This episode of Smarter Care Connections is the sixth and final episode  in our special series celebrating VCHI’s 10th Anniversary. Our guests this week are a triple threat. That’s right, we have three amazing guests – Aneesh Chopra, Dr. Ibe Mbanu, and Meredith Touchstone. They each bring unique expertise and perspective to our work.

Aneesh Chopra is the President of CareJourney, an open data and analytics platform building a trusted, transparent rating system for physicians, networks, facilities and markets on the move to value. He served as the first U.S. Chief Technology Officer under President Obama (’09-’12) and in 2014, authored, “Innovative State: How New Technologies Can Transform Government.” He serves on the Boards of the Health Care Cost Institute, International Digital Accountability Council, IntegraConnect, and Chairs the George Mason Innovation Advisory Council. He earned his MPP from Harvard Kennedy School and BA from The Johns Hopkins University.

Dr. Ibe Mbanu currently serves as Senior Medical Director with Advocate Aurora Health; one the largest clinically integrated health systems in the United States. He serves as senior leadership for the system’s Strategy and Operations Group, as well as Employer Services including Occupational Medicine and Employee Health.  He continues to practice as a Hospitalist seeing patients and teaching as a Clinical Assistant Professor for the University of Illinois School of Medicine. 

Prior to relocating to Chicago, Dr. Mbanu served in leadership with various health systems in Virginia including Bon Secours and HCA.  Dr. Mbanu has been involved in numerous statewide organizations dedicated to the improvement and evolution of healthcare in the Commonwealth.  He is Past President of Virginia Health Information, and recently completed his term as Treasurer and Board member for the Virginia Center for Health Innovation.  Additionally, he served as Trustee for the Richmond Academy of Medicine and Board Director for the Medical Society of Virginia where he also had the pleasure of leading as President of their foundation.

Meredith Touchstone has more than 20 years of experience leading employee benefits for jumbo national employers. Meredith currently leads CarMax’s Benefits, Leaves, and Accommodations teams with overall accountability for those programs supporting more than 26,000 associates across the country. She has deep expertise in innovation, strategy and design, compliance, benchmarking, communications, associate engagement strategies, vendor management, and administration. She is deeply passionate about managing and supporting population health to design resources that positively influence the health journey of employees and their loved ones. Meredith currently serves on Anthem’s Client Advisory Group as well as their Client Innovation Council and Castlight’s Client Advisory Board. Further she serves on the SmarterCare Virginia Employer Task Force as well as the Virginia Task Force on Primary Care.

This episode of Smarter Care Connections is the fifth in our special series celebrating VCHI’s 10th Anniversary. Our guests this week are Marcos Dachary and Kyle Russell. Marcos, Kyle and their respective teams provide data and analytics support that fuels much of VCHI’s work.

Marcos Dachary is a principal and SVP of sales and growth for MedInsight in the Seattle office of Milliman. He joined the firm in 2009. MedInsight is one of the healthcare industry’s most highly regarded platforms for data warehousing and healthcare analytics, and has been adopted by payers, purchasers, providers, and other healthcare clients. Marcos is a member of the Smarter Care Virginia leadership team and serves on VCHI’s Leadership Council.

Kyle Russell is the Chief Executive Officer (CEO) of Virginia Health Information (VHI), the non-profit organization which operates the Commonwealth’s Health Information Exchange (HIE), Emergency Department Care Coordination Program (EDCCP), All Payer Claims Database (APCD) and several other data collection systems. He joined VHI in 2013 and has previously held roles within the organization overseeing strategic partnerships, analytical reporting and program performance. Prior to joining VHI, Kyle managed revenue cycle operations at Hospital Corporation of America (HCA). Kyle serves as adjunct faculty within the VCU Master of Health Administration (MHA) Program, has been published in several academic journals including Health Affairs and sits on the Board of Directors for the National Association of Health Data Organizations (NAHDO) and Covenant Woods Continuing Care Retirement Community.

This episode of Smarter Care Connections is the fourth in a special series to recognize VCHI’s 10th Anniversary. Our guests this week are Richard M. Hamrick, III, MD, MBA and Len Nichols, PhD. Dr. Hamrick was a founding board member of VCHI and is still very involved in our work and Dr. Nichols is our go-to health economist and has consulted on a number of VCHI’s projects from the start.

Dr. Dick Hamrick was the Chief Medical Officer for HCA’s Capital Division. In this position, he spearheaded the division’s activities relating to quality improvement, patient safety and clinical effectiveness, and worked closely with division and hospital personnel and affiliated physicians.

