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Innovative Strategies to Bend Medical Cost Management Trends

  • April 23, 2020
  • 2:00 PM – 3:00 PM ET
  • online
about

The current COVID-19 pandemic is creating significant impacts on medical cost trends across the nation.  As the healthcare industry reacts to the current environment, there are many strategies that can be implemented today in order to handle the affects COVID-19 will have on a health plan’s medical costs.

For most health insurance providers, the bulk of this budgetary bleeding occurs in six key areas: population management, utilization management, service delivery planning, delivery system design, contractual strategy, and benefit/medical management strategy misalignment. Today, more than ever before, there is greater criticality to adopting new cost management strategies to reduce excessive spend, while improving outcomes for members.

This webinar will focus on practical applications to prepare for post-COVID-19 operations by strengthening utilization management, population health management, as well as other key programs in order to better manage medical costs and drive down the spend trend. The presenters will demonstrate industry examples and best practices used by health insurance providers to better control costs while delivering high-quality, cost-effective care to members.

Attendees will learn: 

  • Impacts of COVID-19 on medical spend and key strategies to using utilization management and population health management to control the medical spend occurring across a network
  • Importance of using social determinants of health data to understand where current and future risk exists across Impactable and Intervenable populations
  • Emerging trends health plans are driving to bend the medical cost curve
  • Strategies for aligning provider and member satisfaction with cost management initiatives
  • Innovative approaches to network steerage
  • Advanced approaches to using predictive and prescriptive analytics to impact health and cost outcomes
  • Key strategies to augment health plan revenue

Speakers


Elizabeth Bigham
SVP & General Manager, Clinical Services
EXL Service

Elizabeth Bigham is the Senior Vice President and General Manager over EXL’s Clinical Services business. Elizabeth has more than 25 years’ experience in domestic and international healthcare markets, including holding senior executive positions in care management and operations within health plans as well as a serving as a partner at a top national consulting firm. Elizabeth joined EXL in 2019 where she is currently responsible for the strategy, go-to-market and overall performance of the clinical services line of business.


Victor A. Collymore, MD, FACP
Vice President and Chief Medical Officer
EXL Service

Victor A. Collymore, MD, FACP is the Vice President and Chief Medical Officer at EXL Service, a multi-national company, where he oversees utilization management, coordinates disease and care management, and liaisons with pharmacy, sales and marketing, data and predictive modeling departments, and life sciences. In addition, he has overseen quality and run several medical groups. He understands the key mechanisms by which medical groups and health plans can augment quality of care, quality of service, and be responsible stewards of resources. His knowledge also includes an understanding of appropriate coding and documentation, medical necessity determinations, accreditation processes, and provider/hospital contract negotiations.

His professional business experience includes being the Chief Medical Officer of Community Health Plan of Washington for more than four years, Medical Director at Evercare/United Health Group, Chief Executive Officer of Providence Physician Group, Vice President of the PeaceHealth Medical Group, Medical Director of Care Coordination at Group Health Cooperative, Associate Medical Director and Hospitalist Chief at Kaiser Permanente in Colorado, Assistant Chief/Program Director of the Internal Medicine Residency at Kaiser Permanente in Los Angeles, and Associate Clinical Professor of Medicine at UCLA.

Board certified in Internal Medicine and a Fellow of the American College of Physicians, he received his medical degree at Columbia’s College of Physicians and Surgeons in New York and completed his internship and residency in Internal Medicine at Mount Sinai Hospital in New York.

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