TAHP Medical + Pharmacy Directors Forum – June 2023
These invitation-only events 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.
Hampton Inn, San Jacinto Room, 200 San Jacinto Blvd
Jun 21, 2023
9:00 am - 3:30 pm
AltuviiioTM [antihemophilic factor (recombinant), Fc-VWF-XTEN fusion protein-ehtl], a first-in-class, high-sustained Factor VIII replacement therapy for patients with hemophilia A
Learn about AltuviiioTM [antihemophilic factor (recombinant), Fc-VWF-XTEN fusion protein-ehtl], a novel von Willebrand Factor (VWF) independent recombinant factor VIII therapy that is designed to extend protection from bleeds with once-weekly prophylactic dosing for adults and children with hemophilia A. Altuviiio has a 3 to 4-fold longer half-life relative to standard and extended half-life factor VIII products. It is the first factor VIII therapy that has been shown to break through the von Willebrand factor ceiling, which imposes a half-life limitation on earlier generation factor VIII therapies.
Speaker: Erik Schindler, PharmD, BCPS, Associate Director of Medical Value & Outcomes, Sanofi
UNITY Screen: The Only NIPT To Assess Fetal Risk Beyond Chromosome Abnormalities
Learn about BillionToOne’s UNITY Screen, which is highly accurate at assessing fetal risk for recessive conditions and can identify more at-risk pregnancies than traditional carrier screening alone. With a 93.3% sensitivity, UNITY Screen provides a personalized fetal risk score without needing a paternal sample and has the potential to reduce the cost of identifying one affected pregnancy by 62%. Come learn more about how UNITY Screen may not only save significant costs but also supports more equitable prenatal care.
Speakers: Carrie McGehee, VP of Market Access and Rachel Doyle, MS, CGC, Senior Medical Science Liaison, BillionToOne
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How JUDI® Outpaces Legacy Platforms To Give You More Control and Efficiency
Our presentation will showcase 21st century claim processing technology, emphasizing the efficiency, flexibility, and scalability that it can offer. Specifically, we will focus on our platform JUDI and its Tag and Override features, which simplifies the configuration of benefit designs within minutes. We will highlight a real-life example of how JUDI quickly and efficiently handled a New York State Department of Health mandate, within minutes to ensure compliance compared to the legacy platforms that companies are still using. By emphasizing the benefits of modern technology, we aim to show how it can streamline and improve efficiency, reducing cost and maintaining compliance of pharmacy benefit operations.
Speakers: Jessin Joseph, Pharm D, MBA, Senior Director PBA Services and Phil Vecchiolli, SVP/General Manager, PBA Services, CapitalRx
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Building Healthier Communities: The Power of Technology to Facilitate Community Investment
In this presentation, Unite Us will discuss the growing momentum in the United States toward funding community-based organizations to improve non-medical drivers of health. The talk will also cover new models of funding and sustainable solutions, as well as how technology can facilitate more efficient and sustainable funding for these organizations through the braiding and blending of resources. Attendees will gain insights into the potential for technology to transform community investment and drive better health outcomes.
Speaker: Melissa Sherry, VP of Social Care Integration, Unite Us
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Keeping Healthcare Personal in the Age of AI: How Technology Can Enable Person-to-Person Connections to Engage Members, Improve Outcomes, and Meet Metrics
The world is buzzing with excitement about Artificial Intelligence, ChatGPT in particular, and healthcare is no different. Yet, we know from experience that patients in our medication engagement program crave and value person-to-person connections. As health plans consider digital programs to help them engage their members, improve outcomes, and meet metrics, they can’t afford to prematurely adopt AI interventions and sacrifice quality of care. In this presentation, experts will discuss the power of tech enabled relationships, the role of trust and engagement in improving outcomes and pharmacy metrics, and the importance of multimodal interventions when considering the use of AI in healthcare.
Speaker: Sebastian Seiguer, JD, MBA, Co-Founder & CEO of Scene Health.
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Reimagined Blood Testing for Today’s Consumer
One in 3 commercially insured adults skip routine blood work, risking delayed diagnosis and mismanaged conditions. Blood testing hasn’t changed much in 70 years, yet consumers expect increased convenience and more modern approaches to managing their health. The team at Babson Diagnostics will share recent innovations for closing adherence gaps in routine blood testing by expanding member access with alternative collection methodologies and still delivering the quality test results members and their clinicians depend on.
