Concurrent Sessions

Payment Reform and Care Delivery Transformation | Marketplace Innovation to Drive Health Care Transformation | Effective Strategies for Empowering, Educating and Engaging Consumers | Transforming Health IT and Business Operations in a Post Reform Environment | Driving Innovation to Advance Care | Invitation-Only Luncheons 

Payment Reform and Care Delivery Transformation 

 

Thursday, June 21
11:15 pm – 12:15 pm
 

Is a Payment Model Enough? Critical Tenants of Effective Delivery System Transformation
While the financial components of new payment reform models are critical motivators for changing the system, there are other key elements that require consideration. What is the role of the consumer in payment reform models? How can you leverage data and health outcomes to change provider practices? What are key strategies for gaining provider buy-in? What is the value of the embedded nurse? Hear from leaders in the health plans community about what to consider when developing a payment reform strategy and some of the lessons learned from initial phases of the patient-centered medical home model and accountable care organizations.

  • Paul J. Wallace, MD, Senior Vice President and Director, Center for Comparative Effectiveness Research, The Lewin Group, Inc. (moderator)
  • Mary T. McCluskey, MD, Chief Medical Officer and Executive Vice President, Amerigroup
  • Scott Sarran, MD, MM, Chief Medical Officer, Government Programs, HCSC
  • Robert McLaughlin, MD, FACS, Senior Medical Director, Cigna 

Thursday, June 21
2:40 pm – 3:40 pm
 

What Providers Need from Health Plans to Transform the System
Understanding the needs of providers and provider groups is critical to create real change in the system. What do providers need from plans to facilitate sustainable health care delivery? What are the barriers to fully integrating payment reform models? What are the opportunities for health plans to support providers and assist integration? A panel of providers will discuss necessary elements for successful transformation.

  • Arthur J. Fried, Member of the Firm, Becker & Green (moderator)
  • John Friend, Executive Director, Arizona Connected Care, LLC; and Vice President of Business Affairs / Associate General Counsel, TMC HealthCare
  • Kenneth C. Wilson, MD, MS, CPE, System Vice President, Clinical Effectiveness and Quality, Norton Healthcare
  • Hal Teitelbaum, MD, JD, MBA, Managing Partner and CEO, Crystal Run Healthcare

Thursday, June 21
4:15 pm – 5:15 pm
 

Marketplace Disruption: The Unintended Consequences of Change
Efforts to better engage consumers are demonstrating positive results. But, what are some of the unintended consequences of consumer engagement that health plans should consider including a shift in utilization of specialty services and an increase in claims? As new models are implemented to engage consumers in their health and medical management, it is important to understand how they will impact a health plan. Engaged consumers will require more of a retail-orientation to membership. They will ask more questions, request care coordination more often, and require additional and new access points also resulting in an increase in claims and specialty referrals. This session will take a closer look at the effects of consumer empowerment.

  • Jan Berger, MD, MJ, President and CEO, Health Intelligence Partners (moderator)
  • Richard G. Popiel, MD, former President & COO, Horizon Healthcare Innovations, Horizon Blue Cross Blue Shield of NJ 
  • Andrea D. Gelzer, MD, MS, FACP, Senior Vice President and Corporate Chief Medical Officer, The AmeriHealth Mercy Family of Companies 
  • Amy Compton-Phillips, MD, Associate Executive Director, Quality, The Permanente Federation 

Friday, June 22
10:40 am – 11:40 am
 

Multi-payer Approaches: Creating Common Goals for Stakeholders
Multi-payer, community-based approaches to payment reform are showing positive, sustainable results in some regions. What are the critical elements of this approach, and what does it look like? How do you align payers to agree on basic data goals? How do you find common ground among non-traditional allies? Who are the natural aggregators of information that can serve to drive these approaches? How has the employer community been critical to the success of these efforts? This session will focus on what has been learned and what can be translated to different communities.

