Agenda

Welcoming Remarks: How to Maximize Your Virtual Conference Experience

Panel Discussion: Integrating Data from Population Health, Behavioral Health, SDOH into Care Coordination and other Clinical Teams – Breaking Down Silos

Moderator:

Panelists:

CalAIM's Vision to Integrate Population Health Into Medicaid and How Health Plans Will Adapt to Bring it to Life

CalAIM is a multi-year initiative by California’s Medicaid regulator - the Department of Healthcare Services.  Starting in 2022, it aims to improve the quality of life and health outcomes of California’s Medicaid population by implementing broad delivery system, program, and payment reform. Under CalAIM, the Medi-Cal delivery system will move to a population-based/person-centered model of care with an emphasis on coordinating community-based services and addressing patient's non-medical needs. This presentation will include:

• Overview of the population health components of CalAIM including population-level risk stratification, intensive care coordination for the neediest members, supplemental services (e.g., housing navigation, meals), etc.
• Description of how the program will affect the patient/member experience
• Insight into how the new requirements will impact health plans and the delivery system
• Expected challenges and mitigation strategies

Virtual Networking Break in the Exhibit Hall

Part I Medicare: Integrating Behavioral Health into Your Population Health Programs

• Facilitating Integrated Care between Primary Care, Specialty Care and across the Care Continuum
• Provision of High Touch, High Engagement Case Management Model
• Improvement of Member and Provider Experience and Outcomes.

Part II Medicaid: Integrating Behavioral Health in Primary Care – Supporting Providers through a Value-Based Contract

• Overview of the Psychiatric Collaborative Care model to deliver population-based behavioral health care
• Leveraging partnerships to develop an integration program
• Successes and challenges with VBP

Leveraging Rewards & Incentives Powered by Digital Engagement to Drive Population Health Outcomes

Member engagement is undergoing a rapid digital evolution. We are living in a time when people are relying on technology more than ever before—and healthcare is no exception. Individuals’ receptivity to technology today means that health plans have the opportunity to harness scalable, ongoing digital engagement to accelerate improved outcomes—both at the individual member level and across populations. In this session, we will provide the actionable steps you can take to create powerful, data-driven, digital-first engagement, leveraging rewards and incentives to empower people to take the right actions to improve their health. Discussion topics will include:

• Aggregating clinical and non-clinical data to drive targeted, personalized digital engagement
• Creating a complete member record through “whole person” data synchronization
• Using digital engagement tools to reduce costs and drive profitability
• Activating members through individualized incentives and rewards to close gaps in care faster

The Impact of Utilizing Technology at the Point-of-Care to Drive Value-Based Care

Building a successful value-based care program can be costly and exhaustive to organizations without the right access to data. However, Artificial Intelligence (AI) can give organizations the ability to create a patient phenotype or longitudinal medical record that can power insights for risk, quality, utilization management, and beyond. In this presentation, host Bryan Lee will discuss how and where you can leverage this technology for your VBC program.

Deploying True Population Health Management Through Data-Driven Whole Person Care

• Uncovering social determinant information from traditional plan data sources, public domain data sources, as well as consumer data sources to paint the full picture of the member
• Leveraging all member data available to activate holistic member predictions that guide more meaningful, impactful, and efficient interventions around compliance, utilization, behavioral health, and more
• Building an effective engagement strategy to activate true population health management

Close of Module # 1: Virtual Networking Lunch Break in the Exhibit Hall

Population Health Gets Personal: The Virtual Front Door of Healthcare is Powering a New Era in Population Health

Population health is grounded in the notion that we have the opportunity to work together to improve the outcomes of the communities which we serve. Today, virtual care platforms serve as a front door to convenient, accessible, and guided healthcare powering a new era of clinical collaboration and care delivery. By connecting care providers and patients and improving access to care resources a personalized care experience is evolving and it is helping to deliver on population health in new ways. Join Dr. Lewis Levy, MD, Chief Medical Officer at Teladoc Health as he explores how the virtual front door to healthcare is powering whole-person health and driving better health outcomes every step of the way.

Best Practices: Value Based Payment Models – Keys to Success and Outcomes Results with Primary Care Attribution Models

• Provider & Community Collaborations – Data Sharing
• Bundled Payments/Episodes of Care
• From Upside Only to Shared Risk

Addressing Social Determinants of Health through the Value Based Insurance Design Demonstration

Humana will present their experience participating in the Center for Medicare and Medicaid Innovation (CMMI) Value Based Insurance Design (VBID) demonstration project. Humana has been participating in this model since 2020 and will present experiences in developing and offering a Healthy Food Card, designed to address food insecurity and financial strain for members of low socio-economic status. This session will provide quantitative, qualitative, and experiential evidence around the future of addressing social determinants of health in Medicare Advantage, through VBID.

