Presentation Theater Schedule

3:45 PM – 4:15 PM (dessert break) Artificial Intelligence and the Future of Data Quality
Presented by CAQH

The industry has acknowledged the need to improve the quality of information in health plan provider directories. Consumers expect current information about the providers in their networks, and providers want easier ways to share this information with health plans. Artificial intelligence (AI) has proven to be the next frontier in improving the quality and accuracy of provider directories. Join this session to learn how AI is being used to remedy data quality issues within provider directories, and the next steps the health care community must take to make this an industry-wide reality.

Hassaan Sohail, Manager, Product Innovation, CAQH
Transforming Diabetes through Life-Changing Technology
Presented by Abbott Diabetes Care

This session will provide a snapshot of how continuous glucose monitoring systems can improve the lives of people with diabetes. The speaker will discuss recent studies of how continuous glucose monitoring has improved health outcomes for diabetes patients, and the subsequent cost-savings impact on payer organizations. The speaker will also examine the shifting care for insulin-using patients under this life-changing technology, and how the management of diabetes will be transformed with continuous glucose monitoring systems.

Andrew Weis, PharmD, Manager, Medical Outcomes, Abbott Diabetes Care
5:55 PM – 6:25 PM (evening reception) Compassionate Communications: How Proactive Planning for Member Outreach Enables Rapid Response During a Crisis
Presented by HMS

Natural disasters, prescription recalls, and even public health crisis can threaten patient safety, access to care and medication adherence. To improve the member experience, health plans must proactively contact thousands of individuals and provide important information about access, benefits and coverage. Rapid response is essential, but can also be challenging. This session will focus on incorporating crisis management into member communication plans through innovative messaging and digital technologies. The speaker will offer best practices and lessons learned from recent natural disasters and prescription recalls, including key considerations specific to all member populations. In addition, attendees will learn how to improve brand perception and loyalty with proactive (and compassionate) engagement programs that prioritize member health and safety.

Ellen Harrison, RN, MBA, Vice President, Population Health Market Strategy and Consulting, HMS
Improving Care Management with Predictive Analytics, Social Determinant Data and CRM
Presented by Geneia

Research indicates social determinants of health (SDoH) – housing, transportation, financial security, loneliness and more – drive more than 80 percent of health outcomes. Increasingly, health insurance providers are seeking ways to scale their efforts to mitigate their members’ social determinant-related barriers to care. In this session, attendees will learn how nurse care members use an analytics platform to stratify chronically-ill members, identify and address their social determinants of health, and deliver more personalized care.

Molly Gallaher Boddy, Manager, Strategy Planning, Geneia
6:30 PM – 7:00 PM (evening reception) Augmented Intelligence: Analytics Redefined From Process to Insights
Presented by Genpact

Health plan leaders should work to redefine the role of analytics in their organizations, and move toward building prescriptive engines integrated into business processes. Join this session to learn how one health plan is innovating their analytics journey to drive augmented intelligence in chosen business functions.  Speakers in this session will share learnings from innovative approaches using augmented intelligence,  and how the new processes have enhanced the consumer’s experience.

Himanshu Arora, Chief Data and Analytics Officer, Blue Cross Blue Shield of Massachusetts

Amaresh Tripathy, Chief Analytics Officer, Genpact
Social Media Monitoring: A Holistic Approach to Combat Fraud, Waste and Abuse
Presented by CGI

As the health care industry continues to make significant investments in innovations to combat fraud, waste, and abuse, a health plan’s social media presence should not be overlooked. Social media is more than just an information-sharing platform; it has become a new marketplace and a massive data source. The ability to identify, detect, and scrub improper activities and imposter identities on social media — in real time and in conjunction with other solutions — could translate into saved reputations and costs. Join this session to learn about solutions that incorporate a social media protection service as a necessary safeguard to combat fraud and abuse.

