The health care system could be under enormous financial strain at the best of times. Speakers in this session will discuss how one solution provider works alongside health insurance providers to ensure their organizations are strong, efficient, compliant and healthy.

Rules for delivering high-quality, cost-effective, consumer-centric care have changed. To remain competitive, payers and providers must be ready to share risk and understand where market opportunities for risk-sharing exist. This session will explore research used to identify the best opportunities for payviders, or payer/provider value-based collaboration. Attendees will learn how to create a value-based growth engine supporting sustainable margins and better health for all.

The CMS Interoperability and Patient Access Final Rule is changing the way health insurance providers engage with their members, as it requires consumer access to patient- and provider-level data. View video to learn about innovative technology that can assist health insurance providers with expedient, cost-effective solutions to achieve compliance with regulatory deadlines, while gaining expanded member-specific data insights.

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 two cost drivers in health care, including the rising costs and complexity in the management of specialty drugs, and the challenges of administering laboratory benefits specific to genetic testing and personalized (or precision) medicine. 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.

As we begin shaping our post-pandemic reality, health care organizations must learn to master change. The year 2020 ignited a new era of exponential transformation, as technology reshaped industries and the human experience. As 2021 takes shape, there will be little room for enterprises that choose not to technologically pivot. This session will explore this year’s health technology trends, and how organizations can prepare for the technological advances the future is dictating.

This past year has seen the spread of two viruses: the COVID-19 virus and the medical disinformation virus, which has spread across social media faster than the information promulgated by WHO and the CDC. While COVID-19 may succumb to human ingenuity, medical disinformation may remain the larger threat to public health. This session will discuss what disinformation is, why and how it spreads, and what the government, social media and health professionals can do to counter its impact.

The session highlights lessons from an effort to create a long-term vision for health equity by leveraging community-based health data platforms and community-led partnerships. The effort centers on place-based “hubs”, and aims to move community health beyond addressing critical social needs toward directly tackling poverty, discrimination, and the social determinants leading to poor health.

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.

Data sharing limitations and digital access gaps continue to hamper how people navigate health care. Speakers in this session will share new strategies for making enriched provider data easier to display in directories, when to integrate direct appointment scheduling, and how to plan for a new level of price transparency where both providers and plans offer accurate cost estimates.

In this session, learn how one health care organization launched a year-long pilot program in 2020 that delivered medically tailored meals monthly to its most vulnerable members. Join the speakers as they delve into the pilot program’s specifics and key success metrics.

Systemic health, culture and social inequities 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.

The COVID-19 pandemic has created myriad challenges in the health care sector, but it also created
considerable opportunities for innovators and investors. Overall, funding for health tech organizations have reached record levels, and there are no signs that the pace will slow. In this session, a panel of health tech investors and influencers will offer perspectives on the health tech investment trends and opportunities they expect to see over the next few years.

This session will examine the culture of medicine and how it impacts patient health and the quality of care. Discover the questions we should all be asking to maximize health, avoid complications, and attain high value treatment. Speakers will discuss how we can help evolve physician culture to improve quality and make care more convenient. Learn what health care will look like in the post-coronavirus era, and the impact these changes will have on the health insurance industry.

This session will examine the intersection of health care and technology and the changing landscape of sharing and receiving medical information. Hear how a leading online video platform is collaborating with providers to deliver credible health information and evidence-based health care content to consumers and clinicians. Learn how this approach offers a unique opportunity to connect with underserved communities at scale through a platform that is already integrated into many people’s lives.

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 to 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.

Cell therapies are poised to disrupt the treatment paradigm. While cell therapies hold the promise of improved health and health care costs, the long-term safety, effectiveness, and durability of treatment is often unknown at the time of market approval. In this session, speakers will focus on the importance of establishing the value of new and potentially costly cell therapies, and consider how to formulate post-market infrastructure that addresses multiple stakeholders’ evidentiary needs.

The pandemic has propelled health care at home and people’s perception of the value of home-based care. Both due to COVID and advances in digital health, at-home health has momentum. As virtual care and home health services become a permanent part of health care, consumers may no longer need to go to an office or facility for certain health services. This session will explore what’s next and how health insurance providers are adapting to the at-home health movement.

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.

Join this session to hear about a framework that supports continuous learning and innovation to ensure improved care for all. Attendees will learn how innovative solutions and collaboration across the health care ecosystem can transform quality measurement, value-based payment, and care delivery.

