Predictive Modeling Summit
Predictive Modeling Summit
Predictive Modeling Summit
Predictive Modeling Summit
Predictive Modeling Summit
Predictive Modeling Summit



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Go to Agenda:
Preconference / Day 1

AGENDA: DAY II
Friday, November 14, 2014
7:30 am Continental Breakfast in the Exhibit Hall

CLOSING PLENARY SESSION
8:15 am

Closing Plenary Session: Welcome and Introductions

Clive Riddle
President, MCOL; Publisher, Predictive Modeling News, Modesto, CA (Co-chair)

    Speaker Bio

    Mr. Riddle is President of MCOL, a leading publisher of health care business information founded in 1995. He has overseen the company's growth from its original on-line membership service to now also include a number of divisions encompassing print and electronic publications, directories and databases, webinar services, B2B social media sites, announcement services, website content, the new rNimble healthcare microconsulting service and more.

    A 30+ year veteran of the health care and managed care industry, Riddle has held a variety of high-level leadership positions including 12 years as Chief Executive Officer of a regional hospital owned managed care organization in California. There he was responsible for developing and overseeing HMO, PPO, insurance, clinic and pharmacy operations, where they developed into a $100 million-a-year business. Prior to that, Mr. Riddle held positions of increasing responsibility for the same hospital system, at both the facility and regional level, where he was charged with the implementation of numerous new programs, facilities and services.

    Riddle's first novel: Dorris Bridge, was released in December 2010 and his second novel The Burning Z was released in 2013. Throughout his career, Mr. Riddle has been an active participant on numerous community and professional boards of directors. He is a native of California, and earned his Bachelor of Arts degree in Business Administration, and Master of Public Administration degree at California State University, Stanislaus.
8:30 am

Session VII: Legal And Ethical Concerns Arising From Using Complex Predictive Analytics In Health Care

I. Glenn Cohen
Professor of Law, Director, Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics, Harvard Law School, Cambridge, MA

    Speaker Bio

    Prof. Cohen is one of the world's leading experts on the intersection of bioethics (sometimes also called "medical ethics") and the law, as well as health law. He also teaches civil procedure. From Seoul to Krakow to Vancouver, Professor Cohen has spoken at legal, medical, and industry conferences around the world and his work has appeared in or been covered on PBS, NPR, ABC, CNN, MSNBC, Mother Jones, the New York Times, the New Republic, the Boston Globe, and several other media venues. He was the youngest professor on the faculty at Harvard Law School (tenured or untenured) both when he joined the faculty in 2008 (at age 29) and when he was tenured as a full professor in 2013 (at age 34). Prof. Cohen's current projects relate to health information technologies, mobile health, reproduction/reproductive technology, research ethics, rationing in law and medicine, health policy, FDA law and to medical tourism -- the travel of patients who are residents of one country, the "home country," to another country, the "destination country," for medical treatment. His past work has included projects on end of life decision-making, FDA regulation and commodification. He is the author of more than 70 articles and chapters and his award-winning work has appeared in leading legal (including the Stanford, Cornell, and Southern California Law Reviews), medical (including the New England Journal of Medicine, JAMA), bioethics (including the American Journal of Bioethics, the Hastings Center Report) and public health (the American Journal of Public Health) journals, as well as Op-Eds in the New York Times and Washington Post. Cohen is the editor of The Globalization of Health Care: Legal and Ethical Issues (Oxford University Press, 2013, the introduction of which is available here), the co-editor of Human Subjects Research Regulation: Perspectives on the Future (MIT Press, 2014, co-edited with Holly Lynch, introduction available here), and the author of Patients with Passports: Medical Tourism, Law, and Ethics (Oxford University Press, 2014), with four other books in progress. Prior to becoming a professor he served as a law clerk to Judge Michael Boudin of the U.S. Court of Appeals for the First Circuit and as a lawyer for U.S. Department of Justice, Civil Division, Appellate Staff, where he handled litigation in the Courts of Appeals and (in conjunction with the Solicitor General's Office) in the U.S. Supreme Court. In his spare time (where he can find any!) he still litigates, most recently having authored an amicus brief in the U.S. Supreme Court for leading gene scientist Eric Lander in Association of Molecular Pathology v. Myriad, concerning whether human genes are patent eligible subject matter, a brief that was extensively discussed by the Justices at oral argument. Cohen was selected as a Radcliffe Institute Fellow for the 2012-2013 year and by the Greenwall Foundation to receive a Faculty Scholar Award in Bioethics. He is currently one of the key co-investigators on a multi-million Football Players Health Study at Harvard which is committed to improving the health of NFL players. He leads the Ethics and Law initiative as part of the multi-million dollar NIH funded Harvard Catalyst | The Harvard Clinical and Translational Science Center program. He is also one of three editors-in-chief of the Journal of Law and the Biosciences, a peer-reviewed journal published by Oxford University Press.
    Presentation Material (Acrobat)
9:15 am

