Today’s Challenges For Healthcare Networks and Third Party Payers

Sponsored by: Lehigh University HSE in collaboration with Lehigh Valley Business Coalition on Healthcare

The Healthcare Systems Engineering (HSE) symposium will discuss the rise of mega networks, the challenges they face, and their impact on local communities. Is there any other choice? Will mega networks make healthcare more affordable? Will patient safety and quality be maintained? Also to be discussed how the country will pay for healthcare in the future. How does “pay for value” provider reimbursements lower the growth in health insurance premiums? Local healthcare system CEO’s and a panel of professionals in the healthcare industry will be discussing their thoughts on these topics and answering questions.

Date & Location
Date: May 16, 2017
Time: 2:00 PM to 5:30 PM, 5:30pm to 6:30pm Networking Reception - Beer, Wine and light fare.
Location: Wood Dining Room, Iacocca Hall
Lehigh's Mountaintop Campus - Directions

Cost: Free

*For planning purposes, we ask that you complete this registration by May 10, 2017.

The Lehigh Valley Business Coalition on Healthcare (LVBCH) is a recognized leader in providing access to high quality affordable healthcare.  For over 35 years, LVBCH has been the employers’ voice on value –based healthcare issues in eastern and central Pennsylvania.

A barrier to achieving healthcare value has been the lack of credible information about the cost and quality of care.  Transparency in health care is the exception rather than the rule.  Healthcare cost trends remain more than twice the Consumer Price Index.  Cost and quality data varies greatly and is difficult for consumers to track down.  The Coalition has further expanded its role in collecting and analyzing healthcare and quality with its own employer data analytics initiative.

LVBCH is a member of the Leapfrog Group and is designated a Regional Rollout Organization for the Annual Hospital quality survey which provides critical information to consumers, employers and other purchasers of healthcare throughout the region.

In partnership with the National Business Coalition on Health, LVBCH conducts an evaluation of health plans and pharmacy benefit managers in the region utilizing NBCH’s “eValue8” tool to heighten the focus on quality and effective management of employers’ healthcare dollars.

With more than 30 years of experience in human resources and employee benefits, Croyle is a graduate of Pennsylvania State University and holds an M. A. in human resources management from St. Francis University.

Ana joined the Healthcare Systems Engineering team as a Director and Professor of Practice in 2015. She brings 5 years of experience in product development, analytics, IT and consulting in the healthcare space, spanning patient, provider, and payer areas. She worked with a number of startups in the Lehigh Valley while a student and then a Teaching Assistant in the Integrated Business and Engineering Honors program, as well as on a data mining project for Bayada Home Health. Following her graduation, she joined a boutique IT consulting firm in New York, Netsoft, where her responsibilities included product management, business process re-engineering, requirements definition and business and systems analysis. Her company was later acquired by EPAM Systems, a global provider of software engineering and IT product development services, and Ana transitioned into EPAM’s Healthcare Business Unit. 

Ana earned her Bachelor of Science degree in Integrated Business and Engineering from Lehigh University, and subsequently completed the Master of Science in Industrial and Systems Engineering also at Lehigh University.

Tom has nearly 25 years of experience in the Healthcare Industry. He has worked in healthcare administration, reinsurance, sales, marketing and consulting during that time.  Emerson, Reid & Company the largest group health insurance General Agency in the Northeastern US. Tom works with health insurance agents in Eastern Pennsylvania as a liaison between agents and health insurance carriers.

Tom has served on the Healthcare Legislative Committee of the Greater Lehigh Valley Chamber of Commerce for over twelve years, and served as the Chair for more five of those years. He also served as a member of the Chamber’s Public Policy Committee and Board of Governors for five years.

Tom is a frequent moderator, panelist and speaker at workshops, seminars and other forums relating to healthcare issues.

Brian Nester, DO, was named President and CEO of Lehigh Valley Health Network (LVHN) on November 5, 2014, after serving as the acting president and CEO of LVHN since July 1, 2014.  LVHN is a comprehensive, integrated health network that includes three full-service licensed hospitals with five campuses, a Children’s Hospital, an employed physician group with nearly 1,000 providers, and 11 outpatient health centers. LVHN is its region’s largest employer with more than 13,000 employees.

