The anticipated July 1st deadlines for the CMS Interoperability and Patient Access Final Rule mandates have come and gone. But that doesn’t mean the work is over. Has your healthcare organization met the requirements or are you continuing to execute your plan? Listen to Ngan MacDonald, VP of Healthcare Business Solutions Architecture at HealthLX along with industry expert Khoa Nguyen from KN Consulting and Executive Director Mike Boeder from Children’s Community Health Plan as they share:
the lessons they have learned as it relates to the CMS-9115-F rule
how their organizations and the industry as a whole have handled the mandates from a consultant, vendor, and health plan perspective
what CCHP’s journey has been like (the challenges, the wins, and what’s been important)
what payers should be doing to prepare for the future
Ngan MacDonald, VP of Healthcare Business Solutions Architecture @ HealthLX
Ngan has over 20 years of experience in analytics, information management, healthcare reform, IT strategy, and business transformation having led healthcare projects (large and small) in data, strategy, and implementation. Ngan’s leadership experience includes creating new business functions and managing departmental and program budgets in excess of $80M. She has gained valuable insights by having been on the front lines of HIT just as it had been thrust in the midst of a radical technology and data transformation. Her experience in both consulting and corporate enterprise data functions ensures a deep understanding of both what it takes for companies to execute their strategy and how to leverage expert resources in the market. Prior to joining the company, Ngan was VP Enterprise Data Solutions for the Blue Cross Blue Shield Association. She holds a Master of Science degree in Information Systems from DePaul University.
Khoa Nguyen, CEO, KN Consulting
Khoa is an independent consultant who helps healthcare companies with strategy and planning to support the new federal interoperability and data sharing requirements. He currently leads an interoperability learning collaborative with 30 safety net health plan payers. He started his consulting firm in 2018 to lead a special initiative with California Medicaid safety net health plans and identify opportunities to build group purchasing and shared services. Prior to his consulting firm, Mr. Nguyen was the Chief Strategy Officer for the Health Plan of San Mateo, a local-nonprofit Medicaid managed care plan serving approximately 150,000 residents of San Mateo County, California. He served as an executive leader responsible for organizational strategic planning, policy and advocacy with the State and CMS on issues impacting Medicaid and Medicare programs, leading strategic initiatives and new partnership developments, and operational oversight of Informatics and Marketing and Communications departments. Mr. Nguyen earned his master’s degree in public health policy from the University of Michigan at Ann Arbor.
Michael (Mike) Boeder, Executive Director, Health Plan Operations @ Children’s Community Health Plan
Mike has over 23 years of leadership experience in the healthcare and human services industry. He is a member of the CCHP Senior Leadership Team and is accountable for all operational functions of the health plan for CCHP’s BadgerCarePlus (WI Medicaid) product, the Care4Kids program (Wisconsin’s Foster Care Medical Home) and CCHP’s commercial product line, Together with CCHP. These responsibilities include but are not limited to provider relations, contracting, credentialing, reporting & analytics, member & community engagement, third party administrator vendor management including oversight for claims processing and customer service functions, and commercial product development and health care coordination via Care4Kids. Mike works closely with leaders, staff and community partners in order for CCHP to meet financial health and contractual performance metrics and the execution of CCHP’s strategic plan. Mike participates in System corporate initiatives to help identify and implement growth and alternative managed care opportunities at CCHP that align with System and CCHP initiatives for an integrated and diversified system of care. Mike is active in state and national government relations and is a trained member of Children’s Wisconsin At Our Best organizational culture shaping facilitation team. Mike has a Master’s Degree in Mental Health with clinical certification and management/administration emphasis, is a certified Mediator in the state of Wisconsin and holds a graduate certificate in Non Profit Business Management from the University of Notre Dame.