Summary of Curriculum Vitae for Richard E. Ward, MD, MBA

(Full Curriculum Vitae available here)

Dr. Ward is uniquely qualified to partner with physicians and hospitals to create successful Accountable Care Organizations (ACOs).  He has a strong foundation of education and experience in medicine and business administration, and extensive experience and accomplishments in the four key disciplines that are needed to support ACOs: (1) care management and clinical process improvement, (2) measurement of quality, outcomes and efficiency, (3) clinical practice guidelines and protocols, and (4) information technology.  He also combines practical business experience with academic rigor, having published 27 manuscripts and 6 book chapters, and given numerous invited lectures in university and business settings.

FOUNDATION in MEDICINE and ADMINISTRATION

  • BA (magna cum laude) – Univ of Notre Dame ‘84 (Phi Beta Kappa)
  • MD – Univ of Chicago, ‘90 (school ranked in top 10)
  • MBA – Univ of Chicago, ‘90 (school ranked in top 5)
  • Financial Analyst for U of Chicago Hospitals – 2 yrs full time + 2 yrs part time experience. Developed 5 year budget model.

CARE MANAGEMENT & CLINICAL PROCESS IMPROVEMENT

  • 2006-2010: As VP of Clinical Programs and Medical Informatics at Blue Cross Blue Shield of Michigan, led a team of 420 people and additional dedicated IT and business intelligence staff and consultants to execute the following programs and functions:
    • Pay for Performance Programs, including the Physician Group Incentive Program (PGIP), one of the nation’s largest professional pay-for-performance programs involving over 100 physician groups, including more than 8,000 primary care physicians serving 1.8 million BCBSM members.  The program offered 41 voluntary initiatives focused on diseases, services, information technologies and provider organization capabilities, intended to improve quality and efficiency of care.  Provider incentives under these programs reached a level of more than $60M annual payout to physician organizations.  More information here.
    • Collaborative Quality Improvement (CQI) Programs, including 8 separate multi-hospital consortia (Advanced Cardiac Imaging, Bariatric Surgery, Percutaneous Coronary Interventions, Peripheral Vascular Intervention, Breast Cancer, Thoracic and Cardiovascular Surgery, Hospital Medicine Safety Initiative, and Surgical Quality), involving about $20M in annual support for participating hospitals and coordinating centers to capture, pool and analyze clinical datasets, and to identify and implement best practices and disseminate information about results.
    • Patient-Centered Medical Home Program (PCMH), the nation’s largest such program, involved more than 6,000 primary care physicians working to increase capabilities consistent with the domains of function of the patient-centered medical home, and rewarding over 1800 physicians in roughly 500 primary care office practices with a BCBSM PCMH “designation” that was rewarded with an increase in office visit fees. More information here.
    • Wellness Programs, including smoking cessation, telephonic wellness coaching, work-site wellness initiatives, web-based health risk appraisal and digital coaching, mail campaigns promoting wellness and compliance with preventive services guidelines, and insurance products that incentivized members to complete health risk appraisals, engage in wellness and care management interventions, and accomplish healthy behavior and outcomes goals.
    • Disease Management Programs, including telephonic coaching, web-based “digital coaching”, and shared decision-making programs that supported members’ decisions regarding elective surgical procedures such as back surgery.
    • Case Management Programs (including care transitions programs) focused on coordination of care and coordination of benefits for complex, acute care cases.  Included a large team of employed nurses.
    • Medicare Clinical Programs (3 years), including oversight of vendor-supported programs for disease management, case management and medication treatment management (MTM)
    • Provider-based Care Management Programs, including chronic condition management and care transitions programs carried out by employed staff of 6 large physician organizations with data exchange with the health plan to permit coordination of services, customer reporting and program evaluation.
    • Medical Informatics Department (see below)
    • Clinical Epidemiology and Biostatistics Department (see below)
    • Wellness and Care Management Consulting Department, providing consulting an technical sales support to key and large employers and other customers to help them tailor a “wellness and care management solution” to meet their needs, accomplish their goals and fit within their budget.  This department also explained program statistical information and evaluation results to customers.
    • Pre-Certification Programs (2 years), including telephonic assessment of admission and length-of-stay appropriateness for acute hospital and nursing home admissions.
    • Utilization Management Programs (1 year), including oversight of vendor-supported programs for physical therapy and chiropractic services.
    • Provider Registration and Credentialing (1 year), including vendor selection and implementation of enterprise-class provider information management software.
  • 02-present: Member, Editorial Advisory Board, Journal of Population Management (formerly Journal of Disease Management)
  • 99-03: Member, Editorial Advisory Board, Joint Commission’s Journal on Quality Improvement
  • 97: Member, Editorial Advisory Board, Disease State Management
  • 96: Member, Advisory Board, Nat’l Managed Health Care Congress on Disease Mgmt
  • 90-97: Led successful initiatives for HFMG, including cervical cancer screening, low back pain, smoking cessation, etc.

