Equitable and Affordable Healthcare: A Shared Responsibility
June 22, 2022
Rising health costs and problems with affordability are impacting individuals and families and disrupting healthcare access across the country and in New Hampshire. Over 200 participants joined a discussion on what can be done to make healthcare equitable and affordable in New Hampshire.
Lucy C. Hodder, JD, Director, Health Law and Policy, Professor of Law, UNH Franklin Pierce School of Law, Institute for Health Policy and Practice
Jo Porter, MPH, Director, Institute for Health Policy and Practice
Deborah Fournier, JD, Senior Associate, Health Law and Policy, Institute for Health Policy and Practice
This event was co-hosted with the UNH Franklin Pierce School of Law, Warren B. Rudman Center for Justice, Leadership & Public Service
Provided by Kate Crary, Project Director, Institute for Health Policy and Practice
Senator Shaheen is with us “in spirit” as we “gather to discuss what can be done to achieve equitable and affordable healthcare in New Hampshire and beyond.” “The importance of adequate and affordable health care coverage has been made even more apparent in recent years as we have continued to battle the COVID-19 pandemic… Cost should never be a barrier to crucial medical care and I will continue to work in Congress to expand access to health care and encourage common-sense reform….”
Senator Hasson, a member of the Senate Health, Education, Labor and Pensions Committee, supports ensuring equitable outcomes for patients across the Granite State, creating a healthier and more equitable New Hampshire, and addressing the root causes of existing disparities through programs that help our state’s most vulnerable residents access affordable care.
Impact of Costs on Families
Healthcare Value: Benchmarking Healthcare Affordability and Perceived Value, WestHealth/Gallup, 2022: The West Health-Gallup Healthcare Affordability Index and Healthcare Value Index are drawn from the opinions of more than 6,600 American adults and represent findings from one of the largest surveys fielded during the pandemic on the state of healthcare in America. Each index is comprised of three unique metrics and classifies adults into corresponding categories based on their experiences. The Healthcare Affordability Index assesses the public’s ability to afford the healthcare they need, while the Healthcare Value Index synthesizes Americans’ perceptions of the quality-of-care relative to cost. More here.
Our Health Care System Has Lost Its Way: Why U.S. Heath Care Is Unaffordable and Low Quality, June 2022, FamiliesUSA
New England State Cost Growth Strategy Materials
Rhode Island Resources
New Hampshire Resources
NH DHHS Licensed Facility Roster – compiled by UNH
9:00 - 9:10 AM
Lucy C. Hodder, JD
9:10 - 9:35 AM
Introduction: Jo Porter, MPH
9:35 - 10:40 AM
Moderator: Lucy C. Hodder
10:40 -10:45 AM
10:45 - 11:25 AM
Speaker/Moderator: Lucy C. Hodder
Introduction of Panelists: Deborah Fournier, JD
11:25 - 11:30 AM
Project Director, Institute for Health Policy and Practice
Kate joined the Institute for Health Policy and Practice (IHPP) in October of 2011. Kate is a Project Director, and her work includes assisting with policy and procedure development, project management, group and organizational strategic planning, and curriculum delivery and development. Kate has been a graphic recording artist for the past 7 years and leverages her artistic talents to communicate issues of health equity and social justice through the creation of live murals during presentations, conferences, and public speaking events.
Deborah Fournier, JD
Senior Associate, Health Law & Policy, Institute for Health Policy & Practice
Deborah Fournier serves as the Senior Associate for the Health Law and Policy Programs at the UNH Franklin Pierce School of Law and UNH Institute for Health Policy & Practice. Deborah previously served as Medicaid Director in New Hampshire and as Sr. Director for Clinical to Community Connections at Association for State and Territorial Health Officials. She earned her JD from Northeastern School of Law and is admitted to the practice of law in Massachusetts.
Morissa Henn, DrPH
Associate Commissioner, Department of Health & Human Services, New Hampshire
Morissa Henn, DrPH has dedicated her career to helping families and communities flourish. She currently serves as Associate Commissioner at the New Hampshire Department of Health and Human Services, where she guides cross-cutting efforts across the State and Department to integrate and improve systems, with a particular focus on behavioral health and child welfare. Previously, she served as Community Health Director at Intermountain Healthcare, a not-for-profit 24-hospital, 160-clinic integrated health system based in Utah. Morissa also spent eight years working on child health policy issues in New York City. She completed her Bachelor’s Degree in Community Health and American Studies at Tufts University, her Masters of Public Health at Columbia University, and her Doctorate in Public Health at Harvard University. Morissa was born and raised in Concord, NH, where she now lives with her husband and daughter.
