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Four Dimensions to Modernized Quality of Care: Diverse Perspectives

  • April 15, 2021
  • 11:00 AM – 12:00 PM ET
  • Online
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Traditional efforts to achieve improved quality have focused on closing ‘gaps in care’. Health insurance providers have seen suppressed utilization owing to the pandemic and the after effects have largely forced them to adopt a more proactive and coordinated ‘quality of care’ approach over the traditional reactive ‘gaps in care’ approach.

Additionally, the struggle to get traction on improving quality scores have led to a constant introduction of new and changing programs aimed at aligning payers, providers and patients — from population health to value-based care to the continually altered emphasis on regulatory changes with regards to rule and weight happening yearly. While different approaches have been adopted, some have worked but many have only added burden onto an already overwhelmed delivery system.

Health insurance providers need to adopt different approaches to improve scores and lower costs, ranging from business and engagement strategies, to supporting systems and analytics that can give actionable information and positively impact program improvement. They also need to understand the importance of programs that give results without overwhelming care models.

This panel discussion will enable health insurance providers to form a cohesive connection by paying attention on various strategies across dimensions that impact quality of care, improve scores and reduce cost. These strategies will address the following areas: Data & Analytics, Management of Medical Cost, Provider Coordination & Outreach and Quality Improvement Programs. Our panel of experts will discuss key trends, barriers, best practices and solutions for borderless functioning and enablement of modernized quality of care from a health plan functions and solution partners perspective.

Attendees will learn about the key theme of “Modernized Quality of Care” addressing the below dimensions:

  • Quality Improvement Programs – for holistic ‘quality of care’ monitoring, focused on population health, care management, member segmentation, etc.
  • Data and Analytics strategies – for enabling interconnected systems of intelligence focused on data acquisition, data sharing, developing insights, etc.
  • Provider Contract arrangements – for driving better quality improvement with focus on risk-based arrangements, incentive plans, etc.
  • Provider Co-ordination and Outreach – for driving point-of-care actions with focus on network performance measurement, unified outreach, etc.

Speakers


Barbara Fox, Moderator
Vice President, Healthcare Consulting
FluidEdge Consulting

As a healthcare industry leader for over 29 years, Barbara has is a highly sought out expert in the payor medical management arena. She has an unique talent and expertise which traverses both clinical and technical sides of the business. Barbara has provided her clients with strategic direction, interim operational leadership, departmental reorganization, business process optimization, program development, vendor selection and implementation to meet their goals.

She has an extensive background working with key healthcare organizations including Centene (Buckeye Community Health Plan), Healthedge (Click4Care), CaseNet, Sedgwick (Comp Management), UST Global, Florida Blue, Johns Hopkins, BlueCross BlueShield of Mississippi,  Denver Health, CenCal Health, Amerihealth Caritas, and Kern Health Systems.


Frank Ingari
President, Chief Executive Officer, & Board Chairman
Tandigm

Frank Ingari is President, Chief Executive Officer, and Chairman of the Board at Tandigm. In this role, he is responsible for driving excellence across the organization as it continues too strengthen and grow its population health capabilities to achieve strategic goals and objectives.

With more than 35 years of experience serving the healthcare and information technology industries, Frank has a proven track record of impacting transformational growth. Prior to joint the team at Tandigm, Frank developed a reputation as a successful CEO and leader in healthcare and technology, with past positions at NaviNet, Essence Healthcare, and Lumeris.

Frank received his Bachelor of Arts degree, summa cum laude, from Cornell University, where he studied American Literature and History.


Eric Schultz
President
FluidEdge Consulting

Eric is the President of FluidEdge Consulting. Previously, he served as President & CEO of Harvard Pilgrim Healthcare and Fallon Community Health Plan, and has held executive positions with CIGNA Healthcare, and served on the Boards of the Kenneth Schwartz Center, America’s Health Insurance Plans, the Massachusetts Association of Health Plans, the New England Council, and the Worcester Regional Research Bureau.

Eric has a Bachelor of Science Degree in Biology and a Bachelor of Arts in Economics from the University of Connecticut, and holds a Masters of Business Administration Degree from Yale University’s School of Management.


Jeffrey Springer
Senior Vice President, Product Management
CitiusTech, Inc.

Jeffrey comes with more than 20 years of healthcare industry experience, having worked with leading healthcare technology vendors. At CitiusTech, he drives product management, business analysis and product strategy for all products and solutions. He has led the product management and strategy for analytics at Siemens, care management & analytics at MEDecision and ran a business unit at McKesson to develop new products working with payers & providers. Jeff founded the first payer-provider contract management company in the US.

He holds a Mechanical Engineering Degree and an MBA from University of Pennsylvania – The Wharton School, where he graduated as a Palmer Scholar.