercy achieved Certified Behavioral Health Center status, earned over $850K in value-based reimbursement contract quality bonus awards, integrated three organizations through merger/acquisition, opened a primary care service that was integrated into programming for the severe and persistent mentally ill and homeless populations, and adopted a new performance management program for managers.

Before acting as Pittsburgh Mercy’s COO, Mr. Wolfe served as the organization’s Chief Financial Officer (CFO) and was responsible for the development of internal costing methodologies, contract rate negotiations, and financial forecasting activities. In addition, he coordinated an integrated care program with local partner hospitals to develop a series of diversion and respite programs, as well as specialized primary care, integrated care management, and high utilizer teams, while maintaining 15 straight years of profitability.

Mr. Wolfe was promoted to CFO after serving as the Director of Fiscal and Information Security/Compliance for the health system. In this role, he was responsible for managing the transition of service contracts from fee-for-service (FFS), leading all compliance activities, and implementing a next-generation electronic health record (EHR) system.

Prior to his time at Pittsburgh Mercy Health System, Mr. Wolfe served as Chief Fiscal Officer with the Summit Center for Human Development in Clarksburg, West Virginia, where he was responsible for reporting and budgeting functions and preparing Summit Center’s programs for FFS billing.

Previously, Mr. Wolfe served in billing and collections for two Pennsylvania-based hospitals. First, in his role as a manager for Healthcare Corporation of America (HCA) and as an Accounts Receivables Manager for Brownsville General Hospital in Brownsville, PA, where he managed the accounting and billing system transition systems. Later as a Patient Account Manager for St. Francis Medical Center in Pittsburgh, PA, where he improved collections to hit a 95% rate through the implementation of new billing software and department reorganization.

Prior to working in the health and human services market, Mr. Wolfe spent five years practicing as a Lawyer with at Law Offices of Arch A. Moore in Moundsville, WV. In this role, he provided general legal practice, created and established bylaws for multiple corporations, and handled West Virginia licensing of first vision insurance plan.

Mr. Wolfe earned his Juris Doctor from the West Virginia University School of Law in Morgantown, WV and his Bachelor’s degree with a focus in Political Science and Sociology from West Liberty University, Wheeling, WV, where he graduated Magna Cum Laude.

×

1:00 pm - 4:00 pm

Aligning Your Board To The New Sustainability Challenge: An OPEN MINDS Seminar On Non-Profit Management

Executive Seminar

As the health care industry faces extreme disruption in the wake of COVID-19, board members and executives must work together to understand the changing market and map a plan for recovery and resilience. This timely seminar will focus on:

  • How the disruption in the health and human service market is creating new challenges and opportunities for non-profit providers
  • The changing role of the board in a time of recovery
  • Opportunities for special stimulus funding in a recession

George Braunstein, RN, FACHE

Senior Associate, OPEN MINDS

George Braunstein, FACHE has 40 years of experience in the health and human service industry, leading both private and public organizations – in institutional and ambulatory settings.

While working with OPEN MINDS Mr. Braunstein has completed an array of projects. From strategic planning for Intellectual and Developmental Disability and Brain Injury services, to mergers and acquisitions, Mr. Braunstein is comfortable tackling challenges in any health and human service environment. He has experience with multi-agency networks and recently has served as the head of Delaware State Hospital. Mr Braunstein has provided them with stability and direction as they determine the future of their business.

Prior to joining OPEN MINDS, Mr. Braunstein served as Executive Director of the Fairfax-Falls Church Community Services Board (CSB) in Fairfax, Virginia, which provides community-based mental health, substance abuse and developmental disabled services. During his six-year tenure with the CSB, which had a $150+ million budget and over 1,200 employees, he both reduced the budget and increased service access. Mr. Braunstein also developed the organization’s first fully integrated service model that is combining mental health, substance use treatment and primary care services.

Before his role in Fairfax County, Mr. Braunstein was the Executive Director of the Chesterfield County CSB. In his eight years in that role, he restructured management to flatten the organization, which improved both service and budget performance and eliminated a $1.5 million deficit with no reductions in staff.

Mr. Braunstein also served as the Executive Director of Behavioral Health for Aurora Health Care in Milwaukee – the largest integrated health care system in Wisconsin with 13 hospitals, 20,000 employees and $1.5 billion in annual revenues.  He was responsible for management of all aspects of a $40 million dollar, 800-employee multi-site integrated behavioral health service delivery system.  And, Mr. Braunstein brings managed care experience to the OPEN MINDS team, having served as the director of behavioral health for Family Health Plan Cooperative, a Wisconsin HMO.

Well respected in the behavioral health community, Mr. Braunstein is a fellow with the American College of Healthcare Executives (ACHE) and has served on several boards of local and national associations. He has previously been involved with organizations such as the SAMHSA National Leadership Council, the National Association of Community Behavioral Health, the Virginia Association of Community Services Board, and the Hilliard House.

Mr. Braunstein is a certified clinical specialist in adult psychiatry and is a licensed advanced practice nurse practitioner in the state of Wisconsin. He received his Master of Science in Community Mental Health Nursing and his Bachelor’s in Nursing from the University of Wisconsin-Milwaukee. He also earned a Bachelor’s degree in History Education from Rockford College.  In continuing education, Mr. Braunstein completed psychotherapy training from the Family Studies Center at Northwestern University and the University of Virginia Senior Executive Leadership Institute.

×

Anthony Zipple, Sc.D., MBA

Senior Associate, OPEN MINDS

Anthony M. Zipple, Sc.D., MBA, brings over 40 years of strategic development and leadership coaching experience to the OPEN MINDS team. Dr. Zipple currently serves as a Senior Associate, leading projects related to rehabilitation services, building and operating community services, leadership development, and community behavioral health services.

Prior to joining OPEN MINDS, Dr. Zipple served as the President and Chief Executive Officer for Centerstone of Kentucky, in Louisville, Kentucky. In this role, Dr. Zipple was Responsible to the Board of Directors and Centerstone of America for all fiscal, strategic, and operational aspects of the organizations. With a budget of $125 million and management responsibility for an additional $70 million of services, CKY employed more than 1,800 staff and serves more than 36,000 persons each year. Dr. Zipple successfully led the merger with Uspiritus, a $20 million provider of children’s residential and foster care services, as well as a successful affiliation with Centerstone of America which resulted in creating the largest non-profit community behavioral health company in the United States. Dr. Zipple also expanded integrated health care services, implemented lab services in all large locations and implemented one of the nation’s first health home for people with opioid addiction.

