Monday, May 18, 2020 10 am - 12pm EDT
10:00 |
Co-chairpersons’ Opening RemarksClay Farris,Managing Editor, Mostly Medicaid Steven R. Peskin, MD, MBA, FACP, Executive Medical Director Population Health & Transformation, Horizon Blue Cross Blue Shield New Jersey |
10:05 |
Panel Discussion: Population Health Policy Initiatives – A Growing Focus in Medicare, Medicaid & Duals SNPsPanelists:Paul CottonDirector of Federal Affairs,NCQA Tricia BeckmannDirector,Faegre Drinker Consulting Henry W. OsowskiManaging Partner,Strategic Health Group Moderator:Clay Farris,Managing Editor, Mostly Medicaid |
10:35 |
Omnicell Video |
10:40 |
Panel Discussion: Defining Population Health, SDoH and Health Equity – How Do You Think About Population Health Across Silos?
Moderator:Catherine Brisland, DO, MBA, FCCPMedical Director,Optima Health Panelists:Gregory A. Hanley, FACHE, CPHQVice President, Quality Management & Pharmacy,UCare Keshia Bigler, MPHPopulation Health Portfolio Manager,CareOregon Catherine Macpherson, VPProduct Strategy and Development, Chief Nutrition Officer,Mom’s Meals |
11:05 |
Leveraging Special Supplemental Benefit Authority for Members with Multiple Chronic ConditionsRe-examine the transformational parameters of an MA plan's authority to address the complete spectrum of needs for a member with multiple chronic conditions and functional impairments. Explore how MA plans can use the SSBCI authority to be innovative in confronting key non- health related influencers impacting health status. Examine how some MA plans are using this authority to preemptively address the complex health needs of members rather than reacting to an acute episode. Henry W. Osowski, Managing Partner, Strategic Health Group |
11:20 |
Adapting and Integrating Existing Operations With CMS New Flexibility RulesAs healthcare systems navigate the new CMS flexibility rules, many are trying to determine how to integrate new and/or existing programs into benefit design successfully. Identifying which areas to address, aligning eligibility, as well as determining operational impact and management of the benefit, are some of the challenges when programs are already implemented. It is critical to institute these benefits with a tie back to analysis which allows for decision making moving forward. Hear more about our existing programs addressing these needs, and the challenges with aligning them to benefit design when there are other sources of funding contributing or eligibility requirements. Navigating through the requirements, identifying operational impact, determining eligibility and measuring for success will be discussed. Allison Hess, Vice President, Health Innovation, Geisinger |
11:35 |
Close of Module #1 |
Monday, May 18, 2020 2 pm - 4pm EDT
2:00 |
Opening Remarks |
2:05 |
PROVIDER PANEL: Provider Strategies to Integrate SDoH Work Into the Clinical Initiatives TeamGiven the increasing awareness of non-medical barriers affecting health and well-being, healthcare organizations are developing and deploying interventions to mitigate the Social Drivers of Health (SDoH). Critical to these interventions are strategies to integrate this work back into the medical mainstream in a coordinated fashion to deliver whole-person care. Join us at this panel to learn how 3 physician-leaders from across the country are leading the way in integrating SDoH strategies into traditional medical care. You will learn how their organizations are addressing this issue and what you can do to ensure the work being done in the SDOH space at your organization integrates with your physicians and extended medical team. Moderator:Harry Saag, CEO, Roster Health, Assistant Professor,NYU Langone Health Panelists:Dr. Lora Council, Senior Medical Director,Cambridge Health Alliance Dr. Kathy Jo Carstarphen, Medical Director,Ochsner Health System Isaac Dapkins, Chief Medical Officer, Family Health CentersNYU Langone |
2:35 |
Transformation to Proactive Population Health
Teresa Hall,Director, Health Services, SelectHealth Saeed Aminzadeh,CEO, Decision Point Healthcare Solutions |
2:55 |
Community Level Collaborations to Impact SDoH: Redefining the Health Plan’s Role in Moving “Upstream” to Improve Social and Economic ConditionsShould we focus on downstream interventions, addressing the immediate needs of individuals, or on upstream initiatives that work on eliminating factors that continue poor health in our communities? Some SDoH can most effectively be addressed moving upstream. Suggestions on how to use clinical and public data to address conditions in the community and how to engage with government and business to make change. Jim Milanowski, President/CEO, Genesee Health Plan |
3:10 |
Impact of Member Perception on Outcomes of Population Health Programs
Tejaswita Karve, Ph.D. Director, Medicare STARS Advantage MD Administration, Johns Hopkins HealthCare LLC |
3:25 |
Designing Products for Behavior ChangeWhen we build products, we often have very specific behavioral goals in mind, things we want users not just to think and feel but actually do. And yet our design process so rarely takes what we know about changing behaviors into account. Join behavioral scientist Matt Wallaert as he talks about Competing Pressures Design, a psychology-based method for thinking about product and service design, using science, startups, and plenty of practical examples to help you put theory into practice. Matt Wallaert, Chief Behavioral Officer, Clover Health |
