TAHP Medical + Pharmacy Directors Forum
Full agenda coming soon! These forums offer our health plan Medical and Pharmacy Directors the unique opportunity to interface with their peers and hear from state and national experts as they discuss common challenges and best practices. This a private meeting and is not open to general attendance.
SFA Hotel, Assembly Room, 701 Congress Ave., Austin, TX
SFA Hotel, Assembly Room, 701 Congress Ave., Austin, TX 78701
Apr 24, 2024
9:30 am - 3:30 pm
Sponsored by
Agenda
9:30 AM - 10:15 AM
Improving Value for Underserved Populations with a Community-Based Intervention
- Learn how a scalable peer to peer based solution is building trust and restoring the community fabric across the U.S.
- Learn how that solution is moving the needle for folks enrolled in Medicaid and reducing cost whilst improving quality.
- See the rigorous scientific approach behind those published results.
Speakers:
- Bill Friedman, Vice President of Payer and Provider Engagement, Wider Circle
- Claude Pinnock MD, MPH, Chief Medical Officer, Wider Circle
10:20 AM - 11:05 AM
Why Heart Health Matters & Successes in Achieving Sustained Behavior Change and Health Outcomes
Clinical leaders from Hello Heart will discuss the importance of addressing heart health and implementing proven solutions. Topics will include how Hello Heart’s digital solution drives validated clinical and financial outcomes and works within existing health plan ecosystems.
Speaker:
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Victoria Andrews, NP, Principal Solutions Consultant, Hello Heart
11:10 AM - 11:55 AM
Finally there’s a BetterWay to get blood testing
Blood testing is an essential medical service that informs 70% of clinical decision-making. Yet, testing hasn’t changed much in 70 years and up to 40% of people report skipping recommended testing. To meet the needs of consumers and care providers for a more modern, convenient experience, Babson has created a first-of-its-kind hybrid approach to blood testing that democratizes small-volume collection and centralizes analysis. The introduction of BetterWay blood testing recognizes the growing role of pharmacies in providing comprehensive, personalized care. This presentation will share recent innovations that drive adherence and member satisfaction
Presented by: Babson Diagnostics
12:00 PM - 12:30 PM
Lunch Presentation: TAHP Legislative Update
Following up on TAHP’s Strategy Retreat our Director of Public Affairs, Blake Hutson will discuss TAHP’s groundwork for our upcoming legislative agenda and how you and your organization can be a part of the process.
Speaker:
- Blake Hutson, Director of Public Affairs, TAHP
12:30 PM - 1:15 PM
Fresenius Kabi Biopharma Clinical Portfolio Overview
Presenters Nick Jorris and Ricky Mendoza will delve into a discussion of biosimilar products available at Fresenius Kabi. The spotlight will be on the company’s recently FDA approved medication, Tyenne (tocilizumab-aazg).
Speakers:
- Nick Jorris, PharmD, Medical Science Liaison, Immunology, Medical Affairs, Biosimilars, Fresenius Kabi
1:20 PM -2:00 PM
Improving Maternal Child Health Outcomes: Building and Supporting Texas Pathways Community HUBs
Presented by: Pathways Community Hub Institute
Speaker:
- Sarah Redding, Founder, PCHI
2:00 PM - 2:45 PM
Unmet Needs in COPD with Type 2 Inflammation
Chronic obstructive pulmonary disease (COPD) is a heterogeneous lung condition characterized by chronic respiratory symptoms due to persistent abnormalities of the airways, alveoli, and/or pulmonary vessels leading to progressive lung function decline. COPD with type 2 inflammation, or eosinophilic COPD, is an emerging phenotype of COPD with unique clinical characteristics and outcomes. Patients with COPD with type 2 inflammation experience significant clinical burden, characterized by increased mortality, debilitating symptoms, increased rates of chronic comorbidities, and acute exacerbations of COPD, as well as associated humanistic and economic burdens of disease.
There have been no new treatment approaches approved for COPD for more than a decade. In the U.S., approximately 300,000 people live with uncontrolled COPD with evidence of type 2 inflammation. Dupilumab (Dupixent ® ) is a fully human monoclonal antibody that inhibits the signaling of the interleukin-4 (IL-4) and interleukin-13 (IL-13), key and central drivers of type 2 inflammation. Dupilumab has shown significant clinical benefit in phase 3 trials with five current FDA indications in diseases associated with type 2 inflammation.
Dupilumab has been granted Breakthrough Therapy designation and is currently under Priority Review by the FDA for a sixth potential indication as an add-on maintenance treatment in certain adult patients with uncontrolled chronic obstructive pulmonary disease. *
Speaker:
- Erik Schindler, PharmD, BCPS, Associate Director of Medical Value and Outcomes, Sanofi.
