Patrick Conway, MD, MSc
Patrick Conway, MD, MSc, is Chief Medical Officer for the Centers for Medicare & Medicaid Services (CMS), Director of the Center for Clinical Standards and Quality, and Director of the Center for Medicare & Medicaid Innovation.
The Center for Clinical Standards and Quality is responsible for all quality measures for CMS for all settings, quality improvement programs in all 50 states, value-based purchasing programs, clinical standards and survey and certification of all providers across the Nation, and all coverage decisions for treatments and services for CMS. The Center budget exceeds $1.3 billion annually. The Center for Medicare and Medicaid Innovation is responsible for developing and implementing innovative health care service delivery programs that will help improve and update the Nation’s health care delivery systems. This Center has a growing portfolio testing various payment and service delivery models that aim to achieve better care for patients, better health for our communities, and lower costs through improvement for our health care system.
Previously, he was Director of Hospital Medicine and an Associate Professor at Cincinnati Children’s Hospital. He was also AVP Outcomes Performance, responsible for leading measurement, including the electronic health record measures, and facilitating improvement of health outcomes across the health care system, including all Divisions and Institutes. Previously, he was Chief Medical Officer at the Department of Health and Human Services (HHS) in the Office of the Assistant Secretary for Planning and Evaluation. In 2007-08, he was a White House Fellow assigned to the Office of Secretary in HHS and the Director of the Agency for Healthcare Research and Quality. As Chief Medical Officer, he had a portfolio of work focused primarily on quality measurement and links to payment, health information technology, and policy, research, and evaluation across the entire Department. He also served as Executive Director of the Federal Coordinating Council on Comparative Effectiveness Research coordinating the investment of the $1.1 billion for CER in the Recovery Act. He was a Robert Wood Johnson Clinical Scholar and completed a Master’s of Science focused on health services research and clinical epidemiology at the University of Pennsylvania and Children’s Hospital of Philadelphia. Previously, he was a management consultant at McKinsey & Company, serving senior management of mainly health care clients on strategy projects. He has published articles in journals such as JAMA, New England Journal of Medicine, Health Affairs, and Pediatrics and given national presentations on topics including health care policy, quality of care, comparative effectiveness, and hospitalist systems. He is a practicing pediatric hospitalist, completed pediatrics residency at Harvard Medical School’s Children’s Hospital Boston, and graduated with High Honors from Baylor College of Medicine. He is married with three children.
Karen Jackson is the Deputy Director of CMS’s Center for Medicare and Medicaid Innovation, an organization established under the Affordable Care Act to develop and test new health care delivery and payment models that improve quality outcomes and reduce the overall cost of care to Medicare and Medicaid beneficiaries. Prior to joining CMMI in December 2013, Karen was the Director of the Medicare Contractor Management Group in the Center for Medicare, where she oversaw the transformation of the CMS’s management of its fee-for-service claims processing contractors, the entities that process more than one billion claims annually and pay out more than $400 billion in health care reimbursements. She and her team supported more than 35 full and open procurements, with a total contract value of nearly $10 billion. She led the development of contract oversight and performance evaluation processes that are considered among the best in the agency and has been recognized by the DHHS senior acquisition official for her work as program manager. Karen joined CMS in 1992 as a Presidential Management Intern. She holds a Master of Public Policy degree from the Gerald R. Ford School of Public Policy at the University of Michigan and an undergraduate degree from James Madison College at Michigan State University.
Rahul Rajkumar, MD, JD
Acting Deputy Director
Rahul Rajkumar, MD, JD, an internist, is the Acting Deputy Director at the Center for Medicare and Medicaid Innovation. Prior to arriving at CMS, Dr. Rajkumar was a consultant at McKinsey and Company, where he helped the senior management of leading hospitals and health care payers respond to national reform and the design and operational aspects of accountable care organizations. Dr. Rajkumar previously practiced hospital-based medicine at Brigham and Women's Hospital, where he completed his residency training in Internal Medicine. Dr. Rajkumar holds a BA in History from Yale University, an MD from Yale School of Medicine and a JD from Yale Law School.
The Center for Medicare & Medicaid Innovation organization structure is outlined below:
Office of the Director
Business Services Group
- Division of Executive Operations
- Division of Innovation Program Management
- Division of Budget and Contracting
Learning and Diffusion Group
Medicare Demonstrations Program Group
- Division of Delivery System Demonstrations
- Division of Payment Policy Demonstrations
- Division of Health Promotion and Disease Prevention Demonstrations
Patient Care Models Group
Policy and Programs Group
Preventive Care Models Group
Rapid Cycle Evaluation Group
- Division of Research on Health Plans and Drugs
- Division of Research on Traditional Medicare
- Division of Research on State and Special Populations
Seamless Care Models Group
- Division of Advanced Primary Care
- Division of Accountable Care Organization Populations
Stakeholder Engagement Group
State Innovations Group