  • David Nace, MD, Vice President & Medical Director, McKesson Corporation (moderator
  • Patrick Courneya, MD, Health Plan Medical Director, HealthPartners, Inc.
  • Julie Schilz, BSN,  MBA, Program Director, Patient-centered Primary Care Transformation, WellPoint, Inc.
  • Marc D. Keshishian, MD, Senior Vice President & Chief Medical Officer, Blue Care Network  

Friday, June 22
11:40 am - 12:40 pm
 

Understanding Your “A”s and “B”s: Diving into the USPSTF Recommendations
Health insurance plans have always looked to the United States Preventive Services Task Force (USPSTF) for guidance on appropriate clinical preventive services. Beginning in September 2010, section 2713 of the ACA required that new health insurance plans cover with no cost-sharing certain preventive services, including USPSTF recommendations graded A and B. The USPSTF’s recommendations were created to provide clinical guidance in primary care. Thus translating evidence-based preventive service recommendations from clinical practice into public and private health benefit designs can often present challenges. In this session, attendees will gain an inside look at how Task Force recommendations are developed, the methodology used, and the increasingly transparent process AHRQ and the USPSTF have in place to communicate these recommendations to clinicians and the public.

  • David Grossman, MD, MPH, Medical Director, Preventative Care, Group Health Cooperative; Senior Investigator, Group Health Research Institute; and Member, United States Preventative Services Task Force
  • Andrew Baskin, MD, National Medical Director, Quality & Provider Performance Measurement, Aetna Inc.

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Marketplace Innovation to Drive Health Care Transformation 

 

Thursday, June 21
11:15 am – 12:15 pm
 

Creating a Culture of Innovation for Health Plans
How can health insurers become more innovative and flexible in a heavily regulated market? How do you create an organizational culture that prioritizes innovation and ties it to your organization’s strategic direction? What are some plans doing to break the mold? What are best practices in innovation in health care? This session will focus on design thinking used by engineers and in business management to invigorate creativity and spur a more creative problem-solving process. The speakers will highlight how both leading health plans and other businesses stimulate innovation to stay ahead of the curve.

  • Mohan Nair, Chief Innovation Officer, Cambia Health Solutions (formerly The Regence Group) 
  • Kevin Riley, CEO and President of GuideWell; and Chief Innovation Officer, Florida Blue (formerly Blue Cross Blue Shield of Florida) 
  • Peter Coughlan, Partner, IDEO, LLC
  • Patrick Jordan, Content Specialist, Disney Institute

Thursday, June 21
2:40 pm – 3:40 pm
 

Building Brand Loyalty: Reinventing Your Consumer Approach
Health care is dramatically and quickly moving to a high-touch consumer experience. Consumers will be better educated about their health and more empowered to have input on decisions. From selecting their health plan to their type of coverage and providers, consumers will need to be educated on complex benefit decisions and financial obligations. How can health plans invest in the consumer relationship in new ways? How can health plans manage the end-to-end member experience so that every interaction builds brand loyalty and satisfaction? Attendees in this session will gain insights on how to refresh their brand positioning to recast their value proposition. Additional take-aways include strategies for moving to a high-engagement interaction with socialized consumers and how to structure the member experience to address the whole consumer.  

  • Lindsay Resnick, Chief Marketing Officer, KBM Group

Thursday, June 21
4:15 pm – 5:15 pm
 

Evolving the Business Model: The Right Team, The Right Approach, The Right Technology
From risk selection and market shifts to consumer empowerment and online shopping, health plans must anticipate and prepare for a fast-paced changing environment. The traditional employer-based model of coverage is morphing into an individually accessed marketplace relying on a fragmented, multi-channel network. What are your core strategic goals to build and expand your membership across product lines and market segments? As you revamp your strategy, what other internal changes need to be made? Do you still have the right team and the right management approach in place? Where do you need to make internal investments in staff, technology, and resources that support the evolving business? What technology investments need to be made to support a consumer-directed approach that includes social media and m-health technologies? This session will answer these critical questions and more.

  • Gordon F. Bailey, III, Assistant General Counsel & Senior Director of Health Care Reform, Florida Blue (formally Blue Cross Blue Shield of Florida) (moderator
  • Robert Booz, Vice President and Analyst, Gartner

Friday, June 22
10:40 am – 11:40 am
 

Product Design for a New Business Model
How do you structure benefits in order to manage risk in the new health care environment? What are some of the products being developed that build benefits within the limitations of reform? How do you diversify your strategy to address the changing marketplace? How do you segment your consumers to better understand the market? This session will provide insights into the 2012 health care consumer and how they will impact your current and future product designs.