2:50 PM - 3:35 PM
Optimizing Clinical Acumen to Address High Demand Weight Loss Treatments
Health plans are experiencing a tremendous demand for weight-loss related treatment spurred by the popularity of GLP-1 drugs. Initially designed to treat diabetes, GLP-1 drugs have expanded and off-label uses that include obesity and heart conditions. In recent news, Medicare have announced coverage of Wegovy for patients at risk of heart disease.
Health plans are strained financially and resource-wise by the soaring volume of prior authorizations. This session looks at the rise in GLP-1 related prior authorizations and how health plans can optimize their clinical acumen through the deployment of evidence-based clinical criteria, and digital and AI technology to deliver expedient, clinically-indicated determinations and minimize the cost per authorization.
Speakers:
- Amin Mirhadi, MD
- Scott Cowsill, Vice President and Specialist of Clinical Sales, Sagility Health
3:40 PM - 4:15 PM
Johnson & Johnson Business Overview
This presentation will introduce Johnson & Johnson and Johnson Innovative Medicine to our customers by giving an overall business overview. Johnson & Johnson Innovative Medicine is at the forefront of addressing some of the most devastating and complex diseases of our time. We discover and develop innovative medicines to solve the most urgent unmet medical needs of our time. We act as a convener and connecter of care, bringing together entrepreneurs, NGOs, scientists, corporations, governments, suppliers and others to tackle pressing health challenges.
Speaker:
- Frank Alvarado, Director of Strategic Markets for Texas, Oklahoma, New Mexico, and Arizona, Johnson & Johnson
Speakers
Bill Friedman
Vice President of Payer and Provider Engagement, Wider Circle
Bill has deep expertise in selling and marketing digital health engagement solutions to payers and providers with an intimate knowledge of the health payer landscape. Most recently, Bill led payer sales at Carrot Fertility, a global provider of fertility benefits. Prior to Carrot, Bill led all sales and lead generation for Zipari, a SaaS-based consumer engagement solution for health insurers. His team was instrumental in the company’s growth from startup to scale and eventual acquisition by Thoma Bravo, a leading private equity firm. Additionally, he was Senior Vice President and Chief Sales Officer for Health Republic Insurance of New York, the largest CO-OP health insurance carrier in the nation, leading sales operations, broker relations, strategic sales planning, and marketing growing the company from startup to 220,000 members in less than three years. Prior to joining Health Republic, Bill served as Senior Vice President of Sales at Easy Choice Health Plan of New York, where he was vital in launching the company’s Medicare Advantage products, and Atlantis Health Plan, a provider-owned HMO focused on the commercial health insurance space.
Mr. Friedman’s recent speaking engagements include AHIP and The RISE Summit on Social Determinants of Health.
In his spare time, Bill enjoys live music, playing guitar, the NY Yankees, and he is currently studying for his private pilot’s license. He lives in New York’s lower Hudson Valley with his wife, Lisa, four children, and two poodles.
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Claude Pinnock MD, MPH
Chief Medical Officer, Wider Circle
Dr. Pinnock is a healthcare industry veteran with deep clinical strategy and digital health experience and brings a strong passion for improving access and quality to -elevate health for all with a focus on social determinants of health (SDOH).
As Chief Medical Officer at Wider Circle, Dr. Pinnock is responsible for crafting, directing, and overseeing the execution of the company’s clinical and business development strategy for expanding its Medicare and Medicaid business. In addition, he leads research, and supports the senior leadership team in their efforts to further shape and grow the organization, including collaborating closely with Wider Circle’s product, marketing, and sales teams.
Dr. Pinnock began his clinical career in the United Kingdom, earning his Bachelor of Medicine, Bachelor of Surgery (BMBS) at the University of Nottingham and his master’s in public health from Cambridge University. While he began his career as a practicing physician in rural Cambridgeshire, a personal interest in driving the adoption of value-based healthcare in EMEA eventually led to a position at International Consortium for Health Outcomes Measurement (ICHOM). Following a move to the United States, he held leadership positions addressing service redesign, quality improvement, and strategy in public and private health sectors (Stanford University School of Medicine, Clarify Health Solutions). Most recently, he managed global strategic partnerships in health at Meta, Facebook’s parent company, and led their health partnerships innovation team driving global adoption of vaccines.
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Victoria Andrews, NP
Principal Solutions Consultant, Hello Heart
Clinically trained Nurse Practitioner and Exercise Physiologist with 20+ years of experience in healthcare and direct patient care within family practice clinics, health coaching, and cardiac rehab. Supports innovation, strategic planning and expanding partnerships with payers, employers and health systems by capitalizing on expertise in health and well-being. She is passionate about supporting people and organizations on their health and wellness journey to improve heart health, collaboratively focusing on coaching, lifestyle and behavior change.
Victoria lives in Austin, Texas with her husband, two sons and two dogs. She loves being outside, finding good food to eat, and taking naps after trying to keep up with her kids.
