John Byrnes, Md, D.Aba Email & Phone Number

Sacramento, Ca, Us

Miami Gardens, Fl, Us

As the Chief of Medical Affairs, Dr. Byrnes leads specialty service lines, population health initiatives, high-risk disease management (Episodes of Care), acute and community care management, clinical pharmacy, and initiatives in medical cost management.He co-authored the 2023 medical cost management plan, including advanced population health programs, complex care management, high-risk disease management, bi-directional telemanagement, in-home patient monitoring, and AI for predictive analytics and population risk stratification. Leads specialty services. Co-authored the 2023 plans for specialty services, including cardiology, nephrology, behavioral health, palliative care and hospice, orthopedics, vascular and general surgery, and podiatry. The 2023 financial impact of specialty services (revenue enhancements and cost reductions) is projected at ~$83.2M.Leads the design and implementation of High-Risk Disease Management (HRDM) programs for the Top 15 chronic conditions and surgical procedures. HRDM programs improve patient outcomes and are projected to reduce medical costs by $10-15 pmpm.Provides oversight for acute and community care management. The 2023 case-managed 30-day readmission rate is 9.6% vs. the non-case-managed rate of 17.5%, resulting in a projected $48.7M medical cost reduction.Leads clinical pharmacy services, including P&T Committee oversight, therapeutic exchange programs, high-cost prescriber management, medication use evaluations (MUE), and formulary design. A 2023 cost savings evaluation is in progress.

Roseville, Ca, Us

Spearheaded launch of systemwide virtual behavioral health services, lead physician or advisor for the AH Technology & Innovation Council and the Adventist – Blue Shield California strategic partnership.STRATEGIC PLANNING AND VALUE BASED CAREHe co-authored the 2030 Health Division strategic plan. Served as lead physician for all VBC health plan strategic partnerships and management of Value Based Care (VBC) lines of business for more than 200,000 members. He designed and led multi-million-dollar utilization and quality improvement initiatives. He also led the design of population health and disease management programs.As CEO of AHCN IPA he will lead consolidation of all Adventist IPA networks with a 2030 expansion goal to 10,000 physicians. Currently awaiting regulatory approval.STRATEGIC PARTNERSHIPSHe served as lead physician for the Adventist – Blue Shield California strategic partnership and a member of the Governance Committee.VIRTUAL BEHAVIORAL HEALTH INTEGRATIONServed as the lead executive for system-wide expansion of virtually delivered behavioral health services, including integration with primary care. By end of 2022, behavioral health services will be available to one million unique lives throughout Adventist Health markets. TECHNOLOGY AND TELEHEALTHServed as physician advisor on Technology & Innovation Council and Consumer & Innovation Cabinet whose purpose is to accelerate adoption of innovative technology and therapeutics across AH. This included serving as lead physician or advisor on digital and virtual care expansion including virtual primary care, remote patient monitoring, eConsult expansion with Stanford Health, Get Well Network (digital first patient management for 250 clinical conditions and procedures), and Hospital@Home, among others.BLUE ZONES INSTITUTEServed as a member of Blue Zones Wellbeing Institute and Advisory Committee, an Adventist Health acquisition in 2020.

Roseville, Ca, Us

Led NCR's journey to become the top-performing Adventist Health region in clinical performance. Many quality and safety measures in top decile resulted in multimillion-dollar cost savings.Served as senior physician executive managing clinical performance in nine northern California markets, including hospitals and clinics. Advised market presidents and executive teams on a variety of clinical and operational issues.Provided oversight, mentored, and coached market CMOs, CNEs, and medical directors (hospitals and physician groups) on topics that included credentialing, risk management, medical staff office operations, medical staff governance, peer review, accreditation, physician engagement, quality improvement, patient safety, patient and provider experience, and management of hospitalist and ED physician groups, among others. Led financial, operational, clinical, risk, and regulatory turnaround of 60-bed behavioral health hospital, including: Medical staff office operations, credentialing, and peer review. Provided advice and direction at peer-review committee and medical staff executive committee meetings. Oversight for several state health department and Joint Commission site visits.

