Panel Session 2: Chronic Disease/Care Delivery Innovation Case Study

Panel Session 2: Chronic Disease/Care Delivery Innovation Case Study

Moderated by:

Atul Gawande, M.D., M.P.H
Surgeon, Writer, Public Health Researcher

Atul Gawande is a surgeon, writer, and public health researcher. He practices general and endocrine surgery at Brigham and Women's Hospital in Boston. He is also Associate Professor of Surgery at Harvard Medical School and Associate Professor in the Department of Health Policy and Management at the Harvard School of Public Health.
His research work currently focuses on systems innovations to transform safety and performance in surgery, childbirth, and care of the terminally ill. He serves as lead advisor for the World Health Organization's Safe Surgery Saves Lives program. He is also founder and chairman of Lifebox, an international not-for-profit implementing systems and technologies to reduce surgical deaths globally.

He has been a staff writer for the New Yorker magazine since 1998. He has written three New York Times bestselling books: COMPLICATIONS, which was a finalist for the National Book Award in 2002; BETTER, which was selected as one of the ten best books of 2007 by Amazon.com; and THE CHECKLIST MANIFESTO. He has won two National Magazine Awards, AcademyHealth's Impact Award for highest research impact on health care, a MacArthur Award, and selection by Foreign Policy Magazine and TIME magazine as one of the world's top 100 influential thinkers.

Panelists:

Kenneth Coburn, MD, MPH
Chief Executive Officer and Medical Director, Health Quality Partners (HQP)

Kenneth Coburn, MD, MPH, is the CEO and Medical Director of Health Quality Partners (HQP), a not-for-profit health care quality research and development organization based in Doylestown, Pennsylvania.

For the past 10 years he has been the principal investigator for HQP's Medicare Coordinated Care Demonstration (MCCD), which began enrolling chronically ill Medicare beneficiaries into a randomized controlled trial in April 2002. Prior to founding Health Quality Partners, Dr. Coburn served in leadership roles in PennCARE, an 11-hospital consortium in eastern Pennsylvania.

Past experience also includes working within the disease management division of the University of Pennsylvania Health System, as the Medical Director for Quality at a HMO owned by academic medical centers in Philadelphia (Health Partners), and as the Director of the AIDS Center at the Montefiore Medical Center in Bronx, NY, a New York State Designated AIDS Center.

Dr. Coburn received his undergraduate education at Brown University, his medical degree from the Columbia University College of Physicians & Surgeons, and completed his residency training in internal medicine at the Columbia-Presbyterian Medical Center in NY.  He completed his infectious disease subspecialty training at the Albert Einstein / Montefiore Medical Center in Bronx, NY. He received his Masters in Public Health degree from the Mailman School of Public Health at Columbia University and is currently a doctoral candidate in public health (DrPH) at the University of North Carolina's Gillings School of Global Public Health where he was awarded the Arthur B. Holzworth endowed scholarship in health leadership.

Alan Hoops
Chairman and Chief Executive Officer, WellPoint/CareMore

In March of 2006, Mr. Hoops became Chairman and CEO of CareMore Health Group. CareMore Health Group includes CareMore Medical Enterprises, Inc. and CareMore Health Plan. Previously, Mr. Hoops held the position of Chief Executive Officer, PacifiCare Health Systems (NYSE: PHS). Mr. Hoops co-founded PacifiCare, an $11 billion Medicare-focused HMO based in California in 1977 and later led the rapid expansion of the company during the 1990s.

During Mr. Hoops' tenure as President and CEO from 1993-2000, PacifiCare grew five-fold from $2 billion to $11 billion with approximately 4 million members in 9 states and Guam. During Mr. Hoops' first five years as President and CEO, PacifiCare's stock price doubled. Mr. Hoops started PacifiCare's Secure Horizon's program, which under his leadership, became the nation's largest Medicare HMO health plan, serving more than 1 million Medicare beneficiaries in nine states. Under Mr. Hoops' direction, the company also became a major commercial HMO and one of California's largest managed care insurers.

Since 2000, Mr. Hoops has been Chairman of Benu, Inc., and Enwisen. Mr. Hoops also serves as Board Director for Corvel.

Debbie James, Vice President
Healthways Fitness Division, Healthways

A 20-year veteran of the healthcare industry, Debbie James currently leads Healthways' fitness and physical medicine business units where she oversees strategic direction, growing the top-line revenue and managing all aspects of operations. Her responsibilities include several well-being solutions including SilverSneakers®, the nation's leading exercise program designed exclusively for older adults.

Debbie began her career working for Caremark, Inc., as the Manager of Marketing. She has also held several positions managing large university-based physician practices.  Debbie also spent six years at Express Scripts in various positions; most notably as Regional Vice President and General Manager where she was responsible for operations, account management and finance for the Western Region.

Prior to joining Healthways, Debbie was the Vice President, Business Transformation at Health Net.  In that capacity, she was an integral part of the Medicare program governance, co-chairing the Operations and Marketing Committee. She was also a member of Health Net's Medicare Oversight Committee, the executive governing body for all Medicare business.

Debbie received her Bachelor of Science degree from Southern Illinois University in 1987 and a Master of Business Administration degree from The University of Chicago in 1992.

Mary D. Naylor, PhD, RN, FAAN, Professor in Gerontology, and Director of the NewCourtland Center for Transitions and Health
University of Pennsylvania School of Nursing

Since 1989, Dr. Naylor has led an interdisciplinary program of research designed to improve the quality of care, decrease unnecessary hospitalizations, and reduce healthcare costs for vulnerable community-based older adults. As the chief architect of the Transitional Care Model, Dr. Naylor's work is elucidating the unique needs of chronically ill older adults and their family caregivers and offering high quality, cost-effective, evidence-based solutions to address a major health concern in the U.S. and across the globe.

Her team is also providing a roadmap for others who seek to bring empirically tested research into health care organizations, to improve the quality of health care and to advance the policy changes essential to sustain such approaches to care. Dr. Naylor is also the National Program Director for the Robert Wood Johnson Foundation program, Interdisciplinary Nursing Quality Research Initiative, aimed at generating, disseminating, and translating research to understand how nurses contribute to quality patient care.

She was elected to the National Academy of Sciences, Institute of Medicine in 2005, and serves on their Board on Health Care Services and the Roundtable on Value and Science-Driven Health Care. She also is a member of the RAND Health Board, the National Quality Forum Board of Directors and chairs the Board of the Long-Term Quality Alliance. Dr. Naylor was appointed to the Medicare Payment Advisory Commission (MedPAC) in 2010.

Dr. Naylor earned her bachelor's degree in Nursing from Villanova University, her Master of Science in Nursing and her PhD in higher education administration from the University of Pennsylvania.