Faculty Index

Peter B. Bach, MD, MAPP

Director, Center for Health

Policy and Outcomes

Memorial Sloan-Kettering Cancer Center

Dr Bach’s main research interests cover healthcare policy, particularly as it relatesto Medicare, racial disparities in cancer care quality, and lung cancer epidemiology. A former senior adviser to the administrator of the Centers for Medicare & Medicaid Services (CMS), he serves on several national committees, including the Institute of Medicine’s National Cancer Policy Forum and the Committee on Performance Measurement of the National Committee on Quality Assurance. He chairs the Technical Expert Panel that is developing measures of cancer care quality for CMS.

See pages SP70, SP71

www.ajmc.com/ajmc-tv/live/pcoc13/Bach

Ethan Basch, MD

Director of Cancer Outcomes Research

University of North Carolina Chapel Hill

Dr Basch is a practicing oncologist and director of the Cancer Outcomes Research Program at the University of North Carolina in Chapel Hill. His research focuses on patient-reported outcomes in clinical trials, comparative effectiveness, and quality-of care assessments. He is a member of the Methodology Committee of the Patient-Centered Outcomes Research Institute (PCORI), a member of the Board of Scientific Advisors of the National Cancer Institute, chairs the Health Outcomes Committee of the Alliance for Clinical Trials in Oncology, and serves on the Board of Directors of the International Society for Quality of Life Research.

See page SP75, SP76

www.ajmc.com/ajmc-tv/live/pcoc13/Basch

Jan Berger, MD, MJ

President, CEO

Health Intelligence Partners

Dr Berger founded Health Intelligence Partners 6 years ago as a healthcare consultancy that blends more than 25 years of both business and clinical experience. Prior to founding Health Intelligence Partners, Dr Berger served as senior vice president and chief clinical officer for CVS Caremark. She presently sits on the boards of Care Core National (committees: finance, compensation, search, mergers & acquisitions, and strategic directions), Meals to Heal, The University of Arizona School of Pharmacy, RxAnte, and Midwest Business Group on Health. Dr Berger is the editor-in-chief of The American Journal of Pharmacy Benefits.

See pages SP87

www.ajmc.com/ajmc-tv/live/pcoc13/Discussion5

Amy Berman, BS, RN

Senior Program Officer

The John A. Hartford Foundation

Berman is a senior program officer with the John A. Hartford Foundation. She heads the Foundation’s development and dissemination of innovative, costeffective models of care that improve health outcomes for older adults. She works to advance palliative care and to reduce avoidable readmissions. Berman also works on collaborations with federal partners, including the Centers for Medicare & Medicaid Innovation, the Office of the National Coordinator for Health Information Technology, and the Administration for Community Living. She has openly shared her experiences living with stage IV breast cancer, presenting to the Institute on Medicine.

See pages SP69, SP70, SP71, SP75, SP85, SP88

www.ajmc.com/ajmc-tv/live/pcoc13/

Keynote

Michael E. Chernew, PhD

Co-Editor-in-Chief

The American Journal of Managed Care

Dr Chernew is the Leonard D. Schaeffer Professor of Health Care Policy at Harvard Medical School. His research activities focus on several areas, most notably the causes and consequences of growth in healthcare expenditures, geographic variation in medical spending, and use of Value-Based Insurance Design. Dr Chernew is vice chair of the Medicare Payment Advisory Commission, an independent agency established to advise the US Congress on issues affecting the Medicare program. He is also a member of the Congressional Budget Office’s Panel of Health Advisors. In 2010, Dr Chernew was elected to the Institute of Medicine of the National Academy of Sciences; he served on the Committee on the Determination of Essential Health Benefits.

See pages SP91, SP92

www.ajmc.com/ajmc-tv/live/pcoc13/

Discussion7

Jerry Conway

VP of Reimbursement & Payer Strategy

Foundation Medicine, Inc

Conway joined Foundation Medicine Inc in May 2012 with over 22 years of sales and executive management experience in the routine clinical and esoteric laboratory marketplaces. His experience includes payer contracting and reimbursement in a wide range of business environments, including Fortune 500 and start-up companies. He has previously worked for Metamark Genetics Inc, a national provider of cancer prognostic tests and services, as vice president of reimbursement and payer contracting.

