Medicaid, Managed Care, Youth Substance Abuse and Recovery, Racial Disparities, Home & Community Based Services
HEALTHCARE STRATEGIES, LLC - Denver, Colorado 300+ significant engagements in 40 states . . . . with positive, often breakthrough results. Public sector market strategy, thought leadership, change management in population health; working the interface between private and public benefit. CURRENT WORK: Care coordination and quality improvement for populations with disabilities. LONG-TERM SERVICES & SUPPORTS: Supporting Independent Living Centers; Managed Medicaid; The Independence Center of Colorado Springs; Disability Rights Network of PA; Liberty Resources, Inc. PA; CLASP - Colorado Long-Term Attendant Service Providers. DOMAIN EXPERTISE: Center for Medicare & Medicaid Services: "Chronic Care Improvement" Pilot Domain Expert, 2002; 12 state Medicaid Agencies, National health plans, Care management vendors, Shared decision-making, Start-ups with venture capital, Rx Co's, IT companies; Market positioning, Market strategy. TRADE ASSOCIATIONS: Academy Health / State Coverage Initiatives, Institute for Health & Productivity Mgmt. Population Health Alliance / Disease Management Assoc. of America . . .Ambulatory Surgical Association of America . . . . . PRIVATE SECTOR: PacifiCare, McKesson, Merck-Medco, Pearson Government Solutions, Wargurg Pincus, AT&T, TriZetto, Pfizer, Mitretek Systems, Jones Cable, US West, United Airlines Services Corp, many other Fortune 100/500 companies. PUBLIC SECTOR / NON-PROFITS: DHHS/CMS, Centura Health, Illinois High Risk Pool, Colorado Dept, Healthcare Finance & Policy, Medicaid, Vermont Medicaid, New England Health Consortium, Pikes Peak Behavioral Health . . . HOSPITAL SYSTEMS: Overlook (N.J.), Ohio State Univ. Hospital, Pouder Valley (CO), HealthOne-Aurora, Alexanderia Hospital (VA), Fores Health System (PA), Sinai-Samaritan-Aurora Health (WI), Moses H. Cone (NC), Lafayette Surgery Center (LA), Deaconess Medical Center, (ND) Lakewood Surgical Center CO, Hospice of St. John . . . . .many others.
Jan 1985 - Present
Healthcare Strategies, LLC
Principal - Senior Policy & Change Management Consultant
Business & strategic planning in population health, disease and demand management, decision support and patient self-care strategies for private and public sector organizations. 30 years of proven leadership in change management and project success in 40 states on hundreds of projects models.
Sep 2002 - Aug 2018
Population Health Impact Institute
A vendor neutral, non-profit research, best practices and accreditation body Founded in 2004 by three idealists: Thomas Wilson, PhD, DrPH, Garry Carneal, JD, Gary Montrose, BS/BA. PHII evaluates and promotes credible, transparent, standardized, and replicable population health impact evaluation methods used by private or public organization; independently assessing program impacts on population health programs; Engaged in education, research. benchmarking. Available for contract services. Accreditation program developed (Garry Carneal, JD - CEO of URQC 10 years) to certify credibility of methods used by organizations claiming "positive impacts" derived from any clinical, financial, quality improvement programs; to help improve changes in experience of care, quality of life, bending the cost curve; All Population health, disease management, pay-for-performance and other accountable program can be evaluated large or small on contract basis.
Jul 2012 - Jul 2017
The Independence Center - Colorado Springs (A Center for Independent Living)
Healthcare Strategic Policy Consultant
Work with pubic sector programs that support people with disabilities, families and their community. Secured Foundation grants to pursue in-home medical care, PACE Expansion Pilot, advocating at state Medicaid policy meetings; Co-chaired Colorado Medicaid LTSS Quality Advisory Group to evaluate and improve delivery system cost and quality profiles among community service providers. The Independence Center is the local home of civil rights for people with disabilities and in-home services and supports, the largest in Colorado. The-IC promotes civil rights throughout the greater Pikes Peak - Central Colorado service area and state of Colorado. - See more at: http://www.theindependencecenter.org
Jun 2007 - 2012
Senior Strategy Consultant
A national leader in business and proposal development, specializing in contract procurement and business process improvements to increase market capture and strategic market position for commercial and public sector health plans.
Jul 1999 - Dec 2000
Intellicare America, Inc.
V.P. Business Development
Provider of telephonic nurse advise and triage services for hospitals and physician offices. Responsible for program development, strategic business relationships, patient-provider communication studies and consultation services.
Feb 1986 - Nov 1996
Medical Training International, Inc.
Co-Founder & V. P. Business Development
Developer of multi-media patient eduction programs. Shared Decision Making for medical treatment selection with verifiable proof of understanding and informed consent. Venture funding by PacificCare of California and health plans in Colorado. First to market full SDM demonstration products with digital feed-back loops for patient learning, validation and reporting of comprehension in mid-1980's. Results of comprehension guaranteed and insured by Lloyds of London, UK.