“Episode 80: How to Start Getting Paid for Value with Tom Gregorio from NJII – The New Jersey Innovation Institute”
by Stacey Richter

Listen to the MP3 file directly by clicking here.

Tomas GregorioTomas Gregorio is the Senior Executive Director of Healthcare Systems Innovation at the NJ Innovation Institute. In that capacity he has overall managerial responsibility for program development and execution of NJII’s activities organized under the Healthcare Systems i-Lab. Mr. Gregorio brings a rich and diverse background to the job having served various roles as a senior executive in regional hospital systems as well as with allied consulting and software industries. He was most recently the Sr. Vice President & COO for HealthEC, LLC, a leading provider of best-in-class data connectivity and consulting solutions for the healthcare industry. Prior to that he served as President and CEO of Meadowlands Hospital and before that, at Newark Beth Israel Medical Center was the Vice President Administration and Vice President & CIO. Mr. Gregorio has also been a principal advisor in NJIT’s efforts to establish and build both NJ-HITEC and the Highlander Health Data Network (HDN).

Tom spent seven years of his career as a management consultant with PricewaterhouseCoopers where he worked in over 23 hospitals around the country, hundreds of affiliated and independent practices, and several insurance companies and TPAs. The types of projects he worked on included vendor selection for financial, billing, and clinical systems, system implementation, support operations development, and healthcare business operations management. He also contributed to early HMO models in the Northeast and overall quality and process improvement initiatives. Having developed a deep understanding of hospitals and physician practices’ technology capabilities, he comfortably applies technical solutions to clinical and business problems to accomplish meaningful results for his clients.

As a hospital executive, Mr. Gregorio further developed his ability to oversee complex healthcare operations. Mr. Gregorio’s extensive experience in managing new and existing hospital operations was showcased during the change of ownership of Meadowlands Hospital Medical Center in 2010. As the CEO, he led the team responsible for contract conversions and systems implementations during the transition. He also made key organizational decisions including hiring the executive team, determining which staff members were retained, and negotiating new collective bargaining agreements.

In his roles as CEO, he ensured that senior management and administrative functions of the hospital were in compliance with state and federal regulations, rules of accrediting bodies, and licensing standards. His method of maintaining and improving quality is based on a systems approach: recognizing the value of measuring each aspect of an operation, down to the cost per unit of service. As a result, he instituted control systems for the maintenance of financial, human and capital equipment assets resulting in oversight of all financial affairs and ensuring that services are produced in a cost-effective manner. Tom has proven his ability to identify the root cause of an organization’s problems and make the necessary adjustments to resources and processes. In doing so, he cultivates environments that function effectively, efficiently, and produce results in a timely fashion.

Tom’s commitment to the delivery of quality and compassionate healthcare extends far beyond his administrative experience. Some of his innovations include a project to monitor the health of senior citizens with Diabetes and high blood pressure, and a physician house call service that tracks senior citizens’ health remotely and generates referrals to the hospital, physician or family members; a technology that was unheard of in the US at that time. During his time as VP of Administration and CIO at Newark Beth Israel, he brought his innovations across cultural and international lines with a Bloodless Medicine program and an initiative which brought patients from the Middle East to Newark Beth Israel. His diverse background provides a unique perspective rarely seen in traditional hospital executives.

Mr. Gregorio’s firsthand knowledge of healthcare technology and operational excellence span the entire healthcare landscape. Over the last two years, Mr. Gregorio had the opportunity to begin an Accountable Care Organization (ACO) service line with HealthEC. The population management software and services developed under this project are directly in-line with the new reimbursement models facing the healthcare industry today. HealthEC’s products and services helped one of their clients manage over 100,000 lives and save 6 million dollars through the Medicare Pioneer ACO program. With this project as well as Health Information Exchange technologies like the Highlander Health Data Network, Tom uses his knowledge of hospital operations to promote a change in hospitals from being a revenue source to a cost center. In addition to creating ACO and HIE infrastructures, he has contracted with community physicians and created the value propositions needed to work in a population management based operation. Outpatient services are the future and population health and ACO’s are the vehicles currently in place to make that transition.

Mr. Gregorio is also a professor of Health Information Technology and Management Information Systems at NJIT in Newark NJ. Tom has a BS in Organizational Management Nyack College and an MBA in Management of Technology from NJIT.


00:00 Tom discusses NJII.
03:30 The grant from CMS that NJII just received.
04:30 “It’s our job to provide them the technology and services so that they can understand as a business how to transition to pay-for-value.”
04:50 Who are the 11,000 physicians that need to transition to the pay-for-value service?
05:30 Tom discusses making sure physicians are prepared in time for the payment transition in two years.
08:00 Tom explains where NJII begins in assisting and convincing providers to transition into pay for performance programs.
10:00 Segmenting physicians into three categories, and causing change.
12:30 How NJII can benchmark and stratify physicians’ patients.
13:30 The four phases that NJII has laid out: assess, capture, transform, and manage.
19:30 How NJII estimated the 11,000 physicians that it could assist in the transition.
21:00 How NJII assesses.
22:30 TCM: Transitional Care Management.
25:20 How NJII can help all involved networks benefit from a physician’s transition to value-based pay.
26:40 NJII’s system, ‘Capture’.
29:30 NJII’s transform phase.
31:00 Tom’s advice for trends in this transition.
34:00 NJII’s manage phase.
36:00 You can find out more information by calling 973.642.4500, emailing tomas.gregorio@njii.com, or visiting www.njii.com.