Concurrent Sessions
Educational Tracks
Institute concurrent sessions and networking breakfast symposia are broken into specific tracks that focus on a particular topic – ranging from consumerism to marketplace trends to improved quality, wellness and prevention. Whether you’re attending Institute 2008 to learn about a specific topic area or are looking for a broader range of topics, you can customize your Institute experience. You may choose to attend concurrent sessions in a single track, or mix it up. To help you plan, below is a summary of each track.
Thursday, June 19 11:30 am – 12:30 pm
Forecast 2008
Take a closer look at 2008’s major issues, opportunities, and challenges with one of the industry's leading authors and analysts. Analyze current challenges contributing to the rising cost of health care and potential opportunities for minimizing future growth.
Peter R. Kongstevdt, MD, FACP
Senior Executive, Health & Life Sciences, Accenture3:30 pm – 4:30 pm
Product Innovation and Diversification: Adding Great Value to the Marketplace
Discuss how innovation and diversification in the health insurance marketplace are enabling insurers to maximize their services to their memberships. Take a closer look at how health insurance plans are integrating and modifying products to increase access to benefits. Health care leaders will also discuss how technology is enabling insurers to enhance consumerism and reshape the member experience.
Elizabeth Bierbower
Vice President, Product Innovation, Humana Inc.4:45 pm – 5:45 pm
Personalized Medicine: Clinical Advancements Create a New Paradigm
Examine how biomedical advancements will enable providers to customize treatment and create management plans on an individual basis. Discuss the potential setbacks, the challenges and opportunities for health insurers, and the need for a robust IT infrastructure.
Kristin Brinner, PhD, 2006-2008 AAAS Fellow, Personalized Health Care Initiative, U.S. Department of Health and Human Services –Region IX
Rick J. Carlson, JD, Clinical Professor, Policy Programs; Senior Advisor, Resource Center for Health Policy, Department of Health Services; and Affiliate Professor, Department of Pharmacy, School of Public Health, University of Washington
Friday, June 20 11:30 am – 12:30 pm
Value-based Health Care: What are the New Data and Technology Requirements for Health Insurance Plans?
This session will highlight the multi-stakeholder push that is igniting the value-based movement. Gain insight on the key successes and challenges as clinicians, health insurance plans, PBMs, employers (of all sizes, including Taft Hartley Funds) and consumers shift to health decisions driven by data that define value. Discuss the new emphasis on emerging technologies that enable real-time decisions for appropriate health care use.
David Hom
Chair and Special Advisor, Center for Health Value Innovation
Wednesday, June 18 3:30 pm – 4:30 pm
Are you Prepared? New HIPAA Standards will Affect Your Business Model
The Center for Medicare and Medicaid Services (CMS) is busily working on new HIPAA requirements including changes to the electronic transaction standards, electronic prescribing, and claim attachments. CMS is also moving to ICD-10. Successful implementation will take time, planning, and dedicated resources. This session will focus on what health insurance plans and their business partners need to do to prepare for the new standards.
Kenneth W. Fody, Esq.,
Senior Managing Consultant, Healthcare and Life Sciences, IBM
Harry L. Reynolds
Vice President and Information Compliance Officer, Blue Cross Blue Shield of North Carolina
Tony Trenkle
Director, Office of E-Health Standards and Services, Centers for Medicare & Medicaid Services
Thursday, June 19 11:30 am – 12:30 pm
Information Management Challenges for a 21st Century Delivery System
As the field of health information technology (HIT) rapidly evolves, one of the key opportunities for both the U.S. health care delivery system and the business community is to develop programs that maximize HIT capabilities and their adaptation to various provider sectors. This session will address the operational and technical challenges associated with creating a nationwide, interoperable HIT system and its affect on the overall health care system. Speakers will discuss the changes needed to allow for fast adoption and interoperability, and ultimately return-on-investment.
