Sean Burns joined Highmark in May of 2015 to lead the reimbursement and provider operations area, where is primary accountabilities include everything from payment designs to provider network development strategies. Prior to joining Highmark, he lead a consulting practice within Optum (an affiliate of United Health Group) focusing on Network Management and Payment innovations. In this role he led many strategic consulting engagements helping clients build new contracting and other network strategies. Prior to Optum, Sean spent 12 years at Blue Cross Blue Shield of Minnesota, where he lead the development of many provider contracting strategies that impacted both traditional contracting methodologies and innovative payment models for commercial and government sector product lines. Sean’s experience also includes playing leadership roles in bundle payment strategies, ICD-10, public and private exchange strategies, implemented various technology solutions that supported payment innovation, and many healthcare affordability strategies.

Ann Conrath is a Director of Business Development at Signature Care Management (Signature), a value-based division within Signature Medical Group, Inc., a multi-specialty physician group in St. Louis and Kansas City, MO. In her current role at Signature, Ann has created the organizational structure, financial model, and implementation protocols for several value-based care initiatives, including orthopedic bundled payments and a maternity care home model. Signature, as a leader in value-based care, is the largest orthopedic convener for physician groups in the Bundled Payments for Care Improvement (BPCI) initiative. Ann has spearheaded the success of orthopedic groups through effective management and strategic protocols to improve patient outcomes, reduce unnecessary medical expenses, and maximize financial opportunity in this government value-based program. She is dedicated to improving the alignment between financial incentives and quality care within our healthcare system.

Michelle Copenhaver is the Regional Vice President of Aetna’s Southeast Territories. She has 30 years of experience in the health care industry, both in the clinical realm as a Registered Nurse and as a Healthcare Executive in the payer space. Currently, she leads a team that manages multiple ACO and other Value-Based Model Commercial and Medicare Advantage Collaborations throughout the southeast region including Contracting, Relationship Engagement, Operations and Day-to Day Management Excellence, Strategic Expansion, Establishing Win-Wins for Provider Partnership Relationship, creating Continuous Improvement, Growth and Sustainability.

Mark DeRubeis is the Chief Executive Officer of Premier Medical Associates, the largest multi-specialty practice in the Greater Pittsburgh area. Premier Medical Associates is focused on building better care by delivering a more comprehensive and collaborative model of care than traditional practices. The company has received industry attention and recognition for providing a higher standard of care while improving costs for both patients and payors. Premier Medical Associates was the 2016 recipient of the AMGA Acclaim Award.

Founded in 1993, Premier Medical Associates has a team of approximately 100 healthcare providers in ten locations offering 22 specialties of care. The company currently touches the lives of more than 100,000 patients.

In his role as CEO, DeRubeis is responsible for driving the organization's strategy, growth and commitment to preventative care that delivers the highest quality care with the greatest efficiency. He is a board member for AMGA and the Pittsburgh Chamber of Commerce as well as the co-chair of the Health Careers Futures, a nonprofit supporting organization of the Jewish Healthcare Foundation.

Prior to becoming CEO of Premier Medical Associates in 2004, DeRubeis was the Director of Operations for Alliance Ventures Inc., a subsidiary of Highmark, which owned Premier until it went independent. From 1998-2001, he was the Executive Director of Saint Francis Physicians Incorporated. Prior to that, he was the Vice President of Private Practice for Daniel Stern and Associates, a physician recruitment consulting firm.

A native of Pittsburgh, DeRubeis attended Duquesne University for both undergraduate and graduate work, earning a Bachelor of Arts in Business in 1987 and a Masters in Business Administration in 1992.

John Donlan is the Chief Managed Care Officer for Steward Health Care System responsible for leading payer relationships nationally in support of Steward’s national growth. John joined Steward in 2008 as Vice President of Managed Care and by 2010, became the Chief Operating Officer of Steward Health Care Network. In this role, John led efforts to build and develop Steward’s Accountable Care Organization and drive clinical and financial integration across the Steward Health Care System. By 2016, John had helped develop Steward’s nationally recognized ACO and established an industry-leading portfolio of risk-based clinical programs across the Commercial, Medicare, and Medicaid markets.

