Best Clinical and Administrative Practices



Medicaid at 40: Demonstrating Quality for 50 Million Americans

Speaker Biographies

Jo Ivey Boufford, MD

Jo Ivey Boufford, MD, served as dean of the Robert F. Wagner Graduate School of Public Service at New York University from June 1, 1997 to November 1, 2002. Prior to that, she served as principal deputy assistant secretary for health in the U.S. Department of Health and Human Services from November 1993 to January 1997, and as acting assistant secretary from January 1997 to May 1997. While at HHS, she served as the U.S. representative on the Executive Board of the World Health Organization (WHO) from 1994-1997 and was re-appointed to this position in May 1998.

From May 1991 to September 1993, Dr. Boufford served as director of the King’s Fund College, London England. The King’s Fund is a royal charity dedicated to the support of health and social services in London and the United Kingdom. She served as president of the New York City Health and Hospitals Corporation (HHC), the largest municipal system in the United States, from December 1985 until October 1989. She joined HHC as vice president for medical and professional affairs in March 1982 and was made executive vice president in May 1985.

Prior to her appointment at HHC, she was director of the Residency Program in Social Medicine at Montefiore Hospital and Medical Center in the Bronx, New York, a unique residency training program to prepare pediatricians, internists, and family physicians for inner-city primary care practice with a team and community focus.

Dr. Boufford was awarded a Robert Wood Johnson Health Policy Fellowship at the Institute of Medicine in Washington, D.C. for 1979-1980. She served as a member of the National Council on Graduate Medical Education (COGME) from 1997-2002 and is currently a member of the National Advisory Council for the Agency for Healthcare Research and Quality. She is currently on the board of directors of the United Hospital Fund, the Primary Care Development Corporation, the Village Center for Care and the International Women’s Health Coalition. She is on the Executive Board of the National Association of Schools of Public Affairs and Administration (NASPAA) and was President of NASPAA 2002-2003. She was elected to membership in the Institute of Medicine in 1992 and is a member of its Executive Council. She received an honorary doctorate of science degree from the State University of New York, Brooklyn, NY in May 1992.

Dr. Boufford attended Wellesley College for two years and received her bachelor’s degree (psychology) magna cum laude from the University of Michigan, and her medical degree, with distinction, from the University of Michigan Medical School. She is board certified in pediatrics.

Gary Claxton

Gary Claxton is a vice president and the director of the Health Care Marketplace Project at the Henry J. Kaiser Family Foundation. The Project provides information, research, and analysis about trends in the health care market and about policy proposals that relate to health insurance reform and our changing health care system.

Prior to joining the Foundation, Mr. Claxton worked as a senior researcher at the Institute for Health Care Research and Policy at Georgetown University, where his research focused on health insurance and health care financing. From March 1997 until January 2001, Mr. Claxton served as the deputy assistant secretary for health policy at the U.S. Department of Health and Human Services, where he advised the Secretary on health policy issues including: improving access to health insurance; Medicare reform; administration of Medicaid; financing of prescription drugs; expanding patient rights; and health care privacy. Other previous positions include: serving as a consultant for The Lewin Group; special deputy in the Office of the Assistant Secretary for Planning and Evaluation; insurance analyst for the National Association of Insurance Commissioners; and health policy analyst for the American Association of Retired Persons.

Arnold M. Epstein, MD

Arnold M. Epstein, MD, MA, is John H. Foster Professor and Chairman of the Department of Health Policy and Management at the Harvard University School of Public Health, and chief of the Section on Health Services and Policy Research in the Department of Medicine at the Brigham and Women’s Hospital. Dr. Epstein’s research interests focus on quality of care and access to care for disadvantaged populations. Recently his efforts have focused on public reporting of quality performance data and Medicaid policies. He has published more than 130 articles on these and other topics. His book, Falling Through the Safety Net, Insurance Status and Access to Health Care, won the Kulp Wright Award by the American Risk and Insurance Association in 1994 for the best new book on life and health insurance.

During 1993-1994, Dr. Epstein worked in the White House where he had staff responsibility for policy issues related to the health care delivery system, especially quality management. He was vice chair of the Institute of Medicine Committee on Developing a National Report on Health Care Quality. He has served as chairman of the Board of AcademyHealth and serves on the JCAHO’s Advisory Council on Performance Measurement. He has served on several editorial boards including Health Services Research and the Annals of Internal Medicine. He is currently associate editor for health policy at the New England Journal of Medicine and a member of the Institute of Medicine.

