The United States spends approximately 18% of its Gross Domestic Product (GDP) on health care each year – more than any other developed country in the world. Not only is this model economically unsustainable, but this excessive cash outlay has done little to elevate the overall quality of care.
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. The good news is, by adopting new cost management strategies and making better use of plan, provider, and patient data, health care organizations have the opportunity to reduce excessive spend, while improving outcomes for the people they serve.
This webinar will focus on practical applications of utilization management, population health management, as well as other key programs 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.
SVP & General Manager, Clinical Services
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
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.