Previously, Dr. Zipple was the Chief Executive Officer for Thresholds, in Chicago, Illinois. In this role Dr. Zipple was responsible to the Board of Directors for all fiscal, strategic, and operational aspects of the organization. With a consolidated budget of $48 million and 800 staff, Thresholds was the largest provider of its kind in Illinois. Dr. Zipple was responsible for successfully leading Thresholds through Illinois’ FY 2008-2011 fiscal crisis without delaying payrolls or using lines of credit, as well as reorganizing and strengthening fund development resulting in doubling philanthropic revenue despite the recession. Dr. Zipple developed and expanded the use of high fidelity, evidence-based practices including dual disorders treatment, supported employment, wellness management and recovery, smoking cessation, and assertive community treatment.

Prior to Thresholds, Dr. Zipple served as the Chief Operating Officer for Vinfen in Cambridge, Massachusetts. Vinfen is the largest non-profit behavioral health provider in Massachusetts, with a budget of over $70 million, 200 program sites, and 1,400 employees. During his tenure, Dr. Zipple increased revenues by $9.5 million in his first year as COO. Other accomplishments of Dr. Zipple include the development of Vinfen’s first comprehensive risk management system, resulting in significant reductions in adverse incidents, development of several innovations such as a nationally recognized peer education model for people with severe mental illness, a psychosocial rehabilitation oriented inpatient program, intensive crisis stabilization programs, and a patented comprehensive, web-based client database.

Dr. Zipple earned his Doctor of Science in Rehabilitation Counseling from Boston University. He earned his Master of Business Administration from University of New Hampshire. He earned his Certificate of Advanced Graduate Study in Rehabilitation Counseling from the University of Cincinnati. He earned his Master of Science in Environic Design and his Bachelor of Arts in Government and Philosophy from the University of Notre Dame.

×

8:00 am - 9:00 am

Registration & Executive Networking Breakfast

Networking

Check-in at the registration desk to get your name badge and program materials, then join us in the exhibit hall for breakfast. Take some time to meet your fellow attendees, talk to our sponsors, and prepare for the day ahead.


9:00 am - 10:00 am

Keynote Address With MaryAnne Lindeblad, State Medical Director, Washington State Health Care Authority

Keynote Address

Coming Soon!

MaryAnne Lindeblad

State Medical Director, Washington State Health Care Authority

MaryAnne oversees the Washington Apple Health (Medicaid) program, which serves more than 1.8 million Washington residents. The executive leaders for HCA’s Medicaid Eligibility and Community Support division and Medicaid Program Operations and Integrity division report to MaryAnne. MaryAnne serves on the executive committees of both the National Association of Medicaid Directors and the National Academy for State Health Policy. She also chairs the Centers for Medicare and Medicaid Services (CMS) Managed Care Technical Advisory Committee.

×

10:15 am - 11:30 am

Thought Leader Session With MaryAnne Lindeblad, State Medical Director, Washington State Health Care Authority

Breakout Session

Monica E. Oss

Chief Executive Officer, OPEN MINDS

Monica E. Oss, M.S., Chief Executive Officer and Senior Associate, is the founder of OPEN MINDS. For the past three decades, Ms. Oss has led the OPEN MINDS team and its research on health and human service market trends and its national consulting practice. Ms. Oss is well known for her numerous books and articles focused on the strategic and marketing implications of the evolving health and human service field. She has unique expertise in payer financing models, provider rate setting, and service pricing. She has led numerous engagements with state Medicaid plans, county governments, private insurers, managed care programs, service provider organizations, technology vendors, neurotechnology and pharmaceutical organizations, and investment banking firms – with a focus on the implications of financing changes on delivery system design.

 

×

MaryAnne Lindeblad

State Medical Director, Washington State Health Care Authority

MaryAnne oversees the Washington Apple Health (Medicaid) program, which serves more than 1.8 million Washington residents. The executive leaders for HCA’s Medicaid Eligibility and Community Support division and Medicaid Program Operations and Integrity division report to MaryAnne. MaryAnne serves on the executive committees of both the National Association of Medicaid Directors and the National Academy for State Health Policy. She also chairs the Centers for Medicare and Medicaid Services (CMS) Managed Care Technical Advisory Committee.

×


Best Practice Models For Collaborative Care: Coordination Between Health Plans & Provider Organizations

Breakout Session

The field is moving from talk to action on value-based reimbursement (VBR) and health plan/provider partnerships. This change brings the need for more mature (and integrated) relationships between health plans and provider organizations. The challenge for provider organization executives and their teams is to form the necessary "partner relationship" with payers. What are the keys to forging payer relationships? Approaches may vary, but bringing data to the table when working with payers; committing to an integrated, community-based approach; and knowing exactly what your costs are and the value you can offer in the relationship are fundamental.

This session will focus on:

  • Best practices in building payer relationships
  • Metrics measured to monitor partnership outcomes
  • Case study presentations from organizations that will share their models in successful collaborations

Ken Anderson

Senior Associate, OPEN MINDS

Kenneth J. Anderson brings to the OPEN MINDS team over 40 years of experience in leadership and management, focusing on Medicaid and Medicare programs operated by states, counties, and health plans. Prior to joining OPEN MINDS, Mr. Anderson served as the Vice President of Public Sector Business Development of Optum. In this role, Mr. Anderson was responsible for Medicaid and Medicare business development activities with states, counties, and health plans. Mr. Anderson worked with a variety of Optum services including, behavioral health management, person-centered care management, and medical-behavioral integration. He was also accountable for developing customer relationships, solution design, proposal development, and implementation processes.

In addition to those business development roles, Mr. Anderson was also was involved with internal planning regarding the impact of Medicaid expansion. He had an active role with analysis of market approaches for serving people with I/DD conditions, people with criminal justice involvement, and housing programs. Mr. Anderson was recognized as Optum’s “Top Producer” three times with an average annual sales of over $100M.

