Your Expert Speakers

Josh D. Luke, Ph.D., FACHE,

CSO/Sr. Health Policy Analyst,
Nelson Hardiman Law & Compliagent

Peers describe Luke as innovative, a thought-leader on population management, coordinated care, and readmission prevention. As author of “Re-admission Prevention: Solutions Across the Provider Continuum” -- a best-selling management series book of the year for the American College of Healthcare Executives – and “Ex-Acute”, Luke is internationally known as America’s leading healthcare futurist and motivational speaker. Just listen to what one recent attendee had to say: “Dr. Luke's presentation was not only one of the most informative presentations I have ever seen on the health system of the future, but entertaining as well. He utilizes stories to illustrate and help visualize the real-life experiences that foreshadow what to expect in the future.” His experience includes Executive Faculty at the University of Southern California, Sol Price School of Public Policy, in the Healthcare Administration Department at Cal State Long Beach and also at Cal State Fullerton. He is also a former Board member for the Hospital Association of Southern California and the California Hospital Association Center for Post-Acute Care. Having uniquely worked in acute & SNF, Luke founded the National Readmission Prevention Collaborative in 2013 and the National Bundled Payment Collaborative in 2015, to showcase Best Practice integration models. He currently serves in an Editorial and Advisory Board capacity for several organizations including the Readmission News. A veteran hospital CEO, Luke also designed the Total Wellness Torrance population management strategy working with the ACO, Bundled Payment & IPA teams while serving as Vice President, Post-Acute Services for Torrance Memorial Health System. TWT and its Post Acute Network received the 2013 Excellence in Programming award from CAHF. Josh Luke serves as Chief Strategy Officer & Sr. Health Policy Consultant, for Nelson Hardiman LA NH Strategy & Compliagent.

Sheri Poe Bernard, CPC, COC, CPC-I, CCS-P,

Principal Consultant,
Poe Bernard Consulting

Sheri has developed education, training, and referential medical coding and reimbursement compliance and documentation products for 20 years. She was vice president of Training and Quality at Outcomes Health Information Solutions, providing leadership in the establishment of quality measurement for HEDIS and Risk Adjustment auditors as well as the development of online training for hundreds of coders and auditors at Outcomes. Prior to Outcomes, Sheri oversaw curriculum and test development at the American Academy of Professional Coders, where she was vice president of content development for three years. Sheri worked for 15 years at Ingenix, now Optum, as senior director of product development. She is a frequent national speaker on topics including CPT, ICD-9-CM, ICD-10-CM, clinical documentation and risk adjustment. She is a certified instructor through AAPC, where she is also a certified ICD-10 trainer. She lives in Salt Lake City. She is the author of the AMA's 2015 publication, Netter's Atlas of Surgical Anatomy for CPT Coding.

Sue Caito, RN, BSN, CCM, MSCC, CLCP, LNCC

National Director of Case Management,
Signature Medical Group, Inc.

Sue Caito is the National Director of Case Management at Signature Medical Group, Inc. a multidisciplinary physician group practice based in St. Louis, MO. Sue has successfully managed the development of the BPCI embedded case management program focused on care redesign and measurable quality outcomes for 50,000 annual Medicare patients, implemented in 58 orthopedic practices across the United States. Sue has 20+ years of nursing experience in managed care, high risk, complex catastrophic case management and Medicare Secondary Payer Compliance and maintains certifications as a Certified Case Manager, Certified Life Care Planner, Legal Nurse Consultant Certified and Medicare Set Aside Consultant.

Robert Cawley

Director of Health System Transformation
Adirondack Health Institute

Bob Cawley leads Adirondack Health Institutes’ (AHI) Patient Centered Medical Home Initiatives, Physician Practice Support Organizations and Telemedicine. AHI programs include Adirondack Health Home that provides enhanced coordination of medical and behavioral health care by linking community and social supports with health care for high-risk Medicaid members, and Adirondack Medical Home Initiative involving a network of 100+ primary care providers, five hospitals, and seven health insurance organizations are working together to develop an innovative, patient-centered model of health care that strengthens the role of primary care. Prior to his current role at AHI, Cawley was the program manager at MVP, responsible for Medical Home activities. Earlier in his career, Bob managed MVP’s provider database where he worked with the Professional Relations and Credentialing departments to streamline credentialing and provider directory maintenance processes. He joined AHI in 2012. Cawley earned his bachelors of arts in economics and finance from Kent State University.

Joseph F. Ebberwein, BBA, MPS,

Principal
Longitudinal Health

Joseph is a principal of Longitudinal Health, a consulting firm which develops strategies for providers migrating from volume to value-based care delivery using leading edge technologies. Ebberwein also is founder and CFO of Corstrata, a Telemedicine wound care management company which pairs certified wound clinicians with technology to manage patients with complex wounds. A graduate of the University of Notre Dame Business School, he was a CPA with Arthur Andersen and Price Waterhouse before joining the health care industry in 1990. Ebberwein blends his knowledge of provider reimbursement models and technology to devise strategic positioning in various financial and strategic capacities. He has over 25 years experience in the post acute space, utilizing telehealth for 15 years in home care operations to improve clinical quality outcomes at a lower cost through improved operational efficiencies. He speaks nationally regarding the benefits of integration of Telehealth into care delivery models. Passionate about the culture of serious illness and end of life, he currently serves on the board of the Hospice and Palliative Nurses Association.

Ellen Fink-Samnick, MSW, ACSW, LCSW, CCM,

Owner,
SEFS Supervision Strategies, LLC.

Through professional speaking, mentoring, authorship & consultation, Ellen empowers healthcare's transdisciplinary workforce. Most recently, Ellen co-author the book COLLABORATE© for Professional Case Management: A Universal Competency-Based Paradigm, published by Wolters Kluwer. Ellen is adjunct faculty for George Mason University's College of Health & Human Services, Director of Social Work Education for Athena Forum, LinkedIn Moderator for Ellen's Ethical Lens©, trainer for the National Association of Social Workers, and serves as a current Editorial Board Member for Lippincott's Professional Case Management.

Ellen is an Ethics Category Honorable Mention for the Dorland Health People Awards, recipient of the Master Teacher Award for George Mason University's College of Health & Human Services and Case Manager of the Year for the Case Management Society of America's Washington, DC Chapter. She has served as a Commissioner for CCMC and Chair of their Ethics & Professional Conduct Committee, plus in a variety of leadership roles amid the industry's professional associations. Ellen is a vibrant and revered professional voice.

Barbara Harding, RN, MPA, PAHM, CCM

Senior Clinical Consultant,
BlackTree Healthcare Consultants

Barbara Harding, a Registered Nurse and Certified Case Manager, has extensive experience working with disabled and disadvantaged populations. As a change agent, she has approached solutions to problems using creativity and innovation developing person centered models of care focusing on improved outcomes, patient satisfaction and clinical efficiencies with a focus on population health. She has presented at nationally during the past two years discussing the use of interprofessional teams in the management of complex care patients. More recently, her work has focused on models of care with focus on post-acute care strategies and improved care management through the Bundled Payment Care Improvement project.

Diane Link, RN, MHA

Diane Link, RN, MHA

Senior Clinical Consultant,
BlackTree Healthcare Consultants

As an RN with more than 24 years of home health and hospice experience, Link specializes in all aspects of clinical management including outcome improvement programs, regulatory and compliance programs, episodic management and survey readiness and remediation. Her tenure includes serving in a variety of roles in home health and hospice from field nurse to executive director of home health and hospice. She also served as the community integration executive director for a health system in Maryland focused on building collaborative partnerships with community providers including skilled nursing facility, assisted living facilities and physicians to improve population health and reduce hospitalizations. She was a surveyor for home health, hospice and private duty services for CHAP (Community Health Accreditation Partners). Diane is a frequent contributor to DecisionHealth’s Home Health Line newsletter and is known for her inspiring and knowledgeable presentations at state and national conferences. She is the author of “The Hospice Guide to Quality Care and Reporting: Promoting Sustainability in an Evolving Regulatory Climate”. Diane has a Master’s Degree in Healthcare Administration and a green belt in Lean Six Sigma from Mount Saint Mary’s University in Maryland.