Session VIII: Big Data's Role in Managing Costs and Transforming Care

Alan Krumholz, MD, FAAP, DFACMQ
Vice President, Practice Development, Franciscan Healthcare, La Crosse, WI

    Speaker Bio

    Dr Krumholz has recently retired from the Mayo Clinic Health System (MCHS) for the last fourteen years as VP of Practice Development and Medical Director of Health Tradition Health Plan. He has been the lead physician of many programs to significantly improve the utilization, productivity, and quality outcomes, including the MCHS EMR and the Humedica database projects.

    Prior to joining MCHS, Dr. Krumholz was an associate professor in healthcare informatics at the University of Virginia and served as the Chief Medical Officer for QualChoice of Virginia. In these roles he implemented the use of clinical database reporting, severity adjusting, and trained residents and physicians to interpret their own data. He worked directly with vendors to redesign standard reports for interpretability and ease of use, and re-engineered processes to facilitate a 30% increase in productivity and a 20% decrease in utilization with no increase in staffing.

    Previously, Dr. Krumholz served as a senior Medical Director at Blue Cross-Blue Shield of Massachusetts, managing three Regional Medical Directors and medical management for 800,000 covered lives. He reorganized credentialing and provider profiling and designed BCBSMA's first provider report cards. This yielded the highest provider satisfaction scores in the state while lowering Admits and Days /1000 by 20%. He also served on the original HEDIS reporting design team.

    Earlier in his career, Dr. Krumholz served as a Medical Director for a Hospital PHO, and for MassPro. He was responsible for the design of a Utilization review program for a local hospital, as well as the Maine Medical Foundation, utilizing Wennberg's SAV data. He also was one of the original authors of the Pediatric SI/IS criteria for Interqual. Concomitantly, he was a full time private Pediatric Practitioner for 15 years, and Associate Professor of Pediatrics at University of Massachusetts. While in practice, he also invested to maximize the efficiency of his staff with automated systems as early as 1982.

    Dr. Krumholz is an accomplished speaker at many conferences and academic centers. He has published articles and training materials on Utilization, quality management, physician profiling and physician empowerment. He is a Distinguished Fellow and Past President of the American College of Medical Quality and a Fellow of the American Academy of Pediatrics. He is Board Certified in Pediatrics and Quality Assurance and Utilization Review. Dr. Krumholz holds a BS degree in Physics and an MD from SUNY and completed his Pediatric Residency at the University of Massachusetts.
    Presentation Material (Acrobat)
10:00 am Coffee Break in the Exhibit Hall
10:30 am

Session IX: Clinical Perspective of Population Health and Analytic/Modeling Needs

Kavita Patel, MD, MSHS
Fellow and Managing Director, Clinical Transformation and Delivery Reform, Engelberg Center for Health Care Reform, The Brookings Institution, Washington, DC

    Speaker Bio

    Dr. Kavita Patel is a Fellow and Managing Director in the Engelberg Center for Health Care Reform at the Brookings Institution where she leads research on delivery system reforms, healthcare cost, physician payment and healthcare workforce productivity. Dr. Patel is, in addition, a practicing primary care physician at Johns Hopkins Medicine and a clinical instructor at UCLA's Geffen School of Medicine.