  • Jeffrey Denhard, Director, Business Configuration, Blue Care Network (moderator)
  • Scott P. Polansky, Chief of Business Development, Boston Medical Center HealthNet Plan
  • James Walleshauser, MBA, Vice President, Office of Strategy Management, Independent Health

 

Friday, June 22
11:40 am - 12:40 pm
 

Meeting the Changing Needs of Employers: Maximize Your Value and Fill the Gap
As the value proposition changes and the playing field levels in terms of product design options, how do you differentiate yourself to employers? Are you prepared to offer value added benefits to engage employees to better manage their health? How will the Exchange environment change your strategy so that you can fill the voids and manage your relationships? A panel of leading employers will discuss their business needs, and how they are driving alternative approaches to health benefits in the post-reform environment.

  • Larry Boress, President & CEO, Midwest Business Group on Health (moderator)
  • Jim Dwyer, Vice President, Global Benefits, American Express Company
  • Pamela Hannon, Vice President, Human Resources, Hospira, Inc.

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Effective Strategies for Empowering, Educating and Engaging Consumers 

 

Thursday, June 21
11:15 am – 12:15 pm
 

Carrot or the Stick: The Role of Incentives in Driving Member Behavior
Incentives, whether they are financial or non-financial, can motivate people to move in a particular direction, to change a behavior, or to make a decision. There is a great deal of science aimed at developing and testing innovative ways of applying insights from behavioral economics to improve patient health behavior and affect provider performance. So, what is the intersection between determining the right financial incentive and using decision errors to help people make choices that lead to improved long-term health? This session will focus on how incentives and disincentives can motivate behavior change.

  • Kevin Volpp, MD, PhD, Director, Center for Health Incentives and Behavioral Economics,; Director, UPHS Center for Innovations in Health Care Financing; Professor, School of Medicine and the Wharton School, University of Pennsylvania

Thursday, June 21
2:40 pm – 3:40 pm
 

Strategies for Helping Consumer Make Prudent Decisions
Encouraging consumer engagement in complex purchasing decisions can be a challenge. As the role of the consumer becomes more complicated and more involved, what should health plans consider in their outreach and educational efforts? How do you create sustainable change in consumers and how do you measure success? Hear what other industries have learned that can be transferred to health care.

  • John Young, Vice President, Consumerism, Cigna (moderator)
  • Graham Atkinson, Senior Vice President and Chief Customer Experience Officer, Walgreen Co.
  • Larry Boress, President & CEO, Midwest Business Group on Health
  • Colleen M. Reilly MBA/MSM, President, Total Well-Being

Thursday, June 21
4:15 pm – 5:15 pm
 

From Prevention to Medical Management: Approaches to Establish and Sustain Consumer Engagement in Health
Health care consumer engagement models are designed to enable consumers to better understand, request and choose quality health care, as well as encourage and empower individuals to take ownership of their health care decisions. Innovative programs help consumers change their behaviors to become and remain healthy. What are proven strategies that allow consumers to better access the broader health care system? How can you start with the consumer to figure out what motivates them and what is meaningful? What are effective outreach strategies that are showing clinical success? The speakers in this session will examine how health plans can motivate patients to be their own care managers and the role of health plans to support patients in their well-being.

  • Jeremy Nobel MD, MPH, Medical Director, Northeast Business Group on Health; and Executive Director, NEBGH Solutions and Innovations Center (moderator)
  • Neal Sofian, Director, Member Engagement, Premera Blue Cross
  • Marsha Masten, Vice President, Clinical Strategy and Client Services, Avivia Health From Kaiser Permanente

Friday, June 22
10:40 am – 11:40 am
 

The Power of Measurement: Demonstrating Success in Consumer Engagement Initiatives
There is a great deal of pressure on health plans to demonstrate the effectiveness of consumer engagement strategies. Employers want to find measureable ways that prove the value of benefit package add-ons to increase employee productivity and reduce absenteeism. This session will take a closer look at how health plans are demonstrating results and real behavior change in members. Our speakers will examine indicators of health improvement including whether participation determines success or if measureable health improvements are necessary.

