Payer and provider relationships have historically been adversarial. Successful value-based reimbursement (VBR) programs transform this dynamic, leveraging data analytics to build the collaborative partnerships needed to advance payment innovation.
This webinar will provide learnings from payment innovation leaders, demonstrating how they are leveraging analytic tools to identify value-based payment opportunities and engage providers in the transition from volume to value.
Lili Brillstein, MPH, Director of Episodes of Care,
Horizon Blue Cross Blue Shield of NJ
Lili is a nationally recognized leader in the advancement of Episodes of Care/Bundled Payments as a value based approach for specialty care and in promoting the migration from fee for service to patient centered, fee for quality models. Lili is actively engaged in changing the healthcare delivery and payment paradigm and cultivating functionally collaborative relationships between payers and providers across the continuum of healthcare. Lili is currently Director, Episodes of Care for Horizon Healthcare, the only licensed Blue Cross and Blue Shield health plan in New Jersey, providing coverage to more than 3.6 million people throughout North, Central, and South New Jersey.
Jim Humphrey, MHA, FACHE, Operations Director, Specialty Care Collaboration, Cigna
Jim currently serves as Operations Director for Cigna Healthcare. In this capacity, he directs the nationwide development and implementation of Episodes of Care and other Specialty Care Collaboration programs. He is an experienced executive with over 30 years in healthcare. Jim has worked in the areas of contracting, network development, and managed care operations for several large payors including Maxicare, FHP, Principal Financial Group, and Cigna Healthcare in California, Colorado and Tennessee. His background also includes work in hospital and PHO operations for Tenet and Banner Health. Jim holds a Master’s Degree in Health Administration from Washington University School of Medicine in St. Louis, MO and is an accredited Fellow of the American College of Healthcare Executives.
Mark McAdoo, Vice President, Value Based Payments,
Mark McAdoo is responsible for the strategic direction of the Value-Based Payment team of Change Healthcare. The team is tasked to assist payer and provider customers on the journey to new value-based payment models. In this role, Mark is responsible for allocating the resources and capital invested in the business to integrate HealthQx retrospective data and prospective data into a comprehensive, end-to-end value-based payment platform for the payer and provider markets. Prior to joining Change Healthcare, Mark was co-founder and CEO of HealthQx. While CEO, Mark created the team that built one of the first innovative platforms that combines the power of big data analytics with an operational technology platform that initializes and scales value based payment programs for payers and providers. Today, this platform is operational at some of the largest payer organizations in the United States.