John began his professional career as a Medical Platoon Leader in the U.S. Army’s 1st Armored Division, serving in Germany and Macedonia; and then as a Captain at NATO Headquarters in Belgium. Prior to joining Steward Health Care, John led provider contracting at Tufts Health Plan.

John is an honors graduate from the University of Notre Dame and received his Master’s degree in Business Management from the University of Maryland, European Division. He received the designation of Certified Health Insurance Executive from the America’s Health Insurance Plans (AHIP) Association. John has also taught as adjunct faculty at the Carroll School of Management MBA program at Boston College.

Trisha Frick, RN, MS is the Director of Bundled Rates Contracting for Johns Hopkins HealthCare LLC, Baltimore, MD. Trisha has been with Johns Hopkins Health System since 1986 resulting in more than 30 years health care experience. She started at Johns Hopkins providing direct patient care as a nurse. After providing direct care and supervision for almost a decade, she began her career in Managed Care in 1995. Since then Trisha has created a Bundled Rates Contracting Office that is now managing over $50 million annually in Bundled Rate Contract Revenue. The current service lines for bundled rate agreements include transplants, cardiovascular, bariatric, pancreatic cancer and orthopedic services.

Trisha is responsible for the Travel Surgery Program with the Pacific Business Group on Health. This program represents Walmart, Lowe’s other large group employers and is for joint replacement procedures. This relationship is one of the few direct employer agreements in the nation where employers are paying for travel, housing and health services at identified centers of excellence in exchange for the elimination or reduction in co-pays and deductibles. Trisha is also working on the development of similar programs with other employer groups.

Dr. Kate Goodrich joined the Centers for Medicare and Medicaid Services in September of 2011 where she serves as Director of the Center for Clinical Standards and Quality (CCSQ) and CMS Chief Medical Officer. This Center is responsible for over 20 quality measurement and value-based purchasing programs, implementation of the new Merit-based Incentive Payment System and the Improving Medicare Post-Acute Care Transformation Act, quality improvement programs in all 50 states, clinical standards and survey and certification of all providers across the nation, and all coverage decisions for treatments and services for CMS. The Center budget exceeds $1.3 billion annually.

Previously, Dr. Goodrich served as the Director of the Quality Measurement and Value-based Incentives Group in CCSQ where she oversaw the implementation of over 20 quality, value-based purchasing and public reporting programs across multiple settings. She also co-lead an HHS-wide group to align quality measures across programs, and more recently has worked with numerous private payers to align measures across the public and private sectors. From 2010 – 2011 she served as a Medical Officer in the office of the Assistant Secretary for Planning and Evaluation (ASPE) at DHHS where she managed a portfolio of work on comparative effectiveness research and quality measurement and improvement.

Dr. Goodrich is a graduate of the Robert Wood Johnson Clinical Scholars Program at Yale University where she received training in health services research and health policy from 2008-2010. From 1998 to 2008, Dr. Goodrich was on faculty at the George Washington University Medical Center (GWUMC) and served as Division Director for Hospital Medicine from 2005-2008 and was chair of the Institutional Review Board from 2004-2008. She went to medical school at Louisiana State University in Shreveport, LA, and completed her internal medicine residency and chief medical resident year at GWUMC. She continues to practice clinical medicine as a hospitalist and Associate Professor of Medicine at GWUMC.

Amy Graham serves as Vice President, Strategy and Innovation for FirstHealth. She oversees the Strategy and Innovation department, which consists of business development and planning, executing all transactions for professional services and providing financial, analytics and performance data for the organization. She is also responsible for working with outside legal counsel and state agencies on licensure, certificate of need and other regulatory issues impacting the organization. Prior to her role as Vice President, she served as Director, Business Development. She joined FirstHealth in 1993.

Graham earned a Bachelor of Science degree in Business Administration and a Master of Healthcare Administration from the University of North Carolina in Chapel Hill. Graham is a member of the American College of Healthcare Executives, and actively participates with committees of the North Carolina Hospital Association and the North Carolina Division of Health Service Regulation.