QUALITY, OUTCOMES & EFFICIENCY MEASUREMENT

  • 06-10: Created and oversaw a new Biostatistics and Research Epidemiology Department at Blue Cross Blue Shield of Michigan (BCBSM), including 8 PhD-level and additional masters-trained analysts with training in epidemiology, biostatistics, economics and related disciplines, developing and applying advanced methods for predictive modelling, opportunity analysis, provider performance evaluation and program effectiveness evaluation.  This department also collaborated with researchers at University of Michigan, Michigan State University and other universities on 3 separate competitively funded program evaluation studies for the PGIP program, the PCMH program, and the provider-based care management program.
  • 90-97: Director, Center for Clinical Effectiveness, Henry Ford Health System (7 yrs, incl. 3.5 yrs as Director)
  • 97: Consultant, Institute of Medicine (developed conceptual models of managed care accountability and information flow to support President Clinton’s Managed Health Care Commission)
  • 94-97: Member, National Committee on Quality Assurance (NCQA) Committee on Performance Measurement (oversees all aspects of HEDIS). Led the committee’s long term strategy process.
  • 97: Member, NCQA Cardiovascular Measurement Advisory Panel (oversees new cardiovascular measures for HEDIS)
  • 90-97: Member, Steering Committee of American Group Practice Association Outcomes Management Consortium (involving 50+ multi-specialty group practices)
  • 95-97: Founder & Principal Investigator, SCORE consortium (low back surgery outcomes research consortium including Mayo, Cleveland, Lovelace, Lahey, Henry Ford, Emory, U of New Mexico)
  • 95-97: Member, Michigan Health and Hospital Association Data Issues Task Force
  • 95-97: Member, Board of Advisors, Outcomes Research Digest
  • 91-95: Chairman, Joint Replacement Outcomes Study Committee, American Medical Group Association

CLINICAL PRACTICE GUIDELINES & PROTOCOLS

  • 96-97: Associate Medical Director for Clinical Policy Analysis, Health Alliance Plan (HAP)
  • 95-96: Member, American Association of Health Plans Practice Guidelines Task Force
  • 96-97: Member, Greater Detroit Area Health Council Cancer Standards Task Force
  • 94-95: Member, Michigan Department of Public Health Women’s Cancer Advisory Committee
  • 93: Author of Henry Ford Medical Group Clinical Policy Plan
  • 90-97: Led 10 clinical practice guideline / protocol development teams, Henry Ford Health System & HAP

INFORMATION TECHNOLOGY

  • 06 & 10: Awarded 2 U.S. patents regarding a method and system for care management, combining structured care plans with business process management / workflow automation technology.
  • 06-10: Responsible for Medical Informatics Department at Blue Cross Blue Shield of Michigan which collaborated with IT department to create a wellness and care management platform based on business process management (BPM) technology (licensing patented technology developed by Reward Health Sciences), and collaborated with the business intelligence department to develop analytic databases and a “model-based” reporting framework.
  • 02-06: Chief Medical Informatics Officer, Anceta, LLC (Medical Informatics company founded by American Medical Group Association, Aventis and Accenture to develop national data warehouse of comprehensive longitudinal patient data contributed by large multi-specialty group practices throughout the U.S.)
  • July 99 – present: Founder & CEO, Reward Health Sciences (Health care consulting and web application development. Clients include Blue Cross Blue Shield of Michigan, University of Chicago, University of California San Francisco. Grant collaborators include Henry Ford Health System, Mercy Health System, UCSF.)
  • Dec 98-July 99: VP and General Manager, Health Care Organization Products, Oceania, Inc. Collaborated with SAIC and Oacis on winning proposal for development and nation-wide deployment of Kaiser-Permanente’s Clinical Information System. Authored the clinical decision-support section of the proposal.
  • May 98-Dec 98: Director, Product Management, WAVE Electronic Health Record Product Line, Oceania, Inc. Led team of Oceania and Kaiser staff in development and prioritization of requirements for clinical documentation and patient profile components of Kaiser’s National Clinical Information System. Established within Oceania product management processes based on software industry best practices, including prospect problem analysis, product conceptualization, market validation, competitive analysis, business planning, requirements development, usability engineering, functional specifications review, design and architecture review, product launch, and ongoing evaluation.
  • Sept 97-May 98: Director, Product Management, Care Management Product Line, Oceania, Inc.
  • 94-97: Chief of Clinical Informatics Research and Development, Henry Ford Health System
  • 94-97: Principal Investigator for National Library of Medicine-funded Information Systems Strategic Planning Grant (IAIMS) — the first to be received by a managed care delivery system.
  • 95-97: Chairman of HFMG Information Systems Strategic Planning Committee and author of HFMG Information Systems Strategic Plan.
  • 95-97: Member, HFHS Information Systems Vision & Policy Committee (allocates capital)
  • Developed the only nationally-recognized standards for coding and transmission of health outcomes data.
  • Developed “Flexi-Scan”, a set of software applications for outcomes data acquisition, pooling and analysis, used by the Health Outcomes Institute, the American Medical Group Association Outcomes Management Consortium (50+ multi-specialty group practices), and the SCORE Consortium (Mayo, Cleveland, Henry Ford, Lovelace, Lahey, U of New Mexico, Emory).
  • Developed and validated a neural-network predictive model to predict treatment failure in hip replacement.
  • Ran a small systems consulting company for 4 years which developed a system (now in use for 25 years) to support billing, property analysis, client records, case tracking, and rules-based legal document generation for a large real estate law firm.
  • 17 invited lectures include plenary sessions at 3 “CIO Summit” meetings of managed care delivery system CIOs.

DISSEMINATION OF INFORMATION

  • Published 27 manuscripts and 6 book chapters, gave 40 scientific abstract presentations, and more than 100 invited lectures and workshops on quality, outcomes and efficiency measurement, wellness and care management, clinical practice guidelines and protocols, clinical process improvement, physician incentives, and health information technology.  Detailed listing available here.

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