Isenberg School of Management, UMass Amherst

Keck School of Medicine of the University of Southern California

University of Southern California

Systems leader transforming healthcare, addressing individuals holistically, and incorporating technology and community.

Innovative and local, HPSM serves residents in San Mateo County, California through its Medi-Cal, Care Advantage (Medicare/Medi-Cal), ACE, and HealthWorx lines of business.
Leading health care services including utilization management, pharmacy, quality, and medical directors.  
Leading strategic efforts focusing on integrating health and social care, driving towards healthy and equitable outcomes, and overall resource stewardship.

Health Plan of San Mateo (HPSM)

Chief Medical Officer

Carenodes Health simplifies access to comprehensive health solutions for providers, patients, payers, and employers.

Carenodes

Advisor

Project Angel Food

Board Member

Altopax

Strategic Advisor

Lionrock Recovery

Promoting healthcare transformation, integrating social needs care into healthcare delivery for holistic health, and facilitating systems improvement.
Expertise in Medicare, Medicaid, strategy, contracting, value based payment models, policy, startups, interoperability, due diligence, and portfolio management.

Chris E Esguerra, MD MBA

Physician Entrepreneur and Advisor

We partner with payers, health systems, and others to help individuals stay safe, healthy, and functional at home. Active nationally, our expert In-Home Assessment identify appropriate durable medical equipment, home modifications, personal care assistance hours, and home health therapy services.  We help right size care, improving outcomes, minimize risk, and maintain a consistent ROI.

Periscope

Advisory panel member contributing and helping shape the services fee schedule for the North Carolina 1115 demonstration waiver related to social needs care services.

Advisory Panel for the North Carolina Healthy Opportunities Pilot Service Fee Schedule

Member

Committee on the incorporation of social needs care into healthcare
Report released: http://nationalacademies.org/hmd/Reports/2019/integrating-social-care-into-the-delivery-of-health-care

National Academy of Sciences

Committee Member

California Health Plan with 4.3 M lives.  Focus on Medicaid, Medicare, and Dually Eligible covered individuals. Reporting to CMO.  11 direct reports. 
•	Reduction of unnecessary hospitalizations and hospital readmissions through upstream member support, prevention, and improved utilization management processes
•	Oversee transformation of primary care services at two sites serving 11,500 members/patients in a holistic, longitudinal, outcomes based manner and deploying innovative care models resulting in improved patient experience, better access, better quality, and cost savings
•	Lead strategic healthcare integration and redesign efforts leading to innovative models of care, new payment models, improved outcomes and member growth
•	Support the growth of direct reports and other employees, fostering a culture that promotes a great place to work
•	Serve on multiple state and national workgroups and committees to integrate and enhance health care delivery

Blue Shield of California

Senior Medical Director

Senior Medical Director overseeing California contract with Blue Shield of California
2 million covered lives
Reporting to VP, CMO of California
3 direct reports
Matrixed leadership over utilization management and case management
•	Enhanced cycle times and efficiencies and standardized physician medical necessity review processes resulting in operational savings
•	Enhanced utilization management process and team collaboration leading to improved utilization outcomes
•	Lead cross functional efforts that resulted in reduced overutilization in key services
•	Clinical leader in maintain positive account relationship with Blue Shield of California

Magellan Health

HPSM is a public health plan serving over 140,000 members covered under Medi-Cal, Dual Medi-Cal and Medicare, Healthy Kids, HealthWorx (insurance for IHSS and County employees) and County Low Income Insurance (ACE).
Reporting to Chief Medical Officer.  5 direct reports, 40 staff. Oversaw healthcare operations, specific programs, behavior health.  Partnered with government and community agencies, providers, and private entities.
•	Achieved timeliness compliance within the Utilization Management Program, eliminating backlogs, streamlining processes, and moving towards efficient and effective processes
•	Deployed structured, unified, holistic case management system resulting in an effective, CMS praised model 
•	Facilitated transition of institutionalized, high cost members to community living realizing savings and improved health outcomes through the Community Care Settings Pilot
•	Reduced year over year state audit findings under Quality, Utilization Management, and Case Management
•	Co-created innovative models of care addressing individual’s needs holistically

Health Plan Of San Mateo

Deputy Chief Medical Officer

BHR, Inc serves as the Management Services Organization for Pathway to Wellness Medical Group, operating 5 clinics in two counties and serving over 5000 clients with serious mental illness. 
Reported to CEO
4 direct reports
•	Enhanced patient care and outcomes through development of practice standards, clarification of staff roles, improvement of patient flows, and implementation of team based clinical model
•	Increased revenue through expanded billable services, provider productivity expectations, and contract management
•	Increased patient satisfaction through team based clinical model, improved customer service, and timely clinic flows
•	Successfully implemented electronic health record in pilot site resulting in increased patient time, improved documentation, and improved coding and billing
•	Deployed use of analytics to improve provider productivity
•	Improved patient satisfaction and outcomes through team based care, collaboration with primary care, and revising the patient flow process

Becton Healthcare Resources

Providing coverage for child psychiatrist on maternity leave.

Kaiser Permanente

Pool Physician - Covering Psychiatrist, Child Psychiatry

Behavioral Health and Recovery Services is the Mental Health Plan for San Mateo County providing a wide array of behavioral health services to over 10,000 county residents with over 400 staff.
Reported to Medical Director
5 direct reports, 25 staff total
•	Improved patient outcomes in those with serious mental illness (reduced acute utilization, improved diabetes and cholesterol control) through a pilot integration of primary and behavioral health care that incorporated nurse care coordinators, peer workers, behavioral health staff, and primary care
•	Reduced acute services utilization of patients enrolled in a pilot medication assisted treatment pilot for patients with alcohol use disorder, leading to funding support and widespread adaptation
•	Improved provider productivity and documentation through the streamlining and optimization of the electronic health record and advocacy of configuration and user experience enhancements
•	Enhanced prudent medication prescribing practices and developed medication prescribing criteria by forming and leading a Pharmacy and Therapeutics Committee
•	Graduated two psychiatry resident cohorts through psychopharmacology seminars and evidence based medicine seminars
•	Stabilized psychiatry residency training program during transition between residency training directors, serving as interim training director
•	Improve patient outcomes for those with intellectual disabilities and behavioral health issues overseeing the Puente Clinic, its clinical care, and collaboration with the Regional Center and primary care

San Mateo County Behavioral Health and Recovery Services

Deputy Medical Director, Medical Chief of Adult Services

Based in the South San Francisco Medical Center, provided outpatient services for adults and children as well as inpatient consultation for the medical/surgical units.
•	Revitalized and expanded the role and reach of quality in the psychiatry through case reviews and intervention implementation, and staff training
•	Improved psychiatric patient emergency room experience through development and deployment of decision support tool for emergency room physicians and staff
•	Reduced lengths of stay for patient with delirium in the inpatient setting through risk management, early identification, and clinical protocols
•	Improved collaboration between Department of Psychiatry and Primary Care and Hospitalist resulting in better coordination of care

Kaiser Permanente South San Francisco

Staff Psychiatrist, Department Chief of Quality

Outpatient care in a primary care setting, specialty consultation, inpatient and skilled nursing consultations.
•	Decreased lengths of stay for patients with delirium through the development of a clinical pathway and clinical protocols
•	Graduate two psychiatry resident cohorts and two psychology intern cohorts through Medical Psychiatry seminar series
•	Enhanced patient care and improved outcomes through strong collaboration with primary care and specialty care clinics
•	Maintained a revenue positive program through deep understanding and enhancement of documentation, billing, and productivity

Chris Esguerra, MD, MBA