Speaker: Eric Olson, Founder, Chairman and Chief Operating Officer and Dominic Weilbaecher, VP, Payer Relations, Babson Diagnostics
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Supporting Women’s Eye Health
Vision care is a seen as a must-have benefit for consumers and is a critical component of a holistic health plan. Versant Health Chief Clinical Officer Dr. Neelam Gor will take a closer look at how health plans and their managed vision care teams are uniquely positioned to support women’s eye health in a variety of circumstances, including pregnancy. Dr. Gor will provide an in-depth look at the surprising ways that routine vision care can support early intervention across a number of chronic diseases – especially those that disproportionately impact women – and will highlight ways that the broader health care ecosystem can better support women’s vision care
Speaker: Dr. Neelam Gor, Chief Clinical Officer, Versant Health
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Rachel Doyel, MS, CGC
Senior Medical Science Liaison, BillionToOne
Rachel Doyel is a board certified and licensed genetic counselor who joined BillionToOne in January 2023 with almost 20 years of combined clinical and industry experience. After providing prenatal patient care she made the jump to a medical science liaison role in order to contribute to the efforts of ensuring that cutting edge reproductive molecular testing is applied equitably for all patients. She has previously supported clinician and payer educational efforts for carrier screening, NIPT, and prenatal diagnostic testing. She has participated in the education of genetic counseling graduate students, participated on IRB and ethics committees and is active in local and national genetic counseling organizations. She earned her master’s degree in medical and molecular genetics from Indiana University.×
Jessin Joseph, Pharm D, MBA
Senior Director PBA Services, CapitalRx
Jessin serves as a Senior Director for Capital Rx’s PBA Markets team with a specific emphasis on the growth of the Medicaid line of business. He works closely with health plans and managed care organizations to tailor pharmacy benefit programs unique to each plan’s needs while adhering to state and federal government regulations. Prior to joining Capital Rx, Jessin served as the pharmacy director for Kentucky Medicaid, where he led the fee-for-service pharmacy benefit and provided oversight of the state’s six managed care organizations covering nearly 1.5 million Medicaid members. Before joining Kentucky’s Department for Medicaid Services, he worked as a research analyst for the state’s Office of Health Data and Analytics, leveraging Medicaid data to aid state legislators and executive cabinet members in decisions regarding the intersection of managed care pharmacy operations within the state Medicaid agency. Jessin graduated from Drake University, where he earned his PharmD and MBA.×
David Lakey, M.D.
Vice Chancellor, Health Affairs & Chief Medical Officer, The University of Texas System
David Lakey, M.D. is the Vice Chancellor for Health Affairs and Chief Medical Officer at The University of Texas System, and Professor of Medicine at The University of Texas at Tyler Health Science Center. He serves as the executive sponsor for the Texas Collaborative for Healthy Mothers and Babies, the executive sponsor for the Texas Health Improvement Network, and as the presiding officer of the Texas Child Mental Health Care Consortium. He also serves on the state’s COVID Expert Vaccine Allocation Panel.