Foster Gesten, MD

Foster Gesten, MD, is the medical director for the Office of Managed Care in the New York State Department of Health. Dr. Gesten provides clinical direction and leadership for a team of professionals engaged in quality oversight, performance measurement, and clinical improvement within health plans in New York. Major initiatives include the development of statewide public reporting systems for commercial, Medicaid, and Child Health managed care programs on quality, access, and satisfaction. His interests include population health, health service research, and quality improvement projects directed at prevention services and chronic care.

Dr. Gesten is a co-investigator for a CDC grant addressing asthma from a public health perspective and developed a state-initiated program directed at improving the delivery of prevention services to adolescents. Dr. Gesten serves on the Managed Care Technical Advisory Group (TAG) for the Center for Medicare/Medicaid Services (CMS) and is a member of the National CAHPS Benchmarking Database (NCDB) Advisory Group.

Dr. Gesten was trained in general internal medicine at Brown University.

Karen Hein, MD

Karen Hein, MD, is the immediate past president of the William T. Grant Foundation (1998-2003).

Dr. Hein was the executive officer of the Institute of Medicine (National Academy of Sciences) from December 30, 1994 to June 30, 1998. Dr. Hein is clinical professor of pediatrics, epidemiology and

social medicine at Albert Einstein College of Medicine in New York. From l993-l994 she worked on

health care reform as a member of the Senate Finance Committee staff in Washington, D.C., drafting legislation related to health benefits, workforce, and financing medical education and academic health centers.

Dr. Hein graduated from the University of Wisconsin (l966), attended Dartmouth Medical School

(l966-l968) and received her medical degree from Columbia University, College of Physicians and Surgeons in l970. She was one of the founding members of the Dartmouth Medical School Board of Overseers (1973-1978).

During the past 30 years, Dr. Hein has assumed a variety of roles related to health and health policy through her activities in program development, teaching and clinical research. She directed a model program for health care of juvenile detainees. In l987, she founded the nation's first adolescent HIV/AIDS program. She worked closely with the Board of Education to expand AIDS education to the million students in the New York City public school system. She has written over l50 articles, chapters and abstracts related to adolescent health, particularly focusing on high-risk youth. Her book entitled, AIDS: Trading Fears for Facts, has sold over 100,000 volumes.

As president of the William T. Grant Foundation, she has shaped the current focus of the Foundation’s efforts to “help create a society that values young people and enables them to reach their full potential.” With assets of $250 million, the Foundation pursues this goal by investing in research and in people and projects that use evidence-based approaches. Under her leadership, the Foundation has celebrated the appointment of the 100th W.T. Grant Scholar in 2002 and instituted the W.T. Grant Prize for collaboration among scholars, practitioners, and others in 2003.

Dr. Hein has served as advisor to many city, state, federal, and international organizations. She was president of the Society for Adolescent Medicine in l992. She has been a recipient of several awards including an Assistant Secretary for Health Award (DHHS) in l989, Health Care Financing Administrator's Award (HCFA) in l993, and Stewart B. McKinney Foundation in l994 for leadership in the HIV epidemic.

In the fall of 2003, Dr. Hein shifted her scope of activities to promote global peace through volunteer work related to international health and to youth development, focusing currently on Asia and Africa.

In 2004-2005, she participated in post-tsunami relief work in India designing and implementing health assessments in Child Centered Spaces, as well as visiting and evaluating projects in East Africa (Uganda, Ethiopia) and Southern Africa (Malawi and Mozambique). She is currently a Board member of 12 national and international organizations, including The National Board of Medical Examiners, RAND Health Advisory Board, Consumers Union, CCF and is chair of the Board of the Center for Health Care Strategies.

Nicolette Highsmith, MPA

Nikki Highsmith is senior vice president for program at the Center for Health Care Strategies (CHCS) and is director of the CHCS Purchasing Institute. Ms. Highsmith is responsible for the development and management of training, technical assistance, and grant programs for senior level, Medicaid, and SCHIP state executives, health plans, and consumer organizations. She is also responsible for strategic planning and program development.

