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2017 SPEAKERS
SPEAKERBIOGRAPHIES
Jessica Assefa, Medicare Stars Program Manager, UCare

Jessica Assefa has been the Manager of the Medicare Star Ratings program for UCare,an independent, nonprofit health plan that provides coverage to Minnesotans, for the past two years. Prior to this Jessica served on UCare’s Clinical Compliance team where she was responsible for the trainingand oversight of UCare’s delegated care coordination entities.

In her current roll, Jessica has responsibility for the facilitation and coordination of the Star Ratings program for UCare’s four Medicare Advantage and Dual Eligible products..UCare’s Medicare Advantage product, UCare for Seniors rated “Excellent” by NCQA, has maintained a 4.5 Star Rating, and is very close to becoming a 5 Star plan. UCare’s Medicare portfolio also includes: Minnesota Senior Health Options (MSHO), a D-SNP plan that combines Medicare and Medical Assistance benefits/services for low income Seniors, EssentiaCare – a Medicare Advantage plan from Essentia Health (a local care system) and UCare, andUCare Connect + Medicare – (Special Needs Basic Care) a plan that combines the benefits/services of Medicare and Medical Assistance for Minnesotans with certified disabilities ages 18 to 64.

In addition to her managed care experience, Jessica brings over 20 years of nursing experience in the states of MN, IN and NY working extensively with the geriatric and disabled populations.

Medicare Star Ratings
Theresa A. Bissonnette, MBA/HCM, CPHQ, Director of Risk Adjustment and Quality, North Texas Specialty Physician

Theresa is the Director of Quality for North Texas Specialty Physicians (NTSP) where she is responsible for a Pay for Performance program for physician members, CMS 5 Star strategies, Quality Improvement Projects and Chronic Care Improvement Programs. NTSP is an IPA that accepts risk for United Health Care and Humana lives in addition to owning their own health plans, Care N' Care in Texas and Health Team Advantage in North Carolina. Theresa has 18 years of healthcare experience inclusive of Medicaid, Long Term Care, Healthcare Quality, and Medicare Advantage. Theresa has spent the last 5 years working primarily in the CMS 5 Star arena, first at Physicians United Plan in Orlando, Florida and now with Care N' Care in Fort Worth. Theresa has a Bachelor's degree from Indiana University, a Master's degree from The University of Phoenix and is a Certified Professional in Healthcare Quality.

Medicare Star Ratings
Michelle Coberly, Manager, Medicare Compliance & Quality, Priority Health

Medicare Star Ratings
Noreen Hurley, Program Manager, Star Quality & Performance, Harvard Pilgrim Health Care

Noreen has spent her career in the healthcare arena. She blends operational, strategic and technology perspectives as well as payer and provider expertise to lead major initiatives and strategies. She started in hospital operations and was Director of the Admitting & Registration department in the New England Deaconess Hospital, a Harvard teaching hospital in Boston. Transitioning to IT, she implemented the EMPI (Enterprise Master Patient Index) when the Deaconess merged with the Beth Israel Hospital to form what is now the Beth Israel Deaconess Medical Center. From there she moved to the vendor world and ran implementations of EMPI’s, HL7 integrations and HIPAA EDI transactions for SeeBeyond Technologies. Most recently, she has focused on the payer space. She started and oversaw the Star program at Tufts Health Plan, as well as working in IT, developing a senior products PMO and managing the member call center. Moving back to technology, she developed data driven solutions in the healthcare space while working at Informatica. Her current role is developing the Star program at Harvard Pilgrim Health Care, which has recently re-entered the Medicare Advantage market. As a leader in the Clinical Informatics Division, the program focuses on leveraging non-traditional data and analytics to craft targeted initiatives to improve performance in the Star program and the Harvard Pilgrim Stride product

Medicare Star Ratings
Jason Jean, Quality Manager, Cigna-Healthspring
  • Registered nurse since 1996, trained at the University of Tennessee in Knoxville,
  • Family nurse practitioner since 2000, trained at Vanderbilt University in Nashville,
  • Doctorate of nursing practice since 2016, trained at Vanderbilt University,
  • Care provider, researcher, administrator, author, educator, consultant, and subject matter expert for Vanderbilt University Medical Center, Vanderbilt University School of Nursing, McGraw-Hill publishers, and Cigna HealthSpring,
  • Full time employment associated with Cigna Health-Spring in Nashville, Tennessee. Function as a quality manager and chronic disease educator.