  • Michael D. McGrail, MD, Vice President and Associate Medical Director of Health Solutions, HealthPartners, Inc. (moderator)
  • Elizabeth Dixon, Wellness Director, Chick-fil-A
  • Jill Marie Chapman, Senior Director of Benefits, OfficeMax
  • John Neuberger, Director of Client Partnerships, Quad/Graphics

Friday, June 22
11:40 am - 12:40 pm
 

Engaging New Populations in Health: The Benefits of Health Literacy
Research clearly shows that health and benefits information plays an important role in the health outcomes of individuals. Those with poor health literacy and access to information are more likely to experience poor health, incur significantly higher health care costs, and have a harder time managing their chronic diseases. Nearly nine out of ten adults have difficulty using health information to make informed decisions about their health, profoundly affecting their health and access to care. By 2014, millions of newly insured individuals will be accessing the system, and will need assistance in seeking appropriate providers and sites of care. Learn about innovative efforts in the health plan community that can be applied to your organization.

  • Russell Bennett, MBA, Vice President Latino Health Solutions, UnitedHealthcare (moderator
  • Yolanda Partida, MSW, DPA, Director, Independent Consultant and Former Director, Hablamos Juntos
  • Linda Harris, Team Leader, Health Communication and eHealth Team, Office of Disease Prevention and Health Promotion, HHS 

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Transforming Health IT and Business Operations in a Post Reform Environment 

 

Thursday, June 21
11:15 am – 12:15 pm
 

Aligning Health IT Initiatives, Business Strategies, and Reform Priorities
Health care reform presents many challenges and opportunities. Resource allocation and capital investments are critical to success in times of change. How do you ensure you are making the right investments and developing the right strategy to meet the goals of health care reform? This timely session will demonstrate how you can evaluate your IT and operations structure, and how to reinvest in new ways to meet the new priorities. We’ll examine the potential pitfalls and how to engage in strategies that prove effective.

  • Wayne E. Pietraszek, Principal, McKinsey & Company

Thursday, June 21
2:40 pm – 3:40 pm
 

Balancing Innovation and Regulation: CIOs Weigh in on the Role of Technology in Streamlining Health Plan Operations
The regulatory environment since the passage of the ACA and HITECH has elevated the importance of technology and the Chief Information Officer’s role in streamlining health plan operations. These laws and regulations have contributed to the expansion of the traditional role of the CIO from one of aligning IT and business processes to also include the management of new and innovative products and process to better serve health care consumers. A panel of health plan experts will share their insights and perspectives on the changing environment.

  • Susan Randall-Johnson, Senior Director, Policy and Implementation, Fallon Community Health Plan (moderator)
  • Vincenzo G. Ferri, MBA BS, Vice President & Chief Information Officer, AvMed Health Plans
  • John H. Steber, EVP & Chief Information Officer, EmblemHealth  

Thursday, June 21
4:15 pm – 5:15 pm
 

What's Missing from Your Security and Compliance Efforts? 
Presented by Microsoft Corporation
As your organization is required to process additional health information, expectations around how that data is protected will become increasingly more demanding. The HHS Office of Civil Rights (OCR) along with state attorneys general will be much more active in enforcement efforts than in the past. Auditing and fining organizations for HIPAA violations will become more frequent. Ensuring privacy and maintaining security will always be essential mandates for your organization; but you must also focus on promoting the best health outcomes for your patients, increasing operational efficiency, and safeguarding your organization's market strength. Speakers in this session will talk about how you can increase the focus on security and compliance without stopping innovation and business execution at your health plan. By ensuring HITECH compliance without compromising your operational demands, the speakers will show health plans how to embrace projects like ICD-10 and payment reform while ensuring industry and cutting edge best practices.

  • Eric Mueller, President, WPC Services
  • Hector Rodriguez, Chief Technology Officer, Health and Life Sciences Group, Microsoft Corporation

Friday, June 22
10:40 am – 11:40 am
 

Leveraging Data Analytics to Drive New Operating Models 
As health plans focus on future-state operating models such as accountable care, analytics is becoming the glue to support the transition. In this presentation, the speakers will look at the strategic and practical role of analytics in helping health plans evaluate the marketplace and opportunities for new provider collaborations. Attendees will learn about strategies to use data to improve cost, quality and service through coordinated care delivery and how to support the transition toward the future market environment.

