Medicare Fee-for-Service beneficiaries with serious illness make up less than 10% of the population, but they incur a third of total Medicare cost.1 Many see multiple providers, and their inpatient admission rate is 5 times higher in the last 6 months of life. Recently, the Center for Medicare and Medicaid Innovation (CMMI) has explored new care models to improve health outcomes for seriously ill patients and encouraging health insurance providers who offer Medicare Advantage, Commercial, and Medicaid health plans to join the effort.
This webinar will discuss the approach to the seriously ill patient and the benefits of a comprehensive care model. We will discuss program requirements and the benefits for patients, caregivers and health care providers. We will also discuss how we can apply the learning from this model beyond the Medicare FFS beneficiaries to health plan’s insurance providers’ populations.
Jonathan Rubens, MD, MHPE, FACEP, FAAEM, CHIE
Chief Medical Officer
Jonathan S. Rubens is the Chief Medical Officer of ActiveHealth Management. He brings more than 25 years of experience as a physician leader in both academic and community settings. As the Chief Medical Officer, Dr. Rubens leads a multidisciplinary team of physicians, pharmacists and nurses focused on building effective population health management programs and clinical analytic tools to promote evidence-based patient care.
Dr. Rubens has worked for ActiveHealth since 2011 and was previously the Senior Medical Director. He is board-certified in Emergency Medicine, and a fellow of the American College of Emergency Physicians and American Academy of Emergency Medicine. He earned his Bachelor of Arts degree from the University of Pennsylvania and his Doctor of Medicine degree from Wake Forest University. After serving as chief resident in Emergency Medicine at the Medical Center of Delaware, Dr. Rubens taught Emergency Medicine at Cornell-Weill Medical College/North Shore University Hospital in New York. He went on to study Health Professions Education and earned his master’s degree from the University of Illinois at Chicago. Dr. Rubens is a Certified Health Insurance Executive and has completed executive education at the Kellogg Graduate School of Management at Northwestern University.
Prior to joining ActiveHealth, Dr. Rubens was a full-time attending physician and Vice President and Partner at Regional Emergency Physicians, P.A. in High Point, North Carolina.
Khue Nguyen, PharmD
Khue is dedicated to designing and implementing population health programs to increase quality and access for patients and families, strengthen care coordination and enhance the patient-physician relationship. In the last five years, Khue has led national development of care and payment model for serious or advanced illness management, through collaboration with integrated health systems, ACO networks, and payers. Most recently, Khue led the development of the Advanced Care Alternative Payment Model that was approved by the Physician-focus Payment Technical Advisory Committee and worked with the American Academy of Hospice and Palliative Medicine to provide a uniform set of recommendations for the CMMI Serious Illness Payment Models. Khue was previously COO of CTAC Innovations.
1. Calculation based on Medicare data from the Dartmouth Atlas Project. Available at www.dartmouthatlas.org