NEHI Vice President of Policy Research Tom Hubbard will lead a discussion with two national experts from NEHI member organizations:
The discussion will provide an update on federal policy and potential congressional action on payment and insurance coverage for new and novel therapies, and on potential action at the state level, drawing on findings from NEHI’s March 2019 white paper, Next Generation Therapies in Massachusetts: New Solutions for Coverage and Payment.
For more information, contact Tom Hubbard at firstname.lastname@example.org.
Dr. Michael Sherman is chief medical officer and senior vice president for health services at Harvard Pilgrim Health Care, a leading not-for-profit health plan insuring more than 1.25 million members in Massachusetts, New Hampshire, Maine, and Connecticut. Widely recognized as a pioneer in the development of outcomes-based payment agreements, Dr. Sherman is credited with cementing Harvard Pilgrim’s position as a leader among insurers in crafting deals with pharmaceutical companies that tie payments for a drug to its performance. In 2018, he received Xconomy’s “Contrarian Award” for signing the nation’s first such payment model for a gene therapy, thereby paving the way for these high-priced treatments to be commercially adopted in the United States.
Dr. Sherman’s extensive executive experience spans business development, product management, and medical and clinical affairs. Previous roles include serving as corporate medical director for physician strategies at Humana, as vice president for network and consumer solutions at UnitedHealth Group’s subsidiary Ingenix (now part of Optum), and as chief business development officer for United’s Medicare Part D business. Prior to pursuing an M.B.A. at Harvard Business School, Dr. Sherman received his M.D. from Yale and practiced as a cardiac anesthesiologist. He frequently speaks at regional, national, and international conferences and lectures as a faculty member of Harvard Medical School’s Department of Population Medicine.
Constance A. Wilkinson is a Member of the Firm at Epstein Becker & Green, P.C. in the Litigation and Health Care and Life Sciences Practices in the firm's Washington, DC office, with a primary focus on federal health care contracting. She also serves on the firm’s Board of Directors.
Ms. Wilkinson conducts due diligence and internal investigations and audits and responding to criminal fraud and abuse investigations; analyzes cost allowability and pricing issues for proposals or audits; develops corporate compliance policies and programs; advises pharmaceutical manufacturers regarding pricing under the Federal Supply Schedule, the Medicaid Drug Rebate Program, the Veterans Health Care Act and Section 340B of the Public Health Service Act; litigates bid protests; structures technical data rights agreements.
Ms. Wilkinson has significant experience with audits of fee-for-service and managed care contractors participating in the Federal Employee Health Benefits Program (FEHBP), pharmaceutical pricing and procurement and health care quality improvement activities and external review, including conflict of interest issues.
Tom Hubbard leads NEHI’s projects on coverage and payment for innovative biopharmaceuticals, comparative effectiveness research policy, Real World Evidence, medication management and patient medication adherence. Mr. Hubbard leverages his policy and technology experience to examine ways the country’s health care system can be transformed, focusing on the promotion of medical innovation and the improvement of quality and efficiency in clinical care.
Mr. Hubbard came to NEHI after seven years at the Massachusetts Technology Collaborative (MTC), where he led industry-focused projects and supervised the annual publication of the MTC Index of the Massachusetts Innovation Economy. His work has included supervising the I-495 Technology Corridor Partnership, an industry-municipal collaboration on growth, and leading projects on broadband deployment, federal research funding advocacy, and nanotechnology.
Previously, Mr. Hubbard served as Executive Assistant for Economic Affairs to U.S. Senator John Kerry, as Deputy Director of Development for Massachusetts Governor Michael Dukakis, and as Director of Community Development and Planning for the City of Gardner, Massachusetts.
Mr. Hubbard graduated from Harvard College and holds a masters in public policy from Harvard’s Kennedy School of Government