The health care industry faces ongoing pressure to cut costs, increase efficiency, and deliver high-quality services to patients. Join Bloomberg Law for a half-day live event that provides legal leaders the latest insights on creating successful value-based health care.
This Bloomberg Law briefing, exclusively sponsored by Ropes & Gray, will cover the current regulatory framework, effective delivery and payment models, and the pivotal role of technology.
You are a corporate & industry leader under immense pressure to cut costs, increase efficiency, and deliver the latest in health care for your patients and clients. You are business-minded, strategic and focused on value-based health care models.
Who Should Attend:
1:33 PM Keynote Interview
Bloomberg Law interview with a public sector leader on the current state of value-based health care.
Interviewed by: Shira Stein, Reporter, Bloomberg Law
Hospitals and health systems must deploy new tech capabilities as they transition to value-based delivery and payment and are creating nontraditional partnerships with new entrants into the industry who provide alternative health care service delivery models. Hear about new strategic partnerships created through mergers and acquisitions and how they enhance a value-based approach.
Moderated by: Kathleen Blake, Senior Vice President, Healthcare Quality, American Medical Association
Business models for value-based health care must navigate today’s fraud and abuse laws carefully and find innovative ways to ensure any incentives and compensation are compliant. Hear about what violates current fraud and abuse laws, potential penalties for violation, and possible developments in the regulatory framework that will impact value-based care models.
Moderated by: Betsy Mountenay, Analysis Manager, Bloomberg Law
Mark will discuss the challenges of big data research as it applies to value-based health care, including health services research, how to obtain the necessary data, and how organizations are allowed to collect and use data.
3:45 PM Networking Break
Artificial intelligence and other emerging technology tools can streamline data collection and tracking to ensure quality patient reporting and other value-based metrics. This panel discusses unique PII and PHI privacy issues in health care when implementing this key technology.
Moderated by: Elena Elkina, Partner/Privacy & Data Management Executive, Aleada Consulting
Value-based care has already demonstrated increased savings and quality of patient care, yet health-care organizations still struggle to implement effective business models. This panel explores the current regulatory framework impacting value-based health care, how to incorporate new and emerging technologies into your business model, and where value-based health care is headed so you can prepare.
Moderated by: Betsy Mountenay, Analysis Manager, Bloomberg Law
5:33 PM Cocktail Reception
6:30 PM Program Concludes
Opening Remarks: Welcome from Bloomberg Law
Value-Based Health Care: Strategic Partnerships
Updating the Framework: Fraud & Abuse
Spotlight Session: Insights from Ropes & Gray
Essential Technologies: Key Privacy Concerns
What’s Next?: The Future of Value-Based Care in the Digital Age
Closing Remarks: Wrapping Up from Ropes & Gray
Mark advises clients throughout higher education and the health care industry, including pharmaceutical companies, medical device manufacturers, biotechnology firms, IT companies, hospitals, and universities. He has extensive experience in legal issues related to research with humans and animals, stem cell and genetic research, research grants and contracts, research misconduct, international research and data privacy. In 2012, with Dr. Barbara Bierer, Mark started, and continues to serve as faculty co-chair of, the Multi-Regional Clinical Trials Center of Harvard University and Brigham and Women’s Hospital, a project designed to improve the planning, conduct and regulation of multi-national clinical trials, with a special emphasis on trials in the emerging economies.
Mark was a partner at Ropes & Gray from 2001-2008, before leaving to serve as Executive Vice President and Chief Administrative Officer at St. Jude Children's Research Hospital. Before returning to the firm, Mark also served as Senior Associate Provost for Research at Harvard University. At Harvard, he supervised the University’s sponsored research operations and was responsible for the full range of research policy and compliance issues, including human subjects research, research misconduct, export controls, conflicts of interest, and grants and contracts compliance. In 2012, during a period of intense regulatory scrutiny, Mark served as the managing director of Harvard's Primate Research Center.
Mark has particular experience in establishing legal structures and operational plans for international service and research projects, especially in emerging economies. For St. Jude, he established a vaccine study center in the Eastern Highlands of Zimbabwe, in collaboration with Africa University. While at Ropes & Gray, he started and served as the first executive director of Harvard’s extensive PEFPAR-funded AIDS treatment programs in Nigeria, Tanzania and Botswana, and later served as the chair of the oversight committee for that project. At Harvard, he worked with faculty from across the University to establish service, demonstration and research projects throughout the world, including China, Viet Nam, Colombia, Peru, and the Gulf States, among other countries.