  • Casey Graves, Principal, Deloitte Consulting LLP
  • John Keith, Principal, Deloitte Consulting LLP

Friday, June 22
11:40 am - 12:40 pm
 

Innovative Tools and Technologies for Activating Consumers: From Social Media Tools to Digital Gaming
Digital media strategies are having a significant impact on the delivery of health care. From enabling patients to better manage their health and medical conditions to improving physicians' access to state-of-the-art clinical information and practices, technology is now an integral part of the health care landscape. How does gaming fit into your technology strategy? What about other forms of mobile technologies can motivate consumers and encourage healthy behaviors? How can you determine which vendor and which technology best meets your goals. The health plans speakers in this session will examine the innovative technologies and strategies that you can implement in your organization.

  • Nancy Wongvipat Kalev, MPH, Director, Health Education/Cultural and Linguistic Services, HealthNet
  • Bryce Williams, Director, Wellvolution

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Driving Innovation to Advance Care 

 

Thursday, June 21
11:15 pm – 12:15 pm
 

The Future of Integrated Healthcare Delivery and How Payers Will Benefit
Presented by Accenture
Payers are in a unique position to leverage healthcare IT to create new models of care for their provider networks that will lower hospital admissions and increase value to their members. This session will examine how integrated healthcare delivery – connected health – is evolving and points to a future in which organizations can achieve higher quality, more accessible and cost-effective healthcare while driving integration and innovation. The speakers will present the findings of a year-long international study of the healthcare IT progress toward connected health in 8 nations: Australia, Canada, England, France, Germany, Singapore, Spain and the United States. These national health system models are diverse, but are under similar financial pressures from economic conditions and rising healthcare costs as well as new challenges for more personalized demands for care.  The speaker will discuss the implications for payers of what is occurring in the United and of the global connected health movement.

  • Augusta Kairys, Vice President, Provider Technology and Strategic Partnerships, Highmark Blue Cross and Blue Shield
  • Rick Ratliff, Global Managing Director, ConnectedHealth IT, Accenture 

 

Thursday, June 21
11:15 pm – 12:15 pm
 

Attacking the Obesity Epidemic: How to Achieve Sustained Weight Loss and What It Means for Your Membership
Presented by Healthway
Hear about the results from a randomized, controlled trial designed to examine the effects of two behavioral weight-loss interventions.  The trial not only demonstrated weight loss, but also demonstrated significant sustained weight loss over 2 years. In this session you will learn how the trial was conducted and key design principles that can be applied in weight management programs for large populations.

  • Nathan King, Senior Product Portfolio Manager, Healthways 
  • Arlene Dalcin, Research Associate, Johns Hopkins School of Medicine

Thursday, June 21
11:15 am – 12:15 pm
 

Changing Channels: Positioning for Health Benefit Exchanges, the Expansion of Retail Insurance Markets, and Direct to Consumer Sales
Presented by Cognizant
As each state establishes its own specific Health Benefit Exchange there will be significant differences in health plan participation between states. Underwriting approaches, demographics, regional variations and network availability will likely create wide variations from state to state. A retail-oriented view of consumers will compel insurers to make their products and services easy for individuals to understand and navigate; and the direct-to-consumer sales process will change the way insurers think about consumer behaviors and preferences. This panel discussion will address strategies and technology required to accommodate individual consumer-oriented market segmentation and new customer service requirements; how core platforms will need to adjust to accommodate individual and member-centric products and services; and analytic capabilities required to gain insights into consumer behaviors, preferences, and product performance.

  • Bill Shea, Partner, Cognizant Business Consulting, Healthcare (moderator)
  • Emma Hoo, Director, Pacific Business Group on Health

Thursday, June 21
2:40 pm – 3:40 pm
 

Driving Value: Practical Advice for Successful Value-Based Reimbursement Strategies
Presented by McKesson Health Solutions
The industry is undergoing a fundamental shift toward reimbursement strategies that reward providers for the value of the healthcare services they deliver rather than their volume. To successfully execute this shift, payer organizations need to grapple with issues of program design, provider buy-in, and scalability given complex contracting, payment and reimbursement policies, among others. In this session, two leading insurers will share their insights and best practices for creating, monitoring and optimizing value-based reimbursements programs, with a focus on the underlying technology requirements.