Lucy C. Hodder, JD
Director, Health Law and Policy, Professor of Law, UNH Franklin Pierce School of Law, Institute for Health Policy and Practice
Lucy Hodder is the Director of Health Law and Policy Programs at the University of New Hampshire, Franklin Pierce School of Law and the Institute for Health Policy and Practice, and Professor of Law. She developed and oversees the Certificate in Health Law and Policy program for law students and teaches a variety of health law courses. Lucy’s research projects are focused on developing sustainable and patient centered health care coverage and delivery systems.
She has practiced law in New Hampshire for almost 30 years. She most recently served as Legal Counsel to New Hampshire Governor Maggie Hassan and her senior health care policy advisor, working with the Governor on initiatives to expand access to health, mental health and substance use disorder services and coverage for New Hampshire citizens. Lucy is an experienced New Hampshire health care, regulatory and employment attorney. Previously a shareholder in the firm of Rath, Young and Pignatelli, P.C., and Chair of the firm’s Healthcare Practice Group, Lucy assisted providers and businesses navigate the changing health care environment. Prior to private practice, Lucy served as an Assistant Attorney General in the New Hampshire Department of Justice and began her practice in the San Francisco offices of Brobeck, Phleger and Harrison.
Timothy A. Lash, M.B.A
President, West Health and West Health Policy Center; CEO and President, Gary and Mary West PACE;
Chairman, West Health Policy Center
As President, Tim Lash oversees the development and execution of West Health’s successful aging portfolio across its nonprofit, nonpartisan family of organizations. Using applied medical research, policy analysis, and outcomes-based grantmaking, Lash advances the strategic direction of the organization. He also oversees a robust federal, state, and local healthcare and aging policy agenda as president and chairman of the West Health Policy Center.
His work directly supports West Health’s mission of lowering healthcare costs to enable seniors to successfully age in place with access to high-quality, affordable health, and support services that preserve and protect their dignity, quality of life, and independence. To that end, Lash is also chief executive officer and president of Gary and Mary West PACE, one of the nation’s premiere Programs for All-Inclusive Care of the Elderly (PACE). Established with a grant from the Gary and Mary West Foundation, West PACE offers high-quality, comprehensive, and coordinated healthcare, social services, and supports for seniors who wish to age in place rather than in a nursing home.
Lash has extensive experience shaping and advancing innovative and disruptive healthcare models, establishing collaborations across a diverse group of stakeholders and organizations, creating new growth platform strategies, and executing acquisitions/equity investments. Prior to joining West Health, he held leadership roles at Johnson & Johnson and several other healthcare companies.
Lash maintains a broad range of leadership positions, including sitting on the executive boards of CalPACE, Constant Therapy Health, and Digital Health Corp. He serves on the advisory boards of the American College of Emergency Physicians (ACEP) Geriatric Emergency Department Accreditation (GEDA) and is a member of the U.S. Department of Veterans Affairs Health Services and Research Development Scientific Merit Review Board. Additionally, Lash is a member of the Drug Selection and Medical Trend Committee for Civica Rx, the nation’s first nonprofit generic drug company, which was established in part with a grant from the Gary and Mary West Foundation. He also supports policy leaders as a member of the selection committee for the Health and Aging Policy Fellows Program.
Lash holds an M.B.A. from New York University’s Stern School of Business, with a concentration in finance and marketing. He earned his B.S. in biology from Union College. In his free time, Lash enjoys spending time with his wife and two young daughters. He can frequently be found outdoors camping or hitting the slopes in the winter months.
Chief Executive Officer, West Health; Chair, Gary and Mary West Foundation;
Chair, West Health Institute; Chair, West Health Endowment
As Chief Executive Officer of West Health and Chair of the board of directors for the Gary and Mary West Foundation, the West Health Institute and the West Health Endowment, Shelley Lyford shapes the organization’s overall direction, guides high-impact grantmaking, and develops strategies to improve the lives of seniors in America.
Solely funded by philanthropists Gary and Mary West, West Health is dedicated to lowering healthcare costs to enable seniors to successfully age in place with access to high-quality, affordable health and support services that preserve and protect their dignity, quality of life and independence. West Health is a family of nonprofit, nonpartisan organizations including the Gary and Mary West Foundation and the West Health Institute, in San Diego, CA and the West Health Policy Center in Washington, DC. Together, these organizations work in unison, combining applied medical research, policy, advocacy and outcomes-based grantmaking to advance successful aging.