Dr. Nester had been the chief strategy officer (CSO) at LVHN since 2011. In that role he aligned LVHN’s business development assets with evolving population health management competencies and insurance sophistication in the creation of new partnerships and structures that will facilitate LVHN’s transformation into an accountable care organization.
Dr. Nester came to LVHN in 1998 from an academic post in emergency medicine at Albert Einstein Medical Center in Philadelphia. In addition to CSO, he has served at LVHN as associate vice chair, department of emergency medicine as both the research director and the director of the Lehigh Valley Hospital (LVH)-Muhlenberg emergency department; and as senior vice president for physician hospital network development.

Dr. Nester is a member of the Hospital and Healthsystem Association of Pennsylvania Board, the American Hospital Association Regional Policy Board, and the Healthcare and Pharmaceutical Management Program Advisory Board at Columbia University. He speaks nationally and is published on issues related to physician integration and business development, and has been a guest lecturer at Columbia University’s Graduate School of Business and Mailman School of Public Health on issues related to health care reform and strategy for more than a decade.

He received his DO and MS degrees from the Philadelphia College of Osteopathic Medicine and his MBA from Columbia University in New York, and he is a certified physician executive (CPE) through the American College of Physician Executives.
LVHN is recognized for numerous national honors, including Magnet status for nursing. It has been ranked as a U.S. News & World Report “Best Hospital” for 20 consecutive years, most recently in 2015 in seven care areas. In 2012, LVHN received accreditation from The Joint Commission as the first hospital in Pennsylvania and one of the first three in the United States to be officially certified as a Comprehensive Stroke Center. LVHN also ranks among the nation’s top hospitals for quality and patient safety (The Leapfrog Group).

Rick Anderson has served as President and Chief Executive Officer of St. Luke’s University Health Network in Bethlehem, PA, since 1985. During that time, he has overseen St. Luke’s evolution into a $1.5 billion health care network in the Lehigh Valley region of Pennsylvania and Western New Jersey. St. Luke’s operates seven hospitals and provides outpatient services at almost 300 locations. With more than 10,000 employees, St. Luke’s is the second largest employer in the Lehigh Valley.
During Mr. Anderson’s tenure, St. Luke’s has received more than 130 national awards for quality – including the coveted 100 Top Hospitals Award™ from Truven Health Analytics® in the Major Teaching Hospital category in 2015, 2016  and 2017 – and has been recognized numerous times by Truven among the country’s top cardiovascular hospitals, most recently in 2014. St. Luke’s Quakertown Campus also was recognized as a 2016 100 Top Hospital in the Small Community Hospital category.
St. Luke’s University Hospital in Bethlehem, PA is a Level 1 Trauma Center, a respected major teaching hospital and the Lehigh Valley’s first and only regional medical school campus – created through a partnership with The Temple University School of Medicine.  St. Luke’s is also one of a select group of international training show sites for GE Healthcare.

Mr. Anderson played a major role in the establishment and development of The Bethlehem Partnership for a Healthy Community – an award-winning, national model of 200 partners working to improve the community’s health status.
Mr. Anderson is a member of the Temple University School of Medicine Board of Visitors and the Lehigh Valley Partnership Board of Directors.

Mr. Anderson earned a Master of Public Health in Hospital Administration at the University of Pittsburgh, and completed undergraduate work at the University of Illinois, and in 2011 was named a Distinguished Alumnus and also received the George Huff Certificate of Award for Proficiency in Athletics and Scholarship. He has been named by Becker’s Hospital Review for the last several years as one of the nation’s “100 Non-Profit Hospital, Health Systems CEOs to Know” and he is the longest-tenured health care CEO in Pennsylvania.

Anne Baum is the vice president, Lehigh Valley for Capital BlueCross, the leading health insurer in Central Pennsylvania and the Lehigh Valley. In this capacity, she is the senior leader in the Capital BlueCross Lehigh Valley office. She has over 30 years of experience in healthcare, health insurance, consulting and leadership/culture development.

Anne is a member of the board and executive committee of the Greater Lehigh Valley Chamber of Commerce, Girl Scouts of Eastern PA (First Vice Chair), Northampton Community College Foundation and Lehigh Northampton Airport Authority. She is the immediate past chair of the Greater Lehigh Valley Chamber Foundation.  Anne also serves on the Lehigh University Health Systems Engineering Industry Advisory Board, the Downtown Allentown Community Development Initiative, and the Executive Committee for Building 21.

