Presbyterian Healthcare Services, the Bernalillo County Community Health Council, the University of New Mexico Health Sciences Center Office for Community Health, the New Mexico Alliance of Health Councils, Santa Fe County, and Rio Arriba County 

invite you to join us as we

envision the conditions necessary for a thriving New Mexico!


December 10, 2019

8:30 – 4:30

CNM Workforce Training Center

5600 Eagle Rock Ave NE, ABQ NM 87113


Convene a diverse set of community leaders working to address health-related social needs, with a commitment to create conditions for our communities to thrive.  

Participants will learn about accountable health community models in New Mexico and focus on connecting communities with housing and food access through health systems across the state.  

Participants will hear from our state and local agencies, health systems, and non-profits about how they are addressing health-related social needs and engage in group visioning activities to paint a picture what an aligned system would look like in New Mexico.

Who should attend

Health council members and coordinators, managed care organizations, state agencies, health system leadership, Federally Qualified Health Centers, community service providers, advocates, local government representatives, public health professionals 


 Rishi Manchanda, M.D., MPH

Dr. Rishi Manchanda is President & CEO of HealthBegins, a mission-driven consulting and technology firm that helps healthcare and community partners improve care and the social factors that make people sick in the first place. Client-partners include the American Hospital Association, the CMS Accountable Health Communities model, and health plans and health systems across the country. Dr. Manchanda serves on the board of the Beyond Flexner Alliance, on the California Future Health Workforce Commission, and was a member of the HHS Health Care Payment Learning & Action Network’s Primary Care Payment Model Work Group. 

Dr. Manchanda’s career is marked by a commitment to improving care and social determinants of health for vulnerable populations. He served as director of social medicine for a network of community health centers in south central Los Angeles, was the lead physician for homeless Veterans at the Greater Los Angeles VA, and was the first chief medical officer for a self-insured employer with a large rural immigrant workforce. In his 2013 TEDbook, The Upstream Doctors, he introduced a new model of healthcare workers - the Upstreamists - who improve care and equity by addressing patients' social needs, like food, financial and housing insecurity. The book has become recommended reading in medical schools and universities across the world.

Vanessa Guzman, MS, ME 

Vanessa Guzman, MS, ME is the Associate Vice President of Quality and Network Management at Montefiore Health System and Chief Strategy Officer at Orenda Advantage, a healthcare consulting firm. Mrs. Guzman is an expert in patient and physician engagement strategies, community and social partnerships, clinical reporting, health IT and quality management techniques. 

Her role at Montefiore is to collaborate with more than 7,000 Montefiore employees, as well as independent physicians at Montefiore’s 11 hospitals to implement data driven tools and the clinical infrastructures and community partnerships to promote wellness and improve patient health outcomes. She has also spearheaded new wraparound care structures with the private practice community to promote proactive preventive health, improve delivery and cost effectiveness of chronic care services and procedures. These initiatives help enable Montefiore evaluate what is working, and what needs to be rethought to better meet individual patient needs. 

Mrs. Guzman Quality Improvement portfolio oversight impacts more than $380M in potential revenue to Montefiore Health System. Her portfolio includes, Montefiore’s Next Generation ACO, a top performing ACO in the country, and the only one in NY under the Pioneer model. Mrs. Guzman is credited by MHS leadership in building a successful wrap-around model within its ACO engaging 2,500 providers at the community and partner hospitals level with 2,700 Montefiore employed providers to meet 328 evidence-based quality metrics reported internally and to the federal government. Over the first 5 years of the Pioneer ACO program Montefiore providers made a 28% improvement in quality scores, earning an impressive score of 95% while delivering exemplary care to approximately 450,000 patients. 

Mrs. Guzman has experience leading efforts relating to Quality Care Programs, implementation of the Centers for Medicare and Medicaid Services (CMS) Alternative Payment Models, Medicare Access and CHIP Reauthorization Act (MACRA), Value-Based Payment Quality Improvement Projects and payor arrangements, and supporting Network, IT and Population Health Management programs. With almost 15 years of experience overseeing quality incentives, bonuses and downside risk with the primary goal of advancing quality metrics in value-based programs by enhancing provider, hospital and community coordination and clinical support for its patients. She is a contributor in a number of ACO related case studies moderated by Centers for Medicare and Medicaid Services (CMS) and The Office of the National Coordinator for Health Information Technology (ONC). 

Mrs. Guzman was recently awarded the 2018 Becker’s Hospital Review: “Rising stars: 90 healthcare leaders under 40” and 2017 Modern Healthcare’s “Up and Comers” Award for her accomplishments in healthcare, engagement in her community and successes through her leadership and innovation in leading complex programs across the continuum of care. Vanessa has successfully has managed a hospital and provider networks, VBP arrangements with local and national payors, by engaging building HIE applications, disseminating patient engagement, reporting and Patient-Centered Medical Home (PCMH) models to its network. 

One of Mrs. Guzman’s biggest passions is her involvement in Bowery’s Mission Monte Camp Leadership Academy, an organization aimed towards providing children with mentoring and coaching to help them achieve academic and professional career paths successes by building strong healthy relationships with their communities. 

Mrs. Guzman completed her undergraduate and graduate education in Biomedical Engineering at Columbia University and holds certifications from ASQ in Quality and Organizational Excellence and Quality Engineering. She serves as a board member in nationally recognized patient engagement and social determinants of health committees throughout the country.

Greg Bloom

Greg Bloom is the founder of Open Referral, which is promoting open access to information about the health, human, and social services available to people in need. He is also a visiting scholar at Indiana University’s Ostrom Workshop on the Commons. Previously, Greg managed communications for Bread for the City in DC. He is a cooperative developer and community organizer, with experience in GOTV, class-action labor lawsuits, municipal budget battles, death penalty abolition campaigns, community wireless networks, and even a backyard-chicken legalization movement. He has been a fellow with Provisions Library and Civic Hall Labs, and has published writing in  In These Times,  Civic Quarterly,  Personal Democracy Forum,  and Code for America’s  Beyond Transparency.