Lyford was instrumental in establishing the Gary and Mary West Foundation in 2006. Under her leadership for the past 16 years, the Gary and Mary West Foundation has awarded nearly $250 million to high-impact organizations improving the lives of seniors, their families and caregivers. As CEO and Chair, Lyford leads the foundation’s seminal successful aging work. The Gary and Mary West Foundation is one of only several foundations in the country solely dedicated to aging. Additionally, Lyford is the CEO and Chair of the West Health Institute, which conducts groundbreaking applied and translational medical research. The data generated by the Institute provides the evidence needed for healthcare providers, policymakers, and communities to make more informed decisions about advancing high-quality, affordable healthcare delivery models and support services.
Lyford’s vision has led to the development of several innovative healthcare programs that now serve as national models of excellence. These flagship programs and organizations include California’s first nationally accredited, senior-specific emergency department, the Gary and Mary West Senior Emergency Care Unit at UC San Diego Health, and Gary and Mary West PACE in north San Diego, a Program of All-inclusive Care for the Elderly (PACE) which is the gold standard of care helping seniors to age in place, in the communities that matter to them. Lyford also oversaw the development and now serves as the chair of the first-of-its-kind nonprofit Gary and Mary West Senior Dental Center, which ensures low-income seniors have access to high-quality, affordable dental care integrated with wraparound health and wellness services. These and other models of care are supported by various research initiatives with key collaborators including the American College of Emergency Physicians, the American Geriatrics Society, Brown University, Dartmouth-Hitchcock, the Department of Veterans Affairs, Duke University, Meals on Wheels America, Mount Sinai Health System, UC San Diego Health, and the University of North Carolina at Chapel Hill.
In 2019, Lyford was appointed for a three-year term as a commissioner on the California Commission on Aging, advising the state’s governor and legislature, along with federal, state and local agencies, on issues, policies and regulations that affect California’s seniors. She was subsequently appointed to California’s Master Plan for Aging Stakeholder Advisory Committee. Prior to these appointments, Lyford played a critical role in launching a statewide public awareness campaign called “We Stand With Seniors,” which brought aging to the forefront of the 2018 California gubernatorial race. Under her direction, the Gary and Mary West Foundation was one of the 10 founding organizations behind Civica Rx, the nation’s first not-for-profit generic drug company helping patients by addressing generic drug shortages and lowering the high prices of lifesaving medications. Lyford continues to safeguard the company’s not-for-profit social welfare mission by serving as vice-chair of the board of directors. She is also director of the Civica Foundation, which fosters philanthropic support to manufacture and distribute affordable generic medications, and also acts as an advisor to Civica Scripts, an organization dedicated to bringing lower-cost generic medicines directly to consumers in hospital or retail pharmacies.
Lyford is the co-leader of the West Health Investment Committee and acts as a primary liaison with Northern Trust and Summit Rock Advisors. She is also a member of the Limited Partner Advisory Committee of Martis Capital. In 2022, Lyford received the American Society on Aging Award for outstanding contributions to aging-related research, administration and advocacy.
A dedicated San Diegan, Lyford serves as a board director of the San Diego Regional Chamber of Commerce and the San Diego Regional Economic Development Corporation, where she promotes San Diego as a center for medical research. She is also an advisor to the Wall Street Theater in Norwalk, Connecticut.
Lyford holds a master’s degree in international relations and political economy from the University of San Diego. She grew up on a dairy farm in Vermont and resides in Encinitas, CA. An avid animal lover, traveler, and sports enthusiast, she enjoys running, golfing, skiing, riding horses, and playing basketball.
Ellen Meara, PH.D.
Professor of Health Economics and Policy, Harvard T.H. Chan School of Public Health
Ellen Meara is a professor of health economics and policy in the Department of Health Management and Policy at Harvard’s T.H. Chan School of Public Health, a Research Associate at the National Bureau of Economic Research, and a member of the National Academy of Medicine. Her research examines the effects of public policies and regulations on health care utilization, health and economic outcomes. Her recent work focuses specifically on the impact of changes in insurance coverage, payment strategies, and the implementation of care delivery innovations, often focusing on individuals with disabilities including mental illness and substance use disorders. She has also traced changes in population health over time, and variation in mortality related to education and place. Her research has appeared in over 70- publications in health policy, clinical, and economic journals including recent publications in Health Affairs, the New England Journal of Medicine, and the Journal of Economic Perspectives.