Ms. Highsmith has significant experience in Medicaid managed care, both as a state purchaser and a federal budget official. Previously, Ms. Highsmith was the Deputy Director of the Medicaid Managed Care Program for the state of Massachusetts where she purchased health care on behalf of the state Medicaid agency. Ms. Highsmith was also a senior Medicaid analyst at the Office of Management and Budget, Executive Office of the President in Washington, D.C., where she was responsible for approving Medicaid managed care waivers and developing the federal Medicaid budget. Ms. Highsmith has a bachelor’s degree in history from the University of Texas and a master’s in public administration from American University.

Julianne Howell, PhD

Julianne R. Howell, PhD, joined the staff of the Division of Chronic Care Improvement Programs at the Centers for Medicare and Medicaid Services in December 2004. She is project officer for the contract with Mathematica Policy Research that is developing and implementing the Performance Monitoring System for the Chronic Care Improvement Program – Phase I as well as project officer for the McKesson Health Solutions Chronic Care Improvement Organization that will serve the state of Mississippi.

From January 2003 through November 2004, Dr. Howell was a legislative fellow on the staff of Senator John Kerry, a position she first assumed as a 2002-03 Robert Wood Johnson health policy fellow. Working with both the personal office and the Democratic Staff of the Senate Small Business & Entrepreneurship Committee on which Senator Kerry is ranking member, Dr. Howell led development of the Senator’s positions on health insurance for small businesses, long-term care, and health information technology.

From 1981 to 2002, Dr. Howell led strategic and major program planning for all facets of the Health Sciences at the University of California, San Diego. Among her many contributions, Dr. Howell led the first-ever strategic planning for the Health Sciences overall and the planning for UCSD Healthcare, the delivery system that integrated the hospital and faculty medical group into a single economic and operational entity. She led planning for a new campus hospital and ambulatory care center in La Jolla and modernization of UCSD Medical Center in central San Diego that together have generated strong market position and financial performance while maintaining the Medical Center’s essential “safety net” role in San Diego.

Dr. Howell is associate clinical professor of family and preventive medicine at the UCSD School of Medicine, teaching undergraduates, medical students, and residents about the organization and financing of the health care system and lecturing on strategy and planning in executive leadership programs.

Dr. Howell received her bachelor’s degree from Harvard/Radcliffe College, a master’s in urban studies and planning from Massachusetts Institute of Technology, and a master’s in public policy and PhD from the John F. Kennedy School of Government at Harvard University.

Robert Hurley, PhD

Robert Hurley, PhD, has been a faculty member in the Department of Health Administration at the Virginia Commonwealth University since 1990, where he teaches courses in managed care and organization theory. He has been conducting research in managed care and other health services issues for nearly 20 years. His research has been supported by several federal and state government agencies, and by a number of private foundations. He has published extensively in most of the major health services research journals. He has given more than 250 presentations around the country to a wide variety of audiences and has testified before the U.S. Senate and several state legislatures.

Dr. Hurley has provided consultation services to numerous federal agencies, including PPRC, MedPAC, HCFA, CMS, HRSA, AHRQ, ASPE, and GAO, and to private research firms including Research Triangle Institute, Urban Institute, and Mathematica Policy Research. He has been a senior research consultant to the Center for Studying Health System Change in Washington for the past four years. He also serves on the editorial boards of Health Affairs, Medical Care Research & Review, Milbank Quarterly, and Managed Care Quarterly. Dr. Hurley received his master’s degree in health administration from the Ohio State University and his PhD from the University of North Carolina--Chapel Hill School of Public Health.

John Iglehart

For the last 24 years, John Iglehart has held two editorial leadership positions in the world of health policymaking. Mr. Iglehart has been editor of Health Affairs, a bimonthly policy journal that he founded in 1981 under the aegis of Project HOPE, a not-for-profit international health education organization. Over this same period, Mr. Iglehart also has served as national correspondent of The New England Journal of Medicine, for which he has written more than 100 essays called Health Policy Reports. Health Affairs, a peer-reviewed, multidisciplinary journal, has made its mark by translating health services research and policy analysis into content that is more accessible to members of Congress and other key private-sector and government participants in federal health policymaking. Health Affairs publishes its journal bimonthly but also posts original, peer-reviewed papers on its Web site every week. Health Affairs is the largest circulating health policy journal in the United States and also has subscribers in 25 foreign countries.