Topic: Creating an Effective Pay-for-Performance Program to Increase Star Ratings
Objectives:

  1. Describe the existing Pay-For-Performance landscape
  2. Define three strategies to improve Medicare STAR ratings for diabetes mellitus, rheumatoid arthritis, and cancer screening
  3. Evaluate a specific personalization approach to sustain long term STAR rating success

Medicare Star Ratings
Jennifer Strohecker, PharmD, BCPS, Sr. Director MHI Pharmacy, Clinical Operations, Molina Healthcare

Dr. Strohecker is the Senior Pharmacy Director for Molina Healthcare, in Long Beach, California. She oversees clinical pharmacy initiatives which span MTM services, adherence interventions for STAR and HEDIS metrics, and corporate quality improvement projects. She is actively involved in outcomes research within Molina Healthcare. Her areas of expertise include clinical research, components of effective pharmacist/patient communication, medication adherence, and pharmacy process improvement.

Dr. Strohecker has practiced as a pharmacist for 17 years in a variety of settings including the pharmaceutical industry, community pharmacy, pediatric intensive care unit, cardiology ambulatory care, and as full-time faculty with a college of pharmacy. In 2010, her research with patient-physician communication regarding warfarin and herbal supplements was recognized at The American Heart Association Scientific Sessions Meeting in Chicago, Illinois and the Heart Rhythm Society Meeting in Denver, Colorado as notable media pieces. In 2017, she was selected by PQA to present her Hepatitis C research at their national meeting. She is a nationally recognized speaker for MTM and has chaired several MTM conferences. Dr. Strohecker participates in annual mission trips to Cuba and Guatemala and is an active member of several national pharmacy organizations.

Dr. Strohecker received a Doctor of Pharmacy degree from the University of Florida, followed by postgraduate training, including Board Certification as a Pharmacotherapy Specialist.

Medicare Star Ratings
Donna Sutton, Healthcare Informatics, Director of Medicare Star Quality Programs, SCAN Health Plan

Donna Sutton, Healthcare Informatics, Director of Medicare Star Quality Programs at SCAN Health Plan Donna received her MBA from the University of Southern California (USC) and is a Certified Master Black Belt in Six Sigma. She has over 14 years of experience managing and conducting process improvement projects. Her most recent experience prior to SCAN includes various process improvement roles at OptumInsight and OptumRx. Her responsibilities at SCAN include managing the deployment of and providing oversight over SCAN’s 5 Star programs and interventions.

Medicare Star Ratings
Zivany Garcia Velazquez, Quality Improvement Director, Molina Healthcare Puerto Rico

Zivany García started her Quality career in the food industry during 1995, moving to the biomedical industry in 1998. After completing her graduate studies, she entered the Healthcare Industry in 1999.

Her tasks thru these years of experience in healthcare include, data and reporting management, utilization management, provider network administration, delegated entities liaison, providers educational programs, members wellness programs, physician incentive plans, Star Rating Programs and, Quality Management.

Zivany has developed, implemented and managed Quality Programs for Health Plans and Managed Behavioral Health Organizations. She has established clinical and operational strategies for all business lines, Medicaid, Medicare, Federal Employees, Employers Groups and Commercial Products. She’s been part of the Blue Cross Blue Shield plans and currently part of the Molina Healthcare Family.

Her interventions have steered improvement in Medicare Advantage Plans’ Stars Ratings from 2.5 to 4 stars. On the Medicaid State Contract, her leadership has resulted in the disbursement of $14 million withhold tied to a Quality Retention Fund.

Zivany possess a Bachelor’s Degree in Natural Sciences and a Master’s Degree in Public Health from the University of Puerto Rico. Mother of two teenage boys, has lead volunteer programs with Military Families and the Lutheran Church.

Medicare Star Ratings
John Mark Willis, M.Ed., Senior Director-Star Operations, Cigna-HealthSpring

Medicare Star Ratings
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