Mr. Anderson has also served as the Vice President of Public Sector Quality Improvement & Implementations at OptumHealth, Public Sector. In this role, Mr. Anderson led the public sector managed care program implementations and quality initiatives. He ensured the coordination of services between stakeholders, as well as managing programs to meet customer expectations. Mr. Anderson also served as the Vice President, Public Sector for United Behavioral Health’s operations in Washington State. He was responsible for managing the Project Directors for United’s contracts in King County (Seattle), Clark County (Vancouver), and Spokane County including, budget development, customer relations, and program management.

Before working with United Health Group and Optum, Mr. Anderson was the Managed Care Administrator for California’s Solano County. In that role, he was responsible for the management of the capitated Medicaid mental health system, two primary care clinics, a dental clinic, family planning and perinatal services, and public health funds for indigent individuals. He led a department-wide initiative to integrate service delivery across these funding streams.

Mr. Anderson earned his Master of Arts in Psychology from Chapman College in Orange, California. He earned his Bachelor of Arts in Math from Colorado College in Colorado Springs, Colorado.

×

Jim Coffee, MPA

Chief Operating Officer/Deputy Director, Cowlitz Family Health Center

Jim began his career in health care as an X-Ray Tech, moving into Medical 4 Practice Management in 1984. After relocating to the Boston area he joined Greater Lawrence Family Health Center as their CIO in 1994, in 2004 after completing his Masters in Public Administration Jim moved to Astoria Oregon to become the CEO of the Federally Qualified Health Center there. When the opportunity presented itself to join Cowlitz Family Health Center Jim began working in Longview as Chief Operating Office and Deputy Director in 2015. Jim oversees the daily operations of Family Health Center’s seven medical/dental clinics and three Substance Use Disorder Treatment sites.  Jim is the senior manager on site at FHC’s Harm Reduction Program, talking with clients and providing training on the use of Naloxone and fentanyl testing kits. As part of the team that manages the Syringe Services Program, Jim has been the point person in the expansion of services in that program including disease testing and prevention, family planning, and wound care. FHC began offering primary care MAT at their 14th Avenue clinic in June 2018 and to the Syringe Services Program as a super low barrier entry point. Family Health Center currently has 9 primary care provider waivered to prescribe MAT. Jim works very closely with the FHC Medical Director in the design and operation of FHC’s MAT Program.

×

Susan Foster, MSN, FNP-BC

Chief Medical Officer, Hill Country Health and Wellness Center

Bio coming soon!

×

Margaret Kisliuk, J.D., MPP

Behavioral Health Administrator, Partnership HealthPlan of California

Margaret Kisliuk has extensive experience in the public health care system, including administrative positions with both San Francisco and Marin Counties as well as work with the New York City Medicaid Plan (MetroPlus) and currently with Partnership HealthPlan of California.  Positions included serving as acting Mental Health and Substance Use Director; acting Public Health Director; and Sacramento lobbyist.

Margaret currently serves as Behavioral Health Administrator for Partnership HealthPlan of California, overseeing the mental health benefit for all PHC members (through contracts with Beacon Health Options and Kaiser Health Systems) and developing the Plan’s addiction services benefit.  Immediately prior to this, she was Executive Director for the Northern Region of Partnership HealthPlan, encompassing 7 Northern rural counties, administering the startup of Medi-Cal managed care in these counties.

×

11:45 am - 1:00 pm

Making It Painless! Best Practice Models For Streamlining Authorizations & Continued Stay Reviews

Breakout Session

In the expanding world of managed care and medical - behavioral integration, authorizations for care can be confusing, time consuming, and frustrating. Prior authorizations, concurrent reviews, retrospective reviews and appeals all have different processes. Reviewers may vary by health plan and Managed Behavioral Health Organizations (MBHO). There can be variations in Level of Care (LOC) guidelines and there can be opportunities for obtaining a "preferred" status to reduce the level of authorization effort.

This "how-to-session" will focus on:

  • Understanding the payers' motivations
  • Best practices on easing the pain, streamlining the process, and handling denials
  • What is being reviewed and why

Ray Wolfe, JD

Senior Associate, OPEN MINDS

Raymond “Ray” Wolfe, J.D. brings over 40 years of experience in the health and human services sector to the OPEN MINDS team. Mr. Wolfe currently serves as a Senior Associate, a position in which he utilizes his expertise to successfully lead varying projects for OPEN MINDS. His areas of expertise include managed care and value-based reimbursement models, financial analysis and management, mergers and acquisitions, CCBHC certification, integrated care, performance improvement, and strategic planning.

Before joining OPEN MINDS, Mr. Wolfe served in a 22-year tenure with Pittsburgh Mercy Health System in Pittsburgh, Pennsylvania. Most recently, Mr. Wolfe served as the organization’s Chief Operating Officer (COO), where he was responsible for oversight of all system operations, strategic planning, and performance management. Under his direction Pittsburgh Mercy achieved Certified Behavioral Health Center status, earned over $850K in value-based reimbursement contract quality bonus awards, integrated three organizations through merger/acquisition, opened a primary care service that was integrated into programming for the severe and persistent mentally ill and homeless populations, and adopted a new performance management program for managers.

Before acting as Pittsburgh Mercy’s COO, Mr. Wolfe served as the organization’s Chief Financial Officer (CFO) and was responsible for the development of internal costing methodologies, contract rate negotiations, and financial forecasting activities. In addition, he coordinated an integrated care program with local partner hospitals to develop a series of diversion and respite programs, as well as specialized primary care, integrated care management, and high utilizer teams, while maintaining 15 straight years of profitability.

Mr. Wolfe was promoted to CFO after serving as the Director of Fiscal and Information Security/Compliance for the health system. In this role, he was responsible for managing the transition of service contracts from fee-for-service (FFS), leading all compliance activities, and implementing a next-generation electronic health record (EHR) system.

Prior to his time at Pittsburgh Mercy Health System, Mr. Wolfe served as Chief Fiscal Officer with the Summit Center for Human Development in Clarksburg, West Virginia, where he was responsible for reporting and budgeting functions and preparing Summit Center’s programs for FFS billing.

