Erik Baldwin is an experienced leader in healthcare quality with a broad background in the development of performance improvement strategies that improve quality and safety. Erik currently serves as the Director of Pay for Value at Gateway Health and is responsible for the monitoring and improvement of HEDIS and other performance measures for the Medicaid lines of business. He is a board certified American College of Healthcare Executives Fellow, a Certified Professional in Healthcare Quality, and a Lean/Sigma Black Belt. He has military experience and has worked in the Air Force Surgeon General's Office in Health Benefits and Strategic Planning. Prior to coming to Gateway, Erik spent twelve years at Kaiser Permanente as a leader in quality for both Health Plan and Delivery System functions.
Susan is a registered nurse and certified case manager with decades of experience in the health care field in various management/executive roles. She oversees Complex, High Risk OB and Transplant Case Management, Care Transitions and the care connector support team. Prior to joining AvMed, Susan held various management and executive roles in acute hospitals and HMOs/TPAs/PPOs. This well-rounded experience and knowledge has resulted in skills and experience needed to facilitate successful outcomes.
Sunil Budhrani Chief Executive Officer and Chief Medical Officer
Dr. Sunil Budhrani is the Chief Executive Officer of Innovation Health, a uniquely successful partnership between Aetna and one of the largest health systems in the Washington DC Metropolitan Area, INOVA Health System. Dr. Budhrani is a Board Certified Emergency Medicine Physician who graduated with Honors from the University of Pennsylvania. He went on to complete his Medical Degree at the George Washington University, where he then pursued his Masters in Public Health due to an interest in Population Health Dynamics. Subsequently, he completed his Residency training in Emergency Medicine at the Tufts University School of Medicine in Massachusetts, and went on to Chair and direct Emergency Departments and Urgent Care Centers throughout the East Coast. He co-founded CareClix Telemedicine, a leading pioneer in Telemedicine and Remote Patient Monitoring technologies with users throughout the United States and abroad
Karen Connolly, RN
Senior VP/Quality Improvement and Accreditation Services
Karen Connolly, RN Senior VP/Quality Improvement and Accreditation Services
HealthSun Health Plans, Inc.
Karen Connolly, RN, a health care professional, has over 38 years of extensive experiences in operational leadership in health care quality delivery and management including quality management and improvement in health care. She has been involved in nursing and hospital administration, managed health care, health information, contract administration, risk management and strategic planning. Her expertise and experiences in quality improvement activities have included activities in both the hospital and ambulatory settings and interfacing with a number of external agencies in the promotion of quality and in the use of data to increase access to care and to increase the quality of health care delivery systems. She has worked consultatively in the health plan community with commercial, Medicaid, and Medicare plans in the areas of compliance, QI, operational leadership, accreditation achievement, HEDIS and other key metrics for over 12 years. She has facilitated strategic planning sessions and performed analytical evaluation, database management, and quality improvement of key performance indicators including population health management that have resulted in statistically significant improvements impacting health outcomes particularly focused in the health plan setting, including the achievement of 5 star ratings for a south Florida Medicare Advantage Health Plan. Ms. Connolly has worked with organizations throughout the country in the achievement and continued compliance with accreditation with NCQA, AAAHC, and TJC. Ms. Connolly has been a speaker at national forums on quality metrics and accreditation related issues for over the last 15 years.
Ms. Connolly has been an AAAHC surveyor nationally since 1998 and serves as faculty for AAAHC educational programs. Ms. Connolly serves as the Chair of AAAHC’s Health Plan Advisory Committee and is a member of AAAHC’s Standards and Survey Process Committee. She has served on a number of other committees, workgroups and task forces for AAAHC that have included the Medical Home Advisory Committee, the Task Force on Quality Improvement, the Task Force for Primary Care, and workgroups for Patient Center Medical Home and Scoring Methodology. She is an under graduate of DePauw University School of Nursing in Indiana and did her graduate studies at Oakland University and University of Michigan in Michigan
Dr. Jatin Dave joined New England Quality Care Alliance as Chief Medical Officer in 2016. Dr. Dave is an internist and geriatrician with more than 15 years of diverse health care experience in clinical, academic and managed care settings. He is board certified in internal medicine, clinical informatics, geriatrics and hospice and palliative care.