  • Jim Evans, Vice President, Payment Management and Analytics, McKesson Health Solutions
  • Douglas Emery, MS, Program Implementation Leader, Western Region, Healthcare Incentives Improvement Institute  

Thursday, June 21
2:40 pm – 3:40 pm
 

Performance Analytics: Leveraging Data to Improve the Healthcare Delivery System
Presented by MedeAnalytics
Improving the quality and outcomes through data management has never been more important. Health plans and providers across the country are becoming more transparent, contracting in new ways and rewarding providers for improved performance. Access to timely and actionable data is critical for these efforts to succeed. This session will discuss how disparate data can be utilized to address many business issues in the healthcare delivery system today. Those issues include population management, gaps in care, quality of care, provider performance and business issue reduction, ultimately leading to improved clinical, operational and financial performance.

  • George Louie, MD, Senior Medical Director, Health Net
  • Terry Fouts ,MD, Chief Medical Officer, MedeAnalytics

Thursday, June 21
2:40 pm – 3:40 pm
 

Strategies for Reducing Hospital Readmissions and Length of Stay
Presented by VITAS Innovative Hospice Care®
Partnering with hospice and palliative care providers can be a very effective way for managed care organizations to significantly reduce readmissions. Intervention during the index hospitalization can improve the quality and reduce the length of the initial hospital stay, better prepare the patient and family for discharge, and provide better coordination of care at discharge, resulting in a significant reduction in readmissions. This session will provide insight into payment reform models such as the Hospital Readmission Reduction Program (HRRP) the goal of which is to reduce hospital readmissions. This session will also focus on how hospice and palliative care programs can help providers reduce hospital readmissions by providing comprehensive care to patients in the community, improving discharge planning and coordination of care, while being cost effective and improving quality patient care and patient/family satisfaction.  

  • Jan Berger, MD, MJ, President & CEO, Health Intelligence Partners (moderator)
  • Rhonda Randall, DO, Executive Vice President & Chief Medical Officer, United Healthcare Medical & Retirement
  • Ron Greeno, MD, FCCP, MHM, Chief Medical Officer, Cogent HMG
  • Barry Kinzbrunner, MD, Executive Vice President, Chief Medical Officer, VITAS Corporation

 

Thursday, June 21
4:15 pm – 5:15 pm
 

Facing the Challenges Confronting Health Plans
Presented by Verisk Health, Inc.
Health care coverage and delivery is evolving before our very eyes, raising more questions than it does answers. The complexities of the present and the changes still to come suggest that we must look to the future to solve the problems of today. The panel of experts in this session will discuss how today’s challenges can be leveraged to drive future performance and improve care. The discussion will focus on the need for risk adjustment and identification & stratification to support medical cost control as the market expands through Medicaid eligibility changes and insurance exchanges; the role of quality measurement and provider performance is taking on increasing importance both with new forms of risk contracting and regarding patient engagement and retention; and how plans are both improving their measurement and partnering with their provider network to drive quality.

  • Joel Portice, President, Payment Accuracy Division, Verisk Health (moderator)
  • Brian Day, Director of Advanced Analytics, Highmark
  • Amanda Purvis, Vice President, Service Operations Support, Coventry Health Care

Thursday, June 21
4:15 pm – 5:15 pm
 

Making Connected Health a Reality
Presented by Alere
Much of today’s high cost of care, wasted resources, quality challenges, and consumer frustration can be traced to the fragmentation of our current system. Health plans, providers, and partnering organizations all have key roles to play in making connected health a reality to address these intractable problems, leveraging new technologies and approaches to health care delivery. The session will examine the promise and results of new care models, including the advent of accountable care organizations and the integration of in-home diagnostics and monitoring devices in existing health management models.

  • Gordon Norman, MD, MBA, Executive Vice President & Chief Innovation Officer, Alere, Inc.