Previously, Mr. Wolfe served in billing and collections for two Pennsylvania-based hospitals. First, in his role as a manager for Healthcare Corporation of America (HCA) and as an Accounts Receivables Manager for Brownsville General Hospital in Brownsville, PA, where he managed the accounting and billing system transition systems. Later as a Patient Account Manager for St. Francis Medical Center in Pittsburgh, PA, where he improved collections to hit a 95% rate through the implementation of new billing software and department reorganization.

Prior to working in the health and human services market, Mr. Wolfe spent five years practicing as a Lawyer with at Law Offices of Arch A. Moore in Moundsville, WV. In this role, he provided general legal practice, created and established bylaws for multiple corporations, and handled West Virginia licensing of first vision insurance plan.

Mr. Wolfe earned his Juris Doctor from the West Virginia University School of Law in Morgantown, WV and his Bachelor’s degree with a focus in Political Science and Sociology from West Liberty University, Wheeling, WV, where he graduated Magna Cum Laude.

×


Navigating Health Plans: Keys To Developing Long Term Relationships

Breakout Session

Join our panel of OPEN MINDS Senior Associates with extensive experience working with and for health plans for an open discussion on what it takes to develop long term relationships with health plans. They will share their perspectives, recommend tactics, discuss best practices and answer your questions on building and maintaining relationships for the long haul.

Ken Anderson

Senior Associate, OPEN MINDS

Kenneth J. Anderson brings to the OPEN MINDS team over 40 years of experience in leadership and management, focusing on Medicaid and Medicare programs operated by states, counties, and health plans. Prior to joining OPEN MINDS, Mr. Anderson served as the Vice President of Public Sector Business Development of Optum. In this role, Mr. Anderson was responsible for Medicaid and Medicare business development activities with states, counties, and health plans. Mr. Anderson worked with a variety of Optum services including, behavioral health management, person-centered care management, and medical-behavioral integration. He was also accountable for developing customer relationships, solution design, proposal development, and implementation processes.

In addition to those business development roles, Mr. Anderson was also was involved with internal planning regarding the impact of Medicaid expansion. He had an active role with analysis of market approaches for serving people with I/DD conditions, people with criminal justice involvement, and housing programs. Mr. Anderson was recognized as Optum’s “Top Producer” three times with an average annual sales of over $100M.

Mr. Anderson has also served as the Vice President of Public Sector Quality Improvement & Implementations at OptumHealth, Public Sector. In this role, Mr. Anderson led the public sector managed care program implementations and quality initiatives. He ensured the coordination of services between stakeholders, as well as managing programs to meet customer expectations. Mr. Anderson also served as the Vice President, Public Sector for United Behavioral Health’s operations in Washington State. He was responsible for managing the Project Directors for United’s contracts in King County (Seattle), Clark County (Vancouver), and Spokane County including, budget development, customer relations, and program management.

Before working with United Health Group and Optum, Mr. Anderson was the Managed Care Administrator for California’s Solano County. In that role, he was responsible for the management of the capitated Medicaid mental health system, two primary care clinics, a dental clinic, family planning and perinatal services, and public health funds for indigent individuals. He led a department-wide initiative to integrate service delivery across these funding streams.

Mr. Anderson earned his Master of Arts in Psychology from Chapman College in Orange, California. He earned his Bachelor of Arts in Math from Colorado College in Colorado Springs, Colorado.

×

Paul M. Duck

Senior Associate, OPEN MINDS

Paul M. Duck brings over 40 years of experience in leadership and management focusing on managed care, health information technology organizations, strategy, business development, and market expansion, and customer experience optimization to the OPEN MINDS team.

Prior to joining OPEN MINDS, Mr. Duck served as the Vice President, Strategy & Development at Beacon Health Options. In this role, Mr. Duck led the organization’s strategy and business development efforts – responsible for a 30% increase in net revenue and initiated over $1 billion in revenue generation. Mr. Duck was active in national behavioral health initiatives as an executive of Beacon Health Options, including participating as a speaker at national and state association meetings.

Before joining Beacon Health Options, Mr. Duck was the Vice President of Business Development at Netsmart Technologies. During his tenure, Mr. Duck was responsible for business planning, including, the oversight of strategic activities including acquisitions, development, and execution of strategic initiatives, and positioning, and sales of large strategic customers. He also led the rollout of the company’s benchmarking and data analytics product suite.

Prior to Netsmart, Mr. Duck served as the Chief Executive Officer for Coastal Orthopedics and Pain Management, a large group practice with five clinic locations and two ambulatory surgical centers. As the organization’s chief executive officer, Mr. Duck was responsible for significant positive changes in leadership and corporate culture, financial and operational performance, compliance, and governance. Mr. Duck improved net collections by over $1 million per month and grew the practice through negotiating better contract rates with payers. He also implemented an organizational rebranding initiative and launched a new marketing campaign.

Prior to Coastal Orthopedics and Pain Management, Mr. Duck served as the President and Chief Executive Officer for Florida Radiology Imaging, one of the largest outpatient diagnostic imaging service companies serving the greater Orlando market. During his tenure, Mr. Duck led the construction of three new, full modality, diagnostic imaging locations. Mr. Duck revolutionized the company’s culture by creating a highly attractive and functional work environment.

Mr. Duck earned his Bachelor of Arts in Business Management from Case Western Reserve University. He earned his Associate of Arts in Electronic Engineering Technology from the Electronic Technology Institute. Mr. Duck received an award by Inc Magazine for leading Florida Radiology Imaging as one of America’s fastest-growing companies. Mr. Duck recently served as a contributing author to the book The New Health Age: The Future of Health Care in America.

×

Richard Louis, III

Senior Associate, OPEN MINDS

Richard Louis, III, brings extensive experience in public and for-profit behavioral healthcare administration and business development to the OPEN MINDS team. Mr. Louis was formerly the Executive Director of Strategic Development and Planning, Pacific Region, for Providence Service Corporation.

Prior to OPEN MINDS, Mr. Louis served as the Assistant Director of the San Bernardino County Department of Behavioral Health, the 4th largest county behavioral health system in California, where he was responsible for day-to-day operations of a system serving over 50,000 unduplicated consumers annually through 31 county-operated facilities and 60 contract provider organizations.

