Risk, Care Management, and Engagement for New Members

  • July 30, 2020
  • 1:00 PM – 2:00 PM ET
  • online
about

The COVID-19 pandemic has caused a seismic shift to the economy and access to health care. As unemployment rates reach record highs, a staggering number of Americans are transitioning from employer-provided insurance to Medicare Advantage, Managed Medicaid plans, or the health care marketplace. Challenges with members knowing where and how to access routine and preventive care have only increased with the pandemic. Together, the result can be increased risk and cost to payers.

Quest Diagnostics supports risk identification efforts by helping health insurance providers gain a more comprehensive understanding of new member disease history prior to receiving the first claim. You will learn how access to new member lab history prior to their coverage can help health insurance providers act earlier, when outreach and intervention often have the most impact. In addition, you will learn about our Risk and Gap in Care capabilities that provide essential services in order to close HEDIS and Stars gaps, from telehealth to in-home, lab-based, self-administered testing to help members stay engaged and follow their normal routine of participating in these programs.

Attendees will learn:

  • Insights from laboratory data can help influence care management and risk analysis for new members
  • To identify ways to remove barriers to care with innovative access, engagement and service delivery methods
  • To improve key quality metrics and scores through the year

Speakers


L. Patrick James, M.D.
Chief Clinical Officer, Health Plans and Policy, Medical Affairs
Quest Diagnostics

L. Patrick James, MD, is the Chief Clinical Officer, Health Plans and Policy, at Quest Diagnostics. Prior to assuming this role in 2014, he served in other senior leadership roles within Quest including Sr Managing Director of the Kansas Business Unit. In his current role, Dr James works closely with Health Plans and National Accounts to drive collaborative engagement.

Before joining Quest Diagnostics, Dr. James served in LabOne as Executive Vice President for Pathology and Laboratory Services. He spent nine years with Health Midwest, a 14 hospital integrated delivery system in Kansas City as Medical Director of Hospital Integration which included oversight of the health systems service lines. Dr. James’ experience spans Research Medical Center, St. Joseph Hospital in Denver, Colorado, and National Naval Medical Center in Bethesda, Maryland where he held leadership positions in the clinical laboratory and oversight of quality assurance programs.


Matthew C. Cardoso
Sr. Director, Information Ventures
Quest Diagnostics

Matt Cardoso is Sr. Director, Product Solutions, Health Plans.  Matt has been with Quest Diagnostics Information Ventures franchise since 2016 and in this time, has made significant leadership contributions to both the Health Plan and Health Systems market development, portfolios, and programs.

Prior to joining Quest, Matt held a variety of leadership positions in product management, product strategy and strategic sales for leading population health, EHR, HIE vendors, and health care delivery networks.  Matt earned a B.S. in Biology and B.A. in Economics from UMass Amherst, as well as an M.B.A. and M.S. in Health Informatics from Northeastern University.


Shawn McGinnis
National Sales Director, Quest HealthConnect
Quest Diagnostics

Shawn McGinnis is the National Sales Director for Quest HealthConnect. In her role, she is responsible for leading a team focused on partnering with health plans to close gaps in care by providing solutions for their At-Risk members.

Shawn has more than twenty years’ experience working with Fortune 100/500 companies and start-up entities.  She has broad functional experience in areas of strategic planning, sales and marketing, market development, technology and data analytics, as well as extensive experience with international health care, commercial and senior segments, traditional & managed care plans, pharmacy, wellness, disease management, and ancillary products.

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