Medicare Star Ratings: An Integrated Approach to Improving Medication Adherence Measures

Speakers

DAVID LASSEN, Pharm.D., is chief clinical officer at Prime Therapeutics LLC, where he has oversight of the Minnesota-based PBM’s clinical services and support for its Blue Cross and Blue Shield plan partners. David leads the formulary development, utilization management and clinical program development teams at Prime. His role includes the clinical vision, oversight and strategy development for total health management integration with Prime’s Blues plan partners for the commercial, government programs and emerging individual market segments. During David’s tenure at Prime, he has held various leadership roles on both the client account side of the organization as well as being instrumental in the development of Prime’s utilization management program — including the Clinical Prior Authorization Department, delegation oversight and NCQA/URAC accreditation activities. Prior to joining Prime in 1998, David provided clinical consultation for PharMerica, a national long-term care pharmaceutical company. There, he was responsible for developing and implementing the company’s Medicare Part A Prospective Payment System. This initiative focused on managing appropriate utilization of cost-effective drug therapy to reduce prescription costs for regional long-term care facilities. David holds a B.S. degree in biology from Bethel College in St. Paul, and B.S. and Pharm.D. degrees from the University of Minnesota.

CYNTHIA GRIFFIN, Pharm.D., is senior director of pharmacy government programs at Florida Blue, formerly known as Blue Cross and Blue Shield of Florida, where she is responsible for managing the pharmacy components for the Medicare benefits, maintaining compliance with CMS rules and regulations, and providing oversight and strategic direction for the Medicare Stars program. Cynthia also manages the PBM relationship for the Medicare line of business. Additionally, she collaborates with internal business partners in the senior business unit, corporate compliance, care management, sales, service, network and informatics to support the Medicare pharmacy and Stars operations. Prior to joining Florida Blue in 2006, she served in various other pharmacy-related roles, including pharmacy director for the Duval County Health Department and clinical assistant professor for Florida A&M University. Cynthia has served on numerous boards and committees, including the State Medicaid Physician Prescribing Panel and the American Society of Health Systems Pharmacist Commission on Credentialing, and is currently serving on the Florida State Board of Pharmacy as 2012 chair. Cynthia completed the Executive Leadership Program sponsored by America’s Health Insurance Plans in 2009 and Leadership Jacksonville in 2011. She is a 2009 inductee into the Florida A&M University College of Pharmacy Gallery of Distinction. Cynthia earned a B.S. degree in pharmacy and a Pharm.D. degree from Florida A&M University, completed an Anticoagulation Traineeship program at the Medical College of Virginia, and is a fellow of the American Society of Health Systems Pharmacist.

Moderator: Lauren Flynn Kelly, editor of AIS's Drug Benefit News

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Pharmacy, clinical services and medical directors; strategic planners; product development, contracting and marketing executives; government affairs and compliance directors, and financial and operations executives at

• Health plans
• PBMs and pharmacy benefit administrators
• Pharmaceutical manufacturers
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• Network pharmacies

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