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Nicholas Jorris, PharmD
Medical Science Liaison, Immunology Medical Affairs, Biosimilars, Fresenius Kabi
Ricky is part of the US Medical Affairs team at Fresenius Kabi, a global healthcare company that
specializes in lifesaving medicines and technologies used in the treatment of critically and chronically ill
patients. He is a pharmacist with over 10 years of combined retail and pharmacy benefits management
experience.
Ricky has been a member of Fresenius Kabi US Medical Affairs since 2023. He establishes and maintains
scientific relationships with healthcare professionals. Ricky oversees the mountain territory, covering
the following states: Arizona, Colorado, Montana, Nebraska, Nevada, North Dakota, South Dakota, Utah,
and Wyoming.
Prior to joining Fresenius Kabi, Ricky’s career focused on pharmacy benefits management. He worked as
a clinical pharmacist for a technology health startup, Oscar Health, headquartered in New York City.
Ricky oversaw the timely reviews of prior authorizations, as well as working with the formulary
committee to develop and update the health plans formulary. Before working at Oscar Health, Ricky
worked as a pharmacist supervisor at CVS/Caremark in the specialty guideline management department.
Ricky earned his Doctor of Pharmacy degree from the University of Oklahoma Health Sciences Center in
Tulsa, Oklahoma.
Ricky can be contacted directly at Richard.Mendoza@Fresenius-Kabi.com or on LinkedIn
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Sarah Redding
Founder, Pathways Community HUB Institute
Sarah Redding is the Founder of the Pathways Community HUB Institute®, a nonprofit established in 2015 to support the nationally certified Pathways Community HUB Institute® Model. She has been involved with building new and transformative strategies to provide sustainable community-based care coordination using community health workers over the past twenty-five years. Sarah co-founded the Pathways and Pathways Community HUB Institute Models with her husband Mark. Her focus has always been on improving health equity. Sarah received her medical degree from Wright State University School of Medicine and completed a General Preventive Medicine residency at Johns Hopkins University School of Hygiene and Public Health.
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Erik Schindler, PharmD
Associate Director of Medical Value & Outcomes, Sanofi
Erik Schindler, PharmD, BCPS is an Associate Director of Medical Value & Outcomes at Sanofi. In his role, he serves as the medical scientific lead for population-based healthcare decision makers supporting the Sanofi specialty care portfolio. He is a graduate of St. Louis College of Pharmacy and completed postgraduate residency training at the Medical College of Virginia/Virginia Commonwealth University Health System. His background includes acute care clinical practice, adjunct faculty appointment at the St. Louis College of Pharmacy, experience in pharmaceutical industry medical affairs, along with numerous roles in managed-care pharmacy. Prior to joining Sanofi in 2022, he served as Director of Emerging Therapeutics and Outcome-Based Contracting for UnitedHealthcare. In that role, he was responsible for the clinical review, formulary evaluation, pharmacoeconomic analyses, and outcomes-based contracting strategies with an emphasis on specialty medications and emerging technologies for the commercial UnitedHealthcare population.
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Amin Mirhadi, MD
Faculty Physician at Cedars-Sinai Medical Center
Dr. Amin Mirhadi is a board-certified Radiation Oncologist with more than 20 years of practice experience and currently serves as a Faculty Physician at Cedars-Sinai Medical Center. Dr. Mirhadi has designed highly complex specialty programs for utilization management.
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Scott Cowsill
Vice President and Specialist of Clinical Sales, Sagility Health
Scott Cowsill has 20+ years of experience in the healthcare and operational market niche with focused expertise in UM / prior-auth program development, guideline creation, UM tech enablement and overall mass platform deployment. Scott spent many years in Washington D.C. educating Federal policy makers on CDS (Clinical Decision Support) use that eventually began a law for CMS on 4/1/2014.
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Frank Alvarado
Director, Regional Government Account Team, Southwest Strategic Account Management, Johnson & Johnson
Frank Alvarado, the Director of Strategic Markets for Texas, Oklahoma, New Mexico, and Arizona, boasts over 40 years of experience in the Pharmaceutical Market. His journey began in field sales within the industry, and he has since expanded his expertise across various domains, including Hospitals, Managed Care, PBMs, LTC and Federal markets.
Frank’s extensive background spans Commercial, Medicare, and Medicaid Channels, with a focus on diverse therapeutic areas such as cardiovascular health, infectious diseases, oncology, diabetes, neuroscience, immunology, gastrointestinal conditions, respiratory syncytial virus (RSV), and pulmonary hypertension.
His academic pursuits include studies in Cell and Molecular Biology (MS, Florida Tech), Organic Chemistry (BS, University of Mary Hardin Baylor) . Additionally, he holds a Strategy/Management Business Certificates from the University of Texas. Frank’s contributions extend beyond the classroom; he has coauthored research papers in the fields of Cell and Molecular Biology, Organic Chemistry, and Pharmacology.