Since 1986, Mark has taught at a number of law schools, including Columbia, NYU, Harvard, and Yale. The subjects he has covered include health care law and finance, public health law, the law of human subjects research, occupational health law, and managed care law. He currently holds a faculty position at Yale Law School, where he teaches health care law and finance and public health law, and at the Yale School of Medicine, where he teaches the history of the regulation of the medical profession, medical malpractice, and medical privacy.
Mark’s diverse legal background also includes senior policy and administrative positions at the New York State Department of Health and the New York City Department of Health, where, among other duties, he directed the Ryan White CARE Act program providing medical, substance abuse and mental health treatment to New Yorkers living with HIV/AIDS. In 1993, he served as legal advisor to the health reform efforts at the Clinton White House, and has been president of the New York State Bar Association Health Law Section (2007-2008).
Dr. Blake is Vice President, Healthcare Quality at the American Medical Association, where she leads the payment and quality initiatives of the AMA’s Professional Satisfaction and Practice Sustainability unit and is principal investigator at AMA for the CMS’s Transforming Clinical Practice Initiative. From April 2013 until April 2016, she was executive director of the PCPI®, which includes among its activities the National Quality Registry Network™. A member of the Governing Committee of the National Evaluation System for health Technology (NEST) coordinating center, Dr. Blake was also co-chair of the Health Information Technology Policy Committee of the Office of the National Coordinator for Health Information Technology until April 2017 and co-chair of its Quality Measures Task Force. At AMA, she chairs the Clinical Review Group of AMA’s Integrated Health Model Initiative (IHMI).
Dr. Blake is a clinical cardiac electrophysiologist who received her education and training from the University of Chicago, Stanford University and the Johns Hopkins Bloomberg School of Public Health. From 1988 until 2011, Dr. Blake practiced at the New Mexico Heart Institute, where she also served as President. She is a part-time member of the Johns Hopkins University medical faculty.
Susie Bokermann is an Analyst Manager, Legal Operations & Markets, Bloomberg Law. She creates high-value legal content, practical guidance, and tools relating to legal operations and emerging technologies.
She also serves as a business liaison for Bloomberg Law clients on the west coast and helps to build and manage a broader set of relationships in the Legal Operations space, as well as other fast-growing legal markets such as IP, privacy, and emerging technology.
Susie received her B.A. from Georgetown University and her J.D. from American University, Washington College of law.
John Chesley has been a member of the health care group at Ropes & Gray since 1985. For over 25 years he has focused on meeting the needs of clients in complex transactions and challenging regulatory contexts.
John blends transactional skills with knowledge of tax-exempt organizational law, regulatory issues and securities law. He has served as lead transaction counsel in nonprofit mergers and affiliations (including a major provider-insurer affiliation noted by Modern Healthcare, the Wall Street Journal and others as a "game changer"), as outside general counsel to a health care system, and as borrower's counsel and underwriter's counsel on numerous higher education, health care and other 501(c)(3) financings. He advises a leading university on capital finance matters, and he counsels boards on governance matters.
John’s practice ranges from AAA-rated institutions to distressed credits, with a particular emphasis on complex structuring and strategic relationships at the intersection of industry change.
Mark is a national expert in strategy and innovation, with more than 30 years of consulting experience with health systems, hospitals, academic medical centers, health plans, and physician organizations. In addition to strategy he focuses on mergers and alliances, alignment, enhancing the effectiveness of clinical service lines, and ambulatory and post-acute care development.
Mark is a frequent speaker for regional and national healthcare organizations. He has taught courses for the American College of Healthcare Executives since 1999. He has published in books and authored more than 30 articles.
Cindy Ehnes is an attorney licensed in California and Colorado. She currently serves as Executive Vice President of COPE Health Solutions; a health care consulting firm focused on helping clients succeed at building sustainable integrated, value-based care systems. Cindy provides interim CEO leadership, expert witness services and subject matter expertise.
Cindy served as Gov. Schwarzenegger's Director of the California Department of Managed Health Care for seven years, overseeing health insurance services for 21M Californians. Mrs. Ehnes regulated the operations, clinical and financial performance for 105 health plans and 220-delegated medical groups.
Prior to her move to California in 2002, Cindy served as Chief of Enforcement for the Colorado Division of Insurance.
Cindy’s young daughter was medically uninsurable from birth; this mobilized Cindy to lead a grassroots lobbying effort in 1986 to create Colorado’s high-risk pool. Cindy served as the Consumer representative to the Plan and a 4-year term as Chairman.