Anne has been featured by the EPBJ as a Community Spotlight Award winner and a Top 20 Executive under 40.  In 2005, Anne was selected as a Top 50 Woman in Business by the PA DCED and in 2006, she received the President’s Award from The Chamber. She received the Lehigh Valley SUITS award in 2009 and was selected by the Leukemia and Lymphoma Society as Woman of the Year in 2010. Anne received the Girl Scout’s Take the Lead Award and the Chamber Women’s Business Council ATHENA Award in 2013.  In 2015, she was named as a Woman of Influence by Lehigh Valley Business.

A native of Glenview, Illinois, Anne holds a BS in Biology from the University of Illinois, Champaign-Urbana, IL and MS in Health Systems Management from Rush University, Chicago, IL. She is certified by the Protocol School of Washington as a protocol and etiquette consultant. Anne resides in Lower Saucon Township with her husband and two children.

Joyjit served health payers, providers,  and other health services clients over 17+ years at Strategy&.  He has served clients in US, Europe and Asia.  He is the leader of our “Medical Value” service offerings across provider network management, medical management, pharmacy and informatics; Other areas of expertise include: advised payors and providers on new care delivery and payment models to enable better medical value; led engagements to help health plans monetize and fortify networks, and better influence providers; leader in our Government Center of Excellence, focused on Medicare/Medicaid health plans; authored thought pieces on transforming healthcare delivery, provider payment and informatics.

His prior experience is at Unilever, India and he was a Graduate Engineer at Tata Motors, India.  His education is BS, Indian Institute of Technology (IIT), Kharagpur as well as MBA, Indian Institute of Management (IIM), Ahmedabad

Bob Laszewski is a well-known and highly regarded expert on health care policy from Washington, DC.  He combines a unique blend of 20 years of "inside the Beltway" experience with 20 years of operational experience having run a health insurance business.  He has offered his perspective on health care reform in testimony before several committees of both the House and Senate of the U.S. Congress.  Bob has written and spoken widely on the subject of health care reform and market change.  His media appearances include health care features on NBC, CBS, Fox, CNN, MSNBC, PBS, and NPR.  Additionally, numerous articles about his ideas have appeared in the national and trade press and he has been regularly quoted in many newspapers including The Wall Street Journal, New York Times, USA Today and the Washington Post.  Bob also publishes Health Policy and Marketplace Review, a blog focused on health care policy and marketplace activities.

Donna Sabol
Vice President & Chief Quality Officer
St. Luke's University Health Network

Ms. Sabol’s responsibilities include successful integration and performance of the network performance improvement structure and activities inclusive of medical staff PI functions; development of strategies to improve clinical, service and financial outcomes; staff and management PI education; establishment of accurate data measurement and analysis. 

She provides leadership to the Board, senior operations team, medical staff and nursing to design and implement operational strategies to achieve organizational strategic objectives.

Ms. Sabol has held a variety of management and administrative positions in her 35 years of health care experience.

Currently,  she has direct responsibility for management of the following network functions:  Quality Resources and Performance Improvement, Infection Prevention,  Data Abstraction, Clinical Risk Management, Patient Safety, Clinical Documentation Improvement, Coding, Clinical Trials and Research, and  Care Management.  Ms. Sabol also functions as a project manager for key organizational projects.

Under Ms. Sabol’s leadership, St. Luke’s has achieved a number of national and state awards as well as significant financial awards in national pay-for-performance initiatives and quality awards programs.

SCHEDULE

•    2:00pm: Registration

•    2:15pm: Welcome Ana Alexandrescu, Director Healthcare Systems Engineering, Lehigh University and Tom Croyle, President, LVBCH

•    2:30pm: Panel #1 “The Rise of Mega Networks"

                   Panelists - Brian Nester
                                    Rick Anderson

•    4:00pm: Break 

•    4:15pm: Panel #2 “How will we pay for Healthcare?"

•    5:30pm: Closing Remarks Ana Alexandrescu, Director Healthcare Systems Engineering program, Lehigh University

•  5:30pm to 6:30pm Networking Reception - Beer, Wine and light fare.

Any questions, please contact:

Linda Wismer, Program Coordinator
Healthcare Systems Engineering
610-758-5867
liw511@lehigh.edu