Tom Groom
Senior Vice President, Business Development, RxHub
Donald L. Holmquest, MD, PhD, JD
Chief Executive Officer, California Regional Health Information Organization
Michael J. Ubl
Director IT Strategy and eHealth, BlueCross and BlueShield of Minnesota3:30 pm – 4:30 pm
Leveraging Health Information Exchange to Promote Collaborative Care
Enabling providers, health insurance plan members, and the plan to easily communicate online is a key element in advancing the health care system. Developing secure systems that integrate claims and administrative data with medical histories - including medication and diagnosis history - will streamline the system and enhance the user experience for all stakeholders. Learn about efforts to design tools that not only optimize the member experience but enable providers to access the information necessary for treatment. This session will also discuss how to ensure data security and enhance the claims adjudication process.
Charles Kennedy, MD
Vice President, Health Information Technology, WellPoint, Inc.
Michael S. Sherman, MD, MBA, MS
Corporate Medical Director, Physician Strategies, Humana Inc.4:45 pm – 5:45 pm
Process Analysis & Improvement for the Everyday Business
Sponsored by Microsoft Corporation®Health insurance plans with a diverse mix of health care offerings, multiple operating units, and numerous acquisitions will have to wrestle with a dynamic and constantly changing business processes. Health insurance plans operate in a stringent regulatory environment, making the already difficult task of continuous improvement, all the more complex. Using innovative technology and detailed data and analysis, learn how one health insurance plan standardized the processes at multiple locations previously all running on different systems. Learn how the company is working to reduce unnecessary process redundancies to improve cost savings customer satisfaction, and staff morale.
Maria M. Hare, RN, COHN-S/CM
Manager, Corporate Health Services, Highmark Inc.
Larry R. Heckathorn
Partner, Human Capital Group LLC
Friday, June 20 11:30 am – 12:30 pm
Real-Time Claims Adjudication: Improving Provider and Consumer Relations
With the increase of health care costs and higher demand for health care quality, real-time claims adjudication is revolutionizing the health care system. Take an in-depth look at how health insurance plans are saving time, reducing errors, cutting administrative costs and more importantly, enabling consumers to make informed decisions. Discuss how providers can obtain information and simplify the collection process through the use of real-time claims adjudication technology.
Michael Baker, MBA
Program Manager, UnitedHealth Group
J. Robert Barbour, JD, MPS, CPHIMS
Vice President, Finance for Medical Services and Technical Development, Montefiore Medical Center
Thursday, June 19 11:30 am – 12:30 pm
An Index for Well-Being: The Dow Jones of Health
Sponsored by Healthways, Inc.This session will introduce you to an unprecedented Index on Well-Being, which will provide a daily pulse of the health of individuals, communities, and companies across the United States. Trends and insights culled from 1,000 daily interviews with individuals (more than 100,000 completed interviews to date) will be discussed as well as future implications of the index findings over the next 25 years, ranging from correlations between work/community environment and overall health, benchmarking opportunities for health comparisons, and potential for the index to serve as a leading economic indicator.
Kevin McConville
Regional Managing Partner, The Gallup Organization
Dexter W. Shurney, MD, MBA, MPH
Chief Medical Officer, Healthways, Inc3:30 pm – 4:30 pm
Employer Wellness Programs: From Health Risk Assessment to Health Coaching
As employers look for ways to drive down health care costs, they also look to employees to get healthy and stay healthy. Health risk assessment tools are the first step in determining the workforce’s biggest health risks. Discuss strategies for developing and implementing a wellness program that best meets the needs of employees. Examine how programs that include technology and a high-touch component such as health coaching can promote healthy behavior. Examine strategies for integrating the work of key stakeholders including health insurance plans, benefit consultants, and wellness consultants.
Robert Jaqmin, MD
Principal, Health Management Consulting Practice, Hewitt Associates LLC
Narayanan Ram
Chief Executive Officer, Purple Teal4:45 pm – 5:45 pm
Employee Incentives: Complying with Employee Wellness Program Regulations
Incentive programs are designed to motivate employees to improve their health. Gain a better understanding of the continuum of wellness products currently in the marketplace, examine what employers are doing, and review what legal issues are potentially raised by the products. You will also hear how employers and insurers can design wellness programs to best meet the health needs of today's consumers and provide quality outcomes.
