8:15 am
8:30 am

Hear firsthand about CMMI’s value-based initiatives and the best practices that are working in the current system.

  • Assess provider accountability, current innovative payment and delivery initiatives, and a greater focus on at-risk primary care models
  • Discuss where innovation is happening and how an organization can participate and speed the adoption of best practices
  • Examine the future of data sharing and collaboration across the care continuum
Sanjay Doddamani
Sanjay Doddamani, MD, MBA
Senior Physician Advisor, Center for Medicare and Medicaid Innovation (CMMI)
Centers for Medicare and Medicaid Services (invited)

10:00 am

Leading payer organizations lend insight into their goals for value-based contractual partnerships with providers and manufacturers.

  • Explore how payers perceive value and the quality and outcome metrics they want to incentivize for reimbursement
  • Hear examples of the successes and challenges faced as payers, providers, and manufacturers participate in more value-based contracts

Moderator:

John Doyle
John Doyle, PhD
Vice President, Global Healthcare Innovation Lead
PFIZER

Panelists:

Anthony Nguyen
Anthony Nguyen, MD
Senior Vice President, Population Health Management
UnitedHealthcare

William Shrank
William Shrank, MD, MSHS
Senior Vice President, Chief Medical Officer
Humana

11:00 am

Population health leaders from leading organizations engage in a revealing discussion on the challenges and issues they confronted while designing and implementing successful APMs.

  • Discuss favorable market conditions, partnership development, and collaboration strategies
  • Learn why a health system or medical group chose these models, including:
    • Medicare ACO
    • Medicare Advantage
    • Commercial shared-risk arrangements
    • Bundled/Episode-based payments
    • Direct-to-Employer contracting
  • Hear about challenges faced and steps to mitigate issues during implementation
  • Discuss what’s next for the evolution of chosen models

Moderator:

Amy Mullins
Amy Mullins, MD, CPE, FAAFP
Medical Director of Quality and Payment
American Academy of Family Physicians

Panelists:

Mark Gwynne
Mark Gwynne, DO
President and Executive Medical Director
UNC Health Alliance and UNC Senior Alliance

Derek Novak
Derek Novak, MBA
President, Population Health Services Organization
MercyOne (formerly Mercy ACO)

Devdutta Sangvai
Devdutta Sangvai, MD, MBA
Vice President, Population Health Management
Duke University Health System

12:00 pm
1:30 pm

Spreading infrastructure costs across a broader patient population and developing a unified, payer-agnostic approach to coordinated care ensures success with APMs.

  • Explore which value-based models you should pursue—What suits your organization and aligns with a heightened focus on accountability?
  • Discuss how you restructure your organization to increase enterprise efficiencies in a payer-agnostic approach to value-based care
    • Hear what different population health management frameworks (structure, processes, and technology) look like across organizations
  • Examine how to parlay experience with Medicare into improved relationships and value-based contracts with commercial payers
    • Are payers willing to collaborate and jointly develop a strategy to achieve targeted costs and quality goals?
    • Can agreement about effective communications be reached, i.e. sharing data in a relevant and timely way?

Moderator:

Nicole Bradberry
Nicole Bradberry
Chief Executive Officer and Chairman of the Board
Florida Association of ACOs (FLAACOs)

Panelists:

Dhyan D. Lal
Dhyan D. Lal
Division Vice President, Payer Strategy and Accountable Care, Pacific Northwest Division
CHI Franciscan Health

Christina Lewis
Christina Lewis, FACHE, MPH, RN
Executive Director
St. Luke’s Care Network

Frank Shipp
Frank Shipp, FACHE, MBA
Executive Director, Clinically Integrated Network & Population Health
Valley Health System

Maraya Thorland
Maraya Thorland, MPH
Vice President, Business Development & Performance Management
UNC Health Alliance

2:15 pm

It is important to estimate the financial effects of new initiatives and to be able to withstand potential losses in revenue and cash flow when an organization assumes two-sided risk.

  • Assess the risks and rewards of participating in an APM model to justify the investment and necessary changes to workflow
  • Discuss the strategic advantages to realize savings as a physician-led APM or a hospital-led APM and explore what factors determine success or failure in each of these areas:
    • Post-acute costs
    • Admissions
    • Avoided readmissions
  • