Tuesday, December 15, 2015

Betsey Rhynhart, Executive Director, New Hampshire Accountable Care Partners


Today’s guest is Betsey Rhynhart, the Executive Director of New Hampshire Accountable Care Partners, an Accountable Care Organization or ACO headquartered at Concord Hospital in Concord New Hampshire. New Hampshire Accountable Care Partners was formed as a partnership between four community health systems in Southern New Hampshire: Concord Hospital, The Elliot Health System, Southern New Hampshire Health System, and Wentworth-Douglas Health System. In this podcast Betsey talks about her career, and how her education in public health and her background in insurance and strategy merge in her current role leading the ACO’s efforts. She talks about how the ACO is a learning organization that is helping the participating partners move toward a strategy of providing value-based care, a recurring theme we have been hearing from a number of leaders in recent interviews. Betsey provides an inside view of how the ACO was formed, how it operates, what the organization’s goals and objectives are, and what the participating organizations hope to gain from their collaboration. Betsey’s career and current role are great examples of how public health and direct care are beginning to merge as direct care delivery systems become more involved in population health models.

Links to the Podcast:
Soundcloud
        Unabridged: https://soundcloud.com/healthleaderforge/betsey-rhynhart-executive-director-new-hampshire-accountable-care-partners
        Abrdiged: https://soundcloud.com/healthleaderforge/abridged-betsey-rhynhart-executive-director-new-hampshire-accountable-care-partners
Stitcher: http://www.stitcher.com/podcast/the-health-leader-forge
iTunes: https://itunes.apple.com/us/podcast/healthleaderforge/id981989377

Podcast Outline


Time
Topic
0:02:00
Education and early career
0:17:50
Concord Hospital
0:21:02
Executive Director of Accountable Care
0:24:28
About the ACA, the Triple Aim, and the Triple Problem
0:37:04
New Hampshire Accountable Care Partners
0:41:15
Establishing the ACO
0:45:25
The broad strategy of moving to value
0:53:07
Medicare and CHIP Reauthorization (MACRA) Act of 2015
0:57:16
How are beneficiaries assigned to an ACO?
1:01:31
Primary Care in an ACO Medical Home
1:04:15
Generating shared savings
1:14:05
Listening to the data - the importance of analytics
1:22:17
Shared learning, sharing best practices
1:25:24
Sharing the shared savings, evolving to achieve success
1:30:44
Leadership, mentorship, and advice to early careerists


Links to Topics Discussed:

Concord Hospital

New Hampshire Accountable Care Partners

CMS on Accountable Care Organizations

Medicare and CHIP Re-authorization Act (MACRA)

County Health Rankings and Roadmaps

Boston University's Masters of Public Health

Being Mortal: Medicine and What Matters in the End

American's Association of Health Plans (AHIP)







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Tuesday, December 1, 2015

Dr. Michael Sherman, MD, MBA, Chief Medical Officer, Harvard Pilgrim Health Care



Today's guest is Dr. Michael Sherman, the Chief Medical Officer and Senior Vice President for Health Services at Harvard Pilgrim Health Care. Harvard Pilgrim is a New England-based regional health plan with 1.25 million members. It has been ranked #1 by NCQA for the past ten years. Michael holds Bachelor’s and Master’s degrees from the University of Pennsylvania in Medical Anthropology, he attended Yale Medical School, and is a board certified anesthesiologist. In the mid-1990's he made the decision to pursue an MBA at Harvard Business School with the thought that he would seek to blend together his clinical expertise with a business education, but he was sure of one thing: that he would never work for an insurance plan. In this podcast he tells the story of his career, about becoming a physician, making the transition to executive leadership, and how he ultimately worked for three health insurers (ironically, the payers he said he would not work for). Michael's career involves a great deal of serendipity, but it also shows his deliberateness as he worked to develop the skills he knew he needed to progress as an executive by gaining exposure and experience in a wide array of organizations. He is also quite candid about his successes and challenges, which shows that the road to senior leadership is never smooth sailing.

His discussion of the work he is doing with value-based payment and bundling at Harvard Pilgrim is particularly useful and timely. It is very popular to demonize health insurers, but Michael’s efforts to create win-win arrangements between Harvard Pilgrim and its partners in the provider community shows what is actually possible. It is interesting to see how his passion for developing these agreements meshes with a recurring theme of negotiations from different points in his career leading up to his current role. The podcast concludes with a discussion about Michael's leadership style, and his recommendations for physicians who are looking to make the transition from clinical leadership to executive leadership.

The interview is available in its entirety at the unabridged link below. The podcast outline corresponds with the unabridged version. There is also an abridged version of the interview that focuses primarily on Michael's work immediately leading up to his current role. 



Links to the Podcast:
Soundcloud:
             Abridged: https://soundcloud.com/healthleaderforge/abridged-dr-michael-sherman-chief-medical-officer-harvard-pilgrim-health-care
Stitcher: http://www.stitcher.com/podcast/the-health-leader-forge
YouTube: https://youtu.be/nxkYEFZWuKU

Podcast Outline (these times apply to the full length version)


Time
Topic
0:02:56
background education, becoming a physician
0:13:11
decision to go to business school
0:23:06
the importance of establishing self as a physician before going into business/leadership role
0:25:21
DaVita, Inc.: Director of Corporate Development, DaVita, Inc.
0:30:57
HealthAllies: Vice President, Provider Business Development and Product Management
0:36:37
IMMUSOL: Vice President, Medical Affairs
0:43:08
Thomson Reuters: Vice President & General Manager, Health Plan Solutions
0:54:27
Transition to the payer world: United Health Group
1:00:38
Humana: Corporate Medical Director, Physician Strategies
1:12:43
about Harvard Pilgrim Health Care
1:17:09
Harvard Pilgrim Institute/Harvard Medical School Department of Population Health
1:18:55
Chief Medical Officer and Senior Vice President, Health Services
1:21:52
Paying for value, one size doesn't fit all
1:34:45
Consolidation of Health Insurers
1:36:27
Thoughts on leadership, hiring the right talent, and being an executive
1:51:02
Mentorship
1:52:51
Professional Organizaitons
1:54:26
Advice to clinicians who want to make the transition to clinician executives


Topics Discussed:

Harvard Pilgrim Health Care

Harvard Business School

DaVita

HealthAllies (Optum HealthAllies)

Thomson Reuters

UnitedHealth Group

Humana

America’s Health Insurance Plans (AHIP)



Articles by Dr. Sherman:

              Paying for Value: What's Next?

              How to Design a Bundled Payment Around Value







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