Physician Executive with 30 years of experience in provider and payer practice and administration. Consulting professional focusing on corporate strategic planning, care and payment re-design, wellness, and physician alignment.
With 30 years of experience in clinical medicine and health care management Dr. Ambres has influenced all aspects of the health care industry, including hospital, payer and medical group management.
Dr. Ambres is a partner in the Health Care Strategy Practice of KPMG and is a member of the Global Healthcare Center of Excellence. She leads the National Provider Healthcare Advisory Practice and is Healthcare lead of the Strategy Group. Her focus is in on care delivery system re-design, pre-merger evaluation, post-merger integration, telehealth and telemedicine, and physician alignment.
Formerly, Dr. Ambres served as SVP and Chief Medical Officer for HealthNow, NY, in a return engagement to the parent company of BCBS of WNY and NENY. In this role she was responsible for health care reform strategy and provider and community outreach and communication. She also led the adoption of online care and the company's payment reform and physician network integration and contracting strategy.
Within her own company, Ambres Healthcare Consulting, she facilitated merger discussions between two multi-billion dollar health plans in New York; led leadership and organizational assessments resulting in restructuring for health plans and hospitals; and increased physician productivity, significantly impacting organizations bottom lines while concurrently increasing patient satisfaction.
After residency Dr. Ambres joined Beth Israel Medical Center as an emergency medicine attending physician. She became associate chairman after 18 months and chairman of the department of emergency services in 1994. Under her leadership Beth Israel’s Emergency Services expanded its residency program, grew its physician assistant program and implemented lean thinking and coordination of care pilots with other major clinical departments.
Later as senior manager in the Ernst & Young health care practice she gained a reputation for attracting new business and for developing sustainable operational improvements while aligning physician-hospital incentives.
As senior vice president and chief medical officer for Blue Cross and Blue Shield of Western New York she led the pharmacy services management division, driving savings of over $26 million in two years. She led IT clinical integration, designed a new alternative medicine product, and developed a regional cardiac surgery evaluation program that resulted in elevating the standard of care available for over two million people.
Dr. Ambres was the executive vice president and chief medical officer for Kaleida Health - a five-hospital integrated delivery system - in Western New York with a budget of over $1 billion and 11,000 employees. Working closely with the chief financial officer she led the turn-around that eliminated the operating losses and brought the system to profitability in three years. During this process she implemented a physician practice improvement initiative that brought savings of $35 million and developed a med/surg supply reduction plan that reduced annual expenses by $16 million. She was proud to bring the VISICU program to Kaleida, making it one of the first centers in the nation to adopt this system. The virtual ICU improved the care of the critically ill patient while dropping length of stay by 1.5 days.
In addition, as president of Lifetime Health Medical Group and senior strategy executive at the Lifetime Healthcare Companies (parent of Excellus Blue Cross and Blue Shield), Dr. Ambres led the transition from a capitation/salary model to an value-based incentive compensation model while incorporating innovations in group visits, an electronic health record, advanced access, Medical Home and alternative medicine. Within two years, patient satisfaction scores increased by 27% and improved physician productivity resulted in an increase in revenues in eight of the eleven health centers.
Education and Background:
Dr. Ambres holds a B.S. in chemistry from Rensselaer Polytechnic Institute and received her medical degree from Mount Sinai School of Medicine in New York City. She went on to train at St. Vincent’s Medical Center in surgery and at a joint program in emergency medicine at Georgetown/George Washington/Maryland Institute of Emergency Services. She also holds a masters of science in health policy and management from NYU Wagner School of Public Service and a certification in Acupuncture from UCLA David Geffen School of Medicine (Helms Institute). With a focus on a philosophy of total wellness Dr. Ambres has taken that concept beyond the individual into the corporation. This fosters a patient and wellness-centric enthusiasm that encourages health care professionals to see their work as a gift. In this way she has had a lasting impact on organizations.
May 2012 - Present
KPMG Global Healthcare is at the forefront of helping healthcare organizations around the world define and assess best practices. As part of the Global Center of Excellence her role assists organizations, both payer and provider side, in reinventing themselves through development of new partnerships and joint ventures, evaluation and integration of cutting edge technology, and focusing on value based care, shifting the business model from volume to value contracting. Healthcare systems around the globe are facing more complex challenges each year. Harnessing deep industry experience, insight and technical support the Global Healthcare Center of Excellence and the Healthcare Advisory Practice provide long term support to clients as they tackle these challenges.
Jan 2000 - May 2012
Ambres Health Care Consulting
Consulting company founded to serve the provider, payer, and pharmaceutical health care community• Executive coaching and Strategic planning – assisted health plan CEO in evaluation of senior leadership resulting in restructuring and time-sensitive completion of IT transformation plans• Corporate Board development and education• Merger and Acquisition facilitation (at CEO level) and due diligence – facilitated discussions between two multi-billion dollar health plans to determine merger feasibility. (Won engagement over top 5 consulting firm)• Market Integrity analysis and new product positioning for pharmaceutical industry • Emergency Department and Ambulatory Care management process redesign – worked with Mass General and Brigham and Women’s Hospital department chairs to improve physician productivity.Selected Past Project Examples - between 2000 and 2009:• Emergency Department management assessment, matrix management structure development, process redesign and patient disposition and coding analysis; New York (for CapGemini/Ernst&Young and Upstate NY hospital) – identified additional $16 million dollars in revenue.• Project design and development –‘Urgent Matters’ - Health Care Access, Emergency Services and the Safety Net; New Jersey (for Robert Wood Johnson Foundation)• Managed care operations training and medical management workshops for seven foreign countries, (including Southeast Asia); - Singapore (for Allianz Insurance Companies)• Organizational needs assessment and Chief Executive Officer and Chief Medical Officer search assistance; for Catholic hospital system; New York (for Quick-Leonard-Kieffer)• Organizational medical management needs assessment for managed care organization; Oklahoma City (for Healthcare Resources, Inc.)