Education:

• BS, Business Administration – University of North Carolina, Chapel Hill
• MHA, - University of North Carolina, Chapel Hill

Kari Hedges is Senior Vice President, Commercial Markets & Enterprise Data Solutions, at the Blue Cross Blue Shield Association (BCBSA), a national federation of 36 independent, community-based and locally operated Blue Cross and Blue Shield companies. Hedges is responsible for BCBSA’s commercial markets and data efforts, helping Blue Plans support national clients by leading national network solutions, providing seamless operations between the Blue Cross and Blue Shield companies, and leveraging data to transform healthcare. She also oversees the National Labor Office, an alliance of Blue Plans that work together to serve organized labor. Hedges joined the Association in 1996, concentrating primarily on Blue national inter-Plan business. She earned a bachelor’s degree from the University of Kentucky and an M.B.A. from the University of Notre Dame.

Jennifer is responsible for leading the Network’s transformation to value through improving quality and lowering costs. She leads the Jeffords Institute for Quality which includes analytics, community health teams, wellness, and quality improvement, along with patient safety and regulatory readiness. Prior to joining the UVM Health Network, Jennifer was the Associate Vice President of Population Health responsible for the development and implementation of value based initiatives and programs to support Wake Forest Baptist Health’s success in gainshare and risk contracts. With 20+ years as an experienced healthcare leader in both payer and provider environments, Jennifer’s role is to understand and connect the health care continuum, data and operations which includes the development of organizational capabilities needed to implement and sustain population health management along with community and patient engagement to minimize care fragmentation and reduce care costs.

Jennifer earned a Master's in Planning from Florida State University with an emphasis in Health Policy and a Master’s Certificate of Population Health program at Thomas Jefferson University.

Danielle Lloyd is the senior vice president, private market innovations & quality initiatives at AHIP, the national association representing organizations that provide coverage for health care and related services. She is responsible for assessing insurance market trends and developing policy in the areas of emerging payment models, quality measurement and health information technology interoperability.

Previously, Danielle led Premier’s policy analysis and development activities working with lawmakers, policymakers, and other major stakeholders representing the interests of more than 3,500 hospitals nationwide. She served as a national expert on alternative payment models and played a leading role in Premier’s large-scale provider collaboratives.

Prior to Premier, Lloyd worked on an array of healthcare issues including Medicare and Medicaid payment, quality policies, and health information technology for the American Hospital Association, California Hospital Association, the U.S. House of Representatives Committee on Ways and Means and the Centers for Medicare & Medicaid Services.

She is from Los Angeles, has a bachelor’s degree from the University of Pennsylvania and has a master’s degree in public health from the University of California, Berkeley.

Kristen McGovern is the Executive Director of the Partnership to Empower Physician-Led Care (PEPC), an advocacy organization whose mission is to support independent physicians and practices in moving to value-based care. Kristen is an experienced health care expert with deep knowledge on a range of topics impacting providers, including commercial insurance markets, Medicare, accountable care organizations, new payment and delivery models, digital health, transparency initiatives and more. Kristen is also a Partner at Sirona Strategies. She previously served as Chief of Staff to the National Coordinator for Health IT at the Department of Health and Human Services, and worked at the Office of Management and Budget in the Executive Office of the President.

Vincent McVittie is the Executive Director of Signature Care Management (Signature), a value-based division within Signature Medical Group, Inc. a multi-specialty physician group in St. Louis and Kansas City, Missouri. Vincent has over 20 years of executive experience in healthcare managing and delivering innovative business strategies and solutions with hospitals and large healthcare systems. Vincent has expertise in transforming physician and clinic delivery models in alignment with value-based care goals. Signature, as a leader in value-based care, is the largest orthopedic convener for physician groups in the Bundled Payments for Care Improvement (BPCI) initiative. Vincent is leading Signature’s BPCI Advanced convenership through strategic implementation and operations, tailored to organizations across the country to help them achieve the triple aim.

Grischa Metlay, Ph.D., has supported CMS on key value-based payment initiatives during his five years at MITRE. He has supported the HCPLAN since its inception in 2015, working closely with various multi-stakeholder Work Groups to author White Papers that focused on how to classify APMs for the purpose of measuring adoption, and how to design population-based and primary care models. Grischa works closely with the Catalyst for Payment Reform to execute the HCPLAN APM Measurement survey, and he provides technical assistance for classifying APMs in the HCPLAN Framework.