Before joining NEQCA, Dr. Dave served as the Medical Director of Geriatrics and Senior Care Options for Tufts Health Plan. He also practiced at Brigham and Women’s hospital for 12 years both as a primary care physician and consultant geriatrician. Dr. Dave completed his training in Internal Medicine at the University Of Illinois College Of Medicine and subsequently completed a General Internal Medicine fellowship at New York University. He then completed a fellowship in Geriatric Medicine at Harvard University where he received his master’s degree in public health. Jatin lives with his wife and two sons in Lexington, MA.
Senior Director, Quality, Regulatory, and Strategy Innovations
Anthony Davis Senior Director, Quality, Regulatory, and Strategy Innovations
UPMC Health Plan
Anthony Davis is a Quality Improvement professional with 14+ years of experience building quality improvement initiatives across multiple regions of the United States. His work has pushed forward State, Regional, and National initiatives aimed at risk and quality across the healthcare industry. His work has spanned several large and small health plans as well as working nationally with NCQA.
Anthony currently serves as the current Senior Director for Quality Strategy at UPMC Healthplan in Pittsburgh, Pennsylvania. He leads a staff of 60+ that are responsible for all State and Federal quality improvement initiatives and data submissions for 1.2 Million covered lives across; Medicare, Medicaid, CHIP, Commercial, Exchange and LTSS product lines. In addition to the above key career highlights, Anthony is also an assistant professor and George Washington University where he teaches a Master of Science Course in Healthcare Quality Improvement, and a current Senior consultant/surveyor for NCQA.
His background is in management and operational processes for 15 years, and began working in the Risk Adjustment arena 12 years ago. Ryan has proven himself by helping Medical Groups raise their RAF scores to their proper levels. He directed the movement of a 10,000 member group up 43% over a two year period, and an 1800 member group up 53% in the first year. Ryan achieves these results through chart documentation audits, provider and staff documentation training, and provider relationship building. In his most current role Ryan works with multiple groups to optimize their RAF score, while at the same time achieving CMS 5 Star quality. Ryan explains to these groups that getting their RAF score to the correct level will not only drive revenue, but it will also lead to better patient care with improved documentation habits. Ryan is a Certified Risk Adjustment Coder (CRC) credential through the AAPC.
Charles Folk-Cruthirds is an Analytics Manager at Blue Cross Blue Shield of Louisiana. Before coming to BCBS Louisiana, he worked in decision support at another Louisiana MAO, where he performed trend analyses and reported his findings directly to the C-suite. As Analytics Manager, his primary responsibilities are Medicare Advantage Stars, Medicare Advantage Risk Adjustment, and ACA Risk Adjustment. His team also produces analytics to streamline these processes.
Benjamin N. Hamlin MPH, Senior Research Informaticist
Benjamin N. Hamlin, MPH is the Senior Research Informaticist in the Department of Performance Measurement at NCQA specializing in clinical quality, context-specific decision support and the use of predictive analytics for quality improvement. He is a nationally recognized leader in transformative quality strategies and the principal architect of the HEDIS electronic clinical data system (ECDS) quality measure reporting protocol (www.ncqa.org/ecds). A specialist in application of Clinical Quality
Language (CQL) and Fast Healthcare Interoperability Resource (FHIR) standards to quality measurement, he currently leads the initiative to digitalize NCQA’s entire portfolio of measurement products. Throughout his career, Mr. Hamlin has conducted a wide array of health-related research including strategies for comprehensive chronic disease management, facilitating community-based clinical translational research, identifying health disparities, and designing strategies for the development of healthcare infrastructure in underserved and/or underdeveloped areas.
His principal research interest is patient-level measurement using multidimensional assessment tools and how these can reconfigure quality to focus on those issues that are most relevant to patient-centered care. His particular area of interest comprises the distributed cognition of human-information technology interfaces and how these can improve comprehension of healthcare information.
Kent Holdcroft Executive VP of Enterprise Accounts and Strategic Partnerships
Kent Holdcroft joined PharmMD in March 2013, bringing over a decade of operational, consulting, and sales experience in the healthcare technology and services industry. His leadership at PharmMD has quickly expanded well beyond the management of business development, client negotiations, and relationships, taking on integral roles in marketing operations and product development. His charismatic personality is helping shape the culture of this rapidly growing team.
