Dr. George Oestreich
Dr. Oestreich is providing key strategic consulting on Medicaid issues including health information technology, decision support, program design and care coordination policy development. A major interest is developing transparent integrated patient care management and coordination solutions into current practice. He has unique and comprehensive experience in pharmacy benefit design coupling integrated pharmacy services into mainstream care coordination and service delivery.
Dr. Oestreich served as Deputy Division Director, Clinical Services, for MO HealthNet (MHD), the Missouri Medicaid agency from August 2006 until February 2011. In this position he developed clinical payment policy and related payment edits. He coordinated health information technology for monitoring, support of edits and decision support. Also in his venue was the development and implementation of disease management and care coordination services. The later resulted in a positive return on investment and improved patient outcome indicators.
Dr. Oestreich served as Director of Pharmacy for the agency from 2001 to 2006. Under his leadership, the MHD was an early innovator in Medicaid pharmacy programs integrating aggressive maximum allowable pricing, clinically sound step therapy, productive supplemental rebate programs, high tech prior authorization and physician-pharmacist disease management. These programs provided cost avoidance for the agency that averaged over $100 million annually. In a recent program review the Lewin Group stated, “Pharmacy program leadership staff have an exceptional level of Medicaid and prescription drug management expertise and stand out among Medicaid pharmacy staff nationwide”
During his tenure as Deputy Director of Clinical Services, he has continued providing effective leadership that extends the principals of the incorporation of medical evidence and best practice into the polices of other service areas. The most synergistic have been the integration of high tech solutions into care coordination opportunities. That process has produced greater savings than traditional disease management by focusing on opportunities within targeted disease processes that can be impacted. In this space, Dr. Oestreich has also used population-based queries of integrated claim data to support program initiatives and promulgate policy. Significant increases in patient health status as well as actual short term cost savings and projected long-term savings have been achieved.
From September 2009 until leaving the agency, Dr. Oestreich served as Project Director for Missouri’s healthcare technology grant from the Office of the National Coordinator (ARRA HITEC) as well as the coordinating the states state Medicaid technology initiatives (IAPD and SMHP). The MHD initiatives are yielding a coordinated approach by integrating paid claim data with clinical data. This integrated approach is then presented to state staff for program management and contracted provider clinical staff for coordinated decision support.
One major area of focus since engaging full time in private consulting has been in the 340B drug discount space. Recent changes in the 340B drug discount program have caused an exponential growth in contract pharmacies and associated third party prescription claims adjudication issues. Of particular interest has been the appropriate use of 340B drugs in Medicaid and how to assure duplications with drug rebate discounts do not occur. Of concern are the methodologies previously developed for assuring that only patients of covered entities receive access to the products.
Dr. Oestreich has worked extensively on these and related issues on the behalf of national clients, state agencies and small providers. Unique targeted solutions have proven to be the most effective. As a by-product of this work he has provided articles, presentations, and targeted solutions for unique settings for the use of 340B-discounted drugs.
Dr. Oestreich earned his BS in Pharmacy from the University of Missouri-KC, his Master of Public Administration from University of Missouri-Columbia and his Doctor of Pharmacy from Kansas University. Prior to joining state government in 2001 as he served as Chief Executive Officer of the Missouri Pharmacy Association and the Foundation for Pharmaceutical Care for 13 years. He has a wide variety of pharmacy practice experience in community, hospital, long term care and consulting. He owned a full service community pharmacy until 2007 working and managing it until 1989 when he began working for the association. He served on the Missouri Board of Pharmacy for five years, and as President for 2 of those years. He has received many awards, made multitudes of presentations and co-authored many publications.
Jennifer Kemp-Cornelius, R.Ph., B.S. Pharm., Pharm. D.
Dr. Kemp-Cornelius has over two and half decades of pharmacy practice experience. years of community pharmacy experience, She has over twelve years of major state contract management experience, significant experience in long-term care pharmacy consulting and community pharmacy experience spanning the entire continuum of practice.
Dr. Kemp-Cornelius served as account manager for the MOHealthNet (MHD) clinical services contract provided by Xerox. This contract began as 5 million dollar retrospective DUR contract and pharmacy edit program with a component of disease management. Over her tenure it morphed into a $17 million dollar clinical services program that produced a cutting edge paid claim provider portal that interfaced with a clinical rules engine that juried claims electronically for the majority of MHD services. Additionally the Xerox services interfaced with a hospital precertification program, and a home and community based services program (administered by a sister agency). The system provided an interface for pharmacists to provide and bill for medication therapy management services, unique to other states. Patient care portal was also a by-product of the work and is used extensively in the state’s health home initiative. Supporting all of these services was an integrated help desk that supported deployment and provider operations.
The produced saving projections supported by these services at over a quarter of a billion dollars annually. The system is a part of the reason the state’s Lewin report cited the state’s pharmacy program as one the best nationally. Many states have used some of these tools to support their program but none have replicated the integration and multi-departmental operations.
The Xerox tools were integral for the space to achieve its first integration of health records over the health information exchange initiative. With Dr. Kemp-Cornelius’s operational oversight, the state used the MHD program as the basis for ramping up the functionality of the exchange. The contract was also the vehicle the state chose to support the electronic health records grant program supported by CMS and the ONC.
Dr. Kemp-Cornelius joined the G.L.O. and Associates consulting group in July 2014. Since that time she has not only supported ongoing contracts over a variety of initiatives but has developed her specific client base in the process. Currently she is consulting with a technology vendor to help incorporate an analytic web tool and ad hoc reporting into daily operations for a chronic pain management program, a pharmacy integration project for diabetes and hypertension outcomes, and a health home program. She is also working with a state pharmacy network to provide extensive training for pharmacists interested is supporting patient wellness programs in concert with CDC grants. These programs train, monitor and report on the effectiveness and efficacy of pharmacists service primarily in patients with hypertension and diabetes.
Dr. Kemp-Cornelius was previously responsible for account management, service delivery, and operations for the Xerox contract with MO HealthNet. Responsibilities included working collaboratively with Xerox’s IT department to drive major installations and system updates, managing a retrospective DUR program, managing the process for developing, testing and placing into production new prospective clinical and fiscal editing criteria for pharmacy and medical programs, overseeing the implementation of an inpatient pre-certification system and clinical helpdesk, overseeing deployment and operations of provider and patient electronic health record portals, and overseeing provider outreach and training on new web modules and programs.
Prior to working for Xerox, Dr. Kemp-Cornelius practiced both as a staff pharmacist and then as a pharmacy manager (pharmacist in charge) for one of the busiest chain community pharmacies in the state. She is a licensed pharmacist in the State of Missouri and completed training to be certified by the board of pharmacy in Medication Therapy Services (a program that allows pharmacists to provide clinical services directly to patients using a protocol with a physician).
Dr. Kemp-Cornelius received both her Bachelor of Science in Pharmacy and Doctor of Pharmacy degrees from the St. Louis College of Pharmacy. She is married and has three children.