Mitigating Social Risk to Achieve Higher Star Ratings

As senior vice president and general manager of government programs, Kathleen leads the growth, operations, and finances of government programs with accountability for the overall performance of Regence’s Medicare and Federal Employee Programs (FEP) lines of business and other government contracts. She owns 2.5 billion P & L for these lines of business.

Her work includes oversight of our risk adjustment and Stars area, which supports both Medicare and the individual market and collaborates closely with our clinical and provider teams. Kathleen is an executive liaison with external agencies such as Centers for Medicare & Medicaid Services (CMS), FEP Director’s Office and America’s Health Insurance Plans (AHIP).

She came to Regence in 2017 with a rich career built around commercial and government program health plans with experience from finance to network to medical economics. Before Regence, Kathleen served as the central region president for Humana, where she led membership growth and revenue optimization efforts within their Medicare Advantage business and oversaw risk adjustment, Stars, medical management, and value-based provider agreements. She has also held executive roles at Excellus BlueCross BlueShield in New York managing claims, customer service, membership and provider network strategy and development. Kathleen’s experience spans 30+ years in the health plan industry.

Kathleen received her bachelor’s degrees in accounting and finance at Houston Baptist University and her master’s degree in strategic leadership from Roberts Wesleyan College.

Ashley leads Socially Determined’s core client- and market-facing functions, including client solutions, customer success, content, marketing, strategy, partnerships, policy, and thought leadership. As part of this, she built and manages a multidisciplinary team that leverages the insights generated through the company’s SocialScape® platform, social risk data, and SDOH expertise to manage risk, improve outcomes, and advance equity – at scale.

Ashley is a public health practitioner and researcher by training and an experienced management consultant whose career has bridged health care and public health. Before joining Socially Determined, she helped build and scale successful population health consulting practices for the Premier Healthcare Alliance and Kaufman Hall & Associates. Earlier in her career, Ashley led research and programmatic initiatives for organizations ranging from an academic research center to a network of federally qualified health centers. She also designed, implemented, and evaluated health promotion interventions for the country’s largest local health department.

Ashley holds a Bachelor’s degree from Duke University and a Master’s in Public Health from Columbia. She is a Certified Public Health professional, serves on the National Board of Public Health Examiners, and is a frequent speaker at national conferences on topics related to community health, advancing health equity, and assessing and addressing SDOH risk.

Dawn is responsible for Medicare product development at Independent Health, a Buffalo, NY, community-based, not-for-profit health plan.  Her accountabilities include the development, launch, monitoring and growth of Medicare products while ensuring that the product performance, including financial, membership, quality and benefits, are in line with corporate goals and regulatory requirements.