PCMH 2025 Statewide In-Person Learning Session 6.25.25 - JHF

June 25, 2025

The session will open with a review of the highlights from the Mid-Year PCMH Sprint Surveys and a presentation from PA DHS on the history, evolution, and future directions of the HealthChoices PCMH and PCMH-PNC Programs. An MCO Panel will then highlight improvements that they have observed. Throughout the day, PCMH and MCO participants will engage in interactive sessions, sharing best practices within and across sprint topics. A PCMH spotlight will also feature examples of data-driven QI. To close out the session, teams will huddle to prioritize the tactics you would like to bring back to your team at home.

Agenda

8:30 a.m. to 8:45 a.m. – Welcome and Highlights from the Mid-Year PCMH Sprint Surveys – Robert Ferguson, MPH, Chief Policy Officer, Pittsburgh Regional Health Initiative (PRHI)

8:45 a.m. to 9:30 a.m. – HealthChoices PCMH and PCMH-PNC Programs: History, Evolution, and Future Directions – Gwendolyn B. Zander, Esq., Director, Bureau of Managed Care Operations, PA Department of Human Services’ Office of Medical Assistance Programs (PA DHS OMAP), & David Kelley, MD, MPA, Chief Medical Officer, PA DHS OMAP

9:30 a.m. to 9:40 a.m. – Break

9:40 a.m. to 10:40 a.m. – MCO Panel: HealthChoices PCMH Program Improvements

  • Lakshmi Reddy, MD, Senior Medical Director, Highmark Wholecare; and Stephen Perry, Director of VB Analytics & Operations, Highmark Wholecare
  • Amy Buterbaugh, RN, BSN, Director HealthChoices Business Unit and Enhanced Member Services Unit, Geisinger Health Plan
  • Valerie Van Buren, Director, Quality Improvement and Performance, Jefferson Health Plans
  • Jessica Leibig, MA, LPC, Integrated Health Manager, Population Health Medical Services, AmeriHealth Caritas Pennsylvania and Keystone First
  • Mike Kornhauser, MD, CMO, United Healthcare Community Plan of Pennsylvania
  • Nick DeGregorio, MD, AVP Medicaid Services, UPMC Health Plan

10:40 a.m. to 11:00 a.m. – MCO and PCMH Appreciative Interviews: HealthChoices PCMH Accomplishments

11:00 a.m. to 11:10 a.m. – Transition to Breakout Rooms

11:10 a.m. to 11:50 p.m. Breakout: Troika Consulting in PCMH Sprints

11:50 a.m. to 12:50 p.m. – Networking Lunch

12:50 p.m. to 1:00 p.m. – Transition to Breakout Rooms

1:00 p.m. to 2:00 p.m. PCMH Sprint Knowledge Café Breakouts: Learning Across Sprints

  • Post-Hospital Follow-up Breakout: Rachel Reis, BSN, RN-CCM, Director, Care Coordination, Jefferson Health
  • Blood Pressure Control Breakout: Kim Allen, MSN, RN, CPHQ, Vice President and Chief Quality and Innovation Officer, Delaware Valley Community Health
  • SDOH Interventions Breakout: Laurie Weidner, Director, Practice Transformation, AHN Risk &  Value-Based Care, & Kristen Macey, Project Manager- Extended Care Teams, Primary Care Institute, Allegheny Health Network
  • Well-Child & Well-Care Visits – Hetal Patel, MD, MPH, Family First Health
  • Pediatric Nursing Care Breakout – Heather Goshorn, BSN, RN, Director of Enabling Services, Keystone Health

2:00 p.m. to 2:05 p.m. – Break

2:05 p.m. to 2:20 p.m. – Report Outs from the PCMH Sprint Knowledge Café Breakouts

2:20 p.m. to 3:00 p.m. – PCMH Spotlights: Using Data to Identify and Drive QI Work

  • Kathleen Barry, MS, Deputy Chief Operating Officer, The Wright Center for Community Health
  • Maryann Salib, DO, MPH, Associate Medical Director of Community Health and Wellness, Population Health and Clinical Quality Assurance, Esperanza Health Center
  • Laura Stack, DNP, MBA, RN, NE-BC, Ambulatory Nurse Executive, Tower Health

3:00 p.m. to 3:20 p.m. – Huddles and Report Outs

3:20 p.m. to 3:30 p.m. – Wrap-Up

 