Robert Markette

Attorney
Hall, Render, Killian, Heath & Lyman, P.C.

Robert’s primary areas of practice are health law, Medicare/Medicaid compliance, fraud and abuse, employment law and litigation. He is certified in health care compliance by the Health Care Compliance Board. Robert assists clients including county health departments, home health agencies, private duty agencies, hospices and physicians with a wide range of health care compliance and litigation issues. Robert is a frequent speaker on compliance topics across the country, presenting to the American Health Lawyers Association and the National Association for Home Health and Hospice Care, as well as other national speaking events and numerous state trade association conferences and continuing education sessions.

Regina Mudd, RN, BSN, ONC

System Director, BPCI Operations,
Dignity Health

Regina Mudd has experience in Med/ Surg nursing education and Orthopedic service line coordination. She has participated in multiple performance excellence projects to identify best practices and processes. Most recently has functioned as the project manager for the Dignity Health beta sites in BPCI.

Joseph C. Nichols, MD

President, Health Data Consulting, Inc.
AHIMA approved ICD-10 coding trainer

Dr. Nichols is a board certified Orthopedic Surgeon with a long history in health information technology. He has a wide range of experiences in healthcare information technology on the provider, payer, government, and vendor side of healthcare business. He has served in positions in executive management, system design, logical database architecture, product management, consulting and healthcare value measurement for the last 18 of his 25 years in the healthcare industry.

He has given more than 200 presentations nationally related to ICD-10 and clinical documentation improvement during the past 3 years on behalf of CMS, payers, providers, integrated delivery systems, consulting groups, universities, government entities, vendors, and trade associations. He co-chairs the WEDI (Workgroup on Electronic Data Interchange) translation and coding sub-workgroup and has received WEDI merit awards 3 years in succession. He is also an AHIMA approved ICD-10 coding trainer. He is currently providing consulting services as the President of Health Data Consulting Inc.

Alina Orozco, RN

Director of Managed Care Coordination
Clear Health Alliance

Alina is Director of Managed Care Coordination for Clear Health Alliance, an HIV Specialty Medicaid Plan offered by Simply Healthcare Plans. Working in the HIV/AIDS arena since 1989, she has been privileged to work alongside community and industry professionals focused on serving those affected by HIV and ending the AIDS Epidemic. In addition to case management, her experience includes HIV/AIDS treatment education, counseling and testing, development of HIV prevention programs and training on a state and national level. She currently manages a group of 45 dedicated case managers serving 9,500 plan members in 60 counties of the state of Florida.

Danielle Pierotti, RN, PhD, CENP

Vice President,
Quality and Performance Improvement Visiting Nurse Associations of America

Danielle Pierotti is the Vice President of Quality and Performance Improvement with the Visiting Nurse Associations of America. In partnership with member home health and hospice organizations across the country, she brings innovation to care practices, seeking to continuously improve practice and meet evolving patient needs through the application of evidence. Danielle has been a nurse for more than 20 years, practicing in hospitals, ambulatory and home-based care and serving in medical-surgical, oncology, quality and leadership roles. Prior to joining VNAA, she led hospice services with the largest provider in Iowa, ensuring end-of-life care across 42, mainly rural, counties. She developed and initiated a new specialty role in hospital-based nursing quality guiding the organization to achieve Magnet status. Her doctoral research was an examination of nurse-sensitive outcomes in hospitalized oncology patients.

