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Medicaid Who’s Who Interview: Pam Tyranski

1. Which segment of the industry are you currently involved?

A:  Medicaid and Medicare: clinical and quality program development (including value based purchasing components); drafting MCO bids; supporting program implementations; readiness reviews and accreditation evidence preparation; program assessment and re-structure

2. How many years have you been in the Medicaid industry?

A: Do I have to answer that? I started as a youngin’….since January 1988, so that makes it 30 years. I’ve been in healthcare 35 years

3. What is your focus/passion? (Industry related or not)

A: Building provider/MCO collaboration models Non-Industry: travel

4. What is the top item on your “bucket list?”

A: Visiting the town from which my grandparents immigrated

5. What do you enjoy doing most with your personal time?

A: Spending time with my husband, friends and family at the beach-year round it is beautiful.

6. Who is your favorite historical figure and why?

A: I’m a Court of Henry the 8th junkie- Catherine of Aragon is probably my favorite in that cast of characters. Some may argue she made a few ill-advised moves and trusted people she shouldn’t have, but I view that as being human. And from all I have read about her, she exhibited strength, grace, honor, faithfulness, dignity and kindness until her death. I find the plotting, intrigue, exploitation, maneuvering fascinating in Henry the 8th’s court. As a clinician, reading about the remedies they used (in that era and) to treat the King’s maladies and his own concoctions is also interesting to me.

7. What is your favorite junk food?

A: Water Ice (pronounced- “wooter ice”, yes I’m from Philly)

8. Of what accomplishment are you most proud?

A: Two things professionally: My appointment to the Delaware Board of Nursing, on which I’ve been serving by appointment of the Governors since 2011 and leading a Medicaid MCO start-up that went live in 45 days, passed readiness review, and EQRO.

9. For what one thing do you wish you could get a mulligan?

A: I can’t think of one thing I’d like to do over professionally that I wish I could re-wind for another swing at it. I view every experience as a brick in the wall -they all have their place, and upon each I’ve tried to build on what I learned, the successes I had and more importantly the mistakes I’ve made.

10. What are the top 1-3 issues that you think will be important in Medicaid during the next 6 months?

A: 1) The copayment/cost share and buy-in models in the works or proposed in several states-that will be challenging to providers, and intuitively, I worry that members won’t access care soon enough if they have to pay when they are used to not having any out-of-pocket (initially it may save $, but in the long run, I’m skeptical). 2) The work requirements on the table in a few states-how will that impact the rolls? 3) And my biggie is the national push toward value based purchasing models. For many reasons- a) global payments in various permutations have come and gone in the decades I’ve been in managed care- what is going to make them succeed now, and are we going to invest in those resources? b) in the markets I’ve been supporting, there are very few providers equipped to meet the requirements to support the more sophisticated VBP models, and who is going to fund the resources to prepare them for those models? c) I worry that it is too ambitious, and unrealistic to set goals of converting all/vast majority of providers to VBP contracts in the next few years. Will it push the smaller providers who often are the only ones in underserved areas out of the Medicaid programs because they can’t participate or compete? Will that create access issues?