David Ott, Senior Director, Consulting Services, CGI
8:00 AM – 8:30 AM (breakfast) MDG (AHIP) N/A
8:35 AM- 9:05 AM N/A A Framework for AI-Enabled Population Health
Presented by Cardinal Analytx Solutions

Proof points exist across industries on the power of artificial intelligence (AI) to transform operations and strategy, and the payer world is no different. In this session, attendees will dive deeply into the two major ways AI stands positioned to deliver value to health insurance providers: first, through linear improvements in traditional health plan functions like reserve setting and fraud prevention; and second, through geometric improvements in pairing predictions with targeted screenings and upstream clinical and social-determinant interventions.

Chris DeRienzo, MD, Chief Medical Officer, Cardinal Analytx Solutions
11:55 AM – 12:25 PM (lunch) Engaging the Modern Workforce: A New Focus on Total Well-Being
Presented by Fidelity Investments

The concept of Total Rewards made its debut in the 1990s, as a way for organizations to communicate the value of their compensation, benefits, and work/life programs. While the concept still resonates, today’s employees are looking for more than a transactional “give” and “get” relationship from their employer. Join this session to learn how a corporate focus on total well-being can create new opportunities to engage employees in ways that matter most to them.

Susan Pippin, Vice President, Fidelity Investments
Improving Coding, Billing and Payment of Genetic Tests
Presented by American Medical Association

Upwards of 75,000 genetic tests currently populate the market, with 10 new tests becoming available each day. Accompanying the exponential growth of precision medicine is an increase in instances of inappropriate coding of genetic tests, which can result in significant billing and payment burdens for physicians and their patients. In this session, the speaker will share common genetic testing billing/payment problems, outline an AMA solution pilot, and let attendees know how they can participate.

Peter Guinn, Director, Product Management, American Medical Association
12:30 PM – 1:00 PM (lunch) A Common Sense Approach to Condition-Focused Care Management
Presented by EnvisionRx

Speakers in this session will discuss the trends across various complex disease states, and how a common-sense approach to pharmacy benefit management can benefit both the health plan sponsor and the patient.

Christine Anderson, Vice President, Specialty Products, EnvisionRx

Kelley Riley, MD, Chief Medical Officer, EnvisionRx
Machine Learning to Improve Precision Delivery
Presented by HEALTH[at]SCALE

This session will provide an overview of emerging machine learning platforms that can be used to manage members through the health care continuum, with the goal of improving their outcomes and lowering the total costs of care. In this session, the speaker will focus on three key areas: precision navigation for matching patients to optimal providers; precision interception for identifying plan members who are most at risk for over-utilization of high-cost interventions; and a precision treatment platform that can identify patterns suggestive of fraud, waste, and abuse in relation to ordered diagnostic and therapeutic interventions. The session will conclude with a perspective from early adopters on how the operational use of these technologies in live deployments establishes significant potential to empower organizations managing healthcare risks and costs.

Zahoor Elahi, MS, Senior Vice President, Optum

Mohammed Saeed, MD, PhD, Chief Medical Officer, HEALTH[at]SCALE
5:45 PM – 6:15 PM (evening reception) Improving the Health Care Experience by Keeping it Simple
Presented by Accenture Health

This session will provide insights as to how health care complexities directly correlate to consumer dissatisfaction and lack of engagement, and what health plans can do to simplify the consumer experience. This session will also help attendees reimagine engagement strategies from the consumer’s perspective, with the goal of creating truly human experiences in the moments that matter, and to deal with the health plan’s readiness to change.

Loren McCaghy, Director, Consumer Engagement and Product Insight, Accenture Health

Jeff Willihnganz, Managing Director, Accenture Health
How to Optimize LTSS Management Using a Population Health Platform
Presented by ZeOmega

This session will explore the value and key features of a Long Term Services and Supports (LTSS) capability that is fully integrated within a population health management platform. Attendees will learn the benefits of accurate identification and risk stratification among LTSS participants, data integration and sharing, care coordination between multiple entities, LTSS provider network management, and automated processes. This session will also address the need for systems to support multiple services and providers – traditional and non-medical – in order to collect data from entities lacking robust information infrastructures.

Karen Iapoce, RN, MS, Senior Analyst, ZeOmega
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