2021 Medicare Advantage and Managed Medicaid Updates: Where Are We Headed?
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The ACCC Alternative Payment Model Coalition builds off the success of its Oncology Care Model (OCM) Collaborative by addressing the broader interest in alternative payment models (APMs) beyond the OCM. Speakers discuss how Medicare Advantage and state Medicaid benefits are changing in 2021 and what impact these changes will have on practice operations for oncology practices and providers.
Fred Bentley, MPP MPH, Managing Director, Avalere Health
Tom Gallo, MS, MDA, Executive Director, Virginia Cancer Institute
Tom Kornfield, MPP, Senior Consultant, Avalere Health
This webinar was developed in collaboration with Avalere Health.
The ACCC Alternative Payment Model Coalition is supported by Amgen, Merck & Co, Inc., and Takeda.
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Fred Bentley, MPP, MPH
Managing Director, Avalere
As an expert in fields ranging from payer strategy to hospital–physician alignment and post-acute care, he has worked with providers, including integrated delivery networks, academic medical centers, post-acute providers, and long-term care organizations as well as national and regional health plans. Over the past 5 years, his work has focused on supporting health systems engage in Medicare and Medicaid payment and delivery system transformation initiatives.
Prior to joining Avalere, Fred was a principal in the Accountable Care Solutions practice at The Chartis Group. In this role, he worked with leading hospitals and health systems in developing strategic roadmaps to guide their clinical innovation, population health, and cross-continuum integration initiatives. He also served as a managing director with The Advisory Board Company, managing a team of consultants and analysts who supported provider organizations ranging from physician groups and health systems to post-acute care providers.
Fred holds an MPP and MPH from the University of California, Berkeley, and a BA in political science from Haverford College.
Tom Gallo, MS, MDA
Executive Director, Virginia Cancer Institute
Thomas A. Gallo, MS, MDA, is executive director of the Virginia Cancer Institute in Richmond, Virginia. In this role, he manages all aspects of a 24-provider medical oncology practice with 7 medical offices, ambulatory infusion centers, laboratories, and more than 200 employees. Among his responsibilities are strategic planning, operations, financial management, personnel management, and purchasing.
Mr. Gallo has been an active member of the Association of Community Cancer Centers (ACCC) for more than 10 years. He served as ACCC President from 2018-2019. Currently, he also serves on ACCC’s Governmental Affairs Committee, which he previously chaired. He has presented at a number of ACCC Annual Meetings and has previously served on the ACCC Board of Trustees (2004-2005).
In addition to his involvement with ACCC, Mr. Gallo is a member of the Board of Directors of MD Value Care, an ACO of independent physician practices; past president of the Executive Committee of the MGMA Administrators in Oncology-Hematology Assembly (AOHA); a current member and former president of the Board of Directors of the Virginia Association of Hematologists and Oncologists (VAHO); and a former board member of the Community Oncology Alliance.
Prior to entering the healthcare field, Mr. Gallo was a commercial banker with Marine Midland Bank in New York City and Central Fidelity Bank in Richmond, Virginia.
He received a BA in Economics from the College of William and Mary in Williamsburg, Virginia, and an MS in Finance and a Master of Decision Analytics (MDA) degree from Virginia Commonwealth University, where he was a Dean’s Scholar.
Tom Kornfield, MPP
Senior Consultant, Avalere Health
Tom Kornfield provides analytical support and strategic advice for clients on Medicare Advantage risk adjustment and payment, and on Part D issues. He has over 20 years of public and private sector experience in Medicare Advantage and Part D payment policy.
Prior to joining Avalere, Tom served as a vice president of Medicare policy at America’s Health Insurance Plans (AHIP). During his tenure at AHIP, he led risk adjustment policy discussions with plan members and external stakeholders. Additionally, he oversaw research and analyses about the impacts of Medicare Advantage (MA) payment and risk adjustment policies. He also helped to lead work looking at the distribution of rebates among Part D plans and contributed to analyses of the impacts of restructuring the Part D benefit.
Tom also spent 10 years working at the Centers for Medicare & Medicaid Services (CMS), where he held a variety of positions focused on MA and Part D payment policy. Specifically, Tom analyzed MA bids and payments and changes in MA payment rates, and he created a policy to allow for 5-star MA plans to market and enroll year-round.
Tom holds a graduate degree from the University of Michigan’s School of Public Policy. His undergraduate degree is from Hamilton College.