“PharmMD holds the potential to be a game-changer,” comments Holdcroft. “This team is focused on being the market innovator as emerging regulatory requirements position our solutions to return millions of dollars to our customers, reducing cost, and building healthier lives.” Holdcroft came to PharmMD following multiple successes with AIM Healthcare (now a part of Optum, a United Health Group, Inc. company), rising to National Director as it expanded into new markets. He was a key player as a part of Optum’s growth strategy representing all of Optum’s provider-facing solutions. He managed healthcare accounts in the community hospital, academic medical center, integrated delivery network, as well as a variety of managed care plans and government settings.
Actively involved in the community, Holdcroft currently serves on the Board of Directors at BrightStone, Inc., and as a Stephen Minister. Holdcroft holds a BA in Psychology from the Miami University and a MA in Counseling from The University of Toledo.
Kishore Huilgol , working as an Senior IT Manager responsible for delivering the IT solution to enable the enterprise data on the GuideWell Data Platform
Leads the Team of Technology Architects and data engineering teams that supports Market facing applications for enabling big data technologies and designing and implementing data platform and enabling the same for enterprise needs
Kishore Huilgol has 20 + years of experience in IT and has been with Florida blue from last 14 years focused around development and Enterprise Architecture leading core implementation at Florida blue which involves various technology streams like CRM , BPM and Big data solutions
Dave is a strong leader with 14+ years of experience in Revenue and Clinical Outcomes Program Development and Management in various healthcare environments (Plans, MG/IPA, Academic, and Consulting). Proven record of success in optimizing Operations, PE / Investor Meetings, Maintaining Compliance, Recovering / Maximizing Revenue, Enhancing Clinical Quality and Developing Software and Custom Analytics.
Specialties: RA / HCC, Pay for Performance (P4P), CMS Stars Program, NCQA HEDIS, Off‐shore Software Product Development, HOS, CAS, NCQA Accreditation, Physician Profiling, Encounter Programs, Contract and Claims Analytics.
Previously, Dave served as an independent consultant to healthplans, was Corporate VP, Operations (Revenue and Quality) at InnovaCare Health. He has also performed as Sr. Consultant, Risk Adjustment and Health Plan Operations for Dynamic Healthcare Systems, and in other roles with healthplans.
Creagh Milford, DO MPH, FACOI is a physician executive who serves as the Chief Medical Officer for Healthcare Highways, a healthcare innovation company based in Dallas, Texas. He has a passion for improving healthcare, specializing in population health management, healthcare informatics, analytics, and innovation.
Dr. Milford has held several C-suite positions. Recently, he served as the Chief Executive Officer of FullWell, a population health management services company, which was sold in 2017. Previously, Dr. Milford served as the system-wide division president of population health services of Mercy Health. He served as Assistant Chief Medical Information Officer for Massachusetts General Physician Organization (MGPO) and Massachusetts General Hospital (MGH), a Harvard teaching hospital. He also served as Associate Medical Director for Population Health Management at Partners Healthcare, a Boston-based health system founded by MGH and Brigham and Women’s Hospital.
Dr. Milford remains engaged in national health policy. He was nominated as a Fellow of the National Academies of Medicine, where he participated on the Board on Population Health. He has also held positions within the Centers for Medicare and Medicaid Services and the Department of Health and Human Services Office of the National Coordinator for Health IT, focusing on federal policy for value-based purchasing and health IT.
He earned his bachelor’s degree from the University of Colorado at Boulder and his D.O. degree from the Chicago College of Osteopathic Medicine at Midwestern University. Following a residency at the University of Chicago-North Shore and a fellowship in Health Management and Policy at Massachusetts General Hospital, he earned a master’s degree in Health Management and Policy from the Harvard School of Public Health, where he continues to serve as a guest lecturer.
Jessica has been with Aetna for over 5 years, working specifically to support Innovation Health, a uniquely successful partnership between Aetna and one of the largest health systems in the Washington DC Metropolitan Area, INOVA Health System. Jessica works collaboratively with clinical teams to analyze complex information in support of strategic business plans. Evaluating Innovation Health member’s population health to assess trends and opportunities using healthcare data like medical, pharmacy, lab, survey and utilization data. Prior to her work on Joint Ventures she supported the Nurse Health Advocate Team and large Plan Sponsors. Jessica has her Masters in Public Health in Biostatistics and Epidemiology. Preceding her time with Aetna she worked with the NYC Department of Mental Health and Hygiene and at large Advertising Agencies to market various drugs to Physicians.