 

Target Audience

Nurse

Physician

Social Worker

Learning Objectives

  • Describe the evolution of the HealthChoices PCMH and PCMH-PNC Programs from the perspectives of the PA DHS, MCOs, and PCMHs
  • Describe what leads to success in the HealthChoices PCMH and PCMH-PNC Programs
  • Describe examples of how PCMHs are implementing key interventions during the PCMH Learning Network’s 2025 Sprints
  • Describe preliminary findings and progress from the mid-year sprint surveys
  • Receive advice on how to breakthrough a current challenge with implementing a key intervention in one of the Sprints
  • Describe examples of how PCMHs are using data to drive improvements
  • List next steps and tactics to take back to your team to inform your quality improvement work in the HealthChoices PCMH and PCMH-PNC Programs

Course summary
Available credit: 
  • 6.00 AMA PRA Category 1 Credit™
    The University of Pittsburgh School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
  • 6.00 ANCC
    UPMC Provider Unit is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation
  • 6.00 ASWB
  • 6.00 Attendance
Course opens: 
06/25/2024
Course expires: 
09/30/2025
Event starts: 
06/25/2025 - 8:30am EDT
Event ends: 
06/25/2025 - 3:30pm EDT

The session will open with a review of the highlights from the Mid-Year PCMH Sprint Surveys and a presentation from PA DHS on the history, evolution, and future directions of the HealthChoices PCMH and PCMH-PNC Programs. An MCO Panel will then highlight improvements that they have observed. Throughout the day, PCMH and MCO participants will engage in interactive sessions, sharing best practices within and across sprint topics. A PCMH spotlight will also feature examples of data-driven QI. To close out the session, teams will huddle to prioritize the tactics you would like to bring back to your team at home.

Agenda

8:30 a.m. to 8:45 a.m. – Welcome and Highlights from the Mid-Year PCMH Sprint Surveys – Robert Ferguson, MPH, Chief Policy Officer, Pittsburgh Regional Health Initiative (PRHI)

8:45 a.m. to 9:30 a.m. – HealthChoices PCMH and PCMH-PNC Programs: History, Evolution, and Future Directions – Gwendolyn B. Zander, Esq., Director, Bureau of Managed Care Operations, PA Department of Human Services’ Office of Medical Assistance Programs (PA DHS OMAP), & David Kelley, MD, MPA, Chief Medical Officer, PA DHS OMAP

9:30 a.m. to 9:40 a.m. – Break

9:40 a.m. to 10:40 a.m. – MCO Panel: HealthChoices PCMH Program Improvements

  • Lakshmi Reddy, MD, Senior Medical Director, Highmark Wholecare; and Stephen Perry, Director of VB Analytics & Operations, Highmark Wholecare
  • Amy Buterbaugh, RN, BSN, Director HealthChoices Business Unit and Enhanced Member Services Unit, Geisinger Health Plan
  • Valerie Van Buren, Director, Quality Improvement and Performance, Jefferson Health Plans
  • Jessica Leibig, MA, LPC, Integrated Health Manager, Population Health Medical Services, AmeriHealth Caritas Pennsylvania and Keystone First
  • Mike Kornhauser, MD, CMO, United Healthcare Community Plan of Pennsylvania
  • Nick DeGregorio, MD, AVP Medicaid Services, UPMC Health Plan

10:40 a.m. to 11:00 a.m. – MCO and PCMH Appreciative Interviews: HealthChoices PCMH Accomplishments

11:00 a.m. to 11:10 a.m. – Transition to Breakout Rooms

11:10 a.m. to 11:50 p.m. Breakout: Troika Consulting in PCMH Sprints

11:50 a.m. to 12:50 p.m. – Networking Lunch

12:50 p.m. to 1:00 p.m. – Transition to Breakout Rooms

1:00 p.m. to 2:00 p.m. PCMH Sprint Knowledge Café Breakouts: Learning Across Sprints

