Expertise

Dr. Richard Stefanacci

Chief Medical Officer

EVERSANA ENGAGE

Dr. Richard Stefanacci

Richard has focused his career on improving health outcomes, especially for some of the most vulnerable populations. This has been achieved through several avenues, beginning with his continued active role as a treating internist/geriatrician. He has also put this focus into practice as chief medical officer for several management care plans, including ElderHealth/Bravo/HealthSpring/Cigna and PACE (Program for All-inclusive Care for the Elderly) programs, as well as his current role as a pharmacy and therapeutics committee member for several national plans. On the policy side, Richard served as health policy scholar for the Centers for Medicare & Medicaid Services (CMS) through his role at Thomas Jefferson University, College of Population Health, where he maintains a faculty appointment. He has over 500 publications in addition to delivering well over 1,000 lectures, both nationally and internationally, focused on improving health outcomes. Today, Richard is actively engaged in leading population health activities for numerous health systems and payer groups.

His recognized expertise has led to Richard being appointed to serve on the American Society of Consultant Pharmacists (ASCP) and the AMDA Foundation boards, as well as being an honorary lifetime member of the ASCP and the National Association of Directors of Nursing. Richard has achieved recognition as a fellow in both the College of Physicians of Philadelphia and the American Geriatric Society and was recently awarded the Humanism in Aging Leadership Award from the University of New England.

Richard’s work for vulnerable populations is very personal, stemming from his involvement with the Go4theGoal Foundation (www.Go4theGoal.org), a 501(c)(3) public charity that he founded with his family and friends when his oldest son, Richard, was diagnosed with Ewing’s sarcoma. Since its inception, the foundation has raised several million dollars to assist hundreds of children affected by cancer at nearly 100 children’s hospitals across the country while also funding cutting-edge research to find a cure. This research work is directed by the foundation’s panel of experts, which includes several current and past federal government leaders in rare diseases.

Richard holds a DO and an MS in geriatric healthcare from the A.T. Still University of Health Sciences, as well as an MBA from the Keller Graduate School of Management of DeVry University. He is also an American Geriatrics Society Fellow and a certified medical dosimetrist.

Expertise:

Affordability Programs (PAP, Copay), Pricing, Reimbursement & Market Access, Stakeholder Engagement & Promotion (Patients, Payers, Providers)

Articles by Dr. Richard Stefanacci

Population Health Partnerships To Advance Value-Based Care

The business model for health care in the United States is evolving from a volume-driven model to a consumer-centric, value-driven model. As such, there are new competencies required of hospitals and health systems to effectively manage a population’s health across the continuum of care. Many hospitals and health systems will need to partner with other […]

CMS Proposed Medicaid Rule: Best Price Impacts of Value-Based Purchasing, Co-Pay Assistance Programs, and More

On June 17, 2020, the Centers for Medicare and Medicaid Services (CMS) published a proposed rule outlining nine specific changes to Medicaid regulations. Five of these directly affect manufacturers through changes in administration of the Medicaid Drug Rebate Program (MDRP): Value-based Purchasing Arrangements Line Extensions Patient Assistance Programs MDRP Definition Clarifications Authorized Generics Download EVERSANA’s […]

Where Health Systems are in the Shift to Value: Four Categories

One could make the argument that there are four situational categories under which all health systems now fall on the journey toward more value-based care and away from the fee-for-service model. Assisting health systems in successfully transitioning to value-based care and delivering improved clinical and financial outcomes for their patient populations depends on very different […]

How COVID-19 will Change the Patient Journey, Reimbursement, and Care Delivery

Value-based care has led to much change in healthcare over the years, and COVID-19 is pushing change faster and even further. These changes forced by COVID-19 will have long-term effects on every aspect of care delivery; current healthcare tools and programs such as clinical pathways need to adjust to these changes to continue being helpful. […]

Oncolytic Biosimilars: An Opportunity to Reduce Oncology Treatment Costs

Inclusion of oncology biosimilars in clinical pathways is one approach to reducing costs in this therapeutic area without compromising outcomes for cancer patients. There are currently eight Food and Drug Administration (FDA)-approved oncolytic biosimilars in the US market. Patients, providers, payers, policymakers, and manufacturers are all stakeholders that will be affected by these new biosimilars—and […]

Proactive Steps to Ensure Appropriate Utilization of the First Disease-Modifying Therapy for Alzheimer Disease

Widespread hope exists that aducanumab will soon gain Food and Drug Administration approval as the first disease-modifying therapy for patients with mild cognitive impairment associated with Alzheimer disease (AD), which could significantly impact the management of AD. If approved, challenges need to be addressed to properly identify patients who will benefit from treatment and ensure […]

Clinical Pathways and Policy to Guard Against Misaligned Incentives

The application of clinical pathways and their enforcement through quality metric benchmark setting and appropriate use criteria is needed to guard against perverse financial incentives that encourage overutilization and underutilization. Moving forward, the more diligent payers and integrated delivery networks can be in evaluating and incorporating utilization criteria when establishing clinical pathways, the better off […]

Oncology Treatment Access in 2020 and Beyond

2020 promises to be eye-opening as the coming election will surely provide clarity to the path that we will be taking for oncology treatment access. From international reference pricing, acceleration of biosimilars and generics, and allowance of reimportation – pressure continues to mount to reduce pharmaceutical prices, especially those used to treat cancer. Much of […]

Alexa, Can You Transform Healthcare?

“Alexa…,” “Hey Siri…,” “OK Google…,” “Hey Cortana…,” and “Hi Bixby….” These are the now-familiar “wake words” that we use to interact with our digital assistants and an ever-growing number of smart speakers. Chances are you have even interacted with one or more of these devices today. According to Allied Market Research, the smart speaker market is expected […]

Balancing Access

Value propositions need to justify product pricing by focusing on the burden of severe illnesses and how the products address unmet needs.

Could CMS Policies Impact Investments in CAR T-cell Therapies and Other Innovative Treatments?

Clinical pathways that include CAR T-cell therapy as an option must integrate appropriate guidance on its use and settings of care.

Pathways for Paying for Rare Disease Treatments

This article was written for the Journal of Clinical Pathways Determining how to pay for the treatment of uncommon yet serious diseases is an important consideration in terms of sustainability and patient access. Novel and expensive therapies will create financial pressure for payers’ drug budgets. Clinical pathways have demonstrated success at determining the “right treatment […]

CMO Perspective on World without Medicare Rebates

Written for Med Ad News Magazine by Dr. Richard Stefanacci For chief medical officers (MO) of health systems, a world without Medicare rebates complicates the selection of a preferred treatment while also opening opportunities for improved clinical and financial outcomes. This is the result of Medicare rebates being eliminated, potentially being replaced by patient assistance […]

Engaging Patients in Care Through Greater Access to Medical Records and Clinical Pathways

This article was written for Journal of Clinical Pathways. Without interoperability of medical records between health systems, patients are the best chance for the medical system to provide continuity of care when medical records from a different health system are difficult to obtain. Providing enhanced access to medical records can help patients feel more involved […]

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How the Proposed Elimination of Medicare Rebates Would Impact Clinical Pathways

Government, Policy & Systems Changes Affecting Clinical Pathways This article is written by Dr. Richard Stefanacci, for Clinical Pathways Magazine. The Centers for Medicare & Medicaid Services (CMS) has published a range of new proposed and final rules regarding payment rates and policies affecting providers, payers, and patients. The Trump administration has also laid out […]

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