    Dr. Patel was previously a Director of Policy for The White House under President Obama and a senior advisor to the late Senator Edward Kennedy. Her prior research in healthcare quality and community approaches to mental illness have earned national recognition and she has published numerous papers and book chapters on healthcare reform and health policy. She has testified before Congress several times and she is a frequent guest expert on CBS, NBC and MSNBC as well as serving on the editorial board of the journal Health Affairs.
    Presentation Material (Acrobat)
11:15 am

Session X: Impactability Models for Preference Sensitive Treatments: "Time Opportunity and Expected Savings"

Emily Li
Manager, Health Analytics, SCIO Health Analytics, West Hartford, CT

    Speaker Bio

    Emily Li, M.P.H., Ph.D. Candidate (expected 2015, Brown University) - Senior Manager of Advanced Health Analytics at SCIO Health Analytics. She also holds a Master of Public Health degree from Yale University School of Public Health and went to the School of Medicine at West China University of Medical Sciences in China.

    Emily is a health economist specializing in applications of predictive models and behavioral economics to improve prevention and treatment programs for chronic diseases. Prior to joining SCIO Health Analytics, she worked as a healthcare analyst at the Yale Medical Center and worked on projects sponsored by the World Bank, Pfizer Inc, Yale-China Association, HOPE Foundation, etc. At SCIO, she has developed over 200 econometric models for value-based benefit design (VBBD), Subrogation prepayment model, and different disease management models. She was granted the ?Fresh Thinking? and ?Leadership? awards by the company for creative thinking and outstanding performance. She is a co-author of several peer-reviewed papers and Prof. Ian Duncan's book, Healthcare Predictive Modeling and Risk Adjustment (Actex Publications, 2011).
    Presentation Material (Acrobat)
12:00 pm Adjournment

AGENDA: POSTCONFERENCE SYMPOSIUM
Friday, November 14, 2014
12:15 pm Networking Luncheon for Postconference Attendees

POSTCONFERENCE: PREDICTIVE MODELING AND POPULATION HEALTH
1:00 pm

Welcome and Introductions

Clive Riddle
President, MCOL; Publisher, Predictive Modeling News, Modesto, CA (Moderator)

    Speaker Bio

    Mr. Riddle is President of MCOL, a leading publisher of health care business information founded in 1995. He has overseen the company's growth from its original on-line membership service to now also include a number of divisions encompassing print and electronic publications, directories and databases, webinar services, B2B social media sites, announcement services, website content, the new rNimble healthcare microconsulting service and more.

    A 30+ year veteran of the health care and managed care industry, Riddle has held a variety of high-level leadership positions including 12 years as Chief Executive Officer of a regional hospital owned managed care organization in California. There he was responsible for developing and overseeing HMO, PPO, insurance, clinic and pharmacy operations, where they developed into a $100 million-a-year business. Prior to that, Mr. Riddle held positions of increasing responsibility for the same hospital system, at both the facility and regional level, where he was charged with the implementation of numerous new programs, facilities and services.