Aug 2009 - Mar 2012
SVP and Chief Medical Officer
Responsible for communications on health care reform strategy, quality, medical policy and physician engagement.
Works with all Strategic Business Units, along with the CEO, to promote growth, improved member and provider experiences, and adaption of new tools to improve the delivery of health care to the communities.
HealthNow, NY is parent company to Blue Cross Blue Shield of Western NY and Northeastern NY.
2005 - 2008
Lifetime Health Medical Group delivers health care services to more than 150,000 people in the Buffalo and Rochester communities. With 1100 employees and revenue of $260 million, the group focuses on primary care, ob/gyn and pediatrics. Through eleven health centers, radiology, pharmacy, lab, dental, behavioral health services and alternative therapies are delivered in a coordinated-care environment that assists patients in achieving wellness.• Led transition from basic capitation/salary model to incentive-based compensation model in response to changes in market reimbursement structure, while incorporating innovations in group visits, electronic health record, advanced access, Medical Home and alternative medicine. Improved patient satisfaction scores by 27% in first year.• Improved physician productivity resulting in an increase in revenues in eight of eleven centers.• Member of Senior Executive Strategic Management/Business Transformation team of parent company – Lifetime Health Companies – a $5 billion family of companies that includes provider, long term care, homecare, and health insurance components (Excellus Blue Cross and Blue Shield).
2002 - 2005
Executive Vice President and CMO
Kaleida Health is an integrated delivery system with five hospitals, six out-patient facilities, a nursing home and teaching program serving Western New York with over 11000 employees and a $1 billion budget. I joined the senior team as part of the board’s turn-around agenda to stem the losses and bring the system back to profitability. The system achieved profitability in three years.
• Developed Clinical Practice Improvement Initiative that brought savings of $35 million
Developed new radiology group (18 physicians) covering four hospitals, doubling revenues from 2002 to 2004
• Constructed and implemented new physician contract templates (1800 physicians)• Recruited high quality physician leaders for newly established breast service, Heart Institute, General Surgery and ENT programs • Developed med/surg supply reduction plan that reduced expenses by $16 million• Implemented physician chart documentation model, increasing revenue by over $8 million in first year• Developed new prototypes for healthcare delivery and new group practice model• Implemented new EICU system (VISICU) to improve care of the critically ill patient – 9th institution in the country to implement this system. Length of stay dropped by 1.5 days.
1998 - 2000
Senior Vice President and CMO
• Responsibility for health services management division, business management office and advertising and communications • Developed Cardiac Surgery Evaluation Program – analysis of 14 hospitals providing cardiac surgical services to members developing ‘best practices’ network• Led IT clinical implementation and data warehouse development• Provided leadership to IT clinical integration and led ‘buy vs. build’ decision team and vendor selection process• Product Development – designed and implemented new Alternative Medicine product • Created award winning communications/ad campaign to manage network change messaging• Oversaw Pharmacy Services Management driving $16 million savings over two years• Developed strategic partnerships with Xerox Corporation and Rite Aid Corporation, generating savings of $19 million• Led Document Center development and spearheaded evaluation of an electronic enrollment process
Jan 1996 - Jan 1998
Senior Manager Health Care Practice
• New business development – engaged four new hospital system clients in first year ($3.4 million in revenues)• Operations process redesign and clinical department reengineering- Brigham and Women’s Hospital - Boston• Clinical resource utilization evaluation and physician compensation modeling- Mt. Sinai Medical Center, NY – improved physician productivity and increased ED revenues by 25%; Improved patient satisfaction by 11%• Integrated Delivery System business transformation –Mt. Sinai Hospital, NY, University of Chicago, Long Island Jewish Medical Center, North Shore University Hospital, NY, with fees at risk, doubled client savings promised.• Sales research and sales methodology development• Business change management/ Strategic planning
Jan 1986 - Jan 1996
Attending Physician - Dept. of Emergency Medicine 1986 - 1987Assistant Director - Dept. of Emergency Medicine 1987 - 1994Chairman - Dept. of Emergency Medicine 1994 - 1996• Responsible for Operations/administration of four emergency departments• Profit and Loss responsibility• Developed business plan for departmental growth and facility build-out• Developed productivity-based physician compensation model, doubling physician and PA productivity• Revised fee schedules and developed new Fast track/urgent care delivery model• Supervised and taught residents/ physician assistants• Developed direct home care access through ED• Chair - Clinical Information Systems/Medical Information Systems 1995 - 1996• Design of CIS physician order entry• Co Chairperson, Hospital Quality Resource Management 1990 - 1996