Katherine Scarborough Mills, Esq., MPH
Senior Director, Market Oversight and Transparency, Health Policy Commission, Massachusetts
Katherine (Kate) Scarborough Mills leads Market Oversight and Transparency work for the Massachusetts Health Policy Commission (HPC). Ms. Mills was one of the key architects of Massachusetts’ first-in-the-nation cost and market impact review (CMIR) process and led the HPC’s first cost and market impact reviews, focused on the proposed expansion of the Commonwealth’s largest provider organization.
Ms. Mills currently oversees (1) reviews of provider mergers, acquisitions and other changes to the health care provider market in Massachusetts, including through material change notices and cost and market impact reviews; (2) compliance with and enforcement of the state’s health care cost growth benchmark through performance improvement plans; (3) the state’s registration of provider organizations program designed to increase transparency on the structure and functioning of the health care provider market in Massachusetts; (4) the HPC’s reviews of the value and pricing of high cost pharmaceuticals; and (5) various special projects related to health care market functioning in Massachusetts including ongoing work on opportunities to create a more equitable health care system as well as work on variation in provider prices, out-of-network billing, and the state of community hospitals.
Prior to joining the HPC, Ms. Mills was an attorney with the Massachusetts State Senate, where she worked closely on Chapter 224 of the Acts of 2012, the state’s landmark health care cost control legislation that created the HPC, as well as other health care, public health, and mental health legislation. Ms. Mills earned her B.A. from Harvard College, her J.D. from Northeastern University School of Law, and her M.P.H. from Tufts Medical School.
Jo Porter, MPH
Director, Institute for Health Policy and Practice
Jo Porter, MPH, serves as the Director for the Institute for Health Policy and Practice. She co-chairs the All-Payer Claims Database Council (APCD Council), a partnership program of the National Association of Health Data Organizations and IHPP. Jo has a Bachelor of Science in Microbiology, with a minor in Health Management and Policy, graduating Summa Cum Laude from the University of New Hampshire. She earned her Master of Public Health, with honors, with dual concentrations in Epidemiology/Biostatistics and Social and Behavioral Health from Boston University.
Marie-Elizabeth Ramas, MD, FAAFP
Regional Medical Director, Aledade; Founder, MedRizon Consulting LLC
Dr. Marie-Elizabeth Ramas is a family physician activist with 12 years of experience practicing full scope family medicine with obstetrics in both rural and urban settings. After receiving a license of public health at Toulouse School of Medicine in France, Dr. Ramas completed her bachelor's degree at Washington University in St. Louis, and subsequently medical school, as a National Health Service Corps Scholar, at Case Western Reserve University School of Medicine, in Cleveland, Ohio. She completed her residency training at the Lonestar Family Medicine Residency Program in Conroe, Texas, in 2011. She returned in 2016 to practice community medicine in New Hampshire until 2020, where she shifted her focus onto health care transformation through innovative practice models and joined as Regional Medical Director for Aledade Inc., working with both independent primary care practices and community health centers to provide high quality care for over 150,000 patients. She also continues to provide integrated primary care services as medical director for GateHouse Treatment Center in Nashua, NH.
Dr. Ramas is an avid advocate for high quality, affordable care for all, focusing on how disparities interface between the patient wellness experience and public health. Dr. Ramas began her career in organized medicine as New Physician member on the National Board of Directors of the American Academy of Family Physicians, and currently serves as the National Convener of the AAFP National Conference of Constituency Leaders. A Leadership NH Fellow, she serves locally as President-elect of the NH Academy of Family Physicians, and a member of the NH Medical Society Council. She serves on the Board of the NH Endowment for Health, the Vice Chair of the NH State Health Assessment Advisory Council, as well as chair of the Clinical Committee of the New England Citizen’s Health Initiative.
Dr. Ramas launched MedRizon Consulting as a conduit to promote, what she calls, the foundational health through wellness and equity. Whether it is healthy individuals, organizations or systems of care, health begins with embracing these principles. Her writings have been featured in the American Academy of Family Physicians, as well as the Journal of the American Academy of Pediatrics. She has been featured in both mainstream and news syndications, in the US and abroad speaking on the interface of public health on individual experiences. Her vision is to motivate, inspire and transform others by reframing equity within a relational context.