David Kaplan, MD
Senior Benefits Consultant, Towers Perrin
Friday, June 20 11:30 am – 12:30 pm
Worksite and Retail Clinics: Delivering Wellness Conveniently
In the quest to provide consumers with better access to health care services, the marketplace – including health insurance plans and employers - is creating health clinics at work and in retail stores. Analyze how consumer demand is driving retail care and how this innovative system can deliver consumer-focused care.
Wednesday, June 18 3:30 pm – 4:30 pm
Consumer Engagement: Tools with Traction in the Market
Discover how health insurance plans are employing consumer tools that improve health status and change behavior. Learn about automated mobile and voice solutions that keep consumers healthy and engaged, and learn how to help those needing more intensive interventions.
Lisa Latts, MD, MBA, MSPH
Vice President, Programs in Clinical Excellence, WellPoint, Inc.
Thursday, June 19 11:30 am – 12:30 pm
Health 2.0: The Opportunity and Potential Pitfalls of this New Trend
The Internet is revolutionizing the health care experience as younger and older consumers are turning to the Internet for health information. From expert health blogs that turn medical information into conversation to social networks that inspire with personal stories and progress trackers, examine how the web is not only providing new opportunities for engaging consumers but helping consumers manage their own care. Discuss the potential challenges including health information privacy presented by these new social networking tools.
Carlton Doty
Senior Analyst, Forrester Research
David S. Sobel, MD, MPH
Medical Director, Patient Education and Health Promotion, The Permanente Medical Group3:30 pm – 4:30 pm
What is the Consumer’s Role in Health Care Reform?
The growth of consumerism in health care—and its role as a key component of U.S. health system reform – has been well documented. What has been lacking, however, is information about and insight into the diversity of health care consumers and how our population is changing. Hear about new research examining the characteristics of consumers and their health care beliefs, decisions, use, and attitudes. Discuss how the results from a large consumer study affect the strategies and initiatives of health insurance plans.
Paul Keckley, PhD
Executive Director, Center for Health Solutions, Deloitte LLP
Michael Canning
Partner, Deloitte LLP4:45 pm – 5:45 pm
Learning from Experience: The State of Consumer Directed Health
Examine how the market for consumer directed health products is changing. Discuss employer trends and challenges. Hear more about the employer experience with obtaining data on quality and implementing strategies that not only increase transparency but better enable consumer decision making.
Alexander (Sander) Domaszewicz
Principal, Senior Consultant and National Consumerism Practice Leader, Mercer
Friday, June 20 11:30 am – 12:30 pm
Empowering Consumer Segments: Members with Disabilities
People with disabilities represent a unique segment of health care consumers. Health insurance plans who implement programs that respect these consumers’ needs with emphasis on person-centered, fully integrated care management models will be most effective in serving this consumer base. This session will focus on the importance of involving the consumer in the development of programs and initiatives that address their needs - reflecting on education and empowerment of the consumer, health insurance plan staff and providers. Speakers will also comment on relevant issues from the legislative perspective.
Merrill Friedman,
Vice President, AMERIPLUS, AMERIGROUP Corporation
Driving Quality in the Health Care System
- What are current directions in transparency, clinical performance and outcomes?
- What are some of the leading initiatives aimed at improving the system?
Thursday, June 19 11:30 am – 12:30 pm
Performance-based Networks 2008
Performance-based networks are not new to the health insurance world, but an increased interest in transparency and quality measurement combined with new technologies has made physicians and hospitals the latest subjects of performance information for the consumers. What should health insurance plans consider when evaluating clinician quality and efficiency? What strategies can be used when developing and implementing performance-based initiatives?
Gerald Bishop, MD
Senior Medical Director, West Region, Aetna
Kevin Weiss, MD, MPH
President and CEO, American Board of Medical Specialties3:30 pm – 4:30 pm
Medical Homes: A Comprehensive Approach to Patient Care
The Medical Home concept was first created as a model of care for pediatricians caring for children with special needs in the 1960s and 1970. The usefulness of this model is now being recognized as an effective method for treating chronically ill adult patients. Examine how the medical home model can provide care that is not only timely and well organized, but offers enhanced access for patients to providers. Learn about empirical data demonstrating the effectiveness of the medical home and validating that the collaboration between health insurance plans and physicians can improve compliance and clinical outcomes for patients.
