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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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:

Anchor:

   Unabridged: https://anchor.fm/healthleaderforge/episodes/Dr--Michael-Sherman--Chief-Medical-Officer--Harvard-Pilgrim-Health-Care-egra8g

             Abridged: https://anchor.fm/healthleaderforge/episodes/Abridged-Dr--Michael-Sherman--Chief-Medical-Officer--Harvard-Pilgrim-Health-Care-egra7r

Stitcher: https://listen.stitcher.com/yvap/?af_dp=stitcher://episode/41445563&af_web_dp=https://www.stitcher.com/episode/41445563

iTunes: https://itunes.apple.com/us/podcast/healthleaderforge/id981989377

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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Daniel L. Andrus, Fire Chief for the City of Concord, New Hampshire

Are you a leader? How much do you trust your subordinates? Enough to let them strap you to a litter and let them lower you on a rope over the side of a 30 story sky scraper? Daniel Andrus, the Fire Chief for the City of Concord, New Hampshire, let his subordinates do exactly that. In today’s podcast, Dan tells the story of his 37 year career as a firefighter. Dan has a long list of credentials including master’s degrees in public administration and economics. He is, as he puts it, a continual learner. In addition to his role as fire chief, he serves on the boards of a number of non-profit organizations. This was one of the most educational podcasts for me that I have done so far because I knew very little about the organization and operations of the fire service. The fire service is a critical community resource that every health care executive should have an understanding of, so I was very pleased Dan took the time to share his story and I hope it is useful to health care executives as they think about emergency preparedness.

Links to the Podcast:

Anchor: 

        Unabridged: https://anchor.fm/healthleaderforge/episodes/Daniel-L--Andrus--Fire-Chief-for-the-City-of-Concord--NH-egraa1

        Abrdiged: https://anchor.fm/healthleaderforge/episodes/Abridged-Daniel-Andrus--Fire-Chief--City-of-Concord--NH-egra5e

Stitcher: https://listen.stitcher.com/yvap/?af_dp=stitcher://episode/41266021&af_web_dp=https://www.stitcher.com/episode/41266021

iTunes: https://podcasts.apple.com/us/podcast/daniel-l-andrus-fire-chief-for-the-city-of-concord-nh/id981989377?i=1000357158632

Podcast Outline

Time Topic
0:01:46 a family tradition of firefighting, early career with Salt Lake City Fire Department
0:07:55 formal education
0:11:57 firefighter/paramedic
0:15:47 early leadership - promoted to fire lieutenant
0:19:05 public information officer to Fire Chief for Salt Lake City
0:24:28 becoming a manager - fire captain
0:29:02 Battalion Chief, Emergency Management and Technical Services Division, Salt Lake City
0:33:47 Fire Marshal, Salt Lake City - 2002 Winter Olympics
0:38:16 Battalion Chief, Operations Bureau, Salt Lake City
0:40:47 Deputy Fire Chief, Administrative Bureau (including Airport Bureau and EMS)
                   Board of Community Health Center
                   pursuing an MPA, MS Econ
0:53:28 Coming to Concord
0:56:59 the job of Fire Chief, Concord Fire Department
1:05:14 interfacing with the direct health care and public health systems
1:07:33 involvement in community organizations - knowing your customers
1:12:41 innovative health care delivery with EMS assets - Mobile Integrative Health Care
1:15:14 organizational culture
1:17:45 role of women and minorities in firefighting
1:20:27 why do people join and why do people stay?
1:22:44 leadership
1:28:40 advice about pursuing a career in firefighting and EMS

Links to Topics Discussed:

Fire Department, Concord, NH

Fire Department, Salt Lake City, UT

New Hampshire Fire Academy

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Jill Gravink, Founder and Executive Director of Northeast Passage

Today’s guest is Jill Gravink, the Founder and Executive Director of Northeast Passage. Jill founded Northeast Passage in 1990 as a means of bringing Recreational Therapy out of the inpatient setting and into the community. Northeast Passage works with people who have physical and mental disabilities, using sport and leisure activities to improve the quality of the client’s life and to, as they say at Northeast Passage, “Live beyond disability.” Northeast Passage works with everyone from children to combat veterans, treating more than 3,000 clients last year. In this podcast Jill tells the story of how Northeast Passage came to be, and what it took to grow the organization from just her operating out of the trunk of her car to where it is today. We also discuss how organizations like Northeast Passage are well poised to contribute to the future of health care as the industry shifts to outcomes and value-based reimbursement, and conclude with a discussion about leadership.

Links to the Podcast:

Anchor: https://anchor.fm/healthleaderforge/episodes/Jill-Gravink--Founder-and-Executive-Director-of-Northeast-Passage-egraam

Stitcher: https://listen.stitcher.com/yvap/?af_dp=stitcher://episode/41078139&af_web_dp=https://www.stitcher.com/episode/41078139

iTunes: https://podcasts.apple.com/us/podcast/jill-gravink-founder-and-executive-director-of/id981989377?i=1000356065522