Elena Elkina is a Co-founder and Partner at Aleada Consulting, where she advises clients on privacy, data protection, and information security issues.
Elena is known for her entrepreneurial approach to driving business performance while protecting information and serving as a trusted adviser for her clients. During her 20-year legal career, she has worked with financial and healthcare institutions, Internet of Things, logistics management, and software companies, major law firms, and the government sector on both international and domestic levels.
Over the past decade, Elena has focused on creating enterprise-level global (i.e., European Union, Asia Pacific, Canada) privacy and data protection programs, including developing and implementing regulatory frameworks, risk/gap assessments, maturity models, long-term roadmaps, and data protection policies; designing and employing de-identification and Privacy by Design data handling processes; reviewing products to assess digital marketing compliance; and building privacy and security training and awareness programs. She has worked closely with development and business teams to build cloud, web, and mobile consumer and business products across the globe. Elena also served as a subject matter expert for global companies that were subject to privacy related regulatory enforcement actions, including consent decrees and cease and desist orders.
Elena is a Co-founder and a Board Member for Women in Security and Privacy (WISP), a non-profit organization that aims to advance women in the privacy and security fields. She also serves on the advisory board of StaySafeOnline, Privacy Day where she educates and empowers our global digital society to use the internet safely and securely.
Elena received her law degree from the University of Russian Academy of Education in Moscow, Russia. She received her LL.M. degree from Berkeley Law School, where she studied privacy, technology transactions, and international law. Elena is a Certified Information Privacy Professional (CIPP/US, CIPP/E, CIPP/IT, CIPM). In 2018, she received a Global Mentor Financial Times award “HERoes Champions of Women in Business 2018”.
Brett Friedman is a partner in the health care group and co-head of the firm’s Digital Health practice. Brett has significant experience in advising clients on a variety of complex transactional, enforcement and regulatory matters within the health care and digital health industries. His clients have included
hospitals, managed care plans, pharmacy and dental benefit managers, home care agencies, health IT and telehealth providers, pharmaceutical and device manufacturers, and community-based providers of care to individuals with mental illness and developmental disabilities.
Brett has particular experience counseling both payer and provider clients in responding to the transition to accountable care and value-based payment, including the development of provider risk-bearing organizations, Accountable Care Organizations (“ACOs”), independent practice associations (“IPAs”), and other integrated delivery networks. Brett also routinely advises clients in the course of government investigations, audits, and self-disclosures concerning potential violations of Medicare and Medicaid regulatory authorities and health care fraud and abuse laws. In addition, Brett’s transactional experience includes advising private equity, for-profit and tax-exempt clients regarding health care due diligence, regulatory and reimbursement issues.
Deborah Gersh is the co-chair of Ropes & Gray’s nationally recognized health care practice and the co-leader of the firm Health Care and Life Sciences Industry Group. She has over thirty years of experience advising health care industry clients and investors on mergers, acquisitions, and joint ventures, and the complex regulatory regimes implicated by such transactions. She has also counselled many clients through the implementation of value-based care (“VBC”) initiatives, and is recognized as a leading voice on structuring innovative arrangements, including novel business models and structures designed to foster biotechnology companies expansion beyond their traditional market into the provider space. She also publishes and presents extensively on VBC.
As a leading practitioner also on privacy, data security and cyber-security issues, Ms. Gersh advises clients on an array of data privacy, protection and security matters under HIPAA as well as state privacy and security laws. She has represented clients involved in security incidents involving protected health and other sensitive personal information, including representing clients in matters involving the United States Department of Health and Human Services, Office for Civil Rights, as well as HIPAA security audits and qui tam actions initiated by state and federal government authorities.
Recently, she was part of the firm’s team that secured a landmark victory for LabMD in its dispute with the FTC over the company’s security practices.
Ms. Gersh’s clients include pharmaceutical manufacturers and medical device companies, managed care companies, dental service organizations and practice management companies, academic medical centers and community hospitals as well as private equity and venture capital companies investing in the health care and life sciences industries.
She is a member of the Ropes & Gray Women’s Forum, which promotes professional growth among female lawyers.
Betsy Mountenay is an Analysis Manager on the Regulatory and Compliance Team at Bloomberg Law. In her time with Bloomberg Law, she has focused on a variety of legal issues affecting the health care industry, including fraud and abuse issues involving the False Claims Act, anti-kickback statute, and Stark Law, HIPAA and GDPR privacy and cybersecurity requirements, and health care business and transactional matters. Barred in the state of Maryland, Betsy holds a J.D. from George Mason School of Law and a B.A. from Dickinson College.