Vandna Pandita, MPH is the Vice President of HEDIS® Strategy and Analytics for the AmeriHealth Caritas Family of Companies [ACFC]. In her role, Vandna oversees the full continuum of performance measurement from the acquisition of data to reporting and analytics for the enterprise. In her role, she works collaboratively with internal and external partners to ensure that the AmeriHealth Caritas Family of Companies is best positioned within the marketplace at the state and national level. Prior to AmeriHealth, Vandna has worked for several national health plans, including Aetna, several Blue Cross Blue Shield plans, the Blue Cross Blue Shield Association and Centene. She has successfully led several health plans through NCQA Accreditation, managed HEDIS® reporting, improvement and outreach, and helped develop and implement a successful provider profiling and performance measurement program. In addition to her health plan experience, Vandna managed Risk Adjustment Client Operations for Evolent Health, is a former certified HEDIS® Compliance Auditor and led project management and client solutions for a retrieval, abstraction/coding and analytics vendor supporting health plans and provider groups in their efforts to optimize revenue and improve quality within their populations. Vandna attended the University of California at Berkeley as an undergraduate and received her Master’s in Public Health from the University of California at Los Angeles. Vandna has moved from coast to coast, and although she has spent the last 20+ years working on her southern drawl in Atlanta, these days you will find her running the streets of her new hometown, Philadelphia.
Jennifer Pereur is the Director of Government Programs for Hill Physicians Medical Group, an independent practice association (IPA) in Northern California. The group consists of over 3,000 contracted physicians who provide care to 300,000 managed care members. Jennifer oversees both the Medicare and Medicaid lines of business. Her primary focus since establishing the department in 2011, has been improving the accuracy of Medicare Advantage risk scores. Jennifer has 10 years of prior experience in Network Management at Hill Physicians. She has an extensive background in value‐based physician payments, including the development of physician profiles and reporting metrics. Jennifer took time away from her work at Hill Physicians to lead the client support team at MedeAnalytics. In her role there as the Director of Payer Services, she worked with health plans to integrate analytics into their utilization management and cost containment decision making process. Using the MedeAnalytics platform, she developed dashboards that helped payers and providers collaborate on their shared performance goals. Jennifer has an MBA from St. Mary’s College and currently sits on the Practice Improvement Program (PIP) Advisor’s Committee for the San Francisco Health Plan.
Steven Peskin Executive Medical Director Population Health
Horizon Blue Cross Blue Shield (NJ)
Steven R. Peskin, MD is the Executive Medical Director, Population Health at Horizon Blue Cross Blue Shield of New Jersey. His expertise encompasses physician leadership, population health management, clinical and operational performance improvement in health care, medical education and scientific communications. He has been one of the driving forces for the creation of and successful maturation of value based models in New Jersey.
Dr. Peskin is an Associate Clinical Professor in the Department of Medicine at Rutgers Robert Wood Johnson Medical School. He is a clinical preceptor at The Eric B, Chandler Clinic for interns and residents in Internal Medicine. Dr. Peskin assists with the Population Health and business of medicine training for the Rutgers RWJ Internal Medicine physicians in training.
Dr. Peskin received his bachelor’s degree from The University of North Carolina Chapel Hill and medical degree from Emory University School of Medicine. He completed residency at Saint Elizabeth’s Medical Center in Boston and holds an MBA from the Sloan School of Management at Massachusetts Institute of Technology.
Jeffrey Springer Senior Vice President of Healthcare Solutions
Jeff Springer is the SVP of Healthcare Solutions at CitiusTech where he leads the product management and product strategy. Jeff has 25 years of experience with the last 20+ years in healthcare building products for payers and providers. Prior to joining CitiusTech, Jeff led the analytics division at Siemens healthcare, lead product management and product strategy at MEDecision and ran a business unit at McKesson where he developed new products working with payers and providers. Jeff has an MBA from Wharton where he graduated as a Palmer scholar (top 5% of his class) and a Bachelor of Science from Northwestern with a Mechanical Engineering degree.