See pages SP88, SP90

www.ajmc.com/ajmc-tv/live/pcoc13/Conway

Jeffrey D. Dunn, PharmD, MBA

Senior Vice President

VRx Pharmacy

Dr Dunn is senior vice president at VRx, an integrated pharmacy services management company. VRx incorporates PBM functions, pharmacy & therapeutics (P&T)/formulary management, medication therapy management (MTM)/integrated care management (ICM), and government functions for commercial and Medicare Part D employer groups and health plans. Dr Dunn is a board member at VRx and oversees all clinical responsibilities. He manages the P&T process and formularies for commercial and Medicare Part D, as well as all MTM/ICM activities. He is an active member of the Academy of Managed Care Pharmacy, the American Society of Health-System Pharmacists, and the Utah Pharmaceutical Association. He is a reviewer for the Journal of Managed Care Pharmacy and Managed Care Interface, an editor for the International Scholarly Research Network and Oncology Business News, and sits on the editorial board of The American Journal of Managed Care.

See pages SP91, SP92

www.ajmc.com/ajmc-tv/live/pcoc13/

Discussion7

Kirby Eng, RPh

Director, Oncology Medical Pharmacy Management

CVS Caremark

Eng is responsible for the development and implementation of oncology specialty drug management strategies for CVS Caremark health plan and employer clients. He has more than 16 years of broad oncology experience in specialty pharmacy, manufacturing, sales and market strategic planning, group purchasing, oncology drug distribution, and provider network management. Before CVS Caremark, he held positions with CuraScript Specialty Pharmacy, US Oncology, Oncology Therapeutics Network (McKesson Specialty), Sicor (Teva), and Eli Lilly and Co. He has been an active participant on National Comprehensive Cancer Network task forces involving oral chemotherapy, specialty pharmacy, and risk evaluation and mitigation strategies.

See pages SP91, SP92

www.ajmc.com/ajmc-tv/live/pcoc13/Discussion7

Bruce A. Feinberg, DO

Vice President and Chief Medical Officer

Cardinal Health Specialty Solutions, Clinical Pathways

Dr Feinberg is a leading oncologist recognized for his expertise in oncology and the business of specialty healthcare. He serves as vice president and chief medical officer for the Clinical Pathways business of Cardinal Health Specialty Solutions. Prior to joining the Cardinal Health team, Dr Feinberg was instrumental in establishing Georgia Cancer Specialists (GCS), the largest and first integrated oncologic specialty practice in the southeast. As CEO and president of GCS, he expanded community access to oncology care by bringing the latest cancer treatments, technologies, and clinical trials closer to the patient. In 2012, Specialty Solutions launched PathWareTM Decision Transaction Solutions, a software technology that Dr Feinberg was instrumental in designing, to improve the work flow process for payers and physicians. He is the author of the best-selling Breast Cancer Answers and its follow-up book, Colon Cancer Answers.

See page SP85, SP86

www.ajmc.com/ajmc-tv/live/pcoc13/Feinberg

A. Mark Fendrick, MD

Professor, Division of General Medicine, Department of Internal Medicine and Department of Health Management and Policy

University of Michigan

Dr Fendrick is a professor of internal medicine in the School of Medicine and a professor of health management and policy in the School of Public Health at the University of Michigan. He currently directs the Center for Value-Based Insurance Design at the University of Michigan, the leading advocate for development, implementation, and evaluation of innovative health benefit plans. Dr Fendrick’s research focuses on the clinical and economic assessment of medical interventions, with special attention to how technological innovation influences clinical practice, benefit design, and healthcare systems. He is the co-editor-in-chief of The American Journal of Managed Care.

See pages SP76

www.ajmc.com/ajmc-tv/live/pcoc13/Discussion2

John L. Fox, MD, MHA

Senior Medical Director, and Associate Vice President,

Medical Affairs

Priority Health

Dr Fox is the senior medical director and associate vice president of medical affairs for Priority Health, a provider-sponsored health plan with 640,000 members. He is responsible for technology assessment (medical and pharmaceutical) and utilization and case management. He is engaged in new program development including physician profiling, pay-for-performance programs, integrated specialty pharmacy, and value-based benefit designs. He is currently involved in development of payment reform strategies, including the oncology medical home.