Since 2014, Erica Murray has served as President and CEO for the California Association of Public Hospitals and Health Systems (CAPH). Prior to this appointment by the CAPH Board of Directors, Erica was Senior Vice President; in that capacity, she was responsible for leading the organization’s policy and government relations efforts. She has worked at CAPH since 2005, with a focus on policies to challenge, support and strengthen public health care systems’ successful delivery system improvements, many of which have been fostered by CAPH’s 501c3 affiliate, the California Health Care Safety Net Institute (SNI). These improvements include chronic disease management, language access services, and outpatient service delivery efficiencies
Ms. Murray came to CAPH/SNI with a varied background in health policy spanning the federal legislative and executive branches, as well as the private sector. Prior to joining CAPH/SNI, Ms. Murray served as health policy Legislative Assistant for former U.S. Senator John Edwards (D-NC). She also served as an analyst at the Advisory Board Company, a member-based health care think tank and consulting firm for hospitals and health care systems. From 1997 to 1999, she served as a consultant to the U.S. Department of Health and Human Services, where she helped launch the AIDS Drug Assistance Program, a federal program that provides access to HIV/AIDS medications for uninsured low-income individuals. Ms. Murray holds a Masters of Public Policy and Administration from Columbia University, and received a Bachelor of Arts degree from McGill University in Montreal, Quebec.
Rebecca L. Orttel is a lawyer in Medtronic's Minneapolis offices where she is chief counsel to Value-Based Healthcare Partnerships, a managed care and advisory services business. During her nineteen years at Medtronic, Rebecca also worked in the legal and compliance departments at the European headquarters in Tolochenaz, Switzerland, advised the Neuromodulation business, and she served as a health lawyer in the Corporate Legal Regulatory group. Rebecca also was chief legal advisor to the Medtronic Foundation and helped establish Medtronic Labs, a social business dedicated to incubating healthcare solutions for the underserved. Rebecca received her J.D. cum laudefrom the University of Minnesota Law School in 1997. She received her B.A. from the University of Minnesota Twin Cities summa cum laude and Phi Beta Kappa with a double major in Political Science and German, and she also studied at the University of Bonn. Besides her work in Switzerland, Rebecca has spent much time overseas, including working for the State Department at the U.S. Embassy in Germany, clerking for a global law firm in Dusseldorf, Germany, and interning for the German Parliament.
Phil’s primary responsibilities include providing legal support for Siemens Healthineers as it designs, brings to market and implements new value-based healthcare business models in the US, including enterprise and digital health solutions. He works in the US headquarters of Siemens Healthineers located in Malvern, Pennsylvania. Phil joined Siemens in 2000, where he managed a broad range of complex commercial and employment litigation across the company’s entire industrial portfolio of businesses. He transferred to support the Siemens healthcare division in 2012 as a commercial attorney, prior to the Siemens Healthineers IPO in 2018. Before joining Siemens, he practiced law as an associate at the law firm of Paul, Hastings, Janofsky & Walker and also served as a law clerk in the U.S. District Court for the District of Connecticut. He is a graduate of Wesleyan University (High Honors in Government) and the University of Virginia Law School (Order of the Coif).
Steve Phillips is a Senior Director in Global Health Policy at Johnson & Johnson. He provides global policy leadership and guidance on coverage and reimbursement issues. He particularly focuses on the implementation of value-based payment models, in the US and internationally. In the US, he has expertise with Medicare coverage and reimbursement policy, and value-based payment models. He joined J&J in 2005.
Prior to joining J&J, Steve had over 18 years of experience at the Centers for Medicare and Medicaid Services, most recently as the chief of physician reimbursement and, prior to that, as chief of Medicare's inpatient hospital DRG system. In these positions he oversaw the development of national policy for these two critical parts of the Medicare program.
Lucia Savage is a nationally-recognized thought leader on health information privacy and HIPAA. Using strategic advice to advance digital technology to deliver health care while protecting privacy, she drives Omada Health’s continued commitment to advancing digital health, including the safe, secure, and effective handling of participants’ personal health information. Prior to joining Omada, she served the Obama Administration as Chief Privacy Officer at the U. S. Department of Health and Human Services Office of the National Coordinator for Health IT. She first implemented HIPAA for Stanford University in 2000, and later oversaw the HIPAA compliance and data strategy for California’s pre-ACA health insurance exchange, PacAdvantage, where she served as General Counsel. Lucia has a B.A. with Honor from Mills College and received her Juris Doctor summa cum laude from New York University School of Law.