Prior to joining HCA, Dr. Hamrick practiced pulmonary medicine in Richmond, Virginia for more than 22 years as a member of Pulmonary Associates of Richmond, Inc. He was appointed by Virginia Governors to work groups surrounding policy issues. He led the formation and startup phase of Virginia Care Partners, a clinically integrated network with over 200,000 lives now under contract.

Len M. Nichols, PhD is a non-resident Fellow of the Health Policy Center of the Urban Institute and Professor Emeritus of Health Policy at George Mason University. He is a health economist and the PI of the CAPGI project, and was the coauthor, with Lauren A. Taylor, of the paper that initiated this work. Len has been intimately involved in health reform debates, policy development, and communication with the media and policy makers for 25+ years, after he was Senior Advisor for Health Policy at the Office of Management and Budget (OMB) in the Clinton Administration. Since that time he has testified frequently before Congress and state legislatures, published extensively and spoken to a wide range of hospital associations, hospital systems, physician groups, boards of directors, and health policy leadership forums around the country.

This episode of Smarter Care Connections is the third in a special series to recognize VCHI’s 10th Anniversary. Our guests this week are Drs. Dan Carey and Dr. Mark Fendrick, both of whom have a long history working with the VCHI team.

Dr. Daniel Carey is currently the Senior Vice President and Chief Medical Officer of the Physician Enterprise at Providence, a large multi-state health system based in Washington state. Before he made the move West, he served the Commonwealth of Virginia as Secretary of Health and Human Resources for four years. In that role Dr. Carey oversaw 12 state agencies and led Virginia’s response to the COVID-19 pandemic. Last but not least, he served as director then Vice-Chair of VCHI’s board of directors before departing Virginia in late 2021.

Dr. Fendrick directs the V-BID Center at the University of Michigan, the leading advocate for development, implementation, and evaluation of innovative health benefit plans.  He conceptualized and coined the term Value-Based Insurance Design. His research focuses on how clinician payment and consumer engagement initiatives impact access to care, quality of care, and health care costs.  Dr. Fendrick has authored over 250 articles and book chapters and has received numerous awards for the creation and implementation of value-based insurance design.  His perspective and understanding of clinical and economic issues have fostered collaborations with numerous government agencies, health plans, professional societies, and health care companies.

This episode of Smarter Care Connections is the second in a special series to recognize VCHI’s 10th Anniversary. Our guests this week are Nancy Agee and Debbie Oswalt, two founding board members of VCHI.

Nancy Howell Agee is president/CEO of Carilion Clinic, a $2 billion not-for-profit, integrated healthcare system headquartered in Roanoke, Va. Prior to her current role, Ms. Agee served as executive vice president/COO. During her tenure as COO, she co-led Carilion’s transformation from a collection of hospitals to a fully integrated, patient-centered, physician-led organization. Ms. Agee is a nationally recognized leader in healthcare and immediate past chair of the American Hospital Association. She was named one of the “100 Most Influential People in Healthcare” by Modern Healthcare for the past three years and one of the “Top 25 Women Leaders” by the same national magazine. Ms. Agee is a former member of The Board of Commissioners for the Joint Commission and past chair of the Virginia Hospital and Healthcare Association and the Virginia Center for Health Innovation. Ms. Agee was named Virginia Business Person of the year in 2017 and has been on the list of most influential persons in Virginia for eight years.

Debbie Oswalt is the founding Director of the Virginia Health Care Foundation (VHCF), where she has served for 30 years. Created as a public-private partnership by the Virginia General Assembly and its Joint Commission on Health Care, VHCF’s mission is to increase access to primary and preventive health care for uninsured and medically underserved Virginians. Under Ms. Oswalt’s leadership, VHCF has developed a wide range of innovative initiatives. VHCF has helped more than 800,000 Virginians obtain needed healthcare. Prior to joining VHCF, Debbie honed her healthcare advocacy skills first at the Virginia Poverty Law Center, where she worked as a staff attorney for four years. She also served as Deputy Secretary of Health and Human Resources in the Cabinets of Governors Baliles and Wilder.

This episode of Smarter Care Connections kicks off a special series leading up to the Virginia Center for Health Innovation’s 10th Anniversary celebration in May 2022. For those who are new to us, in January, VCHI officially marked 10 years of improving the value of healthcare in Virginia. This podcast series will feature many of our founding board members and partners who have played a part in our success. Dr. Steve Horan of Community Health Solutions, a longstanding VCHI friend and partner, will be facilitating these conversations.