See pages SP76, SP88, SP90, SP92

www.ajmc.com/ajmc-tv/live/pcoc13/Discussion8

Bo Gamble

Director of Strategic Practice Initiatives

Community Oncology Alliance

Gamble joined Community Oncology Alliance in May 2011 as the director of strategic practice initiatives. He has a diverse range of cancer and other healthcare experience at the national and

local levels. His experience includes serving 13 years as administrator of a multiphysician, multi-location oncology practice in eastern North Carolina. In his other 17 years of healthcare experience, he has served as an independent consultant for hospital patient accounting and IT implementation

projects, national director of client support for a healthcare software company, and business office manager for a 300+ bed hospital. He has served as the president and legislative chairperson

for the North Carolina oncology practice management society, a member of the COA Board of Directors, and the co-chair of the national COA Administrators’ Network.

See page SP92

www.ajmc.com/ajmc-tv/live/pcoc13/Discussion8

Cliff Goodman, PhD

Senior Vice President & Principal

The Lewin Group

Dr Goodman is senior vice president and principal at The Lewin Group, a healthcare policy and human services consulting firm based in Falls Church, Virginia. He has 30 years of experience in such areas as health technology assessment, evidence-based healthcare, comparative effectiveness research, health economics, and studies pertaining to healthcare innovations, regulation, and payment. He directs studies and projects for an international range of government agencies; pharmaceutical, biotechnology, and medical device companies; healthcare provider institutions; and professional, industry, and patient advocacy groups. Dr Goodman served as chair of the Medicare Evidence Development & Coverage Advisory Committee for the Centers for Medicare & Medicaid Services (2009-2012). He is president of the professional society, Health Technology Assessment International, and is a fellow of the American Institute for Medical and Biological Engineering.

See pages SP71, SP75, SP76, SP91, SP92

www.ajmc.com/ajmc-tv/live/pcoc13/Discussion1

Ira M. Klein, MD, MBA, FACP

Chief of Staff, Office of the Chief Medical Officer

Aetna, Inc

Dr Klein is a national medical director in the Office of the Chief Medical Officer, holding the position of clinical thought leadership, responsible for core program development across the enterprise. He recently transitioned from his previous role of almost 2 years as chief of staff to the chief medical officer at Aetna, having been in this role since 2011, and remains as part

of the team responsible for communicating and deploying the strategic efforts of the CMO in multiple areas, including leveraging of business acquisitions, clinical integration, and clinical program development.

See pages SP76, SP77, SP87, SP88, SP90

www.ajmc.com/ajmc-tv/live/pcoc13/Discussion2

Michael A. Kolodjiez, MD

National Medical Director,

Oncology Strategies

Aetna, Inc

Dr Kolodjiez is the national medical director, oncology solutions, Office of the Chief Medical Officer, Aetna. He joined New York Oncology in the winter of 1998, and was a partner in the practice until December 2012. He was an active member of the US Oncology Pharmacy and Therapeutics committee, on the executive committee from 2002 to 2011, and chairman from 2004 to 2011. He served as medical director for oncology services for US Oncology from 2007 to 2011. In this role, he helped direct the implementation of the USON clinical pathways initiative, the integration of the USON EMR into this program, and the development of the USON disease management and advanced care planning programs, now known as Innovent Oncology.

See pages SP87, SP88, SP90

www.ajmc.com/ajmc-tv/live/pcoc13/Discussion5

Karen Lewis, MS, MM,CGC

Medical Policy and Technology Administrator

Priority Health

Lewis oversees medical policy development and works with the medical directors for medical necessity review and grievance and appeals cases. She has been involved in many grant projects, including sudden cardiovascular death in the young, genetics education for healthcare providers, and is currently the insurance champion for a collaborative agreement between the Centers

for Disease Control and Prevention and the Michigan Department of Community Health, evaluating cancer genomics best practices. In addition to her genetics activities, Lewis is an adjunct professor at the Michigan State College of Human Medicine in ethics and humanities.