Certified Speaking Professional, Jeff Tobe’s credentials are impressive. Insider Magazine dubbed him “The Guru of Creativity” and readers of Convention & Meetings Magazine chose him as one of their favorite speakers along with other celebrities including Bill Clinton, Anderson Cooper, Condoleezza Rice and Daniel Pink. He is a creativity and customer experience expert, professional speaker and bestselling author who works with companies and organizations who want to increase their bottom line by changing their customer experience and retaining great talent.
After having started and sold three successful businesses, Tobe founded Coloring Outside the Linesin 1994 and since then has worked with hundreds of clients ranging from ones with less than 20 employees to Fortune 500 companies including Microsoft, PepsiCo, Bank of America, ReMax International and many more!
Jeff Tobe’s most requested programs focus on CREATIVITY/INNOVATION, CUSTOMER EXPERIENCE and EMPLOYEE ENGAGEMENT. His high-energy, high-fun and high-content programs create the ideal presentation for any kind of corporate or educational forum.
His articles have been read in hundreds of publications and he is the author of the hugely popular book, Coloring Outside The Lines. He is the co-author of three other books and his newest book, ANTICIPATE: Knowing What Customers Need Before They Do is quickly becoming one of the hottest business books on the market. He is also the creator of the Touch Point Focus initiative in which he helps clients re-examine their customer touch points
Adele Towers, MD, MPH, FACP Director of Risk Adjustment
Dr. Towers is the Director of Risk Adjustment for UPMC Enterprises, and is also a geriatrician on the faculty at the University of Pittsburgh. At UPMC Enterprises, she is directly involved in the development of healthcare related technology, with emphasis on use of Natural Language Processing (NLP) for Risk Adjustment coding and use of Clinical Analytics to optimize clinical performance. Prior to this role, she has served as the Medical Director for Health Information Management at UPMC with responsibility for Clinical Documentation Improvement as well as inpatient coding denials and appeals. She has been on the faculty in the Division of Geriatric Medicine at the University of Pittsburgh for over 25 years, and continues to see patients at the Benedum Geriatric Center in UPMC. She is the former Medical Staff President at UPMC Presbyterian, and her prior positions have been as Vice Chair for Quality Improvement and Patient Safety for the Department of Medicine, Medical Director of UPMC Home Health, Medical Director of the Benedum Geriatric Center and Medical Director of Primary Care at the Western Psychiatric Institute and Clinic. Dr. Towers has presented the experience at UPMC with use of NLP and Clinical Analytics at multiple regional and national conferences.
Daniel Weaver VP Stars, Quality, & Risk Adjustment
Gateway Health Plan
Daniel Weaver is an established leader with extensive experience developing and implementing intervention strategies to improve Medicare Stars performance. With demonstrated success through innovative programs, Daniel led a Stars Quality team at Highmark for 6 years where they consistently delivered market-leading performance and forward-thinking engagement with providers and members. Daniel moved to Gateway Health Plan to help an underperforming DSNP plan achieve 4 Stars, boost Quality Improvement performance across multiple State pay for performance programs, and expand Risk Adjustment programs.
Cynthia Weiss Director of Quality, Accreditation and Wellness
Cynthia (Cindy) Weiss is a registered nurse with decades of experience in the health care field. As the Director of Quality, Accreditation and Wellness, Cindy has been able to leverage both her knowledge and experience related to quality improvement and her knowledge related to wellness and behavior change to create a successful member engagement program tied to quality improvement and preventive health. Prior to working at AvMed, Cindy held management and senior-level positions at Jackson Health Systems, both within their health plan and within their hospital system.
Mark Wendling, MD
Valley Preferred/Lehigh Valley Physician Hospital Organization
Deb Zeh Sr. Director, Quality Improvement, Provider Performance
Deb Zeh is the Senior Director of Quality Provider Performance at the UPMC Health Plan in Pittsburgh, Pennsylvania. Deb has over 18 years’ experience in the health care insurance industry accompanied by her many years of clinical nursing experience. Her current role includes developing and implementing quality initiatives to support the Physician Pay for Performance Quality Programs. A key role is leading multiple teams which provide education and support to the Network Providers and office staff surrounding Quality Initiatives which are inclusive of the CMS Stars and HEDIS measures.
Deb’s insurance experience includes quality improvement, quality auditing, fraud and abuse investigations, clinical account management, provider relations with a lead role in supporting the Physician Network in the Regional Extension Center Initiative and extensive experience in all aspects of HEDIS operations.