During the past year, our industry has pivoted, innovated, and underscored its role as an essential part of health care’s transformation.
Find it at AHIP Institute & Expo Online. In an environment that encourages innovation, action, and candor, you’ll engage with the best minds from within and outside our industry.
Diabetes, certain types of cancer, asthma and tobacco addiction are costly examples of conditions that disproportionately impact underserved communities and communities of color. However, inventive digital solutions can break through environmental factors that potentiate these health disparities—and promote health equity and empowerment among diverse populations. Learn how to approach digital health in a way that can improve health outcomes for all patients.
This session will focus on three cost drivers in health care, including the rising costs and complexity in the management of specialty drugs, the challenges of administering laboratory benefits specific to genetic testing and personalized (or precision) medicine, and the rising costs related to emergency department utilization. Attendees will learn about new solutions to bend these trends while decreasing the complexity of administering benefits in these categories.
Onboarding members to their medicines in a way that is personalized, convenient and affordable should be a priority for every health insurance provider. Join this session to learn how one organization is assisting members in starting their prescriptions with certainty, and delivering care that assures members they’ll be on the best possible clinical path throughout the duration of their therapy.
The CMS Interoperability and Patient Access Final Rule created challenges that health insurance providers have struggled to efficiently operationalize, with more to be done after the July 1, 2021 deadline. This session will outline the three key phases that payers need to establish an effective interoperability infrastructure, both as purveyors and as consumers of data. The session will incorporate market research and proven cross-industry best practices.
The well-being landscape has changed, especially for health insurance providers attempting to engage their members, employer groups and local communities. Backed by an emphasis on inclusivity, social determinants of health and mental health, one payer is meeting well-being needs and boosting immunity for all. In this session, speakers will discuss how to partner with local communities to address diversity, COVID-19, and create more access to emotional health programs.
The way people manage their health is changing—and so are their expectations. Whole-person care is driving health insurance providers to innovate with virtual care technology to support members across their entire health journey. Join this session to learn the positive impact whole-person virtual care has on clinical, financial and member satisfaction outcomes. Speakers will also discuss how to integrate virtual whole-person health into payer models of care and care coordination.
Health insurance still lags in industry rankings for consumer experience (CX), and there is no question of the consequences for health plan growth. But health insurance CX is not retail CX; the type of CX that works for Amazon may not work for payers and third-party administrators (TPAs). Speakers in this session will discuss how to make CX work effectively for health insurance providers, sharing insights from the wins and pitfalls of more than 200 payers and TPAs.
This session will provide actionable insights on how health insurance providers can foster collaborative relationships that benefit both providers and members. Attendees will learn how timely, transparent, and fair reporting can enhance value-based care initiatives, increase provider engagement, and drive proactive partnerships.
A focus on Social Determinants of Health (SDOH), which drives up to 80% of health outcomes, has compelled many payers to move toward a whole-person model of care and address health-related social needs. Speakers in this session will review the design, implementation, and evaluation of SDOH pilot programs, which can inform effective benefit design and clinical programming. Speakers will also review a pilot program using home-delivered meals to support members facing diabetes and food insecurity.
This session will address how value-based arrangements in addiction treatment are solving critical gaps in care access, quality, and equity. Speakers will discuss how realigning incentives and delivering evidence-based virtual care have the potential to solve the national substance use disorder crisis.
Digital and virtual solutions can offer scalable options to accessing mental health care for stress, anxiety, depression, and more severe mental health needs. Health insurance providers can work to ensure access, quality, and cost are balanced in these new delivery models. This session will examine approaches to balancing access and quality in mental health and measuring the performance of digital delivery models.
Delivering high-quality care in a virtual environment isn’t as simple as access to a webcam. This session will examine how the “virtualist” may quickly become a new specialty, and how providers who receive proper training and ongoing support can be a true asset to the broader health ecosystem. Attendees will learn how leading virtual providers are leveraging virtual-first training and education to deliver care that could exceed in-person industry benchmarks.
Join this session to learn how modern interoperability can help health insurance providers and care providers close gaps in care, improve medication adherence, and boost formulary compliance. Speakers will discuss three practical collaboration use-cases that demonstrate how health insurance providers can keep care providers informed about members’ health or coverage changes.
Systemic health, culture and social inequities that have put many people from racial, cultural and ethnic minority groups at increased risk for poor health outcomes, particularly from COVID-19. This session will examine disparities in underserved communities, and how access and education from a community-based health care destination can help patients remove barriers and achieve better outcomes.
The frequency of misdiagnosis in health care comes at substantial cost, both human and financial. Studies have found that for complex conditions, 20% of diagnoses were incorrect while 66% required modification. In this session, speakers will discuss how misdiagnosis happens and four essential elements for incorporating second opinions in care management. Attendees will learn practical ways to handle misdiagnoses and strategies for improving patient outcomes and reducing costs.
Despite the explosion of telehealth use during the pandemic, challenges persist for growing adoption and achieving equity in access to care. This session will highlight telehealth as a scalable solution and introduce a blueprint for member engagement that supports quality improvements. Speakers will discuss strategies for effective care management in a virtual setting, and how to expand access to services for underserved communities.
