Marian Ryan Email & Phone Number

Dr. Marian Ryan joined the Institute for Healthcare Advancement (IHA) as Chief Policy and Research Officer in March 2020, following thirty-year healthcare and public health career that included direct clinical care, staff training, patient education, health literacy, health program development, and evaluation, performance improvement, and independent health services research. She has held clinical and administrative positions with both payer and provider sectors charged with providing health care for populations challenged by social, economic, and environmental life circumstances. Mid-career, she resigned from her leadership position to earn her PhD in Social Policy (with a concentration in health policy and health services research) at Brandeis University as an AHRQ pre-doctoral fellow. In her position with IHA Dr. Ryan is working to bridge research, policy, and practice with the goals of improving the accessibility and effectiveness of healthcare services and reducing health disparities. She promotes embedding health literacy practices as a pathway to achieving health equity by making health information accessible to and actionable by all. Dr. Ryan launched and oversees IHA’s research program.

Orange County, California Area

Orange County, California Area

Establish and chair a population health cross-functional work group to build a healthcare analytics framework for the organization and prioritize wrap-around services and effectiveness studies for medical management. Develop and validate clinical outcome measures. Standardize claims-based data specifications for member data collection and reporting. Collaborate with Case Management (CM) leadership to facilitate the appropriate allocation of resources and the implementation of evidence-based best practice CM strategies. Provide guidance to medical management on CMS and State regulations and National Committee for Quality Assurance (NCQA) requirements; participate on an internal audit team. Created, tested, validated and distributed monthly chronic condition reports generating chronic condition indicators, utilization, incurred costs, and proprietary risk scores for all markets, products (ACO, Medicare Advantage (MA) and Medicaid cohorts), and membership; and completed effectiveness evaluations for Disease Management Programs, Transition in Care Program, and Case Management services. Identify high risk and at-risk members and beneficiaries.

Orange County, California Area

Completed a comprehensive assessment of the organization’s infrastructure to support optimal chronic illness care and developed NCQA-compliant disease management and clinical programs (Heart Failure, COPD, slowing kidney disease, and Transitions in Care); integrated program components with existing case management program to minimize duplication and improve collaborative, member-centric, team-based care; created practitioner, case manager/educator, member tools and resources to ensure consistency of educational messages; and developed and implemented all staff training programs. Developed the analytics and work flow processes to identify and stratify potential persons for disease management program cohorts. The new Heart Failure Program reduced re-admissions for heart failure by 50% and increased Nurse Practitioner “treat in place” by 100% preventing avoidable ED visits and hospitalizations; the TOC program reduced readmissions of high risk patients by 56%. Provided support to the entire medical management team related to Medicare and Medi-Cal regulatory compliance requirements.

Irvine, Ca

Collaborated with medical leadership in the development of an integrated, innovative Care Management (CM) model; conducted an assessment and identified gaps in our CM Program in meeting CMS MA Special Needs Plan (SNP) Model of Care (MOC) requirements; conducted CM audits for compliance with CMS SNP requirements; performed statistical analyses on CM Program variances across and within market service areas; produced all CMS and State-specific external reports on MOC and ODAG performance measurements; independently authored three Model of Care submissions for CMS Medicare Advantage-Special Needs Plan products−all earning 100% scores; developed member assessments and survey tools for risk assessment and evaluation of the CM Program. Directed clinic efficiency and effectiveness initiatives to improve our primary care center infrastructure, established primary care support services infrastructure for all new primary care clinics in Detroit and ensured compliance with NCQA requirements for Patient-Centered Medical Home recognition.

Multiple Clients: Caloptima, Coalition Of Community Clinics

CalOptima, Orange, CA10/13-1/15 Executive Consultant to the Chief Medical OfficerLed the medical management team in the revision of the model of care for the OneCare dual-eligible MA-SNP plan; revised the health risk assessment (HRA), developed auto-generated patient care plans with potential care goals, developed risk stratification algorithms based upon claims history, and worked with medical officer to establish care ratios and financially-based reporting metrics for the contracted provider networks. Created a new position, the personal care coordinator (PCC) assigned to every enrollee as the point of contact; developed the PCC training program, implemented all initial training sessions and established ongoing professional development. CMS cited the PCC position and many of the new processes as best practices during the successful audit of CalOptima’s OneCare program January 2015.Orange County Coalition of Community Health Clinics, Irvine, CA8/12-1/15 Health Programs and Research ConsultantProject manager and analyst for a grant-funded County collaborative to develop, implement and evaluate a patient-centered medical home model for the safety-net providers; directed pilot project to design and implement a county-wide quality indicator dashboard; verified meaningful use quality measurement reporting.

Directed and implemented health center research projects; conducted a study that analyzed the biometric profiles and trajectories of overweight and obese pediatric patients in collaboration with the UCI Center for Translational Research Community Engagement Unit and served as site coordinator to pilot-test the patient satisfaction survey developed for the Patient-Centered Medical Home NCQA recognition program (AHRQ and Harvard). Analyzed electronic health record data output and developed reports on QI measures, and provider efficiency and productivity. Directed health center quality improvement initiatives and produced quality indicator and provider feedback reports. Led and principle author of a HRSA New Access Point grant application successfully earning the health center’s initial two-year, 1.8 million dollar Federally Qualified Health Center grant.

Worked with principal investigators on the CMS funded grant to develop and evaluate performance measures under the proposed Value-Based Purchasing (VBP) program. Focus of work is how to measure care coordination and impact of VBP on vulnerable populations. Managed a GSK-funded research project on the cost of pneumonia and Chronic Obstructive Airway Disease among Medicare Fee-For-Service beneficiaries. Lead author for published manuscript.

Developed standardized DM protocols - call center, patient and primary care physician - for asthma, diabetes, cardiovascular disease and COPD. Directed the establishment of data algorithms for the identification and stratification of identified managed care members into respective programs and the development of quality improvement measurements. Identified the need and participated in the subsequent development of complex case management for members with multimorbidity and/or six or more prescription medications. Directed the development of standardized communications across all states, including the design and evaluation of health promotion newsletters, and disease-specific newsletters. Wrote the initial protocols for the Medication Management Therapy program for the MA-SNP product.

Re-established a health education department to meet state requirements for government programs. Recruited experienced, professional staff, revised position titles and accountabilities, and revised department policies and procedures. Developed and executed a comprehensive work plan that resulted in innovative population-based interventions, the educational component for an asthma health management system, and the provision of individual medical nutrition therapy to high-risk members. Directed the development and execution of comprehensive cultural/linguistic initiatives for the company. Completed three, comprehensive, needs-assessment reports for State submission. Actively participated on the Quality Improvement Committee and led several internal QI studies. Directed a team of 12 professionals, developed and managed over a million-dollar budget annually, and participated on State-delegated task forces for Medi-Cal Managed Care in CA.

Directed the health education activities of the Child Health and Disability Prevention Program, Comprehensive Perinatal Services Program and other health care agency initiatives.

Ph.D., Health Policy And Health Services Research

Mph, Community Health Education