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 (CMS Innovation Center), 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 the CMS Innovation Center 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
Rahul Rajkumar, MD, JD, is the Deputy Director at the Center for Medicare and Medicaid Innovation. 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 system. This Center has a growing portfolio and is testing various payment and service delivery models that aim to achieve better care for patients, smarter health care spending, and a healthier future for all Americans.
Dr. Rajkumar joined CMS in 2012. As a member of the leadership team, he helped to build the Innovation Center from its startup phase and managed the design and launch of the Center's models. His responsibilities include managing the Center's operations, budget and portfolio, and the design and expansion of new payment models -- and building strong working relationships with health care policy leaders within and outside of HHS.
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.
He has published articles in journals such as JAMA, New England Journal of Medicine, Health Affairs, and given national presentations on topics including health care policy, quality of care, payment reform and the transformation of clinical operations. Dr. Rajkumar holds a BA in History from Yale University, an MD from Yale School of Medicine and a JD from Yale Law School. Dr. Rajkumar is a recipient of a Paul and Daisy Soros Fellowship. He is a practicing internist and is married with two children.
The Center for Medicare & Medicaid Innovation organization structure is outlined below:
Office of the Director
Executive Operations Staff
Business Services Group
- Division of Budget and Administrative Services
- Division of Central Contracts Services
- Division of IT and Operational Services
Learning and Diffusion Group
- Division of Cross-Model Learning and Improvement
- Division of Improvement Dissemination and Model Expansion
- Division of Model Learning Systems
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
- Division of Health Care Models
- Division of Payment Models
- Division of Specialty Payment Models
- Division of Technical Model Support
Policy and Programs Group
- Division of Health Plan Innovation
- Division of Innovation Awards Programs
- Division of Portfolio Management and Strategy
- Division of Project Management and Business Intelligence
- Division of Stakeholder Engagement and Policy
Preventive and Population Health Care Models Group
- Division of Health Care Delivery
- Division of Health Innovation and Integration
- Division of Population Health Incentives and Infrastructure
Research and Rapid Cycle Evaluation Group
- Division of Data, Research and Analytic Methods
- Division of Health Systems Research
- Division of Payment and Accountability Research
- Division of Special Populations Research
Seamless Care Models Group
- Division of Advanced Primary Care
- Division of Financial Risk
- Division of Seamless Infrastructure
- Division of Special Populations and Projects
State Innovations Group
- Division of All-Payer Models
- Division of State Innovations Models