TAHP Medical + Pharmacy Directors Forum
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.
Austin, TX
919 Congress Avenue, Lower Lobby Level
Sep 18, 2024
9:30 am - 3:30 pm
Sponsored by
Agenda
9:30am - 10:15am
Zanidatamab for Second-line Treatment of Locally Advanced or Metastatic HER2+ Biliary Tract Cancer
This presentation in only open to health plan attendees and TAHP staff.
Presentation objectives are to provide an overview of the following information:
1. Overview of biliary tract cancer
2. Disease burden of biliary tract cancer
3. Biliary tract cancer treatment landscape and unmet need
4. Overview of zanidatamab
5. HERIZON-BTC-01: Phase 2 zanidatamab clinical trial design and longer term results
Speaker:
Michael Faithe, PharmD, BCPS- Director-Payer, Value, & Outcomes, Jazz Pharmaceuticals
10:20am - 11:05am
Redefining Pain Management: Integrating Human Expertise & Virtual Solutions to Address the Hidden Challenges of Chronic Pain
With 1 in 5 Americans suffering from chronic pain—more than those affected by cancer, diabetes, and heart disease—addressing this pervasive issue has never been more critical. When pain dominates, it’s all-consuming. Flowly’s virtual clinic model uniquely integrates human expertise with innovative therapeutic modalities to tackle the hidden challenges of pain.
Join us to explore how combining cutting-edge, therapist-delivered pain therapies with virtual, self-guided tools (AI, VR, Biofeedback) can transform the future of effective healthcare.
Speaker:
Celine Tien, CEO & Founder, Flowly
11:10am - 11:55am
Bridging the Gap: The Role of Urgent Care in the American Healthcare System
More and more urgent care centers play a crucial role in alleviating the strain on emergency rooms by providing immediate treatment for non-life-threatening conditions. Dr. Alicia Tezel will highlight how these centers will help reduce wait times and lower healthcare costs by managing minor injuries and illnesses more efficiently. Dr. Tezel will also discuss the increasing importance of urgent care centers in offering accessible healthcare services, especially in underserved areas. Furthermore, she will point out that these centers will often provide extended hours and walk-in services, making them a vital component of the American healthcare system.
Speaker:
Alicia Tezel, CMO, Little Spurs Pediatrics Urgent Care
11:55am - 12:15pm
Lunch Served
12:15pm - 1:00pm
Lunch Presentation - Enhancing Pediatric Care and Reducing Total Cost of Care
Drawing from over 14 years of research with 300 organizations, Coastal Medical’s RightCare Model is now available to support medically complex children and their families. This new value based outcome driven model of care targets the five key outcomes essential for the success of these children and their families. Discover how this model and newly developed resources, tools, training, and support for both providers and families can lead to exceptional outcomes and significant cost savings.
Speaker:
Larry Moorman, Owner Coastal Medical Management
1:05pm - 1:50pm
What’s coming and how to handle it?: Addressing High-Cost Specialty Drug Spend and the Advancements in Cell and Gene Therapies
With the recent surge in FDA approval for costly new therapies and prescriptions, Texas health plans may feel like their budget is a moving target. Dr. Rodney Musselman will share insights and strategies for cell and gene therapies and provide updates on the Cell and Gene Therapy (CGT) Access Model. Byron Harris, PharmD, will discuss effective strategies to manage high-cost drug spend and significance that implementing these strategies can have for health plans. He will also address the increasing demand for GLP-1 agonists including new indications and trends we are seeing with these drugs.
Speakers:
Rodney Musselman, MD, Chief Medical Officer – Commercial and Innovation, Medical Review Institute of America
Byron Harris, PharmD, Vice President – Pharmacy Programs, Medical Review Institute of America
1:55pm - 2:40pm
Predicting and Preventing Complications to Transform Maternal Health in Texas
This presentation explores a novel model of maternal care delivering improved pregnancy outcomes in Texas. We will discuss real-world cases from our programs with Texas health plans to demonstrate how Delfina Care’s cutting-edge technology enables early interventions by predicting complications. These early interventions during pregnancy and postpartum improve maternal and child health outcomes while lowering NICU and maternal readmission rates to reduce the total cost of care.
Speaker:
Senan Ebrahim, MD, PhD, Founder & CEO, Delfina
2:45pm - 3:30pm
Health Equity in Action: Vheda Health’s Clinical Advancements and Impact
This presentation explores the clinical successes and transformative journeys enabled by the Vheda Health program, focusing on health equity, maternal health, and improved diabetic and hypertensive control. We’ll highlight strategies for reaching hard-to-reach populations and addressing health equity in Texas using national best practices. Visual aids will illustrate how our member journey integrates key healthcare elements, driving cost savings, provider engagement, and clinical outcomes.
Speakers:
Amy D’Domenicus, VP, Clinical Development & Design, Vheda Health
Shameet Luhar, CEO, Co-Founder & Board Member, Vheda Health
Speakers
Amy D’Domenicus
VP, Clinical Development & Design, Vheda Health
Amy brings more than 25 years of diverse healthcare experience. At Vheda Health, she leads clinical program design for all Vheda Health chronic care programs, Previously Clinical Director for outpatient practices focusing on Medicare and Medicaid program reform, Amy excelled in roles like Complex Care Manager and PCMH Coordinator at CareFirst. With a background spanning Emergency/Critical Care, Behavioral Health, and Forensic Nursing, Amy is recognized for service excellence and championing patient engagement programs. She holds an RN License and a Bachelor of Science from the University of Maryland, College Park.