    Riddle's first novel: Dorris Bridge, was released in December 2010 and his second novel The Burning Z was released in 2013. Throughout his career, Mr. Riddle has been an active participant on numerous community and professional boards of directors. He is a native of California, and earned his Bachelor of Arts degree in Business Administration, and Master of Public Administration degree at California State University, Stanislaus.
1:15 pm

Predictive Analytics for Use in Enabling Population Health Management

Carol Lauson
Director, Market Planning, LexisNexis Health Care Solutions, Atlanta, GA

    Speaker Bio

    Carol Lauson, Director, Clinical Strategy leads market strategy for the LexisNexis® Clinical Solutions which includes predictive modeling for population health management. Carol holds a Bachelor's in Finance from Boise State University and a Masters in Business Administration from Harvard Business School.
Sharon Montgomery
Director of Clinical Solutions, LexisNexis, Orlando, FL

    Speaker Bio

    Sharon Montgomery, Director, Clinical Analytics Focuses on defining product strategy for the LexisNexis® Clinical Solutions products which offer predictive modeling capabilities for population health management. Sharon has over 25 years of experience in Healthcare Analytics for both payers and providers.
    Presentation Material (Acrobat)
2:00 pm

Predicting Future Resource Use and Risk of Hospitalization for a General Population in NHS England: Adapting US Models and Potential Lessons for the US

Stephen Sutch, MAppSc, BSc
Director of Product Management, ACG International, Bloomberg School of Public Health, Johns Hopkins University, Southampton, United Kingdom

    Speaker Bio

    Stephen Sutch has a special interest in worldwide developments in Patient Classification and its application in Health planning, funding and resource allocation. He began working in the English NHS in 1987 as an Operational Research consultant, modelling hospital and NHS systems. In 1991, he moved to Wales to manage the investigation of casemix and its introduction. In 1994, he moved to the national casemix office in England, continuing work for Wales as a consultant including the move from APDRG to HRG.

    Joining the NHS Information Authority in 1999 he managed the Analytical and Statistics department supporting the development of casemix groupings (Healthcare Resource Groups) and related services in England and Wales until 2004, and to 2006 was Principal Casemix Consultant responsible for the design of casemix groupings for England used for NHS hospital reimbursement. In 2006 he set up an international consultancy company specialising in casemix and health classification, with contracts across Europe, North America and Australia, and associates world-wide.

    < Steve now specializes in population health and primary care applications of predictive models, with research interests in Care Management in Primary Care and the measurement of Multiple Morbidity. Working since 2007 with the team at Johns Hopkins University (USA) on the Adjusted Clinical Groups (ACG) System, he has led projects in a number of countries utilizing existing primary and secondary care data to create population based analyses, and developed expertise in mapping differing classification systems (morbidity and pharmacy) to build whole population databases. Current projects include the development of a measure for care management participation in US care plans, and development of predictive models to assist English family doctors in identifying patients in the population at need of outreach services.

    Steve is a prominent committee member of the world-wide casemix conference PCSI (Patient Classifications International), lectures and provides consultancy Worldwide, on Casemix development and health informatics.
    Presentation Material (Acrobat)
2:45 pm Networking Break
3:15 pm

Persona Based Population Stratification: Incorporating Predictive Modeling into Member Care

Bob Gladden
Vice President, Center for Analytics, CareSource, Dayton, OH

    Speaker Bio

    Bob Gladden is Vice President for the Center for Analytics at CareSource, a nonprofit Medicaid organization with over 1 million members. He leads analytics for the organization that guide its mission-driven focus. Bob has over 30 years of experience in the fields of health care analytics, health care administration, actuarial science, underwriting and finance with major consulting organizations, hospital systems, management companies and payers. Bob holds an MA degree from Bowling Green State University.
Cathy Meade
Director, Healthcare Analytics, CareSource, Dayton, OH

    Speaker Bio

    Cathy Meade is Director for Healthcare Analytics at CareSource, a nonprofit Medicaid organization with almost 1 million members. She currently leads the health care analytic efforts for the organization, with a focus on diagnostic and predictive analytics that maintains a strong practical sense of helping the organization achieve its mission-driven focus. Cathy has over 20 years of experience in the fields of health care analytics, business process improvement, finance and IT within the health care, technology and banking industries. Cathy holds a BA degree in business from Capital University.
    Presentation Material (Acrobat)
4:00 pm Postconference Adjournment

Go to Agenda:
Preconference / Day 1




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