Improving End of Life Care for Medicare Advantage Plans Utilizing the Hospice VBID Model

Bringing Collaborative Risk Models to Underserved Rural Populations

Modeling risk agreements in small rural communities can be a challenge due to smaller populations, and leaner provider networks. The collaborative risk model focuses on an entire county Medicaid population and bring together various local providers including primary care, behavioral health, and hospital. Since 2017 Columbia Pacific CCO has been engaged county partners in collaborative risk model to bolster shared accountability for Medicaid populations. In this session you will learn about the financial model, quality measures, shared investment, and lessons learned.

Virtual Networking Break in the Exhibit Hall

New Analytics and Predictive Modeling to Determine Social Needs and Apply Supplemental Benefits

While health-related social needs (HRSNs), such as housing insecurity, food insecurity, and poor social support, are widely known to adversely affect health, payers and healthcare organizations rarely know the prevalence of HRSNs across the populations they serve in order to effectively implement and invest in population health interventions. This presentation will discuss how one health plan assessed the comprehensive HRSNs of its member population, using these data to generate insights and opportunities for quality improvement and innovative benefit design to improve the health and quality of life of its members.

Accessing and Mobilizing Data to Identify Risk to Drive Intervention

• Managing the information lifecycle to effectively use data to drive interventions and continuous improvement.
• Leveraging a responsive, multi-dimensional population assessment to identify programmatic needs
• Risk stratification approach and integrating stratified member lists into intervention workflows
• Example of using this framework for COVID-19 interventions

Building Healthier Communities Through Data-Driven Whole Person Care

• Connecting payers, providers and healthcare communities for patient-centered care
• Leveraging SDoH, clinical data along with claims and other data sources to drive more effective care
• Utilizing technologies and proven strategies to ensure better health and financial outcomes

Close of Module 2: Virtual Networking Reception in the Exhibit Hall

The Beginning of the End, Or the End of the Beginning – Strategies for Dual Eligible Members Who Still Have Not Engaged on Covid-19

Leveraging CBOs to Address Impacts of SDoH on Vulnerable Older Adults

Healthcare spending is disproportionately concentrated on older adults managing chronic diseases or functional limitations, and our nation’s rapidly growing senior population leaves more vulnerable to the effects of social determinants of health (SDoH). Partnerships between health plans and community-based organizations (CBOs) are a powerful way to address the impacts of SDoH. Join this session to learn how Meals on Wheels America works with its network of CBOs to harness their strengths and local know-how to provide holistic, person-centered care for high-risk, high-need older adults at a national level.

Solving for Health Inequities Through CBO and Provider Partnerships

Gateway Health will share how it built a successful program aiming to solve for members health inequities within a community. Truly making a positive impact on inequities within a community, is not a single source solution.  Any program aiming to address inequities requires a commitment and partnerships with trusted and existing community based resources, which is why Gateway Health could not do this alone. The Community must be involved in every step of the process to effect real change.

Virtual Networking Break in the Exhibit Hall

Incorporating Health Equity in SDOH Strategy

Many of the programs that address social determinants are addressing symptoms of deep societal issues that have plagued our communities for centuries.  Racism, sexism, agism are all root causes of many neighborhoods that have lacked investment, growth and opportunities for generations.  CareSource is embedding health equity into all aspects of care and ensuring that is serves as a foundation of the Life Services and Care management models. 

• Defining health equity
• Discussion of health equity as a part of SDOH foundation
• Examples of how Life Services is impacting minority populations

Community Level Collaborations to Impact SDoH: The Evolving Role of the Health Plans in Moving “Upstream” to Improve Social and Economic Conditions

Should 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.

Connecting in the Community: Creating a Forum for Providers, CBOs, State and Local Agencies and the Health Plan

PacificSource Health Plans, a Coordinated Care Organization in Central Oregon serving the Medicaid population, created a Community Huddle to connect the health plan, providers, community based organizations and local government agencies (health departments, recreation and parks, fire, police, disaster preparedness, etc.).  The Huddle provides a service opportunity and a meaningful link to agencies serving vulnerable residents. The Huddle provides a forum for agencies to communicate information on new programs, updates to local services, legislative changes impacting the community, webinars and conferences of interest and provides space for individual needs to be posted.

Isolation and Recovery Sites for the Most Vulnerable Populations

Close of Conference