See pages SP86, SP87

www.ajmc.com/ajmc-tv/live/pcoc13/Lewis

Ellen Matloff, MS

Director, Cancer Genetic Counseling

Yale Cancer Center

Matloff is a research scientist in the Department of Genetics and the director of Cancer Genetic Counseling at Yale Cancer Center/Yale School of Medicine in New Haven, Connecticut. She came to Yale in 1995 to start the Cancer Genetic Counseling program, which is now one of the largest in the country. She has received several research grants, has lectured internationally on cancer genetics, and has published extensively on the topic of cancer genetic counseling and testing. Matloff was also a plaintiff in the well-known BRCA patent case against Myriad Genetic Laboratories, in which gene patents were banned by a unanimous Supreme Court decision in June 2013.

See page SP67

Lee N. Newcomer, MD, MHA

Senior Vice President,

Oncology, Genetics and Women’s Health

UnitedHealthcare

At UnitedHealthcare (UHC), Dr Newcomer has strategic responsibility for oncology, genetics, and women’s health. A boardcertified medical oncologist, he began his management career as a medical director for Cigna Health Care of Kansas City in 1990. From 1991 to 2000, Dr Newcomer was the chief medical officer at UHC, where his work emphasized the development of performance measures and incentives to improve clinical care. Dr Newcomer was a founding executive of Vivius, a consumerdirected venture that allowed consumers to create their own personalized health plans. He returned to UHC in 2006 to focus on combining clinical, financial, and administrative incentives for improved and affordable cancer care.

See pages SP77, SP85, SP88, SP90

www.ajmc.com/ajmc-tv/live/pcoc13/Newcomer

Scott D. Ramsey, MD, PhD

Director, Cancer Technology Assessment Group

Fred Hutchinson Cancer Research Center

Dr Ramsey is a general internist and health economist. He is a full member in the Cancer Prevention Program, Public Health Sciences Division at the Fred Hutchinson Cancer Research Center, where he directs the Hutchinson Institute for Cancer Outcomes Research, a multidisciplinary team devoted to clinical and economic evaluations of new and existing cancer prevention, screening, and treatment technologies. In addition, Dr Ramsey is a professor in the School of Medicine, School of Pharmacy, and the Institute for Public Health Genetics at the University of Washington.

See pages SP88, SP90, SP91

www.ajmc.com/ajmc-tv/live/pcoc13/Ramsey

Dennis Scanlon, PhD

Professor of Health Policy and Administration

Pennsylvania State University

Dr Scanlon is a professor of health policy and administration at The Pennsylvania State University, College of Health and Human Development. He serves as principal investigator for the Robert

Wood Johnson Foundation’s Aligning Forces for Quality evaluation and is a consultant on an Agency for Healthcare Research and Quality study, “Assessing a Statewide Multi-Stakeholder Chronic Care Model Implementation.” Scanlon also serves on the editorial boards of several journals.

See pages SP71, SP75, SP77, SP85

www.ajmc.com/ajmc-tv/live/pcoc13/Discussion1

Manasi A. Tirodkar, PhD, MS

Research Scientist

The National Committee for Quality Assurance

Dr Tirodkar is a research scientist at the National Committee for Quality Assurance. With a background in medical anthropology and health services research, she has extensive experience with survey and case study methodology as well as health systems and practice transformation. She has worked on measure development projects spanning different disease conditions and populations (cardiovascular, cancer, geriatrics) and directs projects related to evaluations of the patient-centered medical home and shared decision making. She recently completed directing a mixed-methods AHRQ-funded project on PCMH practice transformation. She recently started a new project to evaluate the impact of patientcentered oncology care in a pilot funded by PCORI.

See pages SP71, SP75

www.ajmc.com/ajmc-tv/live/pcoc13/Discussion1

Phyllis Torda

Vice President, Quality Solutions Group

The National Committee for Quality Assurance

Torda is vice president for the Quality Solutions Group at the National Committee for Quality Assurance (NCQA). In that capacity, she leads NCQA’s efforts to work with federal and state governments and private organizations on quality assessment issues. In her 17 years at NCQA, Torda has led a wide variety of activities related to performance measurement, quality assessment, and reporting. She is the principal investigator for NCQA’s contract with the Centers for Medicare & Medicaid Services (CMS) to develop performance measures for the Medicare population and to evaluate Medicare Special Needs Plans. She has also led NCQA’s activities to develop measures of inpatient psychiatric care and cancer care for CMS and to develop measures for reporting from electronic health records for CMS and the Office of the National Coordinator for Health IT.

See pages SP77, SP85

www.ajmc.com/ajmc-tv/live/pcoc13/Discussion3