Prior to his work with San Bernardino County, Mr. Louis was the Vice President of Government Operations for College Health Enterprises. In this role, he pioneered the development of public sector partnerships, contracts, and community mental health system joint ventures in California by creating some of the first inpatient psychiatric hospital-based, outpatient, day treatment, and institutional specialty treatment programs for county, state, and federal government agencies including L.A. County Department of Mental Health, L.A. County Probation Department, California Youth Authority, California Department of Developmental Disabilities, California Department of Corrections & Rehabilitation, and U.S. Immigration Customs Enforcement/Homeland Security.

Mr. Louis has served in a number of leadership roles with several organizations in the community including: the California Hospital Association – Center for Behavioral Health, Advisory Board, and SCAN Health Plan – Advisory Board; the Board of Directors of the Forensic Mental Health Association of California, College Hospitals, and the Intercommunity Child Guidance Center of Whittier; and testified on behalf of the National Association of Psychiatric Healthcare Systems before President Bush’s New Freedom Commission on Mental Health. Mr. Louis is currently a volunteer police officer with the City of Monterey Park Police Department in East Los Angeles serving since 1987 and currently holds the rank of Captain. Mr. Louis was recently appointed to the City of Claremont Police Commission in Los Angeles County.

He is a graduate of Whittier College and of the Police Academy of Rio Hondo College.

×

1:00 pm - 2:30 pm

Lunch On Your Own

Networking

The Institute hotel is located on Newport Beach, steps away from many local restaurants. Stop by the registration desk for a listing of restaurants.


2:30 pm - 3:45 pm

Moving To Virtual Health: New Approaches For Consumer Scheduling To Accommodate Rapid Access For Care

Breakout Session

The consumer experience in behavioral health is shifting. Care that once took place in a physical location is now occurring in a variety of virtual settings. Organizations are leveraging technology to create a personalized experience that helps consumers find and access the care they need, at the time and place that's right for them. As these technologies are gaining adoption, providers need to support these programs by building the internal capacity to expand access and to effectively manage the scheduling process.

In this session, attendees will:

  • Best practices for incorporating virtual care into your "brick and mortar" organization, and what you need to know and do to ensure reimbursement
  • Adapting workflow processes for scheduling, obtaining consumer consent, emergency intervention and communications between providers, consumers, and schedulers
  • Hear from organizations that have successfully implemented virtual care programs and how they have addressed rapid access to care

Paul M. Duck

Senior Associate, OPEN MINDS

Paul M. Duck brings over 40 years of experience in leadership and management focusing on managed care, health information technology organizations, strategy, business development, and market expansion, and customer experience optimization to the OPEN MINDS team.

Prior to joining OPEN MINDS, Mr. Duck served as the Vice President, Strategy & Development at Beacon Health Options. In this role, Mr. Duck led the organization’s strategy and business development efforts – responsible for a 30% increase in net revenue and initiated over $1 billion in revenue generation. Mr. Duck was active in national behavioral health initiatives as an executive of Beacon Health Options, including participating as a speaker at national and state association meetings.

Before joining Beacon Health Options, Mr. Duck was the Vice President of Business Development at Netsmart Technologies. During his tenure, Mr. Duck was responsible for business planning, including, the oversight of strategic activities including acquisitions, development, and execution of strategic initiatives, and positioning, and sales of large strategic customers. He also led the rollout of the company’s benchmarking and data analytics product suite.

Prior to Netsmart, Mr. Duck served as the Chief Executive Officer for Coastal Orthopedics and Pain Management, a large group practice with five clinic locations and two ambulatory surgical centers. As the organization’s chief executive officer, Mr. Duck was responsible for significant positive changes in leadership and corporate culture, financial and operational performance, compliance, and governance. Mr. Duck improved net collections by over $1 million per month and grew the practice through negotiating better contract rates with payers. He also implemented an organizational rebranding initiative and launched a new marketing campaign.

Prior to Coastal Orthopedics and Pain Management, Mr. Duck served as the President and Chief Executive Officer for Florida Radiology Imaging, one of the largest outpatient diagnostic imaging service companies serving the greater Orlando market. During his tenure, Mr. Duck led the construction of three new, full modality, diagnostic imaging locations. Mr. Duck revolutionized the company’s culture by creating a highly attractive and functional work environment.

Mr. Duck earned his Bachelor of Arts in Business Management from Case Western Reserve University. He earned his Associate of Arts in Electronic Engineering Technology from the Electronic Technology Institute. Mr. Duck received an award by Inc Magazine for leading Florida Radiology Imaging as one of America’s fastest-growing companies. Mr. Duck recently served as a contributing author to the book The New Health Age: The Future of Health Care in America.

×


Specialty Primary Care Models That Work For Consumers With Complex Needs

Breakout Session

The primary care market is being reinvented before our eyes. The rapid expansion of retail care, increasing health plan investment in primary care practices, and changing delivery models enabled by technology are all contributing to shifting perceptions about where and how primary care is delivered. Amid these changes, we're also seeing payers shift toward supporting "specialty" primary care (and specialty medical homes). Health plans are looking for best practice models that integrate care coordination with long-term services and supports, medical, pharmacy, behavioral health, and social services - and coordinates/provides primary care. In this session, we'll discuss this new model for primary care for complex consumers and explore how it is reshaping the market for provider organizations.

The session will include:

  • A review of the trends reshaping the primary care market for complex consumers and the foundations of emerging specialty primary care models
  • A discussion on the implications of the market shift for specialty provider organizations
  • Case study presentations by organizations that have developed specialty primary care models for complex consumer populations

Ray Wolfe, JD

Senior Associate, OPEN MINDS

Raymond “Ray” Wolfe, J.D. brings over 40 years of experience in the health and human services sector to the OPEN MINDS team. Mr. Wolfe currently serves as a Senior Associate, a position in which he utilizes his expertise to successfully lead varying projects for OPEN MINDS. His areas of expertise include managed care and value-based reimbursement models, financial analysis and management, mergers and acquisitions, CCBHC certification, integrated care, performance improvement, and strategic planning.

