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Last-Minute Gaps in Care Strategies

Last-Minute Gaps in Care Strategies

Chad Baugh

Chief Strategy Officer,
ReferWell

As ReferWell’s Chief Strategy Officer, Chad Baugh oversees all revenue-generating activities for the company, including sales, marketing, product pricing and customer strategy. His more than 20-year career in health care includes, most recently, revenue management at Teladoc Health, where he delivered triple digit revenue growth within the large and midsize health plan market segment.

Chad served as general manager, complex case management, for Best Doctors prior to Teladoc Health’s acquisition of the company in 2017. At Best Doctors, he had P&L responsibility including product design, sales, account management, finance, legal and operations. He has served in leadership roles at Edifecs, Allscripts, dbMotion and GE Healthcare.

Chad earned a Bachelor of Science in Computer Science from the University of Phoenix and an MBA in Strategy, Finance and Entrepreneurship from the University of Chicago Booth School of Business.

He is a Veteran of the United States Marine Corps.

Vandna Bhrany, MPH

Vice President, HEDIS Strategy & Analytics,
AmeriHealth Caritas

In her role, Vandna leverages her experience in quality and risk adjustment operations to support members and providers regarding performance reporting and the member and provider experience.  Her area of influence spans analytics, plan operations and digital integration of data and processes in the transition to interoperability.

Before AmeriHealth, Vandna 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.

Marsha Barlocker, RN, BSN, MS

Senior Director, Quality & Case Management,
HealthTeam Advantage

As the Director of Quality, Marsha is responsible for the overall Medicare Advantage STARS program at HealthTeam Advantage, focusing on the quality of care for our members, patient experience, and health outcomes. She brings over 27 years of clinical nursing experience in a wide range of medical settings—18 years of medical management and supervisory experience focusing on consumer-oriented leadership and 12 years of Medicare Programs experience. Marsha has both a BS and an MS in nursing.

In addition, she has numerous certifications, including Certified Professional Coder (CPC), National Association for Healthcare Quality (CPHQ) and, most interestingly, National Aquatic Fitness Certification.

Marsha began her Medicare career in 2004 as a Case Manager/Prior Authorization Auditor with Altius Health Plan. In 2012, she started with Humana, Inc., and moved up in the ranks to the Lead Stars Quality Medicare Advantage and Part D Programs. Most recently, she was the Director of Quality Improvement and Patient Education for Cucamonga Valley Medical Group. She has been viewed as an expert in Nursing Quality Core Measures and NCQA National Standards of Care and is well versed in CMS Star Ratings, HEDIS, Acumen Patient Safety, CAHPS/HOS, Medicare Advantage and Part D programs.

Frank Izquierdo

Senior Vice President Provider Solutions and
Strategic Alliances, AvMed

For over thirty years, Frank successfully worked in medical management and operations as an executive, entrepreneur, and consultant throughout the state of Florida.

In his current role, he is accountable for setting enterprise-wide strategic direction and tactical leadership for provider contracting, network development, and provider relations.

Prior to joining AvMed, he was Corporate Vice President of InnovaCare Health, where he developed a risk-based strategy and innovative financial models resulting in the successful launch of a Medicare Advantage expansion market in South Florida.

As a consultant, Mr. Izquierdo successfully launched a management services organization (MSO) created to manage a risk arrangement between a Medicare Advantage health maintenance organization (HMO) and a multispecialty physician group in Southeast Florida. He has also consulted various entities on matters of healthcare contracting, strategic negotiations, healthcare delivery structure design and financial analyses.

From 2009 to 2012, he was president of Health Revenue Recovery, LLC (HRR), which was a consulting and auditing firm specializing in business development and hospital revenue cycle management. HRR specialized in zero-balance audits of managed care accounts and their respective recoveries. HRR acquired a large hospital account and created its own proprietary software to facilitate the audit process within its first year of operation.

From 2005 to 2009, he was Vice President of Network Operations for VISTA, a Coventry Healthcare plan in Florida. In that position, Frank was responsible for a statewide budget of over $200 million. At VISTA, he was also responsible for the negotiation and maintenance of 88 contractual relationships between the managed care plan and its contracted hospitals. His leadership was, in no small way, responsible for the turnaround of the Vista Health Plan.

He holds a Bachelor of Science in Liberal Arts & Sciences with a specialization in Statistics from the University of Florida, 1989.

Last-Minute Gaps in Care Strategies

If your plan is struggling to meet performance and quality goals for 2023, there’s still plenty of time to turn things around and ensure members get the preventative care they need while raising your plan’s quality scores by closing care gaps across the healthcare ecosystem.

Annually, gaps in care cost the U.S. healthcare system a staggering amount of time and money. In the complex world of healthcare management and care coordination, closing gaps in care is critical to improving health outcomes and reduce costs. In addition, improving quality metrics directly correlates to identifying and addressing care gaps.

Our expert panel will share strategies health plans can use to understand gaps in care throughout the member journey. Hear how plans leverage data and real-time analytics to effectively and efficiently close time-sensitive care gaps to improve HEDIS, Stars and other quality scores.

Topics include:

  • Create actionable quality programs to eliminate barriers to care
  • Capture and exchange new data sources to close time-sensitive care gaps
  • Ensure better care collaboration between providers and health plans
  • Enhance follow-up care to boost member engagement

 

Chad Baugh

Chief Strategy Officer,
ReferWell

Vandna Bhrany, MPH

Vice President, HEDIS Strategy & Analytics,
AmeriHealth Caritas

Marsha Barlocker, RN, BSN, MS

Senior Director, Quality & Case Management,
HealthTeam Advantage

Frank Izquierdo

Senior Vice President Provider Solutions and
Strategic Alliances, AvMed

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