Michael Olsen serves as Senior Director Network Strategy and Contracting at Beth Israel Deaconess Care Organization (BIDCO), a value-based physician and hospital network and Accountable Care Organization (ACO) in Eastern Massachusetts comprised of 8 hospitals and more than 2,500 physicians. His role is to oversee the negotiation and implementation of BIDCO’s various contracts across commercial, Medicare and Medicaid markets including all risk based contracts. Michael develops financial models for both hospitals and physicians, analyses the impact of contracts, and implements strategies that support the transition to value-based care models. In 2017, he played a key role engaging providers and working with insurers to finalize terms for BIDCO’s participation in the Commonwealth’s MassHealth ACO pilot program.

In addition to his contracting responsibilities Michael also oversees BIDCO’s enrollment department. This operationally focused department works with all of BIDCO’s contracted payors to ensure that all physicians entering BIDCO are correctly enrolled and linked to BIDCO’s contracts. The enrollment department develops standard processes and transparent performance metrics to ensure we are continuously improving our enrollment process and exceeding stakeholders expectations.

Michael’s career with BIDCO was built on a foundation of strategy, contracting, and finance experience, rising through management to senior leadership positions. Prior to his present role at BIDCO, Michael was the Assistant Vice President of Provider Contracting for Cigna HealthCare, where he was responsible for all hospital, physician and ancillary contracts for the plan’s New York market. He managed a team which was tasked with optimizing provider engagement and maximizing participation in value based alternative payment methodologies including Accountable Care Organizations and other risk contracts. He has also help positions with multiple Massachusetts-based health plans, including Partners Healthcare, Harvard Pilgrim Health Care, and Neighborhood Health Plan.

Michael earned a Bachelor of Arts in Business Administration from University of Washington, graduating Cum Laude and Beta Gamma Sigma, and his Masters of Business Administration from the University of Virginia, Darden Graduate School of Business Administration.

Dr. Pham is responsible for developing and refining Anthem’s provider payment models that reduce the cost of care while rewarding improvements in quality and access. Additionally, she is focused on developing new products and networks built on a foundation of value-based care, and overseeing Anthem’s Enhanced Personal Health Care initiative, a program that focuses on patient-centered care and reimburses doctors for value-based, rather than volume-based, performance. Prior to joining Anthem in 2017, Mai was a founding official at the Center for Medicare & Medicaid Innovation (CMMI), where she served as Chief Innovation Officer and was responsible for implementation of the alternative payment model provisions of the Medicare Access and CHIP Reauthorization Act (MACRA) and other multi-organizational initiatives for the Center. Mai’s earlier work at CMMI included responsibility as the Director of the Seamless Care Models Groups, overseeing the design and testing of models on accountable care organizations and advanced primary care, including the Pioneer and Next Generation ACO Models and Comprehensive Primary Care Initiative. Previously, she was senior health researcher and co-director of research at the Center for Studying Health System Change and Mathematica, an independent health policy organization. A general internist, Mai has published extensively on payment policy issues including care fragmentation and coordination, and also practiced for several years at safety net clinics in the Washington D.C. area. Mai received her undergraduate degree from Harvard University, her MD from Temple University, and her MPH degree from Johns Hopkins, where she was also a Robert Wood Johnson Clinical Scholar.

Erin Smith, JD, Director II of Payment Innovation at Anthem where she focuses on development and implementation of specialty payment models. Prior to Anthem, Erin was the Director of Public Policy at Cardinal Health where she serves as the lead policy expert for public payment policy and value-based care models for the Federal Government Relations group. She also led the policy arm for naviHealth, a Cardinal Health company, in which she focused on bundled payments, care transitions, and post-acute care. Prior to Cardinal Health, Erin worked at CMS in the Center for Medicare and Medicaid Innovation, leading the team that developed bundled payment models and implemented the Bundled Payments for Care Improvement Initiative. Erin served as a Medicare physician payment policy expert on the Physician Fee Schedule at CMS. She also brings experience from her time with the World Health Organization in Geneva, Switzerland, and Avalere Health.