Led consulting practice focused on physician engagement, quality and patient safety, population health management, care management redesign, and cost containment.CONSULTING CLIENTS o Baptist Health (Tennessee): Achieved $10 million in UM cost savings.o Nebraska Methodist Health System: Designed value-based care program for rural hospitals and physician networks.o ProMedica (Health System): Advised MIPS, MACRA, CPC+, and Alternative Payment Model (APM) evaluations.o Harris Methodist (Texas Health Resources, Fort Worth Texas): Designed three-year strategic plan for quality, safety, cost avoidance, and data management, plus CMO and medical director training.CARE MANAGEMENT REDESIGNSubcontractor to Navigant Consulting – 1.5 year engagement to redesign care management program. Co-designed care management/utilization management program resulting in multi-million-dollar savings. Coached CMOs throughout the client system.TEACHING Served on national faculty for ACHE, HFMA, and AAPL. Taught “3 Faces of Quality” for AAPL. Designed and provided a variety of courses at ACHE and HFMA national conferences and for The Physician Leadership Academy produced by Exceptional Leadership LLC Created two national conferences - Quality BootCamp and HRO Academy.BOARD POSITIONSNational Board of Directors - Healthcare Financial Management Association (HFMA)Board of Advisors - Exceptional Leadership LLC BOARD subcommittee on curriculum - American Association of Physician Leadership (AAPL).EXECUTIVE LEADERSHIPCo-founded Healthcare’s INNER CIRCLE – roundtable groups for C-Suite executives.PATENTS AND TRADEMARKSPatent: patient gown design.Conference Trademarks: Quality BootCamp and HRO Academy.PUBLICATIONS:• The Safety Playbook: A Healthcare Leader's Guide to Building a High-Reliability Organization, Health Administration Press, November 2018• The Quality Playbook: A Guide for Healthcare Leaders, Second River Healthcare, October 2015

Cleveland, Ohio, Us

SCL Health is a faith-based, nonprofit healthcare organization founded by the Sisters of Charity of Leavenworth in 1864 with $2.5 billion revenue, 11 hospitals, more than 100 clinics, home health, hospice, mental health and safety-net services in Colorado, Montana, and Kansas.Designed and implemented quality, safety, lean, and outcome reporting programs which identified over $65 million in cost reductions. Provided leadership for clinical integration, ACO development, Medicare Shared Savings Program, care management, and electronic medical record implementation.Created a physician leadership academy, mentored, and coached CMOs and CMIOs.Lead executive for pharmacy operations and clinical risk management – generated multimillion-dollar cost reductions in both areas.

Grand Rapids, Mi, Us

As Chief Quality Officer at Spectrum Health Dr. Byrnes authored strategic plans and led system-wide initiatives resulting in $65M+ is revenue gains/expense reductions and 100+ quality designations from Truven, Healthgrades, Leapfrog, CMS, and the State of Michigan. Spectrum Health was ranked in the 15 Top health systems six years in a row and many hospitals were included in the 50/100 Top Hospitals. Serious Safety Events (SSER) decreased by 90% in the Helen DeVos Children’s Hospital.Designed customized pay-for-performance programs with commercial payers resulting in over $20 million in revenue gains.Provided interim leadership (1.5 years) for the Meijer Heart Center, a 164-bed free standing heart hospital.Provided interim leadership for employed physician group (12 months). Designed the medical group population health, quality and safety programs resulting in 90% of targeted HEDIS measures in the top decile from 2005 to 2012. Directed patient centered medical home certification and implementation of chronic care management programs and patient registries for high-volume chronic diseases. Established aggressive physician recruitment and retention programs.Co-led system integration activities to engineer the continuum of care between all Spectrum owned and affiliated patient care locations. Designed an outcome reporting system for all hospitals, the medical group, and continuing care division. More than 50 clinical dashboards were created for high-volume, high-cost, adult and pediatric medical conditions and surgical procedures. Dashboards were the foundation to improved clinical performance and cost avoidance reference above.Created a physician leadership academy. Designed a two-year curriculum in partnership with AAPL and medical school faculty. Over 40 participants are now in leadership positions. Created one system-wide, team-based training program that combined continuous quality improvement, patient safety, and process improvement (lean).

San Diego, Ca, Us

Sharp HealthCare, an integrated delivery system in San Diego, consisted of seven hospitals, two medical groups, an IPA, and health plan. Annual revenues were in excess of one billion dollars. Greater than 70% of system revenue was in the form of capitation agreements.Led electronic medical record implementation and process improvement with a team of 12 industrial engineers. Go-live expected to yield over $20 million in cost savings. Order sets standardized across the system using evidence-based medicine guidelines.Managed three system-wide service lines - orthopedics/neurosurgery, cardiovascular, and oncology with total revenue of approximately $120 million. Significant improvements in patient outcomes generated for all three service lines.Designed quality improvement, patient and medication safety, and outcome reporting programs for all hospitals and the medical group.Led clinical research activities with approximately 400 clinical trials, IRB activities, and FDA reviews. Also accountable for CME programs, clinical epidemiology, centralized credentialing, and all accreditation programs.

Albuquerque, Nm, Us

At Lovelace Health Systems, Dr. Byrnes held senior executive positions including CEO, Lovelace Healthcare Innovations and VP, Quality and Innovation. He received a $10.5 million grant to lead one of the first national demonstration projects in population health management, The Episode of Care program. He led the design and implementation of eighteen disease management programs. At the end of three years, significant improvements in patient outcomes and reductions in the total cost of care were realized. LHS gained a significant competitive advantage leading to rapid expansion and membership growth. The work was published in peer reviewed journals and several books. Episodes of Care was first used at LHS and trademarked. The trademark was later released in the hope of widespread adoption within healthcare.

Anesthesiology Residency Program

Internal Medicine Internship

Doctor Of Medicine - Md

Bachelor Of Arts - Ba, Human Biology