Richard G. Popiel, MD, MBA
Vice President and Chief Medical Officer, Horizon Blue Cross Blue Shield of New Jersey
David Howes, MD
President and CEO, Martin’s Point Healthcare4:45 pm – 5:45 pm
Challenges to Addressing Disparities in Health Care: Data Collection and Use
Among the obstacles to addressing racial and ethnic disparities in health care is the challenge of obtaining accurate and reliable data. From identifying and measuring the gaps in care and determining the factors contributing to these gaps to evaluation of interventions designed to close the gaps, data collection is a key issue. Hear about public and private efforts to collect and use adequate data to identify and address disparities in health care.
Jane Sisk, PhD
Director, Division of Health Care Statistics, National Center for Health Statistics, The Center for Disease Control and Prevention
Friday, June 20 11:30 am – 12:30 pm
Chronic Care: New Delivery Models for Improved Outcomes
Improving ambulatory care for the chronically ill holds the greatest hope for cost reduction through investments in IT and process re-engineering. Learn about a new model of care that provides team-based, proactive, electronically enabled, high touch medical care, managed with a nurse case manager and supervised by a physician. Discover how one employer launched a chronic care delivery model that works with physician practice operations to develop evidence-based chronic care treatment.
Joseph Gifford, MD
Chief Medical Officer-Washington, Regence BlueShield
Wednesday, June 18 3:30 pm – 4:30 pm
Culturally Competent Hypertension Disease Management for African Americans
Presented by Daiichi Sankyo, Inc.The prevalence of hypertension in African Americans in the United States is among the highest in the world. More than 40% of African American adults aged 20 years and older have hypertension. African Americans also have a 20% higher chance of developing heart disease than the general population. Gain an awareness of the patient and physician-related barriers to hypertension control among African Americans, uncover how to better engage and motivate your African American members with hypertension to achieve better control of their condition, and learn about a novel approach to help address healthcare disparities.
Chris Droukas
Senior Manager, Healthcare Quality, Daiichi Sankyo, Inc.
Thursday, June 19 11:30 am – 12:30 pm
Integrated Healthcare Management: The Final Mile in Healthcare
Presented by The TriZetto® Group, Inc.Each healthcare constituent group of providers, brokers, employers, and consumers has its own systems' processes, which have operated largely in uncoordinated silos in the past. To create the shared information and aligned incentives necessary for successful interaction across the healthcare supply chain, payers must drive the convergence of health benefit administration, care management, and constituent engagement. Join healthcare leaders as they explore strategies and best practices for Integrated Healthcare Management ― the framework that can help improve the healthcare system.
John F. Jesser
Health Care Management Executive, WellPoint, Inc.
Steve O'Dell
Regional Vice President, Molina Healthcare System
Rob Scavo
President, Product Management, Core Administrative Solutions, The TriZetto® Group, Inc
Janice W. Young
Program Director, Payer IT Strategies, Health Industry Insights, Gartner Inc.Improving the Value of Health Care and Redefining the Consumer Experience
Presented by CVS CaremarkThis session will serve as a platform to discuss the ways in which health insurance plans can consistently deliver the lowest overall cost and drive positive health outcomes through a proactive approach to consumer health. Using detailed case studies, the panelists will provide the audience with a clear understanding of how plan design, innovative specialty solutions, and strategic programs with retail-based clinics can transform the pharmacy continuum of care through informed, valuable engagements.
Jan Berger, MD
Chief Clinical Officer, CVS Caremark
Chris Bodine
President, Health Care Services, CVS Caremark
Dave Golding
Executive Vice President, Caremark Specialty Pharmacy
Michael Howe
Chief Executive Officer, Minute Clinic3:30 pm – 4:30 pm
Keeping Pace with Treatment Trends: A Look at Smoking Cessation Coverage
Presented by Pfizer IncAs demand increases for quality health care at lower costs, health insurance plans have been increasing their focus on offerings that better encourage smoking cessation among members. According to a recent Milliman report, “Each employee or dependent who quits smoking reduces annual medical and life insurance costs by at least $210 almost immediately.” This panel discussion will provide varied perspectives on the changing landscape of smoking cessation treatment and coverage. Discussion topics include increasing employer engagement in smoking cessation; treatment and measures updates; and examples of innovative health insurance plans providing coverage and support of members seeking to quit.