First up, we have a look back at VCHI’s start with Dr. Bill Hazel and VCHI President and CEO, Beth Bortz.

Dr. Bill Hazel is currently the Senior Deputy Executive Director of the Claude Moore Charitable Foundation. Dr. Hazel served the Commonwealth for eight years as Secretary of Health and Human Resources. He was the founding board chair of VCHI. His past leadership roles also include service as the President of Medical Staff of INOVA Fairfax Hospital and as a past member of Inova’s Board of Trustees and Trustee of the American Medical Association. He has even served as Team Physician for the Washington Commanders and DC United. He holds an M.D. degree from Duke University School of Medicine and served his Orthopedic Surgery residency at the Mayo Clinic in Rochester, MN.

Beth Bortz, is VCHI’s President and CEO. Prior to joining VCHI, she served for nine years as the Executive Director of the Medical Society of Virginia (MSV) Foundation, where she developed and led programs in health care quality improvement, medication assistance, public health awareness, and physician leadership. Earlier in her career, she spent time at the Virginia Health Care Foundation and Virginia General Assembly’s Joint Legislative Audit and Review Commission.

On this episode of Smarter Care Connections, Steve Horan, PhD, CEO of Community Health Solutions and member of the Smarter Care Virginia evaluation team is back to interview John Mafi, MD and Michelle Rockwell, PhD on their research on the impact the COVID 19 pandemic had on both low and high value care.  

John N. Mafi, MD, MPH is an assistant professor of medicine in the Division of General Internal Medicine and Health Services Research at the David Geffen School of Medicine at UCLA where he also practices and teaches general medicine and primary care. He also serves as an Affiliated Natural Scientist in Health Policy at RAND Corporation. Dr. Mafi completed his undergraduate studies at Northwestern University and then went on to complete medical school at Case Western Reserve University. He then finished his internal medicine residency training at Beth Israel Deaconess Medical Center in 2012, where he also served as Chief Medical Resident in 2013-2014. Dr. Mafi completed the Harvard Medical School Fellowship in General Internal Medicine and Primary Care at Beth Israel Deaconess Medical Center and earned his MPH at the Harvard T.H. Chan School of Public Health in 2015.

Dr. Mafi’s research focuses on quality and value measurement and how electronic health records can improve the value of care among older adults. He has led several national analyses assessing the epidemiological trends and predictors of harmful or low value care, or patient care that provides no net benefit in specific clinical scenarios. He is currently leading several national studies and working to leverage electronic health records to measure and improve the value of healthcare delivery among older adults.

Michelle Rockwell, PhD is an Assistant Professor of Family & Community Medicine at Virginia Tech and a Senior Research Associate at Carilion Clinic in Roanoke, Virginia. Her research focuses on the measurement, evaluation, and de-implementation of low-value care in the primary care setting. She is also interested in the patient-clinician relationship and specifically exploring trust as a predictor and outcome of successful de-implementation of low-value care. With more than 20 years of experience as a Registered Dietitian, Michelle is also interested in nutrition and lifestyle approaches to disease prevention and treatment.

Smarter Care Virginia

In this episode, Smarter Care Virginia lead evaluator Dr. John Mafi chats with colleague and fellow low-value care crusader, Dr. Ishani Ganguli on her research around low-value care cascades and reducing low-value care at the health system level. The two discuss the importance of clinician feedback; communication strategies to reduce low-value care; how local health system culture can sink low-value care reduction efforts; and the importance of considering the harmful care cascades that can result from even one low-value health service.

Ishani Ganguli MD MPH is an Assistant Professor of Medicine and a primary care physician at Harvard Medical School and Brigham and Women’s Hospital Division of General Internal Medicine and Primary Care. Her research focuses on the value of ambulatory care, the use and consequences of low-value care, and how health care policies and primary care payment and delivery models shape patient and clinician behavior, health outcomes, and spending. Dr. Ganguli serves as an Associate Editor at JAMA Network Open. She is also a journalist who has written about science and health care for The Boston Globe, Reuters, The New York Times, and The Washington Post, among other publications. She received her AB, MD, and MPH from Harvard University and completed internal medicine/primary care residency and a health policy and management fellowship at Massachusetts General Hospital.

Low-Value Care at the Actionable Level of Individual Health Systems

Cascades of Care After Incidental Findings in a US National Survey of Physicians

In this episode, VCHI President & CEO, Beth Bortz talks to Nancy Giunto, executive director of the Washington Health Alliance about the approach they have taken to report on and improve healthcare value in Washington state.