Sam Quintero

Statewide Program Manager, Community Relations,
Clear Health Alliance

Sam began his career as an HIV/AIDS Treatment Educator and Advocate in 1999 at AIDS Project Los Angeles, a nationally known and highly respected AIDS Service Organization. Once he moved back to his home State of Florida, he worked as a Medical Case Manager for Mercy Hospital’s Ryan White and PAC Waiver Programs and became a Supervisor for the for the same health institution thereafter. In 2006, Sam was presented with a career opportunity abroad, and for the following 5 years lived and worked in Barcelona, Spain as an Executive Director of a non-profit HIV/AIDS Service Organization. In 2011, he returned to the States and joined the South Florida AIDS Network team, SFAN at Jackson Memorial Hospital to be the Ryan White/Medicaid eligibility supervisor and Medical Case Manager for persons living with HIV/AIDS. A year later he was invited to join Simply Healthcare Plans to launch the first Medicaid Specialty Health Plan in Florida, Clear Health Alliance, as a Case Manager/Managed Care Coordinator. During his time working with Clear Health Alliance, his Case Manager/Care Coordinator position evolved onto different areas of responsibility and roles within the Specialty plan, e.g., “South Florida Outreach Coordinator”, “Statewide Outreach Specialist”, “Provider Relations Regional Manager,” and his current position as a “Statewide Program Manager, Community Relations.” Therefore, he has a complete knowledge and full understanding of every aspect of the Medicaid Specialty Health Plan, Clear Health Alliance. Sam is currently a board member of the Miami-Dade HIV/AIDS Partnership, the official county planning board for HIV/AIDS services. He also attends and serves as a community liaison for all HIV/AIDS planning boards in the State of Florida.

Jennifer Searfoss, JD, CPOM, CHCI, CMCS

Founder and CEO,
SCG Health

Jennifer is a certified medical coding specialist, certified healthcare coding instructor and certified practice office manager by the Professional Association of Healthcare Coding Specialists. Jennifer was the vice president of external provider relations for UnitedHealthcare, where from 2007 to April 2011, she established and led the Provider Communications & Advocacy unit. Jennifer also has served as the external relations liaison for the Washington, D.C.-based Government Affairs Department of the Medical Group Management Association (MGMA). Jennifer received her undergraduate degree in health science and policy from the University of Maryland, Baltimore County and law degree from the University of Maryland.

Alison S. Tothy, M.D.

Chief Experience and Engagement Officer, Associate Professor of Pediatrics,
University of Chicago Medicine and Biological Sciences Division

From high level strategy to oversight in development, implementation, and execution of the vision and strategy of the Patient Experience and Engagement Program, Dr. Tothy provides content expertise to help to identify and implement national best practice service level standards, patient-centered care strategies and innovative approaches to patient care. Prior to her current role, Dr. Tothy served as the Associate Chief Medical Officer for Patient Experience at University of Chicago Medicine, as well as the Medical Director and Section Chief of Pediatric Emergency Medicine at the University of Chicago. Dr. Tothy is a Certified Patient Experience Professional and has extensive leadership training including certificates in Lean Healthcare, Team STEPPS, the Chicago Management Insititute at the Booth School of Business, and Patient Experience Leadership from the Beryl Institute. She is a recognized national physician leader in both Pediatric Emergency Medicine and patient experience. Recent speaking engagements have included: The Leapfrog Group, Brand Health for Google, Press Ganey, Beryl Institute, the World Congress, and UHC. Additionally, as a Media Spokesperson for the American Academy of Pediatrics (AAP), Dr. Tothy has spoken in various media settings on many pediatric topics. Dr. Tothy received her B.A. from Brandeis University and obtained her M.D. from Mount Sinai School of Medicine in New York City. She completed a residency in Pedatrics and a fellowship in Pediatric Emergency Medicine at Children’s Memorial Hospital through the Feinberg School of Medicine at Northwestern University. She is currently an Associate Professor in the Department of Pediatrics at the University of Chicago and is a physician in the Pediatric Emergency at the University of Chicago Comer Children’s Hospital.

Susan Weber, RN

Susan is a registered nurse with more than 19 years of nursing experience including more than 14 years in home health. She has served as a field nurse case manager, administrator, chief operations officer and chief nursing officer. As a health care consultant and co-owner of The Aspen Group, she helped providers achieve and maintain regulatory compliance. She participated in many successful state licensure and Medicare accreditation/deemed status surveys. She also has two years of experience as a home health and hospice surveyor.