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Payor/Provider: Coordination of Disease Management

Panelists will discuss the coordination of preventative and health services in disease management. This panel will explore barriers and potential solutions to effectively coordinating services for patients with complicated chronic diseases. The discussion will also include other critical and pertinent topics such as reimbursement policy and who (health plans or provider groups) can best provide patient services. These issues will be discussed from both an administrative and business perspective.

Confirmed Panelists:

Moderator & Panelist Bios

David Goodman, MD, Co-founder and CEO, Momentum Health Solutions, Inc.
David currently serves as co-founder and CEO of Momentum Health Solutions, Inc. a healthcare services company focused on creating a scaleable and integrated approach to delivering occupational medical care, wellness/prevention and disease management services to employees at work. He also serves on the board of directors of NeuroMetrix (NASDAQ:NURO), a neurodiagnostics and therapeutics company. Previously, David was the founding CEO of LifeMasters Supported SelfCare, a leading disease management services company. David also served as President and CEO of BaroSense, an emerging company developing implanted devices for treating obesity. While in medical school, David co-founded Aradigm (OTC:ARDM) an innovator in aerosol drug delivery technologies.

David began his career as the first engineer at Nellcor Incorporated, co-inventing the disposable sensors for the pulse oximeter. He has an MSE in Bioengineering from the University of Pennsylvania and his MD, cum laude, from the Harvard-MIT Division of Health Sciences and Technology. David holds 18 patents.

Andrew Halpert, MD, Senior Medical Director, Blue Shield of California
Andrew Halpert, MD is the Senior Medical Director, Network Medical Management. In this capacity he oversees a wide range of clinical activities spanning case and disease management. In addition, his team performs multiple network oversight functions and handles member appeals and quality of care cases.

Prior to joining Blue Shield, Dr. Halpert was a practicing internist and the Chief of the Harvard Vanguard Division of Medicine at Brigham and Women's Hospital where he was responsible for the management of the hospital based programs for this large multi-specialty medical group.

After receiving a BA from Harvard University, Dr. Halpert graduated from the UCSF School of Medicine and then completed his internship and residency in Internal Medicine at Stanford University Hospital.

Michael J Belman, MD MPH, Medical Director of Clinical Quality, Blue Cross of California
Dr Michael Belman joined WellPoint/Blue Cross of California 11 years ago and is currently Medical Director of Clinical Quality for the West region that includes, California, Nevada and Colorado. His responsibilities include oversight of external accreditation requirements, quality improvement activities for both the HMO and PPO networks, disease management programs, relationships with the medical leadership of contracted medical groups and production of the annual Blue Cross Provider Group and PPO Physician Quality Scorecard.

Prior to joining Blue Cross Dr Belman was the Director of Pulmonary Medicine at the City of Hope Medical Center and subsequently Director of Pulmonary Physiology in the Division of Pulmonary/Critical Care Medicine at Cedars Sinai Medical Center and Professor of Clinical Medicine at UCLA. In addition to research papers on clinical topics related to pulmonary medicine he has also published studies on health services research and clinical quality improvement.

Dr Belman received his medical degree from the University of the Witswatersrand in Johannesburg, South Africa. He completed his Internal Medicine training in Tel Aviv, Israel and his pulmonary training at Case Western Reserve University in Cleveland, Ohio. He is board certified in Internal Medicine, Pulmonary Medicine and Critical Care. In 1997 he obtained a MPH degree from the Department of Public Health at UCLA.

Paul Swenson, Executive VP - Administration, John Muir Health
Mr. Swenson joined John Muir Health as Executive Vice President-Administration in January 2006 after serving as a strategic consultant to various hospital, health plan and physician organizations during 2005. His current responsibilities comprise finance, human resources, information technology, legal, compliance and community benefit. Previously, Mr. Swenson was with Blue Shield of California (1988-2004) in various positions including CFO, SVP for the Northern Region business unit and EVP-Corporate Development. Between 1990 and 1998, he held several general management positions with Aetna's health plan organization in California. Prior to that, he was Chief Operating Officer for Bay Pacific Health Plan (1998-1999), and for the 1996-1998 period served as a senior manager for the Amherst/Ernst and Whinney healthcare consulting practice. Mr. Swenson holds a B.A. from Duke University and M.B.A. from the University of California, Berkeley.

Wells Shoemaker, MD, Medical Director, California Association of Physician Groups
Dr. Shoemaker is the medical director for the California Association of Physician Groups (CAPG), representing 150 organized medical groups serving over 13 million Californians in coordinated, prepaid systems of care. Dr. Shoemaker also serves as co-chair of the California Quality Collaborative, a statewide collaborative of purchasers (PBGH), 3 major health plans, and CAPG. (www.calquality.org). Between 1995 and 2006, he served as the first medical director for the regional Medi-Cal managed care program in the Central Coast, and then the medical director of an IPA in Santa Cruz County.

Before assuming full time administrative roles, Dr. Shoemaker practiced primary care pediatrics for 17 years, founded an intensive care nursery and a human lactation center, taught in a family practice residency program, and organized a county wide diabetes program. He completed the California Healthcare Foundation leadership fellowship in 2002-2004.