Nathana O’Brien Sharma is Senior Product and Commercial Counsel at Labelbox, and Policy and Corporate Counsel at MobileCoin. Nathana is also Faculty at Singularity University, where she writes and speaks for international audiences on emerging technologies, the future of technology, law and business.
Nathana worked as an Intellectual Property Associate at Gunderson Dettmer, a leading emerging company and venture capital law firm. While at Gunderson Dettmer, Nathana helped a range of technology companies on data privacy and cyber security strategy. She has also worked at the Israeli Supreme Court and the Center for Creative Technologies.
Nathana is a JD/MBA graduate of Yale Law School and the Yale School of Management, as well as Singularity University’s 2012 Graduate Studies Program.
Shira Stein is a reporter at Bloomberg Law covering health-care oversight on Capitol Hill, including drug pricing, changes to the Affordable Care Act, and health-care consolidation. She also writes unique enterprise and data stories about a wide variety of topics in health care, including LGBT health, rural health, and medical education. Shira is an alumna of American University and formerly interned at The Washington Post.
John P. Wiegand is an attorney in the San Francisco office of the Federal Trade Commission. He practices antitrust law, primarily in the health care and telecommunications industries. He has been involved in several health care matters that have resulted in litigation, including hospital merger and physician price fixing cases. He was part of the Commission’s trial team in North Texas Specialty Physicians.
Mr. Wiegand has addressed policy issues relating to the application of the antitrust laws to the health care and telecommunications industries in both published articles and speeches. In the 2003 Federal Trade Commission/Department of Justice Hearings on Health Care and Competition Law and Policy, he served as both a moderator and a presenter. For the 2014 and 2015 FTC Workshops, Examining Health Care Competition, he served as an organizer and a moderator.
He has received the FTC’s Paul Rand Dixon Award for Legal and Economic Analysis. He earned his J.D. in 1985 from the University of Illinois, and his A.B. in 1982 in economics from the University of Chicago. He is admitted to the bar of Illinois, and he is a member of the Federalist Society’s Practice Group for Corporations, Securities and Antitrust.
Brian is a healthcare privacy and regulatory attorney in San Francisco. He has worked with Seattle Children’s Hospital Research Institute, the Nemours Children’s Health System, Willis Towers Watson, Apple, and currently Clover Health, a startup building a Medicare Advantage health insurance company. He has addressed privacy and technology from healthcare provider, payer, employer and tech company’s perspective.
Ropes & Gray is a preeminent global law firm with approximately 1,400 lawyers and legal professionals serving clients in major centers of business, finance, technology and government. The firm has offices in New York, Boston, Washington, D.C., Chicago, San Francisco, Silicon Valley, London, Hong Kong, Shanghai, Tokyo and Seoul, and has consistently been recognized for its leading practices in many areas, including health care, life sciences, privacy & cybersecurity, private equity, M&A, tax, antitrust, litigation & enforcement, and intellectual property, among others.
With more than forty years of history serving the health care industry, Ropes & Gray has one of the leading health care practices in the country. More than 60 attorneys represent virtually every sector of the global health care industry, including health care service providers, health care investors and financial institutions, pharmaceutical and biotechnology companies, medical device manufacturers, managed care organizations and payors, health care technology and digital health companies. Our interdisciplinary team of health care lawyers is equally experienced in transactional, regulatory, enforcement and litigation work.
Our attorneys go beyond legal representation by partnering with clients as trusted business advisors. We look ahead to emerging trends as well as regulatory and government enforcement developments that could potentially affect our clients’ businesses and provide timely analyses and advice that help our clients maintain their competitive advantage. In the past five years, we have launched several major initiatives in response to emerging changes in the market, including one focused on Value-Based Health Care and a closely related one on Digital Health. The shift to VBHC has created opportunities and challenges for the health care, including digital health where an effective VBHC program relies on access to technology and data. Ropes & Gray’s deep understanding of key issues affecting the industry has made us a valuable partner as the convergence of technology and health care continues to develop. Both initiatives feature a dedicated microsite to serve as a one- stop hub where clients can find a wealth of guidance and resources, including teleconferences, webinars, articles, primary source materials, research binders, etc. (see https://www.ropesgray.com/en/Value-Based-Health-Care-Initiative)
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