Paul Aitken MD MPH
Lebanon,United States
Summary
An accomplished and caring physician executive with a hybridized leadership style combining participative, delegative, and transformational approaches who establishes direction and communicates through a compelling vision. Excels in team building and goal setting, adept at managing roadblocks for measurable success. Proven track record of establishing collaborative interdisciplinary partnerships for innovative programs. Achieves shared goals of improved healthcare outcomes at a lower cost.
Overview
26
26
years of professional experience
1
1
Certification
Work History
Chief of Population Health, Associate Dean for Clinical Integration
Stony Brook Medicine
09.2023 - Current
- Provide leadership and accountability for the IDN, ACO and the system wide Population Health and Clinical Integration initiatives and outcomes
- Earned ACO Shared Savings of $9m in 2024
- Lead four divisions including Care Transformation /Integration, Quality Management, Care Management & Pharmacy Management
- Developed a Multiple Chronic Condition Care Model and partnering on the development of a Data Lake with Health IT Division designed to promote Just-In-Time population health risk management
- Leading the implementation of new Health Equity strategy including the development of process to analyze social determinant data and barriers to care
Clinical Transformation Consultant
CQI Clinical Transformation Consultants
01.2019 - Current
- Provide strategic insights and actionable recommendations to address complex questions related to clinical transformation, healthcare systems innovation, population health management, and value-based care
Senior Vice President, Population Health & Chief Medical Officer
AvMed
03.2022 - 09.2023
- Provide leadership and oversight of the Population Health Division consisting of 150 employees across four departments including Population Health Management, Quality Management (including credentialing), Utilization Management & Pharmacy Management
- Conducted capabilities profile of all contracts, programs and data reporting of the Population Health division to assure alignment to mission, vision, strategic pathways and goals
- Saved $2m in unwarranted operational cost
- Negotiatiated $15m savings on PBM contract
- Developed new monthly utilization management and cost of care reporting package
- Developed strategy to address avoidable ED use and impactable inpatient admissions / readmissions
Chief Medical & Clinical Transformation Officer
GEHA
08.2019 - 10.2021
- Provide leadership and oversight of the Clinical Operations Division consisting of 160 employees across four departments including Population Health Management, Quality Management, Medical Management, Pharmacy Management & Accreditation
- Served as Founding Chair of GEHA Corporate Quality Council and Member Executive Diversity and Inclusion Council
- Developed and implemented a corporate wide Quality Management Council and Program
- Formed an interdisciplinary Clinical Operations Project Performance Team (COPPT)
- Created an 'assembly line of solutions' by aligning the COPPT directly to the corporate strategy
- Decreased average blood pressure levels in 59% of eligible hypertensive members, Decreased average blood glucose levels in 44% of eligible diabetic members, 22% completion rate in a new Medication Therapy Management (MTM) program, 34% completion rate in new anxiety / depression screening program
Senior Medical Director, Clinical Transformation
AETNA/CVS
02.2012 - 08.2019
- Managed two Joint Ventures and seven large Accountable Care Organizations in the eastern US region with Population Health Risk Management and Clinical Integration initiatives to improve quality, elevate efficiency and enhance the healthcare experience for consumers and providers
- Improved adherence to evidence-based guidelines through data analysis and chronic disease/ case management strategies while decreasing avoidable utilization (ER, inpatient, readmissions) for rising risk and complex care members
- Analyzed clinical care across the continuum of the risk pyramid, reviewed medical / pharmacy claim data, identified opportunities to improve clinical and financial outcomes
- Used claims and clinical data to identify optimal sites of service to optimize quality and cost (Laboratory, Radiology and Specialty)
- Promoted generic medication and therapeutic equivalent utilization
- Improved quality measures (STARS, HEDIS) and decreased unwarranted utilization
- Developed an evidence-based Wellness and Chronic Condition Strategy
- Served as Aetna’s liaison to the American Gastroenterological Society, the National Colorectal Cancer Roundtable and the National Lung Cancer Roundtable
- Served as Physician Team Leader for Aetna’s Gastrointestinal Condition Analysis Team
- Developed Health Equity Colorectal Screening Program for Aetna Employees
- Member Clinical Policy Team developing Clinical Policy
- Utilization Management, Prior Authorizations, Peer to Peer discussions
Residency Program Director
PENN STATE UNIVERSITY / PENN STATE HEALTH
06.2005 - 02.2012
- Responsible for the overall quality, administration and maintenance of accreditation of the Residency Program in Family and Community Medicine with related oversight of fifty attending and resident physicians
- Achieved certification as Patient Centered Medical Homes by the National Committee for Quality Assurance for 2 practices caring for underserved populations