Thursday, June 21
4:15 pm – 5:15 pm
 

The Changing Role of Pharmacy in the Era of Health Care Reform: Advancing the Science of Pharmacy to Improve Adherence
Presented by CVS Caremark
Health care costs continue to rise and has the potential to be unsustainable long term following implementation of many of the health care reform provisions that will take effect in 2014. One of the contributors to rising health care costs is lack of pharmacy adherence. Today, up to a quarter of all hospital and nursing home admissions are the result of patients simply not following their medication directions. Additionally, patients that are not taking their medications as directed visit doctors three times more often and incur $2,000 more in costs per year than adherent patients. In order to improve health and reduce overall medical costs, health plans need a strategy to increase adherence. Strategies for best-in-class adherence include: basic education repeated consistently, innovative plan designs, clinical support programs with ongoing communication and Pharmacist/Nurse/MD counseling. Learn from a case study how managed pharmacy benefit can improve adherence by getting members to understand their health, and what they can do to improve it.

  • Leslie Dukker Doty, Vice President, Member Engagement, CVS Caremark

Friday, June 22
10:40 am – 11:40 am
 

Improving Population Health – Together with Providers
Presented by Optum 
Increased competition and the rapidly evolving health care environment is making it imperative for plans to take a collaborative, data-driven approach; truly partnering with providers to improve quality, increase member engagement and improve overall population health.  Industry experts will come together during this panel for a lively discussion focused on proactive ways to engage provider networks, successful care management strategies and new payment models.  

  • Miles Snowden, MD, Chief Medical Officer, Optum (moderator)
  • Jim Guyn, MD, Vice President & Senior Medical Officer, Medica
  • Simeon A. Schwartz, MD, President and CEO, WESTMED Practice Partners
  • Michael Sherman, MD, Senior Vice President and Chief Medical Officer, Harvard Pilgrim Healthcare, Inc.

Friday, June 22
10:40 am – 11:40 am
 

Supporting and Motivating Patients: The Evolution of Health Coaching
Presented by GlaxoSmithKline
The US is experiencing an evolution in how health quality is defined.  With an increasing focus on health outcomes, care management is being recognized as a necessary tool to better manage overall health and wellness.  Equally as important is ensuring patients take an active role in achieving their health goals.  This session will focus on the evolving role of care management and health coaching in motivating patients to take charge of their health, and the need for innovation in care management programs, with insights from patients, health plans and provider groups on what’s working and what’s needed for the future. 

  • Karen Lawson, MD, Assistant Professor, Family Medicine, Program Director, Health Coaching, University of Minnesota (moderator)
  • Peggy Flowers, MSPH, Senior Director, Care Management Solutions, GlaxoSmithKline
  • Ruth Wolever, PhD, Director of Health Psychology and Research Director, Duke Integrative Medicine, Director of Behavioral Health and Lifestyle Coaching, Duke Diet and Fitness Center, Duke University School of Medicine
  • Twyla L. Johnson, MPH, MBA, Manager, Provider Engagement, Performance & Partnerships, Highmark Blue Cross and Blue Shield  

Friday, June 22
10:40 am – 11:40 am
 

Health Care Coverage Remodeled: Why This Time is Different
Presented by Milliman
How are the payment reform efforts today different from past efforts to restructure the system? This session will explore the changes and innovations since the 1990s that give us new hope. Specific areas of discussion will include technology innovations, improved information, reimbursement methods, and changes in attitudes. Attendees will walk away from the session with inspiration and concrete ideas about how they can make managed care work in this new healthcare reform environment. 

  • Todd Fessler, Director, MedInsight Sales and Marketing, Milliman, Inc. (moderator)
  • Clark E. Slipher, FSA, MAAA, National Health Practice Director, Milliman, Inc.

Friday, June 22
11:45 am - 12:45 pm
 

The New Bar for Population Health: Transformational Change with Science, Technology and Insights
Presented by Wellness & Prevention, Inc. a Johnson & Johnson Company
As healthcare demands greater accountability in access, quality, and clinical efficacy of medical care delivery, we must demand the same of population health management programs and services. As we push members to become more accountable for managing their health, we must offer them quality behavior change programs proven to help them sustain behavior change. It is time for health plans to raise the bar on what their population health behavior change solutions can deliver, driving appropriate medical utilization and reduced medical costs, fostering competitive differentiation and member satisfaction. This session will highlight how we are redefining the concept of well-being, using strong behavioral science insights, new technologies, and unique individual data to engage more members, sustain more behavior change, and promote greater care management data integration.