3:40 |
Collaborative Care Model: Integrating Behavioral Health into Primary CareThe degree of integration of behavioral care into the primary care setting may vary from selective screening, diagnosis, brief treatment, and referral to a fully integrated care approaches in which all aspects of primary care consider and incorporate both the physical and behavioral perspectives. Since launching our PCMH and ACO models in 2011, Horizon-BCBSNJ has appreciated the value of greater emphasis on Behavioral Health in the primary care setting. To that end, we developed and deployed tools to support BH in primary care. We have evolved our payment models. More recently, clinical decision support and virtual collaborative care models have been introduced. Steven R. Peskin, MD, MBA, FACP, Executive Medical Director Population Health & Transformation, Horizon Blue Cross Blue Shield New Jersey |
4:00 |
Close of Module #2 |
Tuesday, May 19, 2020 10am - 12pm EDT
10:00 |
Opening Remarks |
10:05 |
Redesigning Case Management to Focus on Value Relationships – the Evolving Role of the Health Plan
Dr. Dirk Wales,Chief Medical Officer, Cigna-HealthSpring |
10:20 |
Panel Discussion: Innovating Services for Dual Eligibles -- If You Can Make It There, You Can Make It AnywhereMedicare-Medicaid Dual Eligibles are commonly considered hard to serve because they are, as a group, more prone to multiple chronic diseases and social determinants of health barriers. But leading D-SNPs are engines for innovation in serving this hard-to- serve population. In this session, hear from some of the leading innovators in the field about new ways to serve Duals with tactics that are working with hard-to-serve Duals. Engage in provocative conversation about the transferability of these innovations to your members. Moderator:Michael S. Adelberg, Principal, Lead, Healthcare Strategy Practice, Faegre Drinker ConsultingFormerly, Director of Medicare Advantage OperationsCMS Panelists:Hany Abdelaal, President, CHOICE Health Plans Kimberly Smathers, Managing Consultant, The Lewin Group (Contractor to CMS) |
10:45 | Taking a Value-Added Approach to Opioid Addiction -- Combatting Substance Abuse Disorders (SUD)
Keshia Bigler, MPH, Population Health Portfolio Manager, CareOregon |
11:00 | VBID Case Study: 4 Innovative Rewards and Incentives ProgramsMedicare has approved Optima to offer this Rewards and Incentives Program as part of the Value-Based Insurance Design (VBID) model. Optima is offering 4 unique Rewards and Incentives opportunities to members in 2021 – Wellness and Health Planning, Diabetes and Behavioral Health, Medication Therapy Management, and Part D Vaccines. Hear about this unique VBID model and why the federal government is moving forward and encouraging such programs. Catherine Brisland, DO, MBA, FCCP, Medical Director, Optima Health |
11:15 | Integrating SDoH Into Current Disease-Specific Programs – Capturing And Utilizing Data To Identify Gaps in CareLeveraging SDoH data to inform and drive healthcare program management and delivery can maximize the positive effects on Member health outcomes. Data sources, such as claims data, survey data, encounter data provide insight on utilization, quality, and patient experience, however, does not capture Member choices related to SDoH needs. At Inland Empire Health Plan (IEHP), SDoH data is used to influence decision-making. Complementing existing healthcare data with Member SDoH data, allows IEHP to assess SDoH needs, link Members to appropriate community services, improve overall health, and drive health equity. Maria Pugo, DrPH, MPH, Health Services Evaluator, Health Services Research & Evaluation, Inland Empire Health Plan |
11:30 | Making the Transition from Cost Containment to Cost AvoidanceIn this session, we will review the complete transformation process from traditional health plan cost containment strategies to a comprehensive, data-driven Population Health Management program that results in cost avoidance. We will discuss how the entire health plan must be engaged to support Population Health Management and the gaps that exist in most organizations. We will cover each of the following areas:
Gregory A. Hanley, FACHE, CPHQ, Vice President, Quality Management & Pharmacy, UCare |
11:45 | Case Study: Partnering with Analytical and Clinical Teams for Integrated SDoH Programs
Konark Rana, Director, Product Strategy and Development, Gateway Health Plan |
12:00 | Operationalizing SDoH, Population Health Case Management: Workflow, AI and Other Technology ToolsLearn how Kaiser has used the Epic EMR tools to incorporate the collection of Social Determinants of Health (SDOH) and how we can build care pathways to manage patient care and track action results. With the first instance of the solution available in the fall of 2019, we'll be evaluating the patient volumes referred for services, and their usage. We'll be evaluating improved outcomes and if we can measure improvement by addressing social care needs. We're also going to be looking at predictors to help us maximize services to help us achieve greater efficiencies in offering services. Our plans are clear, in this session I'm expecting to be able to present real solutions and initial assessment of performance. Joe Crimando, Interim Director, Population Health, Kaiser Permanente |
12:15 | Close of Conference |