Prior to joining U. T., Dr. Lakey was the Commissioner of the Texas Department of State Health Services. From 1998 to 2006, he served as the chief of the Division of Clinical Infectious Disease and medical director of the Center for Pulmonary and Infectious Disease Control at the University of Texas Health Center in Tyler. Dr. Lakey graduated from Rose Hulman Institute of Technology, Indiana University School of Medicine, and completed his internal medicine, pediatrics, and infectious disease training at Vanderbilt University Medical Center.×
VP of Market Access, BillionToOne
Carrie McGehee joined the BillionToOne team in August 2021. Carrie is passionate about expanding access to novel diagnostic tests and is recognized for her ability to gain coverage and contracts with Medicare, Medicaid, and private insurance companies. Her work has been defined by developing and implementing strategic and innovative ways to overcome challenges that accelerate top and bottom-line growth. Carrie brings over 20 years of experience working with molecular diagnostic companies and has held several leadership positions including 11 years at Genzyme Genetics and 6 years at Sequenom Center for Molecular Medicine, the first company to bring non-invasive prenatal testing (NIPT) to the market. Carrie and her team were instrumental in policy development for NIPT and contracted with over 200 payers in the US. Carrie started her career in healthcare as a neonatal intensive care and pediatric Registered Nurse. She graduated from North Texas Central College with a degree in Nursing.×
Founder, Chairman and Chief Operating Officer, Babson Diagnostics
Eric Olson is the founder, chairman, and chief operating officer of Babson Diagnostics, a healthcare technology company reimagining diagnostic blood testing. He was instrumental in incubating the first-of-its-kind technologies behind Babson Diagnostics at Siemens Healthineers, where he spent more than 10 years in a variety of leadership roles related to the company’s laboratory solutions. He left to launch Babson in 2017. Eric earned a bachelor of science degree in Biology from the Massachusetts Institute of Technology and a master’s degree in Technology Management from the University of Pennsylvania.×
Erik Schindler, PharmD, BCPS
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.×
VP of Social Care Integration, Unite Us
Melissa Sherry is the Vice President of Social Care Integration at Unite Us, where she works to design payments technology and services to increase funding for social care and community capacity building. She previously served as Director of Population Health Innovation and Transformation at Johns Hopkins HealthCare, where she implemented population health management strategies focused on addressing the social determinants of health. Dr. Sherry specialized in translating available population health data into meaningful and actionable strategies to reduce costs, improve health outcomes, and improve patient satisfaction, with a focus on long-term sustainability.×
SVP/General Manager, PBA Services, CapitalRx
Phil is responsible for the growth and expansion of Capital Rx’s PBA business. He has oversight of market-facing initiatives including direct client development. Phil brings over 30 years of diverse healthcare experience including pharmacy, behavioral health, and general executive leadership. He led national sales and client success teams for Aetna and United Health Group as well as other large healthcare organizations. Phil is experienced in the health plan, health system, employer, and government market segments and brings a proven track record of success to this high-growth area of Capital Rx’s enterprise offering.
Phil has a BS degree in Marketing from Penn State University and has completed several advanced healthcare leadership programs. He loves spending time with his family which includes his wife and two daughters. Phil also enjoys music and sports and resides in the Philadelphia area.×
VP Payer Relations, Babson Diagnostics
Dominic Weilbaecher is VP of Payer Relations at Babson Diagnostics, responsible for leading payer engagement and market access strategy. He has more than 20 years of experience in reimbursement, revenue cycle management, and contracting strategies that enhance collaboration and financial success. He was Regional Sales Director of Health Plans at Quest Diagnostics and has led market access for Agendia, Oncocyte, BillionToOne, and Pathnostics. In addition, Weilbaecher has consulted for laboratories in reimbursement, medical policy inclusion, and contracting.×
Sebastian Seiguer, JD, MBA,
Co-Founder & CEO of Scene Health
Sebastian is the CEO and co-founder of Scene (previously emocha), a medication engagement company that provides personalized, breakthrough medication support by combining video technology, clinical coaching, and validated interventions to radically improve medication adherence rates. In 2014, Sebastian spun Scene out of Johns Hopkins with Dr. Bob Bollinger and other medication adherence experts to help communities served by public health departments, health plans including Medicaid and Medicare, and health systems. Scene is now the standard of care for infectious disease adherence monitoring and is scaling quickly. Sebastian started his career as an attorney with Allen & Overy in London before launching his first company in Munich, Germany, in 2000. He earned his law degree from Columbia Law School and his MBA in Health Care from Johns Hopkins University.×
Dr. Neelam Gor
Chief Clinical Officer, Versant Health
Dr. Neelam Gor, an ophthalmologist, serves as the Chief Clinical Officer at Versant Health. After receiving her training at the Emory Eye Center, Dr. Gor practiced medical and surgical ophthalmology in her previous roles prior to Versant Health. Dr. Gor is responsible for overseeing the medical policy process, the clinical review team under clinical operations, and staying abreast of the latest vision industry developments and regulations. In addition, she supports various teams in the company to develop clinical strategy for ensuring the delivery of the highest quality of services to customers. She is highly skilled in managing clinical teams and overseeing clinical affairs at Versant Health. With her deep understanding of the medical and regulatory landscape in vision care, Dr. Gor is committed to help deliver the best possible services and products to customers. She is a strong advocate for patient-centered care and with her passion for ophthalmology, she is a highly respected leader in the industry well positioned to help drive continued success.×