  • Kevin Wildenhaus, PhD, Senior Director, Science and Innovation, Wellness & Prevention, Inc.  

Friday, June 22
11:45 am - 12:45 pm
 

Integrated Care Management Beyond the Health Plan Walls
Presented by DST Health Solutions 
In today’s continually evolving healthcare landscape, health plans must be proactive in their efforts to dramatically improve coordination and quality of care. Join this insightful and relevant panel discussion where industry experts share latest trends and best practices on extending care management collaboration beyond the health plan. In this session the panelists will discuss critical elements supporting the continuum of care management including the emerging models of collaborative care, the primary stakeholder responsibilities across the healthcare spectrum, the innovative care collaboration strategies, and technology requirements to achieve financial and clinical success.

  • Larry Loo, Director, Business Development and Operations, Chinese Community Health Plan
  • Teri Mullaney, Product Solutions Officer, DST Health Solutions
  • Mehrad Shafa, MD, Principal, Medical and Healthcare Consultants LLC
  • Janice Young, Program Director of IDC Health Insights' Payer IT Strategies Program 

 

Friday, June 22
11:45 am - 12:45 pm
 

Insights. Innovation. Inspiration. A Roadmap to Improve Consumer Engagement
Presented by Target 
The healthcare industry is facing disruption, and one of the most important solutions ahead is greater engagement of the consumer.  While the industry is shifting to embrace this heightened need, creating active engagement among consumers remains challenging. This session will address how adopting a retail mindset may help bridge the gap between talking about good health and activating it.  Speakers will discuss how applying retail learnings -- simplicity, connectedness, insights, inspiration and innovation – can drive consumer engagement and action in healthcare. 

  • Marc Baer, Director of Healthcare, Target
  • Angela Churchill, Senior Director, Client Strategy, Optum

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Invitation-Only Luncheons   


Thursday, June 21, 2012
12:15 pm – 1:30 pm
 

Luncheon educational sessions will be hosted by the following companies. Space is limited. RSVP is required.

Analytics in Healthcare: Actionable Insights to Deliver Business Value
Presented by Infosys Public Services
Obtain invite: 
vj_bala@infosys.com 

In a recent survey of Health Plans, we found that analytics is a top investment area. Not surprising given the potential for analytics to impact multiple areas that touch brand image, members, care delivery, health and wellness, and compliance. Health Plans need to build capabilities to “access-analyze-act” on insights that deliver business value.

Health Plans are looking at analytics to target the individual market for new customer acquisition and member retention, as well as deriving actionable insights on provider performance, and so on. During our session, we will address some key questions and “next practices” on how to leverage analytics across the member, provider, claims, sales, and marketing domains.

Speakers: 

Saurabh Agarwal, AVP, Infosys Public Services 
Cristian Ilie, Managing Principal and Co-founder, Visual Intelligence
Siva Nandiwada, AVP, Infosys Public Services
Sumeet Seth, VP of IT, D.C. Chartered Health Plan Inc.
Eric Paternoster, CEO, Infosys Public Services

 

Improve Outcomes, Engage Members and Reduce Healthcare
Costs with a Connected Healthcare Ecosystem

Presented by ActiveHealth, iTriage, and PayFlex
 

Obtain invite: esabin@payflex.com 

This session will focus on emerging trends in today’s ecosystem and how leveraging technology can drive greater value and performance in your healthcare delivery system, while lowering costs. From this discussion, you will walk away with an understanding of how to effectively manage your population’s health data to reduce employer and employee costs while improving health and outcomes through engagement. Our speakers will provide insight into how to successfully implement mobile technology within your plans to drive member engagement, reduce unnecessary hospital visits and increase network compliance. You’ll also learn about the value of technological innovations that will inevitably change the way a consumer connects their tax-advantaged accounts to their health plans and providers.