Health insurance providers can deliver digital health solutions without compromising the quality of care their members will receive. This session examines sequences of treatments for musculoskeletal pain, and how early, clinical-grade care can be delivered virtually through market-leading technology. The speaker will cite examples that show the breadth of measurable, positive outcomes that virtual solutions can provide.

Join this session to learn about the common care gaps that affect members with diabetes, and the tools available to close gaps across medication optimization, medication adherence, preventive screenings, lifestyle and comorbidity management, and blood glucose and blood pressure monitoring. Speakers will discuss how predictive analytics can be used to deliver appropriate services to members with diabetes according to their individual care needs.

This session will describe how one health insurance provider transformed its care management model into one that is community-anchored, member-centric, population-based, and clinically rigorous. Speakers will discuss how the model is positioned to understand local practitioners’ access, availability, and clinical style, as well as regional resources to address social determinants of health.

As insurtech continues to evolve, there are greater opportunities to close gaps in care, improve efficiencies, drive member engagement, and lower health care costs. The goal is to power effective medical cost management through consumer-centric experiences. Speakers in this session will provide perspectives on how to empower providers to deliver value-based care at scale.

Health insurance providers seek a modern, holistic approach to fraud detection, and want to improve the efficacy of cost containment operations. Artificial intelligence (AI) is being used to improve fraud, waste, abuse, and payment integrity programs for payers and deliver next-level outcomes. Speakers in this session will discuss best practices for creating an AI-driven, unified approach to cost containment, in order to improve access and transparency across the cost containment spectrum.

The session will examine the role of intelligent insights in providing whole person care. A holistic view into the unique needs of each person enables health insurance providers to anticipate a member’s needs, effectively mobilize care teams, and deliver the best support. Attendees will learn how combining clinical expertise with intelligent insights can deliver better health outcomes for members, reduce the total cost of care, improve consumer experience, and keep members at home.

Join this session to learn how the virtual primary care landscape has evolved, gaps in care it addresses, data-proven impacts to members and payers, and how it may form the future of virtual care. Speakers will discuss how one organization is innovating virtual primary care, and can navigate members through the care continuum with high-quality care that improves access, outcomes and affordability.

Health insurance providers are creating alliances and partnerships, as never before, to harness the power of innovation. Sometimes it is breakthrough or disruptive, but often it takes the form of a better or faster way of doing what only two companies can do together. Speakers in this session will examine what is driving the surge in alliances, and what makes them work, or not.

Creating visibility into your members’ utilization can help health insurance providers identify gaps in care and improve health outcomes. Automatic admission, discharge, and transfer (ADT) notifications can seamlessly flow to payer case management systems, so quality of care can be maintained. Join this session to learn how health insurance providers can use technology to improve provider-to-provider communication without increasing expense or workloads.

How can health insurance providers engage patients proactively and manage their health comprehensively, particularly when integrating mental health care? Join this session to learn the benefits of the data-driven care model that can positively impact outcomes, increase member engagement, and reduce costs. Speakers will provide actionable takeaways for health insurance providers seeking to offer members an integrated primary health model.

Health insurance providers are becoming more proactive in conducting outreach to their members. Speakers in this session will share how data-driven models can identify at-risk members, vulnerable populations, and underserved communities for additional programs and services. Attendees will also learn how data insights enabled outreach to encourage protection, prevention, and vaccine uptake in the fight against COVID-19.

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.

Maternal health has been proclaimed a national priority given the high cost of care and the poor clinical outcomes for women in the US. The current standard of maternal health care is primed for innovation. Join this session to hear from a top employer, renowned reproductive endocrinologist, and a technology leader in women’s and family health about a virtual-first care model that is delivering better health outcomes at every stage of the family-building journey.

This session will examine how alternative payment methods (APMs) can drive clinical integration of primary and specialty care to advance whole-person, person-centered care. Topics covered will include barriers to integrating specialty care into APMs; opportunities for expanding outcomes-based payments across the care continuum; and lessons learned from innovative payment and delivery models that leverage specialist participation.

Health insurance providers consistently seek ways to enhance the patient and provider experience and ensure that patients receive safe, clinically appropriate care. AHIP launched the Fast Prior Authorization Technology Highway (Fast PATH) to better understand how electronic prior authorization (ePA) processes could impact and improve prior authorization. Speakers will discuss the results of Fast PATH and explore the role ePA plays in making meaningful improvements to prior authorization.

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.