Inside Look: One Payer’s Approach to Quality Scoring

  • October 24, 2017
  • 2:00 PM – 3:00 PM ET
  • Online
about

Selecting a new physician can be a real head-scratcher for consumers. While people consider location, personal references and out-of-pocket costs, health plans can also provide clear information on provider quality to help guide their members to good decisions.

In this webinar, you’ll hear from Wellmark Blue Cross Blue Shield, currently serving more than 2 million members in Iowa and South Dakota. Wellmark, in conjunction with its consumer transparency partner, HealthSparq, displays a quality score that’s shared as a numeric index rating summarizing a primary care physician’s performance against various quality measures. It’s enabling users to assess a physician’s quality at a glance.

During the session, you will:

  • Find out how Wellmark worked with 3M to develop the Value Index Score and implemented a strategy to share the quality score with physicians and consumers
  • Learn how to use quality measures to drive members to better value-based decision making
  • Discover ways to simplify what quality means for your members

Who should attend: Health plan executives


Speakers:


Dan Medin, VP of Service Product Strategy & Delivery, HealthSparq
Dan’s team is accountable for delivering consumer-friendly, relevant and integrated services that enable a robust, personalized shopping experience; support effective navigation of the health care system; and result in consumers, health plans and employers getting the most out of their health care dollars. The team’s focus is on adding service capabilities to complement HealthSparq’s digital tools and drive a deeper and more impactful customer experience.

Dan has 18 years of experience in the health care industry. Prior to joining HealthSparq, Dan spent seven years with Regence BlueCross BlueShield in multiple capacities. He was part of the team that designed and implemented the first generation transparency tools for the health plan.

Dan is passionate about driving change within the health care industry and developing tools and services that allow consumers to take ownership of their own health care journey.

 

Mike Fay, VP of Health Networks, Wellmark Blue Cross Blue Shield
Mike joined Wellmark Blue Cross and Blue Shield in 1984 and was promoted to Vice President of Provider Economics in June of 1998.  In that role he led the Provider Economics team in developing, implementing, and maintaining all hospital, physician, and other provider compensation strategies and claims-payment editing processes at Wellmark, including the development and implementation of the universal contracting.  In his current role as Vice President, Health Networks and Innovation, he is involved in numerous strategic initiatives including innovation around product, providers and care management, trend management, and strategic consulting with key groups.  In addition, he continues to provide strategic direction and leadership to Network Economics, Network Innovation, Care Innovation, Consumer Transparency and Provider Contracting.

Mike earned his bachelor’s of business administration degree in accounting from Iowa State University.  He is currently a member of the Iowa Chapter of the Healthcare Financial Management Association and is a graduate of the Greater Des Moines Leadership Institute.


Sheryl Terlouw, Director, Network Innovation, Wellmark Blue Cross Blue Shield
Sheryl Terlouw is director of Network Innovation for Wellmark Blue Cross and Blue Shield of Iowa.  She is responsible for leading provider network initiatives including Accountable Care Organizations (ACOs).  Sheryl joined Wellmark in 2002. Prior to joining Wellmark, Sheryl was with the Iowa Department of Human Services, Centers for Medicare & Medicaid Services, and state medical associations.  She has a Bachelor’s degree in business administration from the University of Iowa and a Master’s degree in public administration-health care from Drake University.