Dr. Susan Nedza is the Chief Medical Information Officer (CMIO) for Rural Healthcare Solutions. She has over three decades of experience as a leader in designing, researching, and implementing the compliant government and private payer value-based programs that impact hospitals, out-patient facilities, emergency departments, SNFs and ambulance providers. She has accomplished this work at the international, national, and local levels. Susan’s success can be attributed to her ability to draw upon her technical expertise in performance measurement to aid organizations in adapting to changes in payment models. She has been recognized for her work by the Centers for Medicare and Medicaid Services, the American Medical Association, and the American College of Emergency Physicians.
Susan received her BS from Gannon University in Erie, Pennsylvania, and her MD from Loyola-Stritch School of Medicine in Chicago. She completed her emergency medicine residency at Christ Hospital and Medical Center and served on its faculty through 2001. In 2014, she became Board Certified in Clinical Informatics by the American Board of Preventive Medicine. She received her MBA from The Kellogg School of Management of Northwestern University in 2001. She was awarded the Master of Liberal Arts degree from the University of Chicago in 2019. In 2021, she completed certificate programs in Global Health Delivery and Teaching Higher Education through HarvardX. In 2021, she received the Colin Rorrie, PhD Award for Excellence in Health Policy from the American College of Emergency Physicians.
Susan served as a Chief Medical Officer at CMS from 2003-2008. In this role, she served the critical need to facilitate communication between the agency and Medicare and Medicaid providers. These providers included Critical Access Hospitals and Tribal Health Systems in Minnesota, Wisconsin, Michigan, Ohio, Indiana, and Illinois. In 2007, she was selected to join a team of experts charged with implementing the Hospital Acquired Infection, Hospital Value-based Purchasing, the Physician Quality Reporting Initiative, and the Physician Resource Use Reporting programs. She received the CMS Administrator’s Citation for this work in 2008. Through these assignments, she acquired expertise in the development and implementation of quality measures. After leaving CMS she became the Vice President of Quality and Patient Safety at the American Medical Association. She built upon these experiences to become an expert in the development, approval, and adoption of new payment models across the health care system. This expertise led to her appointment in 2021, as the chair of the Workgroup tasked by the CMS contractor, Acumen LLC with the development of emergency medicine-specific cost measures that will likely be incorporated across CMS programs.
In 2017, Susan designed a new payment model that was mandated by federal law as she envisioned, designed, and built the Physician Focused Payment Model, the Acute Unscheduled Care Model, for emergency services. The model is under consideration for integration into CMS population health-based alternative payment models. In the meantime, it is currently being tested and implemented by emergency department staffing organizations and private payers in a number of states. She is currently completing work that will align the model with the Rural Emergency Hospital legislation currently being implemented by CMS.