Washington, D.C.

Nashville, TN

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Exploring Value- Based Specialty Care – Cancer and Cardio

  • October 18, 2018
  • 1:00 PM – 2:00 PM ET
  • Online
about

Oncology and cardiovascular care are top areas of quality and cost concern for health insurance providers. Rapid advances in clinical innovations (or therapies/regimens), escalating costs and the uncertain value of new therapies pose unprecedented challenges for health insurance providers to provide access to high-quality yet affordable specialty care. There isn’t yet a widely adopted playbook for health insurance providers to effectively manage the transition to value-based specialty care.

This case study webinar will demonstrate how health insurance providers can combine the use of capitation, advanced clinical support, and high-performing specialty physician networks to provide members with evidence-based, cost-effective cancer and cardiac care.

Attendees will learn:

  • How capitating a specialty care partner for a defined, comprehensive scope of oncology and cardiovascular care services can significantly reduce PMPM costs while ensuring clinical quality
  • About the range of improvement in financial and clinical value payers can expect
  • Which different types of alternative payment physician reimbursement models can be used to align providers and payers in a proprietary, narrow specialty physician network
  • How a well-designed clinical decision support platform with oncology and cardiovascular clinical pathways creates value and ensures quality
  • Which success factors support effective cancer and cardiac quality management under capitation

Speakers


Stanley Forston, Jr, MD, MPH
Sr. Medical Director – Provider Solutions
New Century Health

Stan Forston, MD, joined New Century Health in 2012. His responsibilities include client strategic account management, clinical product development and provider engagement with New Century Health’s quality management systems.  Prior to joining New Century Health, he was Executive Vice President, Medical Management of a large mid-western oncology practice where he was engaged in contracting strategy, reimbursement analysis, federal and commercial compliance and strategic planning. Previously Dr. Forston was CMS Carrier Medical Director and Associate Medical Director for Blue Cross Blue Shield of Alabama ‘s commercial business.  Earlier in his career as a pediatrician in private practice, he regularly managed children with cancer. Dr. Forston received his MD from the University of Kentucky College of Medicine, his pediatric residency training at UAB Children’s Hospital, Birmingham, AL and his MPH from the Johns Hopkins Bloomberg School of Public Health.