Before joining OPEN MINDS, Mr. Wolfe served in a 22-year tenure with Pittsburgh Mercy Health System in Pittsburgh, Pennsylvania. Most recently, Mr. Wolfe served as the organization’s Chief Operating Officer (COO), where he was responsible for oversight of all system operations, strategic planning, and performance management. Under his direction Pittsburgh Mercy achieved Certified Behavioral Health Center status, earned over $850K in value-based reimbursement contract quality bonus awards, integrated three organizations through merger/acquisition, opened a primary care service that was integrated into programming for the severe and persistent mentally ill and homeless populations, and adopted a new performance management program for managers.

Before acting as Pittsburgh Mercy’s COO, Mr. Wolfe served as the organization’s Chief Financial Officer (CFO) and was responsible for the development of internal costing methodologies, contract rate negotiations, and financial forecasting activities. In addition, he coordinated an integrated care program with local partner hospitals to develop a series of diversion and respite programs, as well as specialized primary care, integrated care management, and high utilizer teams, while maintaining 15 straight years of profitability.

Mr. Wolfe was promoted to CFO after serving as the Director of Fiscal and Information Security/Compliance for the health system. In this role, he was responsible for managing the transition of service contracts from fee-for-service (FFS), leading all compliance activities, and implementing a next-generation electronic health record (EHR) system.

Prior to his time at Pittsburgh Mercy Health System, Mr. Wolfe served as Chief Fiscal Officer with the Summit Center for Human Development in Clarksburg, West Virginia, where he was responsible for reporting and budgeting functions and preparing Summit Center’s programs for FFS billing.

Previously, Mr. Wolfe served in billing and collections for two Pennsylvania-based hospitals. First, in his role as a manager for Healthcare Corporation of America (HCA) and as an Accounts Receivables Manager for Brownsville General Hospital in Brownsville, PA, where he managed the accounting and billing system transition systems. Later as a Patient Account Manager for St. Francis Medical Center in Pittsburgh, PA, where he improved collections to hit a 95% rate through the implementation of new billing software and department reorganization.

Prior to working in the health and human services market, Mr. Wolfe spent five years practicing as a Lawyer with at Law Offices of Arch A. Moore in Moundsville, WV. In this role, he provided general legal practice, created and established bylaws for multiple corporations, and handled West Virginia licensing of first vision insurance plan.

Mr. Wolfe earned his Juris Doctor from the West Virginia University School of Law in Morgantown, WV and his Bachelor’s degree with a focus in Political Science and Sociology from West Liberty University, Wheeling, WV, where he graduated Magna Cum Laude.

×

4:00 pm - 5:00 pm

The Payer Perspective: An OPEN MINDS Forum On Management Best Practices

Town Hall

Ken Anderson

Senior Associate, OPEN MINDS

Kenneth J. Anderson brings to the OPEN MINDS team over 40 years of experience in leadership and management, focusing on Medicaid and Medicare programs operated by states, counties, and health plans. Prior to joining OPEN MINDS, Mr. Anderson served as the Vice President of Public Sector Business Development of Optum. In this role, Mr. Anderson was responsible for Medicaid and Medicare business development activities with states, counties, and health plans. Mr. Anderson worked with a variety of Optum services including, behavioral health management, person-centered care management, and medical-behavioral integration. He was also accountable for developing customer relationships, solution design, proposal development, and implementation processes.

In addition to those business development roles, Mr. Anderson was also was involved with internal planning regarding the impact of Medicaid expansion. He had an active role with analysis of market approaches for serving people with I/DD conditions, people with criminal justice involvement, and housing programs. Mr. Anderson was recognized as Optum’s “Top Producer” three times with an average annual sales of over $100M.

Mr. Anderson has also served as the Vice President of Public Sector Quality Improvement & Implementations at OptumHealth, Public Sector. In this role, Mr. Anderson led the public sector managed care program implementations and quality initiatives. He ensured the coordination of services between stakeholders, as well as managing programs to meet customer expectations. Mr. Anderson also served as the Vice President, Public Sector for United Behavioral Health’s operations in Washington State. He was responsible for managing the Project Directors for United’s contracts in King County (Seattle), Clark County (Vancouver), and Spokane County including, budget development, customer relations, and program management.

Before working with United Health Group and Optum, Mr. Anderson was the Managed Care Administrator for California’s Solano County. In that role, he was responsible for the management of the capitated Medicaid mental health system, two primary care clinics, a dental clinic, family planning and perinatal services, and public health funds for indigent individuals. He led a department-wide initiative to integrate service delivery across these funding streams.

Mr. Anderson earned his Master of Arts in Psychology from Chapman College in Orange, California. He earned his Bachelor of Arts in Math from Colorado College in Colorado Springs, Colorado.

×

5:00 pm - 6:00 pm

Executive Networking Reception

Networking

Wrap up the day by taking time to network with your colleagues and partners. Take some time to discuss the day's events while enjoying a drink and hors d'oeuvres.


8:00 am - 9:00 am

Registration & Executive Networking Breakfast

Networking

Check-in at the registration desk to get your name badge and program materials, then join us in the exhibit hall for breakfast. Take some time to meet your fellow attendees, talk to our sponsors, and prepare for the day ahead.


9:00 am - 10:00 am

Keynote

Keynote Address

Coming Soon!


10:15 am - 11:30 am

Thought Leader Session With Keynote

Breakout Session

Ken Anderson

Senior Associate, OPEN MINDS

Kenneth J. Anderson brings to the OPEN MINDS team over 40 years of experience in leadership and management, focusing on Medicaid and Medicare programs operated by states, counties, and health plans. Prior to joining OPEN MINDS, Mr. Anderson served as the Vice President of Public Sector Business Development of Optum. In this role, Mr. Anderson was responsible for Medicaid and Medicare business development activities with states, counties, and health plans. Mr. Anderson worked with a variety of Optum services including, behavioral health management, person-centered care management, and medical-behavioral integration. He was also accountable for developing customer relationships, solution design, proposal development, and implementation processes.

In addition to those business development roles, Mr. Anderson was also was involved with internal planning regarding the impact of Medicaid expansion. He had an active role with analysis of market approaches for serving people with I/DD conditions, people with criminal justice involvement, and housing programs. Mr. Anderson was recognized as Optum’s “Top Producer” three times with an average annual sales of over $100M.