×Senan Ebrahim, MD, PhD
Founder and CEO, Delfina
Senan Ebrahim, MD, PhD, is a physician-scientist and entrepreneur dedicated to creating technology to improve global and maternal health. He has an MD and PhD from Harvard in Computational Neuroscience. Senan founded Delfina to create lifesaving AI-powered pregnancy care to solve the maternal health crisis after personally witnessing the challenges faced by pregnant patients and their care teams. Senan also founded Hikma Health, a tech nonprofit creating digital health solutions for refugees, migrants, and other vulnerable populations. Senan enjoys surfing, swimming, and hiking with his son.
×Michael Faithe, PharmD, BCPS
Director-Payer, Value, & Outcomes, Jazz Pharmaceuticals
Michael Faithe is pharmacist and one of the field-based scientific leads for medical payer engagement strategy for Jazz marketed and pipeline products in Oncology and Neuroscience. He is the medical point of contact for key US regional and national payers.
Prior to industry, Michael worked as an inpatient Clinical Pharmacy Specialist in Neurosciences at the University of Colorado Hospital. He was involved in the clinical care of patients with epilepsy, stroke, neurosurgery, and other neurological disorders. Michael has been a guest lecturer and preceptor at the University of Colorado School of
Pharmacy.
Michael resides with his wife and two kids (6 and 2) in beautiful Grand Junction, CO where he enjoys mountain biking, yoga, golf, cross country skiing, camping, and playing the guitar.
×Byron Harris, Pharm D
Vice President - Pharmacy Programs, MRIoA
Byron Harris, PharmD, is the Vice President of Pharmacy Programs for Medical Review Institute of America (MRIoA). In this role, Byron provides oversight of operational and clinical pharmacy services for commercial, Medicare, Medicaid, and Exchange plans. He also works closely with MRIoA’s PBM partners to develop and implement innovative strategies to improve member utilization management experience, reduce high-cost specialty drug spend, identify, and reduce inappropriate utilization, and other operational efficiency programs.
×Shameet Luhar
CEO, Co-Founder & Board Member, Vheda Health
Shameet Luhar brings nearly twenty years of experience leading and growing payor-focused technology companies. Shameet currently serves as the CEO of Vheda Health, a virtual health engagement company dedicated to accelerating health equity for everyone by providing simple access to care from anywhere. Under his guidance, the largest government payors partner with Vheda Health, delivering an 87% engagement rate and 20% medical savings. Previously at Anthem and CareFirst BCBS, Shameet developed member care models, earning URAC’s 2013 Gold Medal for his Medicare STARS Outbound Call program. He holds an MS in Medical Informatics from Northwestern University and a BS from the University of Maryland. A cycling enthusiast, Shameet enjoys long-distance and HIIT rides. Connect with him on Peloton – imshamazing.
×Rodney Musselman, MD
Chief Medical Officer - Commercial and Innovation, MRIoA
Dr. Rodney Musselman joined Medical Review Institute of America (MRIoA) in May 2013 as a medical director and now serves as the Chief Medical Officer – Commercial and Innovation. Dr. Musselman provides clinical leadership to drive the expansion of clinical solutions and growth of MRIoA. He is also involved with the clinical quality management activities of the company.
Prior to joining MRIoA, Rodney completed his undergraduate and medical training at Indiana University School of Medicine and became board certified in Family Medicine in 2003. Dr. Musselman was in clinical practice as a family doctor for 10 years before joining MRIoA.
×Alicia Tezel
CMO, Little Spurs Pediatric Urgent Care
Dr. Alicia Tezel was born and raised in Lima, Peru. At the age of 16 her family moved to Vienna, Austria where she graduated from high school at the Vienna International School.
After graduation she received a scholarship through the Peru Texas Partners program to attend the University of Texas at Austin, where she graduated magna cum laude with a degree in Plan II honors. She then attended the University of Texas Health Science Center at San Antonio for medical school and pediatrics residency.
Following residency, she worked in the Christus Santa Rosa Children’s Emergency Room for over thirteen years. During this time, she met Dr Thomas Spurgat, and in 2006 they opened the first Little Spurs Pediatric Urgent Care in San Antonio. Since then, Little Spurs has grown to 19 locations in San Antonio and Dallas.
Dr. Tezel has served on the Bexar County Child Fatality Review Board, and is past president, and current board member of the San Antonio Pediatric Society. She is also on the board of the Urgent Care Association and is the current Treasurer. One of her proudest accomplishments as Chief Medical Officer at Little Spurs is the accreditation through the Urgent Care Association. She feels that the rigorous accreditation standards have helped enhanced patient care and added a level of professionalism to the clinical staff.
Dr. Tezel resides in San Antonio along with her husband Mark who works for the National Park Service. They have four children and four grandchildren. They enjoy spending time with the family, traveling and hiking throughout our National Parks.
×Celine Tien
CEO & Founder, Flowly
Celine Tien is the founder and chief executive officer of Flowly. In her role, Celine leads a team focused on building an accessible and effective virtual clinic model for chronic pain and anxiety management. Flowly’s virtual clinic model specializes in addressing the bio-psycho-social aspects of the pain and anxiety experience, integrating expert support through licensed therapists and access to at-home biofeedback and VR therapy.
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