Before 1981, Mr. Iglehart served for two years as a vice president of the Kaiser Foundation Health Plan and director of its Washington, D.C. office. During the decade 1969 to 1979, Mr. Iglehart held a variety of editorial positions, including the editorship of National Journal, a privately published weekly on federal policymaking. Mr. Iglehart was elected to membership in the Institute of Medicine (IOM) of the National Academy of Sciences in 1977 and served on its Governing Council for six years (1985-1991). He also is an elected member of the National Academy of Social Insurance and serves on the Advisory Board of the National Institute for Health Care Management. Previously, Mr. Iglehart served on the boards of the American Board of Medical Specialties, the Educational Commission for Foreign Medical Graduates, and AcademyHealth. He holds a degree in journalism from the University of Wisconsin-Milwaukee and has been a journalist-in-residence at Harvard University.

Risa Lavizzo-Mourey, MD, MBA

Risa Lavizzo-Mourey, MD, MBA, is the fourth president and chief executive officer of The Robert Wood Johnson Foundation, a position she assumed in January 2003. She originally joined the staff in April 2001 as the senior vice president and director, Health Care Group. Prior to coming to the Foundation, Dr. Lavizzo-Mourey was the Sylvan Eisman Professor of Medicine and Health Care Systems at the University of Pennsylvania, as well as director of the Institute on Aging. Under both Democratic and Republican administrations, Dr. Lavizzo-Mourey was the deputy administrator of the Agency for Health Care Policy and Research, now known as the Agency for Health Care Research and Quality, within the Department of Health and Human Services. While in government service, Dr. Lavizzo-Mourey worked on the White House Health Care Policy team, including the White House Task Force on Health Care Reform where she co-chaired the working group on Quality of Care.

Dr. Lavizzo-Mourey’s contributions to health and health care include service on many federal committees such as the National Committee for Vital and Health Statistics, where she chaired the Subcommittee on Minority Populations; and the President’s Advisory Commission on Consumer Protection and Quality in the Health Care Industry as well as private bodies such as the Board of Directors of the American Board of Internal Medicine and the Board of Regents of the American College of Medicine. Dr. Lavizzo-Mourey recently completed work as co-director of a congressionally requested Institute of Medicine study on racial disparities in health care resulting in the publication of Unequal Treatment, Confronting Racial and Ethnic Disparities in Health Care. She is the author of scores of articles and several books.

Dr. Lavizzo-Mourey is a member of the Institute of Medicine of the National Academy of Sciences. She is the recipient of two honorary doctorates and numerous other awards, including ones from the Harvard School of Public Health, Department of Health and Human Services, The National Academy of Sciences, American College of Physicians, National Library of Medicine, American Medical Women’s Association, National Medical Association, and University of Pennsylvania.

Dr. Lavizzo-Mourey earned her medical degree at Harvard Medical School followed by a master’s in business administration at the University of Pennsylvania's Wharton School. After completing a residency in internal medicine at Brigham and Women's Hospital in Boston, Massachusetts, Dr. Lavizzo-Mourey was a Robert Wood Johnson Clinical Scholar at the University of Pennsylvania where she also received her geriatrics training.

David Levin, MD

David M. Levin, MD, is a vice president for medical affairs (VPMA) at Sentara Healthcare, a non-profit integrated delivery system based in southeastern Virginia. Dr. Levin has worked in diverse areas including credentialing, disease management, quality improvement, patient safety, information systems, and new program development. Dr. Levin is the founder and medical director of “Partners in Pregnancy”, an innovative Sentara program which seeks to improve birth outcomes for both the commercial and Medicaid population. Dr. Levin also serves as on-site VPMA for Sentara Leigh Hospital, a 250 bed community hospital.

Sentara Healthcare is a regional integrated delivery system (IDS) comprised of multiple hospitals, managed care, home health, skilled nursing facilities, and physician practices. Sentara is consistently ranked as one of the top 10 non-profit IDSs in the country by Modern Healthcare magazine. Sentara Health Management, a managed care organization with more than 300,000 members was awarded NCQA’s Excellent rating at its last published review. Sentara Family Care (SFC), a managed-care Medicaid program with 100,000 members, is the largest Medicaid HMO in Virginia. SFC has utilized a number of innovative programs in member and provider services, disease management, outcomes measurement, and physician profiling.

