Overview
OPEN MINDS senior consultant, Ray Wolfe, J.D., will provide this training on national service delivery trends affecting ADDP members across Massachusetts. This event will address issues directly affecting the organizational readiness of community-based organizations for health care reform, including enhanced technological, financial, and data analytic processes. According to Dr. Wolfe, " The time is now to move from determining what our future needs are to planning how we will address them."
Purpose/Background
Enhancements to quality and efficiency are demanded in the coming years by the impending reforms to MassHealth. Of particular significance is the recently launched MassHealth Community Partner (CP) program, which is poised to change the long-term services and supports (LTSS) landscape in Massachusetts. Implications of these reforms directly impact technological and data management business operations of I/DD providers. Reforms will also result in a significant increase of clients enrolled in OneCare and SCOs, which adds further administrative complexity.
This training will review trends affecting the future of I/DD on the national level. In so doing, issues related to organizational readiness will be highlighted, including financial readiness, billing processes, value-based purchasing methods, and technological and quality measurement enhancements. Dr. Wolfe will also examine organizational challenges such as the "crisis of size", including issues related to acquisition, mergers, and methods for preserving autonomy. Finally, he will underscore the implications of national trends for I/DD providers in Massachusetts in the near- and longer-term.
Intended Audience
Senior leadership and management, finance and billing staff, as well as board members are encouraged to attend.
Learning Objectives
• Identify national payer landscape and opportunities for the Massachusetts I/DD provider;
• Review illustrative case studies of states' experiences;
• Develop effective strategies for mitigating risk and creating a road map for organizational success;
• Educate about value-based purchasing and alternative payment opportunities; and
• Evaluate relevant agency-wide quality, technology and financial systems.
About the Speaker
Raymond “Ray” Wolfe, J.D. brings over 40 years of experience in the health and human services sector to the OPEN MINDS team. Mr. Wolfe currently serves as a Senior Associate, a position in which he utilizes his expertise to successfully lead varying projects for OPEN MINDS. His areas of expertise include managed care and value-based reimbursement models, financial analysis and management, mergers and acquisitions, CCBHC certification, integrated care, performance improvement, and strategic planning.
Before joining OPEN MINDS, Mr. Wolfe served in a 22 year tenure with Pittsburgh Mercy Health System in Pittsburgh, Pennsylvania. Most recently, Mr. Wolfe served as the organization’s Chief Operating Officer (COO) where he was responsible for oversight of all system operations, strategic planning, and performance management. Under his direction Pittsburgh Mercy achieved Certified Behavioral Health Center status, earned over $850K in value-based reimbursement contract quality bonus awards, integrated three organizations through merger/acquisition, opened a primary care service that was integrated into other service programming, and adopted a new performance management program for managers.
Before acting as Pittsburgh Mercy’s COO, Mr. Wolfe served as the organization’s Chief Financial Officer (CFO) and was responsible for the development of internal costing methodologies, contract rate negotiations, and financial forecasting activities. In addition, he coordinated an integrated care program with local partner hospitals to develop a series of diversion and respite programs, as well as, specialized primary care, integrated care management and high utilizer teams, while maintaining 15 straight years profitability.
Mr. Wolfe was promoted to CFO after serving as the Director of Fiscal and Information Security/Compliance for the health system. In this role, he was responsible for managing the transition of service contracts from fee-for-service (FFS), leading all compliance activities, and implementing a next generation electronic health record (EHR) system.
Prior to his time at Pittsburgh Mercy Health System, Mr. Wolfe served as Chief Fiscal Officer with the Summit Center for Human Development in Clarksburg, West Virginia, where he was responsible for reporting and budgeting functions and preparing Summit Center’s programs for FFS billing.
Previously, Mr. Wolfe served in billing and collections for two Pennsylvania-based hospitals. First, in his role as a manager for Healthcare Corporation of America, (HCA) as an Accounts Receivables Manager for Brownsville General Hospital in Brownsville, PA, where he managed the accounting and billing system transition systems. Later as a Patient Account Manager for St. Francis Medical Center in Pittsburgh, PA, where he improved collections to hit 95% rate through the implementation of new billing software and department reorganization.
Prior to working in the health and human services market, Mr. Wolfe spent five years practicing as a Lawyer with at Law Offices of Arch A. Moore in Moundsville, WV. In this role he provided general legal practice, created and established bylaws for multiple corporation, and handled West Virginia licensing of first vision insurance plan.
Mr. Wolfe earned his Juris Doctor from the West Virginia University School of Law in Morgantown, WV and his Bachelor’s degree with a focus in Political Science and Sociology from West Liberty University, in Wheeling, WV, where he graduated Magna Cum Laude.