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Terri L. Welter
Principal, ECG Management Consultants, Inc.
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Ms. Welter is
a Principal in ECG Management Consultant's Washington, D.C.,
office and head of ECG’s Contracting and Provider
Performance practice. She has extensive experience in the
areas of managed care and provider payment, including
strategy development, reimbursement, contract negotiations,
and operations. She has recently been closely involved in
assisting hospitals, medical groups, payors, and industry
associations with understanding the types of arrangements
that will be needed to successfully react to healthcare
reform and to establish contracting structures that
facilitate hospital/physician alignment and clinical
integration. Ms. Welter is a frequent national speaker on
the topics of evolving provider payment vehicles and ACO
development. Ms. Welter holds a master of science degree
with a concentration in healthcare administration from
Villanova University and a bachelor of arts degree in
preprofessional studies from the University of Notre Dame.
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Alan L. Mytty
Director,
Payer Contracting, Carle Foundation Hospital
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Alan L. Mytty, of Indianapolis, is the Director of Payer
Contracting at Carle Foundation Hospital, Urbana. He has
nearly thirty years of experience in the healthcare field.
Mr. Mytty was most recently a consultant to Carle Foundation
Hospital and two health plans. Previously, Mr. Mytty was
the CEO of a provider-insurance company joint venture health
plan in the Bahamas and a provider owned health plan in West
Virginia. He also served for nearly ten years as the
President and CEO of PersonalCare in Champaign, Illinois.
Mr Mytty's current duties include negotiate contracts and
payment arrangements with health plans and networks for
Carle Foundation Hospital and Carle Foundation Physician
Services; developing managed care strategy for Carle
Foundation; comparing the performance of payers; and
analyzing and report on the increased volume of uninsured
patients. Mr. Mytty attended the U.S. Air Force Academy.
He holds bachelor’s and master’s degrees from the University
of Nebraska, and has earned the designation of Fellow from
the Academy for Healthcare Management. He is a licensed
agent for health and life insurance.
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Christopher J. Kalkhof, MHA, FACHE
Director, Healthcare Industry Group, Alvarez &
Marsal
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Chris is a Director with Alvarez & Marsal’s
(A&M) Healthcare Industry Group based out of New York, with
more than 26 years of diverse healthcare, health plan and
managed care management experience. He specializes in
managed care strategy development and contract negotiations;
contract implementation and integration with revenue cycle;
provider-payer collaborations, physician alignment and
integration strategy; and the alignment of payer strategies
with hospital service lines/pricing.
Over the last several years, Chris has spent much of his
time assisting clients to optimize their net managed care
revenue potential through specific payer strategies,
improvements in the contracting process and the integration
of both with organizational service line and physician
alignment business models; with a resulting combined net
revenue improvement of nearly half a billion dollars as well
as enhanced competitive market positioning.
Prior to joining A&M, Chris served as a SVP of Managed Care
for a multi-hospital system, a VP of Managed Care at a
community hospital, a Director of Marketing Administration
and Provider Relations for a statewide health plan, a
Partner in a practice management firm and as the national
Managed Care lead for two consulting firms.
Chris received his Master of Health Administration degree
from Tulane University and his Bachelor of Science, degree
from Allegheny College. He is a Fellow in the American
College of Healthcare Executives, an Advanced Member with
the HFMA. Chris is a frequent presenter for various national
and regional professional associations.
A&M is a leading independent professional services firm
which specializes in organizational turnarounds,
restructuring and performance improvement services; actively
working with both the not-for-profit and for-profit
healthcare sectors, on both a consulting and interim
management basis.
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William DeMarco
President & CEO
Pendulum HealthCare Development Corporation
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William J. DeMarco MA
CMC is the President & Chief Executive Officer of Pendulum
Health Development Corporation, and DeMarco & Associates,
Inc., a national, independent healthcare consulting firm
specializing in healthcare delivery system redesign and
transformation. The firm specializes in research and
strategy development, organization development of successful
provider owned enterprises and marketing management
including product design and promotion. Mr DeMarco is
recognized as a leader in the research, design and
implementation of community based health plans. Since his
involvement in several startup health plans in Minnesota in
the early 1970s Bill and his team of management consultants
clinical specialists and reimbursement analysts have
assisted employers and physicians in developing better
relationships with insurers up to and including developing
local solutions to deliver and finance care.
Using Health Services
Research from its affiliate Pendulum HealthCare Development
Corporation (www.pendulumhealth.com),
DeMarco and Associates assists both provider and employer
clients in addressing prospective payment approaches in
order to build Pay for Performance models to develop direct
employer/provider contracting entities, benchmarking
collaboratives under the new value purchasing legislation as
well as Accountable Care organization development and
management.. Mr. DeMarco is a well-known author having
written or contributed to over a dozen books on managed care
topics. His most recent book Performance Based Medicine
will be released in January 2011. He holds a master’s degree
in organizational development from DePaul University. He a
past faculty member of Loyola Law School’s graduate program
and DePaul University MBA program on entrepreneurial
management.
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 Cyndy Nayer, M.A.
President, CEO and co-founder of the Center For Health Value
Innovation
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Cyndy Nayer, M.A., is a Founder of the Center for Health Value
Innovation and serves as its President and Chief Executive Officer.