Dr. Levin holds degrees in biology and medicine from Brown University, completed his residency in family and community medicine at Brown in 1991 and a fellowship in academic family & community medicine at Eastern Virginia Medical School (EVMS) in 1994. He is also a former vice chairman for clinical affairs in the Department of Family and Community Medicine at EVMS. Dr. Levin has extensive experience in practice management and is a member of the American College of Physician Executives. He also brings to bear over 25 years of experience in information technology and has worked with a wide variety of clients in the development of clinical and educational IT applications. He is married to Dr. Beth Levin, an obstetrician-gynecologist. The Drs. Levin live with their three children along the banks of the beautiful Nansemond River in Suffolk, Virginia.

Estelle Richman

Secretary of Public Welfare Estelle B. Richman's career spans more than 30 years of public service, including her most recent position as managing director for the City of Philadelphia. Prior to her appointment as managing director, Ms. Richman served as director of social services for the City of Philadelphia.

Other positions she has held include the City of Philadelphia's commissioner of public health and deputy commissioner for mental health, mental retardation and substance abuse services; and assistant director with the Positive Education Program (PEP) in Cleveland, Ohio, a day treatment program for children with behavior problems.

A nationally recognized expert on issues of behavioral health and children's services, Ms. Richman has been honored for advocacy efforts by the Alliance for the Mentally Ill, the American Psychiatric Association, and the American Medical Association, among others.

Ms. Richman holds a master's degree from Cleveland State University, Cleveland, Ohio.

She is the mother of two children and enjoys spending time with her three grandchildren.

Cathy Schoen

Cathy Schoen is vice president for health policy, research, and evaluation of The Commonwealth Fund and oversees the Fund's survey work and programs on health care coverage and access. She also serves as the executive director of the Fund's Task Force on the Future of Health Insurance. Before joining the Fund in 1995, Ms. Schoen was on the research faculty of the University of Massachusetts’ School of Public Health, where she taught health economics and was also the director of special projects at the Labor Relations and Research Center. During the 1980s, she directed the Service Employees International Union's Research and Policy Department in Washington, D.C. She served as staff to President Carter's national health insurance task force, with a focus on payment issues, Medicaid, and low income populations. She was also senior health advisor during the 1988 presidential campaign. Prior to federal service, she was a research fellow at the Brookings Institution in Washington, D. C. She holds an undergraduate degree in economics from Smith College and a graduate degree in economics from Boston College. She has published multiple articles and reports on health care, labor, and social policy issues, and co-authored the book Health and the War on Poverty. On behalf of The Commonwealth Fund’s International Health Policy Program, her recent publications include international studies comparing U.S. health care experience to other nations.

Stephen A. Somers, PhD

Stephen A. Somers, PhD, is the president of the Center for Health Care Strategies (CHCS), which he founded in 1995 with a major grant on Medicaid managed care from The Robert Wood Johnson Foundation (RWJF). As CEO of CHCS, he is responsible for the organization’s growth into a nationally recognized center of expertise on best practices in managed care for beneficiaries of this country’s safety-net health coverage programs. CHCS now receives support from multiple philanthropies, including the Annie E. Casey, David and Lucile Packard, and California HealthCare Foundations, as well as The Commonwealth Fund and Kaiser Permanente. Recently, CHCS began working on two major collaboratives addressing racial and ethnic disparities. One collaborative is with 10 of the nation’s largest commercial health plans and is supported by the Agency for Healthcare Quality and Research and RWJF. The other, funded by Commonwealth and RWJF, is with state Medicaid agencies and Medicaid managed care plans across the country. Early in 2005, CHCS also initiated a major project, funded primarily by the Community Benefit Office of Kaiser Permanente, on innovative practices in disease management for people with multiple chronic conditions.

Prior to starting CHCS, Dr. Somers was an associate vice president and program officer at The Robert Wood Johnson Foundation. Before joining the Foundation, Dr. Somers was a staff member at the U.S. Senate Special Committee on Aging, a legislative assistant to U.S. Senator John Heinz of Pennsylvania, and the executive secretary of the U.S. Commissioner of Education’s Task Force on Urban High Schools in the former U.S. Department of Health, Education, and Welfare. Dr. Somers serves as a visiting senior research scientist and lecturer at Princeton University’s Woodrow Wilson School of Public and International Affairs. He earned his PhD in the politics of education from Stanford University.

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