Patrick M. Tigue
Commissioner, Office of Health Insurance Commissioner, Rhode Island
Commissioner Patrick M. Tigue was appointed to serve as the State of Rhode Island’s fourth health insurance commissioner in January 2021. Throughout his career, he has focused on expanding access to care and improving affordability and quality in the health care system through delivery system reform and payment reform. At OHIC, Commissioner Tigue has prioritized ensuring coverage for COVID-19 testing, treatment, and care, accelerating delivery system reform, increasing health care affordability, increasing access to behavioral health care, advancing the statewide expansion of telehealth services, and promoting transparency and accountability for health care costs.
During his tenure as health insurance commissioner, he has led the state commercial health insurance policy reform and regulatory enforcement agency to protect the interests of consumers, encourage fair treatment of providers, improve the health care system as a whole, and guard the solvency of insurers as a member of the governor’s cabinet. Commissioner Tigue saved consumers $41.7 million by cutting increases proposed by insurers for 2022, advised on the statewide impact of the proposed consolidation of the state’s two largest hospital systems through overseeing the development and dissemination working papers focused on policy considerations and payment model characteristics, and expanded access to telehealth by supporting new statutory requirements such as reimbursement parity for behavioral health and primary care and cost-sharing and prior authorization parity. Prior to his appointment, he served as a principal at Health Management Associates where he provided executive advisory services to public and private sector clients related to publicly funded health care.
Previously, Commissioner Tigue served as assistant secretary for health and Medicaid director at the State of Rhode Island Executive Office of Health and Human Services where he led the Medicaid Program, serving approximately 300,000 residents and managing a $2.5 billion annual budget. He successfully managed the program within budget constraints while maintaining eligibility and benefits including expanding access to life-saving hepatitis C treatment. Commissioner Tigue also negotiated an extension of the Rhode Island Comprehensive Demonstration 1115 waiver with the Centers for Medicare and Medicaid Services to preserve critical federal flexibility and funding including support for the state’s Medicaid accountable care organization program. During his tenure, he served as east regional representative for the board of directors of the National Association of Medicaid Directors.
Commissioner Tigue earned his master’s degree in public policy from Brown University. He holds a bachelor’s degree in English from the College of the Holy Cross.
Victoria Veltri, JD, LLM
Executive Director, Office of Health Strategy, Connecticut
Victoria Veltri, JD, LLM, is the Executive Director of the State of Connecticut Office of Health Strategy, appointed to serve as the first head of this agency in February 2018. She was reappointed by Governor Ned Lamont in 2019 to oversee the office’s mission to implement comprehensive, data driven strategies that promote equal access to high quality health care, control costs and ensure better health for the people of Connecticut.
Under her leadership, the office thus far has:
- Developed the five-year strategic plan with stakeholders
- Developed the Connecticut Healthcare Affordability Index
- Incorporated the first cost caps for hospital and hospital system mergers and acquisitions to contain health care price growth
- Launched the Connecticut Health Information Exchange
- Implemented Executive Order No. 5 to develop cost growth and quality benchmarks and primary care spending targets and delivery reforms
- Implemented Community Health Worker (CHW) Advisory Board to advise DPH on the creation of certification and training standards for CHWs
- Launched the Covered Connecticut Program
Ms. Veltri participates in the National Academy of State Health Policy (NASHP) State Leaders Work Group on Hospital and Health System Costs, the New England States Consortium Systems Organization (NESCSO) ongoing work groups on regional opportunities for state government in health care oversight and regulation. She is a Milbank Memorial Fund Fellow.
From 2016 to 2018, she was the Chief Health Policy Advisor in the Office of Lt. Governor Nancy Wyman, coordinating the state’s health reform initiatives, including the State Innovation Model Initiative, the Health Care Cabinet and other initiatives. She acted as the Lt. Governor’s liaison on health care issues with state agencies, community organizations and the private sector.
She is a member of the Board of Directors of the Connecticut Health Insurance Exchange (d/b/a Access Health CT), and previously served as a member of the Board of Directors of Connecticut Partners for Health. Ms. Veltri has extensive legal experience in health care advocacy and in legislative policy and she lectures frequently at colleges, universities and conferences on health reform and Connecticut health care initiatives.
Prior to joining Lt. Governor Wyman’s staff, Ms. Veltri was the state's Healthcare Advocate in the Office of the Healthcare Advocate (OHA). She oversaw OHA in its mission to: assist health insurance consumers with managed care plan selection; educate consumers about their health care rights; directly assist health insurance consumers with filings of complaints and appeals, and; pursue systemic healthcare advocacy.