Under her direction, CHVI, a national, non-profit organization, has
grown into the nation’s premier organization dedicated to sharing the
evidence of improved health and economic outcomes through value-based
designs. Nayer is a nationally recognized thought leader on value-based
benefit design and continues to provide education, insight and guidance
to CHVI's growing membership as well as to government leaders, national
media, and other industry stakeholders. She has been a vital part of the
emergence, adoption and change in the value-based designs and,
specifically responsible for, their link to outcomes-based contracting™
and consumer-directed health. Nayer continues to champion and develop
these concepts through ongoing research initiatives with CHVI members
and partners and through keynote presentations at national conferences
and business coalition events. A published authority on health quality
improvement with value-based designs, Ms. Nayer has authored numerous
industry papers, articles and books including co-authoring CHVI’s first
book, “Leveraging Health: Improve Health Status and Bend the Trend on
Financial Outcomes with Value-Based Designs,” in 2009 and personally
authoring a consumer handbook for value-based health decisions in 2006,
“101 LifeTips for Personal Health Management" in which she
defines the roadmap for becoming the CEO of one’s health-wealth
portfolio, a copyrighted concept.
She is the former Chair of the Missouri Governor’s Council on Health and
Fitness where she convened and advised the establishment of the Office
of Women's Health for the State. Ms. Nayer also received the CEO
Leadership Award for Consumer-Directed Health in 2008.
As the voice of CHVI and a health improvement expert, Nayer forged
multiple strategic alliances for the Center, aligning its resources to
share the business and academic evidence of improved health status and
reduced health cost trend when consumers have access to affordable
prevention, risk management, and chronic care. Committed to making
value-based designs and outcomes-based contracting an integral component
of health system transformation, Nayer is leading CHVI in its support of
major efforts in both the public and private sectors.
A graduate of Washington University, Nayer also holds a graduate degree
in Gerontology with a special focus on Healthy Aging and is a frequent
speaker and lecturer on a variety of healthcare issues. For more information about the Center for Health Value Innovation,
please visit http://www.vbhealth.org/.
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Michael Jacobs, R.Ph.
Principal and
National Clinical
Practice Leader
Buck Consultants
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Michael S. Jacobs is a Principal and National Clinical Practice Leader at
Buck Consultants, LLC. Michael has served at Buck since 2004, and works
with clients and the pharmaceutical industry to obtain optimal outcomes
on the design, pricing,
funding, impact, administration, and implementation of integrated
pharmacy and clinical benefit programs.
He also assists clients with Medicare Modernization Act Part D programs,
and possesses substantial knowledge in the following areas: managed
care, long term care distribution, state and government programs,
various employer and Taft Hartley group pharmacy benefit design and
consulting, commercial insurance, hospital distribution and pricing,
non-profit organizations, and the provider industry. His particular
focus is on integration of medical and pharmacy claims information, data
analysis and employee and patient impact of these programs, as well as
strategic planning for healthcare coverage in future years, based on
payer priorities and business models are included in his practice.
Previously, Michael was Regional Pharmacy Practice Leader, Southeast,
for Mercer Human Resource Consulting from 2000 to 2004, where he served
as a member of the National Leadership Team. From 1997 – 2000 he was
Vice President Managed Care Markets Sales & Marketing with
Advance-Paradigm Inc. Before that he served with
Aetna Insurance in 1997, Express Scripts from 1993 – 1997. CIBA-Geigy
Pharmaceuticals from 1985 – 1993 and Band Pharmacy, Daily Drugs &
Seven-Van Pharmacy (latter two owned) from 1978 – 1984.
Michael is a Registered Pharmacist in the State of Michigan, is a Member
of the Academy of Managed Care Pharmacy, Member of the National Council
for Prescription Drug Programs, and serves on the Board of Directors for
the Center for Health Value Innovation. University and a B.S. degree from Peking
University, Beijing, China, 1995
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Rong Yi, PhD
Senior Consultant
Milliman, Inc.
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Rong Yi, PhD is a senior consultant with the Boston office of
Milliman. She joined the firm in 2009. Dr. Yi has extensive experience
in risk adjustment and predictive modeling for healthcare, workers
compensation, and other fields. She has worked with private insurers,
providers, employers, government agencies, and researchers in the U.S.
and other parts of the world. She is a frequent speaker at professional
and academic conferences.
Dr. Yi’s expertise includes risk adjustment for public programs and
health reforms, and predictive modeling for risk management. She
pioneered in the areas of workers compensation predictive modeling, risk
adjustment for the uninsured population, risk based provider profiling,
risk adjustment for small group underwriting, and models supporting the
Patient-Centered Medical Home. She also led the adoption of diagnosis
based risk adjustment in the recent German health reforms, and is
assisting foreign government organizations in their research and
strategy for their future health reforms. Most recently, Rong
received a grant from the Robert Wood Johnson Foundation to develop risk
adjustment implementation guidelines for state health insurance
exchanges.
Before joining Milliman, Dr. Yi was a major contributor to commercial
and governmental risk adjustment systems in wide use today. She holds a
Ph.D. in Economics from Boston University and a B.S. degree from Peking
University, Beijing, China, 1995
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Value Based Reimbursement Methodologies & Models
Plus Much More