Tamara Lewis, MD
Medical Director for Community Health, SelectHealth
Greg Pawlson, MD, MPH
Executive Vice President, National Committee for Quality Assurance (NCQA)
Andrew Webber
President and CEO, National Business Coalition on HealthGain Agility, Savings and Competitive Differentiation by Using Administrative Transactional Portal Platform
Presented by ikaSystemsAn integrated portal strategy moves administrative transactions like enrollment, underwriting, and medical management to the portal environment. This leaves the claims system to do what it was designed to do, process claims. Portal technology moves transactions closer to the source, reducing administrative tasks from the health insurance plan, improving the quality of information and increasing access to information internally among departments and externally among consumers, providers, and purchasers. Integrated portals have resulted in reductions in the time to process an application—from 3 per hour per person up to 24 per hour per person. Learn first hand how leading insurers have realized real savings and improved knowledge management through an integrated portal strategy.
Cynthia Burghard
Vice President, Market Intelligence, ikaSystems
Carole Henry
Executive Director Underwriting, Presbyterian Health Plan
David Henderson
Chief Marketing Officer, MVP Health
Susan Nelson
Executive Director, Commercial Products and Sales, Presbyterian Health Plan4:45 pm – 5:45 pm
The Benefits of Collaborative Health Care Management
Presented by MEDecision, Inc.Health care payers are increasingly recognizing the benefits of collaborating on patient care. Most believe that collaboration can improve care quality and affordability, increase operational efficiencies and help foster better patient-physician relationships. This presentation will focus on the role of health care payers in collaborative health care management.
Andrew Schuyler, MD
Executive Medical Director, Healthcare Management and Health Affairs, Horizon Blue Cross Blue Shield of New Jersey
David St.Clair
Founder and CEO; MEDecision, Inc.Connecting Health Care with Information
Presented by IngenixTransforming the health care system requires collaboration among numerous stakeholders: health plans, physicians, hospitals, pharmaceutical companies, and more. Join this session to hear how health plans are working in innovative ways to gather and exchange valuable information throughout the health care system. By driving technology implementation, data quality, and adoption of sound analytic methodologies, leading health plans are helping improve the quality and quantity of information available to health care stakeholders, thus driving more affordable care and better health outcomes.
Andy Slavitt
Chief Executive Officer, Ingenix
Friday, June 20 11:30 am – 12:30 pm
The "Deep Dive": Results from an Enhanced Care Management Intervention
Presented by Health DialogEnhanced care management interventions have demonstrated real results in improving member health outcomes. Speakers in this session will present the design, implementation and results of a state-of-the-art enhanced care management program. Speakers will discuss how the program features advanced analytics, outreach, and coaching, to promote broader and deeper reach into one health insurance plan’s member population. Results are compelling - and industry leading.
Lance Lang, MD
Vice President & Senior Medical Director, Health Net
David Wennberg, MD, MPH
Chief Science & Products Officer, Health DialogSource Data and Quality: Critical Components of a Value-driven Model for Transparency and Measurement
Presented by ViPS, IncThe desire to measure the value of care in the U.S. healthcare system has never been greater. Providers are concerned about having access into the measures and want to verify that the measures are not only correct but understand how these measures affect patients and services to improve the quality of the care provided. Recent discussions about how to best meet these requirements have highlighted the need for more meaningful data, transparent measure development, and the strategic use of this information. The speakers in this session will examine the role of data quality in the life cycle of healthcare value measurement. They will also provide an overview of the key considerations health insurance plan managers need to address in order to obtain, manage, and report quality- and performance-related information.
Joseph C. Nichols, MD
Medical Director, Healthcare Informatics, ViPS, Inc
Donald D. Storey, MD
Former National Medical Director, Aetna