Richard Snyder, M.D. is the senior vice president, chief medical officer, and clinical care transformation officer at Independence Blue Cross (Independence). In this role, he is the company’s chief clinical spokesperson, and he has overall corporate responsibility for medical, quality, and pharmacy management, and all clinical policies and programs.

Dr. Snyder currently leads the Independence effort to drive clinical care transformation by bringing vital clinical information to the point of care, integrating and coordinating care management efforts and more closely aligning financial incentives between Independence and its participating physician and health system partners. This Facilitated Health Network model will provide the cornerstone for creation of a more streamlined, high quality, satisfying and affordable experience for Independence members. Dr. Snyder is active in a variety of state and professional advisory committees. He chairs the National Council of Physician and Pharmacy Executives at the Blue Cross Blue Shield Association, and serves as chair of the board of HealthShare Exchange of Southeastern Pennsylvania, a regional health information organization and serves on the board of directors for the American Heart Association of Southeastern Pennsylvania, Great River Affiliate.

He is a member of the American Medical Association, the Pennsylvania Medical Society, the American Academy of Family Physicians, and the Pennsylvania Academy of Family Physicians.

Dr. Snyder is a graduate of Franklin & Marshall College and the Medical College of Pennsylvania. He is board certified by the American Board of Family Medicine.

Steve Spaulding has executive responsibility for payment reform initiatives for Arkansas Blue Cross and Blue Shield and its family of companies. These include establishment of collaborative health ventures and clinically integrated networks, oversight for implementation and support of patient-centered medical homes, provider network contracting, provider reimbursement, commercial pharmacy Programs, information management and analytics, and medical management. Spaulding joined Arkansas Blue Cross in 1983 as a marketing representative in the Hot Springs region and was named an account executive in 1991 for USAble Administrators. He was named regional marketing manager for eastern Arkansas in 1993. He served as regional executive of the South Central region headquartered in Hot Springs from 1994 until 2002, when he was promoted to vice president of Internal Operations. In 2008, he was promoted to vice president of Enterprise Networks. In January, 2017, he was named Executive Vice President and Chief Health Management Officer for the enterprise.

A native of Breckenridge, Mich., Spaulding received his bachelor’s degree from Alma College in Michigan. He is a chartered life underwriter and a certified health consultant. He received Professional status in the Association of Healthcare Management in 2005 and completed the Ross School of Business Executive Education program at the University of Michigan in Ann Arbor in 2012.

Miriam Sullivan is the Vice President of Pharmacy and Clinical Operations for Tufts Health Plan. In this role, she is responsible for strategy development and oversight of clinical, operational and financial management related to pharmacy services, behavioral health services and utilization management for 1.1 million Commercial, Medicare and Medicaid members.

Before joining Tufts Health Plan, Ms. Sullivan was a consultant with Therapy Management Innovations, a consulting firm specializing in clinical and financial management of services rendered in outpatient and long term care settings. Prior to that, she was a regional sales manager with Smith & Nephew Rolyan, a manufacturer of orthopedic and rehabilitation equipment.

Ms. Sullivan earned an M.B.A from Brandeis University and a B.S. from Tufts University.

Margaret Verity is the Executive Director of Health Transitions for the Population Health Services Organization (PHSO) of Adventist Health System. In this role she champions and supports strategies to promote and reinforce models of care across various care settings including acute, post-acute, ambulatory and end of life to ensure appropriate and timely discharge positioning, improved care transitions and cost reductions among specific populations.

With over 20 years of experience at Adventist Health System/Florida Hospital, Margaret has served the organization in various leadership roles in the areas of Health Information Management, Care Coordination, Clinical Documentation Improvement, Care Management, and Utilization Management. Prior to assuming her position within the PHSO in 2018, Margaret served as the Assistant Vice President of Clinical Operations at Florida Hospital, where she led the organization in successful implementation of Clinical Documentation Integrity Program, transformed the Care Management department to increased RN presence, implement Emergency Room Care Management and improved patient throughput and transitioned the Health Information Management Department to a centralized service model to include collaboration with campus administration and relocation of staff.

Margaret received her bachelor of Health Information Management from University of Central Florida and has a master of business administration from Webster University. She is a member of the American Case Management Association. She and her husband Hal, live in Winter Park, Florida and have one son and three dogs.