Multistakeholder collaboratives are working hard to liberate data and achieve true interoperability in a time when data exchange is even more important. They aim to create essential use cases and guidelines, to remove barriers to scalability and incubate new initiatives. This session will highlight real-world progress of the standards-based strategies, and examine next steps for these initiatives in social determinants of health, cancer care, value-based care and infrastructure scalability.
This session will highlight an innovative tool that can help health insurance providers monitor progress on closing disparities within their state, while also assisting communities within their state to meet health equity goals. Learn how one health insurance provider sought input and collaboration from key statewide stakeholders to address health inequities. Speakers will discuss the development process for the health equity tool, as well as lessons learned and results to date.
By leveraging analytics and clinical insights, health insurance providers can design provider networks that promote value over volume. Provider practice patterns can be monitored to enable organizations to understand types of behavior most aligned with cost savings opportunities, including how address the consequences of delayed and deferred care. Join this session to learn how health insurance providers can use analytics to proactively manage care for at-risk and vulnerable populations.
Health insurance providers can set themselves apart by building on CMS’s interoperability and transparency rules to develop an ecosystem of digital tools for consumers. In this session, speakers will discuss solutions to help payers meet upcoming compliance deadlines, and how they can optimize their digital strategies to create opportunities for meaningful consumer experiences that drive patients to actively participate in their own health care.
This session presents a vision for a tightly interoperable integration between a payer’s clinical and administrative systems. Attendees will learn how the member experience improves — and better decisions are possible — as data siloes between these systems are removed. The speakers will contrast simple interoperability and data transparency with a true transformation of care. They will explain why empowered care managers and members, plus better cost/benefit decisions, are the ideal outcomes.
Health insurance providers can strategically engage their member populations by combining socio-demographic data on health care attitudes, lifestyles, and behaviors with claims-based member data that has been granularly segmented. Join this session to learn how payers can use these data insights to close gaps in care, improve member health outcomes and achieve higher STAR ratings across their member populations.
New research indicates the role of payer operations is expanding, though many organizations have yet to realize the full implication and opportunity of this shift. This session will highlight disruptive trends in payer operations, and how these trends could challenge organizations to view operational data in new ways. Speakers will discuss how the industry’s investment in data and intelligent solutions could expand operational leaders’ traditional responsibilities.
Limited access to providers could be why some patients with behavioral health disorders forgo needed treatment. This session will provide an overview of digital tools for behavioral health care; these tools are designed to make care accessible and more efficient for members and providers. Attendees will learn about common digital modalities in behavioral health care and some early research on their use and efficacy.
One way to make a sustainable change in health care is to reimagine care delivery and patient engagement. This includes creating a sustainable plan to address care coordination needs, understanding the impact of telehealth and specialty providers, and implementing new strategies to address quality measurement. In this session, attendees will learn practical strategies for reinventing and reshaping care, with the goal of creating a model of patient-centered, high-value care delivery.
Friction in the current payer-provider claims process has led to a host of solutions, which could consume a sizeable amount of health care spend. Speakers in this session will present use cases that outline key solution requirements to solve this issue. Attendees will also learn how a new technology for payers and providers can allow them to streamline and automate claim transactions with full transparency.
Health insurance providers want to ensure their benefit plans meet employee expectations and remain price and feature competitive. In addition to responding to emerging issues like remote workforces, mental health needs, and pandemic-driven financial stresses, how can payers be on the right side of disruption caused by COVID-19? Speakers in this session will highlight strategies payers can use to retain current employer groups and gain new ones during this extraordinary time.
As estimates suggest over $300 billion is lost annually to health care fraud, waste, and abuse (FWA), the industry must innovate by creating new ways to mitigate losses. In this session, attendees will learn from an actual case study how AI technology, data scientists and FWA experts developed behavioral features and profiles to identify atypical services, thus enabling accurate and efficient fraud mitigation.
Health insurance providers are looking to data-driven digital solutions for long-lasting change that impacts member experience, restores operational excellence, and improves financial strength. Join this session to learn how payers can reshape and accelerate their digital strategies to deliver positive outcomes across the health care value chain.
No travel required for this year’s conference. All you’ll need is access to your computer or mobile device.
You’ll find a fully interactive conference experience – from start to finish. Chat with other conference attendees, speakers, exhibitors. Take the opportunity to ask questions in sessions. And, with a digital briefcase available for downloadable materials, no worries about stuffing your suitcase with valuable information.
Accenture is a leading global professional services company, providing a broad range of services and solutions in strategy, consulting, digital, technology and operations.
Change Healthcare is inspiring a better healthcare system.
Driven by data, Inovalon identifies gaps in care, quality, data integrity, and financial performance
Mom’s Meals is a leading national provider of refrigerated, home-delivered meals and nutrition services.
Optum combines technology, data and expertise to power modern health care.
Teladoc Health is the global virtual care leader, offering the only comprehensive virtual care solution.
The First and Only Consumer Experience Platform Built for Health Insurance