Podcast Outline

Time	Topic
0:01:34	Educational background
0:02:47	Defining recreational therapy
0:05:16	Art of recreational therapy, about NEP
0:06:36	History of recreational therapy
0:08:03	Getting certified in recreational therapy
0:08:40	First job after graduation
0:10:45	Use of aquatics in physical therapy
0:11:40	Starting NEP and initial vision
0:14:46	NEP’s first clients
0:17:11	NEP initial funding and sponsors
0:18:00	Coming back to UNH to teach
0:19:57	NEP’s early days, lessons learned, partnerships
0:23:24	Defining “universal design”
0:24:44	Growth of NEP in clients and funding, future NEP sustainability
0:27:52	Beginning to charge clients fees for service, NEP financial difficulties
0:29:58	Development of recreational therapy at NEP, associated grants
0:33:21	Learning to manage an organization
0:36:21	Merging NEP with UNH
0:38:13	Defining and using “strength-based” in therapy
0:39:31	Importance of integrating therapy within the community
0:44:04	Role group dynamics play in therapy
0:45:00	Receiving veterans’ adaptive sports grant, addressing veterans’ therapy needs
0:50:00	Long term relationship with Veterans’ Affairs after grant, current work with VA
0:52:10	Broader healthcare reimbursement trends away from FFS towards outcome and value-based payments
0:54:58	Change in role as executive director with UNH merger
0:56:38	The future of NEP
0:58:55	Changes in strategy and vision of NEP over time
1:00:41	NEP’s current organizational structure, working with UNH students
1:02:27	Changes in personal leadership style over time, lessons learned
1:05:46	How to find the right people for leadership positions
1:06:57	Philosophy on leadership and its challenges and opportunities
1:11:35	Importance of organizational culture
1:13:47	Early career mentors, importance of mentorship
1:16:47	Advice for people who want to address social needs
1:19:05	Advice for people interested in a career in recreational therapy

Topics Discussed:

Northeast Passage

American Thereapeutic Recreation Association

Adaptive Sports

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Thanks to Sameer Panesar for production support.

Greg Townsend, Vice President of Business Intelligence and Analytics, Commonwealth Care Alliance

Today’s guest is Greg Townsend, the Vice President of Business Intelligence and Analytics at Commonwealth Care Alliance in Boston. Greg’s path to leadership in health analytics traces the coming of age of analytics in health care. Greg’s educational background began in public health working with disease management and health promotion, which led him to roles in risk management and quality improvement, two fields that rely heavily on data. These early roles helped him develop the skill set that he uses today to support the Commonwealth Care Alliance’s mission of providing health care to some of Massachusetts’ most needy citizens. The podcast concludes with Greg’s thoughts on leadership and his advice to people who are interested in entering the field of health analytics. An abridged version of the interview that focuses only on Greg’s work at Commonwealth Care Alliance is also available.

Links to the Podcast:

Anchor: 

Unabridged: https://anchor.fm/healthleaderforge/episodes/Greg-Townsend--VP-of-Business-Intelligence-and-Analytics--Commonwealth-Care-Alliance-egra63               

Abridged: https://anchor.fm/healthleaderforge/episodes/abridged-Greg-Townsend--VP-of-Business-Intelligence-and-Analytics--Commonwealth-Care-Alliance-egra8e

Stitcher: http://www.stitcher.com/podcast/the-health-leader-forge

iTunes: https://podcasts.apple.com/us/podcast/greg-townsend-vp-of-business-intelligence-and/id981989377?i=1000354725112

Podcast Outline:

Time	Topic
0:01:31	Educational background, college internships
0:03:11	Moving to North Carolina after college, initial jobs
0:05:12	Preventive health work at Blue Cross Blue Shield of North Carolina
0:07:00	Defining “disease management” and its history
0:08:28	Lessons learned from first jobs
0:10:22	Quality Improvement work at Harvard Pilgrim
0:13:37	Performance Improvement work at Elliot Health System
0:15:20	The role of the Joint Commission in accreditation
0:17:25	Other responsibilities at Elliot Health System
0:20:26	Leadership lessons learned at Elliot
0:24:52	Performance Improvement/Evaluation work at Tufts New England Medical Center
0:29:49	The importance and process of prioritizing
0:31:19	Quality Management work at Health Dialogue Analytics Solutions
0:34:30	“Unwarranted variation” in health care
0:36:07	Work in health analytics prior to HDAS
0:37:55	Tools used in health analytics
0:38:56	How prior work experiences contributed to knowledge in health analytics
0:39:52	Clinical partnerships work at Accretive Health and work on reimbursable codes with providers and CMS
0:45:04	Business Intelligence work at Commonwealth Care Alliance
0:47:28	Working with dually eligible patients (Medicare & Medicaid) and the importance of primary care
0:50:48	Assembling a primary care team through CCA
0:52:08	Work with capitated payments in healthcare
0:54:15	Lack of access to care for Medicare and Medicaid patients, the importance of home health care
0:56:06	Integration of specialty and inpatient care into capitated payments
0:56:41	Teamwork in healthcare and home health evaluations
0:59:17	Greg’s role, responsibilities at CCA
1:00:43	Problems solved using health analytics
1:02:28	Products created using health analytics
1:04:40	Difference between and use of “predictive” and “prescriptive” analytics
1:06:52	Evolution of analytics and its integration into health decision making
1:08:15	Challenges faced in the implementation of health analytics
1:10:11	The future of health analytics and its integration into health care
1:11:40	Personal leadership philosophy
1:13:28	Personal mentors in leadership
1:15:21	What to look for when hiring leaders
1:16:36	The role of a good mentor
1:18:17	Who looks to you as a mentor?
1:19:36	Advice for those interested in health analytics

Links to Topics Discussed:

Commonwealth Care Alliance

Masshealth

Plymouth State Health Promotion Program

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Thanks to Sameer Panasar for production assistance.