Roger Howe Email & Phone Number

consulting in healthcare and in the business and administrative aspects of healthcare, including:Payor operations: Utilization management, Case management, Disease Management, quality management, plan design, provider relationsThe business of healthcare provision: strategic planning; governance; organizational structure and function; accounting; cash controls; payer relations; change facilitation; mediation; contract design and negotiation; facility planningMedical Staff relations: strategic planning; organization; discipline; negotiations; facilitation; arbitration.Change management: strategic and tactical planning; inclusion activities; facilitation, mediation and negotiationGeneral trouble-shooting

internal and external spokesman for the Care Management Department in a small (85,000 enrollees) HMO in a provider community with little exposure to managed care. Retired: October 2, 2009. Duties included:Maintain UM standards (admissions and bed days)Shift emphasis to Case Management and Disease ManagementImprove relationships with provider communityParticipate in the development of a collaborative relationship among departments in the HMOParticipate in the development of and assist with the underwriting of new product offeringsAccomplishments:Stable UM rates with less friction with provider communityBest reputation with physicians of any plan in the state2002 was first profitable year in company history ($10 M loss in 1999)2003 profit was $4 million, twice the 2002 profit2004-2009 were again profitable; the company has gone from an AM Best rating of C- to B over this time.Instrumental in transition to new electronic platform (Facets)Case Management is gaining momentumOutsourced Disease Management for three years, then insourced the program; it is growing in volume and successDeveloped an in-house "Population Management" which has achieved operational and marketing success for the companyParticipated in the design of a consumer-directed health planInstituted a "pay for performance" program for primary care physiciansTransitioned PBM companies; instituted a value-based formularyActively participated in creating a successful bid for FEHBP programActively participated in fraud and waste detection programs

Wrote: "Where Have We Failed? A Systemic Analysis of U.S. Health Care" published in 2002 by the American College of Physician Executives.

The fifth full-time Physician Manager in an HMO with membership of 350,000. After losses in 1999 and with anticipated losses in 2000, the CMO was hiring to rebuild. My duties included:Utilization Management (hands-on, including hospital rounds) Quality ManagementPhysician interfacing - important relationships with hospitalists, primary care physicians, and selected specialistsSupport to internal departments including customer relations and claims. Accomplishments:Reduced Medicare bed days by 200 pmpm (1450->1250)Reduced Acute Rehab Hospital use by 75% (working with Orthopedists)Worked with Claims to improve claims adjudication process and outcome. Collaborated with hospitalist groups on expectations and efficiencies. Participated in improvement in Medical Expense Ratio from about 95% to 89%

The full-time Administrative Physician in a growing Foundation-model medical group associated with the Sutter Health system; CMO of the group. Duties included:Recruiting and Retention programs for physiciansInternal consulting regarding operations of care centers (12 offices in 7 towns)Administration of the physician salary systemMonitoring all financial systems and results of the groupResponsible for medical group budget of $37 millionOversaw medical foundation department of seven to staff recruiting, payroll, HR, benefits administration programs for the Group. Accomplishments of the group during my time there: Oversaw (and recruited) an increase in group size: 1997 110; 1998 150; 1999 reached 160 in February. Medical group lost $0.9 million in 1998; salary cuts and operational changes brought positive bottom line of $1.5 million in 1999. Published monthly newsletter. Installed new EMR systemInstalled an intranet. Converted HR tracking to electronic database.Position deleted in reorganization

Second-ranked physician executive in a growing IPA-model HMO. The enrolled population (HMO, POS, PPO and Medicare-risk) expanded from 75,000 to 225,000, and participating (contracted) physicians from 2,500 to 4,000 over a two year period. Duties and accomplishments: Utilization Management, Quality Management, Case Management and Provider Relations. NCQA accreditation passed. Promoted on departure

Organized, sold partnerships in and ran a five year limited partnership organized for the purpose of purchasing a CT scanner for our remote rural community.

My partner and I established this not-for-profit, tax exempt, Community Clinic in response to our inability to make financial ends meet taking care of MediCal (California Medicaid) patients and our sense of moral obligation that they receive care. We created, incorporated, founded, oversaw, sat on the founding Board of Trustees, and acted as supervising physicians for the PA we hired to staff the clinic. I wrote the articles of incorporation, bylaws, and all of the policies and procedures required to be a community clinic.; Rural and relatively isolated.

Care NetworkA forming IPA designed to unite the efforts of primary care physicians from the San Francisco Bay Area to the Oregon border. Facilitator of the strategic planning meeting, an organizing principal, and an officer. Membership reached 75.

A multi-site medical group: organizer and facilitator of the strategic planning effort, officer and member of the Board of Directors, Medical Director (designed Utilization, Quality, Credentialing, Discipline and Appeals mechanisms). The group joined 30 primary care physicians in Redding, Mt Shasta and three other Northern California communities (maximum separation of over 75 miles) into a single incorporated group practice.

Chair, Surgeons' CommitteePaid 1/5-time position as Chair of the Surgery Department. This 32-bed rural hospital was nearly decertified by JCAHO in 1992 due to problems in the surgery department. On re-inspection in 1993, we received a full 3-year accreditation. The department included two orthopedists, three general surgeons, one urologist, one ENT, and myself. Quality management and leadership were the primary issues.

Elected member of the Board of Trustees to represent the XI Trustee District of the California Medical Association.

Participated as a primary consultant/mediator in dispute between physicians and hospital administration at an isolated northern California hospital.

This was a position of leadership representing recognition by the faculty. I served in this role during the

Captain promoted to Major. I was assigned an executive officer and a supply officer and told to requisition the personnel and equipment necessary to run a mobile 60 bed surgical hospital. We were operational and on maneuvers in the Alaskan midwinter within 6 months - with commendations.

I was the commander of the only medical facility in a radius of 100 miles, and one of two physicians serving a population of about 4000 people.

Mmm

Residency, Family Practice; Ucsf

Education record

Md

Bs, Medical Sciences

Of; Master; Associate, Health Systems Management; Medical Management; Clinical Professor

Taught a course on a system-based approach to healthcare. Adjunct Assistant Professor, Department