Nancy Guinto is the executive director of Washington Health Alliance, a multi-stakeholder nonprofit that offers objective reporting of progress on measures of health care quality and value, as well as a trusted forum for critical conversations about health care system improvement. Since joining the Alliance in September 2014, Nancy has overseen the organization’s strategic direction, including its legislative agenda, continued statewide expansion, and the publication of new reports. Nancy is also responsible for the Alliance’s partnership with the Washington State Health Care Authority, which includes the development and publication of results for the Washington Common Measure Set on Health Care Quality and Cost.

Nancy has had a long career in health care, with stops along the way at the National Institutes of Health, the American Hospital Association, Intermountain Health Care, and Providence Health & Services.

Nancy is often sought out for speaking engagements regarding quality performance, value in health care and how to facilitate collaborative processes.

Washington Health Alliance

In this episode, Smarter Care Virginia team member Steve Horan, PhD, CEO of Community Health Solutions, chats with Dr. T.A. Lucktong and Jane Colwell at Carilion Clinic about their approach to reducing low-value pre-0perative testing. They share detailed insights into what has and hasn’t worked for their team.

Jane is currently serving as the Quality Improvement Facilitator Team Leader with Carilion Clinical Advancement and Patient Safety where her role includes organizing continuous improvement initiatives, managing high profile improvement projects, facilitating IA² and RCA² patient safety work and coordinating organizational reporting for national hospital rating surveys.

Prior to this role, Jane served as the first practice RN for the Carilion Clinic Plastic Surgery Cosmetic Center where she advanced to perioperative quality specialist. In this role, she facilitated the inaugural work of preparation, application, and successful survey for the AAAASF accreditation. 

In addition to her 10 years with Carilion, Jane has also worked at the Salem Veteran’s Affair Medical Center and Medical University of South Carolina where her clinical experiences included Medical/Surgical Trauma, Outpatient Surgery, Pre-anesthesia, and Post-anesthesia care for adult and pediatric populations.

Jane’s professional highlights include Carilion SHINE Award Program winner 2016, 2021, Carilion Clinic lead reporter for FDA MedSun, and Virginia Tech College of Medicine co-presenter for Patient Safety Event Management lecture.

Jane graduated from Furman University with a BA in Political Science and attained her BSN from Medical University of South Carolina. She completed her MSN with a focus on Leadership in Healthcare Systems from Grand Canyon University.  As a member of the Sigma Theta Tau Nursing Honor Society, Jane as served on the Tau Phi Chapter Board of Directors.

Dr. Lucktong earned his medical degree from the University of Virginia and completed general surgery residency at Allegheny General Hospital in Pittsburgh. Afterwards, he completed a fellowship in Advanced Gastrointestinal Surgery and Laparoscopy at the University of North Carolina, Chapel Hill. Dr. Lucktong joined Carilion in 2002 and developed a practice specializing in complex laparoscopic and robotic surgery. From 2005 to 2016, he served as Medical Director of Bariatric Surgery. In this role, he led Carilions Bariatric Surgery program through initial Center of Excellence certification in 2006 and subsequent recertifications in 2010, 2013, and 2016. For his work in Bariatric Surgery, Dr. Lucktong has been recognized multiple times in The Roanoker magazine Top Docs Issue and in Our Health magazine for Best Bedside Manner. Dr. Lucktong has had a longstanding interest in medical education and joined Carilion in part to be involved with medical student and resident education. In 2004, he became the surgery student Clerkship Director and continued in this role from early development of the Virginia Tech Carilion School of Medicine (VTCSOM) through the schools first decade. In 2014, Dr. Lucktong received the Leonard Tow Humanism in Medicine Faculty Award and was the VTCSOM nominee for the Gold Foundation Humanism in Medicine Award. He was also honored then as a faculty inductee into the Alpha Omega Alpha and Gold Humanism Honor Societies. In 2015, he was named Clinical Educator of the Year-Roanoke Region by the Edward Via College of Osteopathic Medicine. He was recognized by the Carilion Surgery Residents as 2007 Teacher of the Year and 2019 Faculty Mentor of the Year. Over the span of his career, his scholarly activity has included multiple peer-reviewed publications, book chapters, and academic presentations. In 2019, Dr. Lucktong transitioned to a new role as Co-Director of Surgical Quality where he is working to make a positive impact on patient care quality and safety at Carilion Clinic.

Smarter Care Virginia

Carilion Clinic

Cariliion Clinic Pre-Op Testing Flyer [pdf]

Carilion Low-Value Surgical Pre-Op Testing – Smarter Care Instructions [pdf]