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Tuesday August 2, 2005
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7:00 am
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8:00 am
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8:15 am - 9:15 am
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Brent James M.D.
Executive Director
Institute for Health Care Delivery Research
Vice President, Medical Research and Continuing Medical Education
Intermountain Health Care
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9:15 am - 10:00 am
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This session will address:
- Challenges in implanting a pay-for-performance reimbursement model
- Physician buy-in is an important element of success: how to achieve it through a large provider network
- Application of evidence based medicine as the foundation of a pay-for-performance program
- Attribution of performance and pay-out algorithms
- How to provide physician actionable information
- From Annual Bonuses to changes in Fee Schedule
- Pay for performance and Disease Management: How to make them work together
In an effort to address the evidence gap among populations with less restricted coverage, a quality-based physician incentive program was implemented in a preferred provider organization (PPO) setting where responsibility for patient care is more likely to be shared between multiple physicians and bias from systematic interventions designed to improve care processes and outcomes, such as reminders, benefit coverage for screenings, and disease management programs, is less likely to occur. We examined the extent to which appropriate care, as determined by 11 quality indicators, is affected by providers who participate in the program compared to providers who choose not to participate. The results not only provide support for the use of quality physician incentive programs but also provide a means for achieving a higher level of quality care in these populations, given that PPOs are increasingly playing the role as the plan of choice in the U.S. |
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Antonio Legorreta M.D., MPH
Professor, Health Services
Research Department
UCLA School of Public Health
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10:00 am
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| 10:00 am - |
Comparing the Challenges and Strategies of Pay-for-Performance Contracting for Large and Small Health Plans |
| This session will contrast the challenges and opportunities in contracting with large and small plans considering factors of scale, volume and influence. |
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Charles D. Baker
President and CEO
Harvard Pilgrim Health Care, Inc.
 View Biography
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Jonathan Scheff MD
Senior Vice President and Chief Medical Officer
HealthNet Inc.
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| 10:45 am - |
A Case Study from Blue Cross of California — Beyond Pay-for-Performance: Results from 3 years of Data |
In this session you will:
- Acquire strategies to use quality data from pay-for-performance to improve healthcare of populations using quality data to build efficient and effective networks
- Discern the use of pay-for-performance data to improve quality of care through measurement of geographical and health disparities
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Jeff Kamil M.D.
Chief Medical Officer
Blue Cross of California
VP and Regional Medical Director
WellPoint Health Networks
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| 11:30 am - |
Networking Refreshment Break |
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Sponsored by:
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| 12:15 pm - |
Implementing Pay-for-Performance in Local PPO Markets |
This session will address:
- Proven strategies for community involvement, education, and collaboration
- Engagement of local players/stakeholders to create a cohesive structure and plan and make pay-for-performance a long-term viable strategy
- Washington and Utah markets as examples of effective pay-for-performance implementation
- Experiences from the physician recognition program developed by Regence
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Mark C. Rattray MD
National Medical Director
UnitedHealthcare
View Biography
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| 1:00 pm - |
Executive Luncheon with Moderated Roundtable Discussions |
| >> View Roundtable Discussion Group Topics |
| 2:15 pm - |
Real-World Experiences in Paying-for-Performance |
Thomson/Medstat will present its experience with pay-for-performance programs and share what it has learned from being the general contractor for Bridges to Excellence and what clients are currently doing "on the ground" around paying for performance in its four markets.
In this session you will:
- Design practical strategies from real life examples from Employers, Health Plans, Government and Providers
- Discover "what works" from administering the Bridges To Excellence Program
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David Schutt M.D.
Associate Medical Director
Thomson/Medstat
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10:00 am
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| 10:00 am - |
IT Implementation for the Physician Practice — Redesigning Structure and Cost |
In this session you will:
- Analyze how pay-for-performance has incentivized adoption of IT to support quality
- Consider the correlation between IT adoption and clinical results
- Establish learned from the nature of and type of technology adopted by participating physician organizations
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Tom Davies
Chairman, IHA Board of Directors
Integrated Healthcare Association
View Biography
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Tom Williams
President
Integrated Healthcare Association
View Biography
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| 10:45 am - |
A Case Study from Partners Health Care System: Lessons Learned from System-Wide IT Innovation for Quality Care |
In this session you will:
- Delve into the challenges of Partners’ implementation of computerized physician order entry (CPOE) systems for inpatient care and the implementation of electronic health records (EHRs) for outpatient care in a heterogeneous network
- Examine how pay-for-performance contracting can provide powerful incentives to deploy health care IT infrastructure, and how IT infrastructure is necessary to succeed in the next generation of pay-for-performance contracts
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Jeff Levin-Scherz M.D., MBA
Chief Medical Officer
Partners Healthcare
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| 11:30 am - |
Networking Refreshment Break |
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Sponsored by:
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| 12:15 pm - |
A Case Study from Geisinger Health System - 5+ Years of Data on Physician Engagement |
In this session you will:
- Examine how one plan created a sustainable successful pay-for-performance program while controlling costs and gaining physician stakeholder buy in
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Bruce Hamory M.D., FACP
Executive Vice President and Chief Medical Officer
Geisinger Health System
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| 1:00 pm - |
Executive Luncheon with Moderated Roundtable Discussions |
| >> View Roundtable Discussion Group Topics |
| 2:15 pm - |
Use of Data Warehouse Technology to Improve Clinical Quality |
In this session you will:
- Understand the rationale for developing a clinical data warehouse for the purposes of quality improvement and pay for performance
- Gain insight from the challenges faced in developing a high integrity clinical data warehouse
- Employ techniques to improve quality using a clinical data warehouse, including disease registries, point of care reminders and patient interventions
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Douglas Allen M.D., MMM
Chief Medical Officer
Greater Newport Physicians IPA
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3:00 pm
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4:45 pm
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5:00 pm
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