Mr. Anderson has also served as the Vice President of Public Sector Quality Improvement & Implementations at OptumHealth, Public Sector. In this role, Mr. Anderson led the public sector managed care program implementations and quality initiatives. He ensured the coordination of services between stakeholders, as well as managing programs to meet customer expectations. Mr. Anderson also served as the Vice President, Public Sector for United Behavioral Health’s operations in Washington State. He was responsible for managing the Project Directors for United’s contracts in King County (Seattle), Clark County (Vancouver), and Spokane County including, budget development, customer relations, and program management.

Before working with United Health Group and Optum, Mr. Anderson was the Managed Care Administrator for California’s Solano County. In that role, he was responsible for the management of the capitated Medicaid mental health system, two primary care clinics, a dental clinic, family planning and perinatal services, and public health funds for indigent individuals. He led a department-wide initiative to integrate service delivery across these funding streams.

Mr. Anderson earned his Master of Arts in Psychology from Chapman College in Orange, California. He earned his Bachelor of Arts in Math from Colorado College in Colorado Springs, Colorado.

×


Best Practices For Community Reintegration: From Custody Back To The Community

Breakout Session

When re-entering the community, most offenders face significant social adaption issues that can have a negative impact on their family relationships, their ability to find jobs or housing, or to get a formal education. Unless they receive help coping with these issues, they risk getting caught up in a vicious cycle of reoffending, reconviction, and social rejection.

In this session, we will discuss:

  • Best practices in designing models for community reintegration
  • Developing and managing critical outcomes for success
  • Case study presentations from organizations successfully managing community reintegration programs

Richard Louis, III

Senior Associate, OPEN MINDS

Richard Louis, III, brings extensive experience in public and for-profit behavioral healthcare administration and business development to the OPEN MINDS team. Mr. Louis was formerly the Executive Director of Strategic Development and Planning, Pacific Region, for Providence Service Corporation.

Prior to OPEN MINDS, Mr. Louis served as the Assistant Director of the San Bernardino County Department of Behavioral Health, the 4th largest county behavioral health system in California, where he was responsible for day-to-day operations of a system serving over 50,000 unduplicated consumers annually through 31 county-operated facilities and 60 contract provider organizations.

Prior to his work with San Bernardino County, Mr. Louis was the Vice President of Government Operations for College Health Enterprises. In this role, he pioneered the development of public sector partnerships, contracts, and community mental health system joint ventures in California by creating some of the first inpatient psychiatric hospital-based, outpatient, day treatment, and institutional specialty treatment programs for county, state, and federal government agencies including L.A. County Department of Mental Health, L.A. County Probation Department, California Youth Authority, California Department of Developmental Disabilities, California Department of Corrections & Rehabilitation, and U.S. Immigration Customs Enforcement/Homeland Security.

Mr. Louis has served in a number of leadership roles with several organizations in the community including: the California Hospital Association – Center for Behavioral Health, Advisory Board, and SCAN Health Plan – Advisory Board; the Board of Directors of the Forensic Mental Health Association of California, College Hospitals, and the Intercommunity Child Guidance Center of Whittier; and testified on behalf of the National Association of Psychiatric Healthcare Systems before President Bush’s New Freedom Commission on Mental Health. Mr. Louis is currently a volunteer police officer with the City of Monterey Park Police Department in East Los Angeles serving since 1987 and currently holds the rank of Captain. Mr. Louis was recently appointed to the City of Claremont Police Commission in Los Angeles County.

He is a graduate of Whittier College and of the Police Academy of Rio Hondo College.

×

Ann Carter, BSN RN

Clinical Program Manager, Ohio Prison Pre-Release Program, Unitewd Healthcare Community Plan of Ohio

Ms. Carter currently reside in Mansfield, Ohio near the historic Ohio State Reformatory where the film Shawshank Redemption was filmed. Graduate of Arizona State University with over 35 years of experience primarily in behavioral health nursing including correctional experiences at Mansfield Correctional Institution, Marion Correctional Institution, and Richland County Jail.

Employed with United Health Group (United Healthcare and Optum) for the past seven years.  Behavioral health roles included Senior Clinical Quality Analyst and Clinical Program Manager for Utilization Review.  Currently serve as the Clinical Program Manager for the Ohio Prison Pre-Release Program under the Ohio Community Plan (Medicaid) line of business.  In this role, I serve as the liaison between the Ohio Department of Rehabilitation and Corrections (ODRC) and the Ohio Community Plan.

×

11:45 am - 1:15 pm

Lunch On Your Own

Networking

The Institute hotel is located on Newport Beach, steps away from many local restaurants. Stop by the registration desk for a listing of restaurants.


1:15 pm - 2:30 pm

Financial Forecasting Models For Fee For Service, Case Rates & New Service Lines

Breakout Session

Finance leaders are under more pressure than ever to support their organizations by managing uncertainty, volatility, and risk. As a result, financial forecasting has become more critical and complex. Organizations must have a system in place that provides the tools and data to build models for financial forecasting, specifically for Fee For Service, Case Rates & New Service Lines. Ray Wolfe, Senior Associate, OPEN MINDS, will lead this session and discuss:

  • Best practices for building financial forecasting models
  • Learn what you need to know about revenue cycle management to receive prompt and proper payment for value-based, risk-sharing, shared savings and bundled payment models
  • Case studies of organizations that have successfully navigated through new revenue models

Ray Wolfe, JD

Senior Associate, OPEN MINDS

Raymond “Ray” Wolfe, J.D. brings over 40 years of experience in the health and human services sector to the OPEN MINDS team. Mr. Wolfe currently serves as a Senior Associate, a position in which he utilizes his expertise to successfully lead varying projects for OPEN MINDS. His areas of expertise include managed care and value-based reimbursement models, financial analysis and management, mergers and acquisitions, CCBHC certification, integrated care, performance improvement, and strategic planning.