- Doubled the size of the residency program from 18 to 36 residents / year creating greater access to primary care services
- Obtained ~ $1m in grant funding from the Health Resources Service Administration entitled Translating Evidence into Outcomes that Matter which ultimately, incorporated Evidence-based Guidelines into outpatient practices leading to measured improvements in chronic condition and immunization outcomes in underserved clinic population
Director of Rural Community Medicine
UNIVERSITY OF NORTH CAROLINA / NEW HANOVER REGIONAL MEDICAL CENTER
07.1998 - 06.2005
- Responsible for direct and resident supervisor roles for inpatient, outpatient care including low risk obstetrics
- Obtained ~ $1m from the Health Resources Service Administration and the Duke Foundation leading to establishment of a Community Oriented Primary Care Program and improvements in access to high quality care for underserved residents of rural southeastern North Carolina
Education
Master of Public Health -
Columbia University, School of Public Health
New York , NYFellowship - Public Health and Preventive Medicine
State University of New York At Stony Brook, Department of Preventive Medicine
Stony Brook, NYResidency - Family Medicine & Community Medicine
Duke University Medical Center, Department of Community And Family Medicine
Durham, North CarolinaInternship - Obstetrics and Gynecology
New York University Medical Center/Bellevue Hospital
New York , NYDoctor of Medicine -
State University of New York at Buffalo, School of Medicine
Bachelor of Science - Physician Assistant Program
City College of New York/ Sophie Davis School of Biomedical Education & Harlem Hospital
New York, New YorkSkills
- Active listening
- Strategic Planning
- Population Health Risk Management
- Quality Management
- Pharmacy Management
- Care Management
- Utilization Management
- Clinical Policy
- Medical & Claims Data Analytics
- Integrated Care Delivery
- Value-Based Contracting
- Wellness
- Prevention
- Evidence-Based Medicine
- Change Management in Matrixed Organizations
Management Training
- Certified Physician Executive, Certifying Commission in Medical Management, 2013
- Resolving Conflict, Advanced Applications in Quality Management, Crucial Confrontations, Three Faces of Quality, Physician in Management, Managing Physician Performance, American Association for Physician Leadership
- Echelon: Leadership in Health Care, Penn State University/Hershey Medical Center
- Information Mastery: Evidence Based Medicine, University of Virginia
- Master in Public Health, Columbia University Mailman School of Public Health
Faculty Appointments
- Visiting Clinical Professor, STATE UNIVERSITY OF NEW YORK AT STONY BROOK, Stony Brook, New York, 01/01/23, Present
- Full Clinical Professor, PENN STATE UNIVERSITY, Hershey, Pennsylvania, 01/01/11, 12/31/12
- Associate Clinical Professor, PENN STATE UNIVERSITY, Hershey, Pennsylvania, 01/01/05, 12/31/11
- Assistant Clinical Professor, UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL, Chapel Hill, North Carolina, 01/01/98, 12/31/05
- Assistant Clinical Professor, STATE UNIVERSITY OF NEW YORK AT STONY BROOK, Stony Brook, New York, 01/01/96, 12/31/98
Certification
- Pennsylvania Medical License, current active
- North Carolina Medical License, current active
- New York Medical License, current active
- Certified Physician Executive, Certifying Commission in Medical Management
- Fellow, American Academy of Family Physicians
- Diplomate, American Board of Family Medicine
- American Board of Preventive Medicine, 01/01/02, 12/31/12
- Diplomate, National Board of Medical Examiners
Timeline
Chief of Population Health, Associate Dean for Clinical Integration
Stony Brook Medicine
09.2023 - Current
Senior Vice President, Population Health & Chief Medical Officer
AvMed
03.2022 - 09.2023
Chief Medical & Clinical Transformation Officer
GEHA
08.2019 - 10.2021
Clinical Transformation Consultant
CQI Clinical Transformation Consultants
01.2019 - Current
Senior Medical Director, Clinical Transformation
AETNA/CVS
02.2012 - 08.2019
Residency Program Director
PENN STATE UNIVERSITY / PENN STATE HEALTH
06.2005 - 02.2012
Director of Rural Community Medicine
UNIVERSITY OF NORTH CAROLINA / NEW HANOVER REGIONAL MEDICAL CENTER
07.1998 - 06.2005
Doctor of Medicine -
State University of New York at Buffalo, School of Medicine
- Pennsylvania Medical License, current active
- North Carolina Medical License, current active
- New York Medical License, current active
- Certified Physician Executive, Certifying Commission in Medical Management
- Fellow, American Academy of Family Physicians
- Diplomate, American Board of Family Medicine
- American Board of Preventive Medicine, 01/01/02, 12/31/12
- Diplomate, National Board of Medical Examiners
Master of Public Health -
Columbia University, School of Public Health
Fellowship - Public Health and Preventive Medicine
State University of New York At Stony Brook, Department of Preventive Medicine
Residency - Family Medicine & Community Medicine
Duke University Medical Center, Department of Community And Family Medicine
Internship - Obstetrics and Gynecology
New York University Medical Center/Bellevue Hospital
Bachelor of Science - Physician Assistant Program
City College of New York/ Sophie Davis School of Biomedical Education & Harlem Hospital
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