Reducing Hospital Readmission Rates: Strategies for Health Plans and Health Systems

Speakers

PAGE BABBIT is director of provider engagement, performance and partnerships at Highmark, Inc., where she is accountable for advancing the development of strategic design and deployment of new health care delivery strategies, including patient-centered medical homes, accountable care organizations (ACOs) and fee-for-value programs, which contribute to provider transformation. She is responsible for the execution of major business initiatives and health services strategies, focusing primarily on identifying and developing optimal provider partnership opportunities. Ms. Babbit previously was director of clinical informatics and process improvement at The Western Pennsylvania Hospital, where she directed operations for process improvement, infection control and the patient and family education center.

NICK GETTAS, M.D., is chief medical officer of regional accounts at Cigna Corp., where his responsibilities span sales, quality and provider networks, including collaborative accountable care relationships and total medical cost management. Dr. Gettas is a board-certified family physician and a cum laude graduate of the University of Toronto, Faculty of Medicine, with many years of clinical, teaching and administrative experience. He joined Cigna in 1998. His responsibilities within Cigna have spanned Medicare and commercial populations, insured and self-insured products, and national and regional accounts clients.

GUY D’ANDREA is president and founder of Discern, LLC. Since starting the consulting firm in 2004, Mr. D’Andrea has worked with leading health care organizations nationwide — including The Leapfrog Group, Bridges to Excellence and the National Business Coalition on Health — to design, implement and evaluate pay-for-performance and value-based purchasing strategies. He specializes in assessing the return on investment from these programs and has built ROI models for several clients. Prior to launching Discern, Mr. D’Andrea spent seven years as vice president at URAC, where he was responsible for the development of the firm’s accreditation programs, including quality standards for PPOs, utilization management organizations, case management organizations and consumer-directed health care. Prior to URAC, he spent five years working on managed care regulatory and policy issues with the American Association of Health Plans (now AHIP) and the Maryland Association of HMOs.

DOREEN SALEK, R.N., is director of population management partners for Geisinger Health Plan where she is responsible for leading the Beacon Community Case Management program. She has worked at Geisinger for 15 years, including service as a registered nurse in the Adult Intensive Care Unit, as well as experience in hospital and professional billing and coding, project management, and medical management. In her current role she is focused on transitions of care across the continuum, as well as strategies around enhancing quality and reducing readmissions, as well as innovations, such as telemonitoring. Ms. Salek earned her Bachelor of Science from Colorado State University and her nursing diploma from the Geisinger School of Nursing. She holds certifications as a Certified Coding Specialist and Certified Professional Coder.

Moderator: Steve Davis, managing editor of AIS's Health Plan Week and Inside Health Insurance Exchanges

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