Before joining OPEN MINDS, Mr. Wolfe served in a 22-year tenure with Pittsburgh Mercy Health System in Pittsburgh, Pennsylvania. Most recently, Mr. Wolfe served as the organization’s Chief Operating Officer (COO), where he was responsible for oversight of all system operations, strategic planning, and performance management. Under his direction Pittsburgh Mercy achieved Certified Behavioral Health Center status, earned over $850K in value-based reimbursement contract quality bonus awards, integrated three organizations through merger/acquisition, opened a primary care service that was integrated into programming for the severe and persistent mentally ill and homeless populations, and adopted a new performance management program for managers.

Before acting as Pittsburgh Mercy’s COO, Mr. Wolfe served as the organization’s Chief Financial Officer (CFO) and was responsible for the development of internal costing methodologies, contract rate negotiations, and financial forecasting activities. In addition, he coordinated an integrated care program with local partner hospitals to develop a series of diversion and respite programs, as well as specialized primary care, integrated care management, and high utilizer teams, while maintaining 15 straight years of profitability.

Mr. Wolfe was promoted to CFO after serving as the Director of Fiscal and Information Security/Compliance for the health system. In this role, he was responsible for managing the transition of service contracts from fee-for-service (FFS), leading all compliance activities, and implementing a next-generation electronic health record (EHR) system.

Prior to his time at Pittsburgh Mercy Health System, Mr. Wolfe served as Chief Fiscal Officer with the Summit Center for Human Development in Clarksburg, West Virginia, where he was responsible for reporting and budgeting functions and preparing Summit Center’s programs for FFS billing.

Previously, Mr. Wolfe served in billing and collections for two Pennsylvania-based hospitals. First, in his role as a manager for Healthcare Corporation of America (HCA) and as an Accounts Receivables Manager for Brownsville General Hospital in Brownsville, PA, where he managed the accounting and billing system transition systems. Later as a Patient Account Manager for St. Francis Medical Center in Pittsburgh, PA, where he improved collections to hit a 95% rate through the implementation of new billing software and department reorganization.

Prior to working in the health and human services market, Mr. Wolfe spent five years practicing as a Lawyer with at Law Offices of Arch A. Moore in Moundsville, WV. In this role, he provided general legal practice, created and established bylaws for multiple corporations, and handled West Virginia licensing of first vision insurance plan.

Mr. Wolfe earned his Juris Doctor from the West Virginia University School of Law in Morgantown, WV and his Bachelor’s degree with a focus in Political Science and Sociology from West Liberty University, Wheeling, WV, where he graduated Magna Cum Laude.

×


Lack Of Access To Care & Care Continuity Challenges: How Providers & Payers Are Addressing

Breakout Session

Across the country, consumers struggle to gain access to mental health services with many waiting weeks or months to receive the treatment they need. Despite high demand, the health and human services industry is just beginning to figure out how to provide that access. Payers and providers, along with software vendors and technology companies not traditionally associated with health care are working collaboratively to address the problem of access and to ensure continuity of care to prevent readmissions and unnecessary or improper treatment.

In this session, our panel of payers and providers will share their perspectives and discuss what techniques and technologies are succeeding in the quest to drive greater access.

Paul M. Duck

Senior Associate, OPEN MINDS

Paul M. Duck brings over 40 years of experience in leadership and management focusing on managed care, health information technology organizations, strategy, business development, and market expansion, and customer experience optimization to the OPEN MINDS team.

Prior to joining OPEN MINDS, Mr. Duck served as the Vice President, Strategy & Development at Beacon Health Options. In this role, Mr. Duck led the organization’s strategy and business development efforts – responsible for a 30% increase in net revenue and initiated over $1 billion in revenue generation. Mr. Duck was active in national behavioral health initiatives as an executive of Beacon Health Options, including participating as a speaker at national and state association meetings.

Before joining Beacon Health Options, Mr. Duck was the Vice President of Business Development at Netsmart Technologies. During his tenure, Mr. Duck was responsible for business planning, including, the oversight of strategic activities including acquisitions, development, and execution of strategic initiatives, and positioning, and sales of large strategic customers. He also led the rollout of the company’s benchmarking and data analytics product suite.

Prior to Netsmart, Mr. Duck served as the Chief Executive Officer for Coastal Orthopedics and Pain Management, a large group practice with five clinic locations and two ambulatory surgical centers. As the organization’s chief executive officer, Mr. Duck was responsible for significant positive changes in leadership and corporate culture, financial and operational performance, compliance, and governance. Mr. Duck improved net collections by over $1 million per month and grew the practice through negotiating better contract rates with payers. He also implemented an organizational rebranding initiative and launched a new marketing campaign.

Prior to Coastal Orthopedics and Pain Management, Mr. Duck served as the President and Chief Executive Officer for Florida Radiology Imaging, one of the largest outpatient diagnostic imaging service companies serving the greater Orlando market. During his tenure, Mr. Duck led the construction of three new, full modality, diagnostic imaging locations. Mr. Duck revolutionized the company’s culture by creating a highly attractive and functional work environment.

Mr. Duck earned his Bachelor of Arts in Business Management from Case Western Reserve University. He earned his Associate of Arts in Electronic Engineering Technology from the Electronic Technology Institute. Mr. Duck received an award by Inc Magazine for leading Florida Radiology Imaging as one of America’s fastest-growing companies. Mr. Duck recently served as a contributing author to the book The New Health Age: The Future of Health Care in America.

×

2:30 pm - 3:00 pm

Networking & Raffle Prize Drawing

Networking


3:00 pm - 4:00 pm

Closing Keynote

Keynote Address

Coming Soon!

Monica E. Oss

Chief Executive Officer, OPEN MINDS

Monica E. Oss, M.S., Chief Executive Officer and Senior Associate, is the founder of OPEN MINDS. For the past three decades, Ms. Oss has led the OPEN MINDS team and its research on health and human service market trends and its national consulting practice. Ms. Oss is well known for her numerous books and articles focused on the strategic and marketing implications of the evolving health and human service field. She has unique expertise in payer financing models, provider rate setting, and service pricing. She has led numerous engagements with state Medicaid plans, county governments, private insurers, managed care programs, service provider organizations, technology vendors, neurotechnology and pharmaceutical organizations, and investment banking firms – with a focus on the implications of financing changes on delivery system design.

 

×