  • Post-Hospital Follow-up Breakout: Rachel Reis, BSN, RN-CCM, Director, Care Coordination, Jefferson Health
  • Blood Pressure Control Breakout: Kim Allen, MSN, RN, CPHQ, Vice President and Chief Quality and Innovation Officer, Delaware Valley Community Health
  • SDOH Interventions Breakout: Laurie Weidner, Director, Practice Transformation, AHN Risk &  Value-Based Care, & Kristen Macey, Project Manager- Extended Care Teams, Primary Care Institute, Allegheny Health Network
  • Well-Child & Well-Care Visits – Hetal Patel, MD, MPH, Family First Health
  • Pediatric Nursing Care Breakout – Heather Goshorn, BSN, RN, Director of Enabling Services, Keystone Health

2:00 p.m. to 2:05 p.m. – Break

2:05 p.m. to 2:20 p.m. – Report Outs from the PCMH Sprint Knowledge Café Breakouts

2:20 p.m. to 3:00 p.m. – PCMH Spotlights: Using Data to Identify and Drive QI Work

  • Kathleen Barry, MS, Deputy Chief Operating Officer, The Wright Center for Community Health
  • Maryann Salib, DO, MPH, Associate Medical Director of Community Health and Wellness, Population Health and Clinical Quality Assurance, Esperanza Health Center
  • Laura Stack, DNP, MBA, RN, NE-BC, Ambulatory Nurse Executive, Tower Health

3:00 p.m. to 3:20 p.m. – Huddles and Report Outs

3:20 p.m. to 3:30 p.m. – Wrap-Up

 

 

Hilton Harrisburg
One North 2nd Street,
Harrisburg, PA
United States

Robert Ferguson, MPH, Chief Policy Officer, Pittsburgh Regional Health Initiative (PRHI)

Gwendolyn B. Zander, Esq., Director, Bureau of Managed Care Operations, PA Department of Human Services’ Office of Medical Assistance Programs (PA DHS OMAP)

David Kelley, MD, MPA, Chief Medical Officer, PA DHS OMAP

Lakshmi Reddy, MD, Senior Medical Director, Highmark Wholecare

Stephen Perry, Director of VB Analytics & Operations, Highmark Wholecare

Amy Buterbaugh, RN, BSN, Director HealthChoices Business Unit and Enhanced Member Services Unit, Geisinger Health Plan

Valerie Van Buren, Director, Quality Improvement and Performance, Jefferson Health Plans

Jessica Leibig, MA, LPC, Integrated Health Manager, Population Health Medical Services, AmeriHealth Caritas Pennsylvania and Keystone First

Mike Kornhauser, MD, CMO, United Healthcare Community Plan of Pennsylvania

Nick DeGregorio, MD, AVP Medicaid Services, UPMC Health Plan

Rachel Reis, BSN, RN-CCM, Director, Care Coordination, Jefferson Health

Kim Allen, MSN, RN, CPHQ, Vice President and Chief Quality and Innovation Officer, Delaware Valley Community Health

Laurie Weidner, Director, Practice Transformation, AHN Risk &  Value-Based Care

Kristen Macey, Project Manager- Extended Care Teams, Primary Care Institute, Allegheny Health Network

Hetal Patel, MD, MPH, Family First Health

Heather Goshorn, BSN, RN, Director of Enabling Services, Keystone Health

Kathleen Barry, MS, Deputy Chief Operating Officer, The Wright Center for Community Health

Maryann Salib, DO, MPH, Associate Medical Director of Community Health and Wellness, Population Health and Clinical Quality Assurance, Esperanza Health Center

Laura Stack, DNP, MBA, RN, NE-BC, Ambulatory Nurse Executive, Tower Health

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

imageIn support of improving patient care, this activity has been planned and implemented by the University of Pittsburgh and The Jewish Healthcare Foundation. The University of Pittsburgh is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

As a Jointly Accredited Organization, University of Pittsburgh is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved under this program. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. University of Pittsburgh maintains responsibility for this course. Social workers completing this course receive 6.0 continuing education credits.

Physician (CME)
The University of Pittsburgh designates this live activity for a maximum of 6.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nursing (CNE)
The maximum number of hours awarded for this Continuing Nursing Education activity is 6.0 contact hours.

Other health care professionals will receive a certificate of attendance confirming the number of contact hours commensurate with the extent of participation in this activity.

Available Credit

  • 6.00 AMA PRA Category 1 Credit™
    The University of Pittsburgh School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
  • 6.00 ANCC
    UPMC Provider Unit is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation
  • 6.00 ASWB
  • 6.00 Attendance
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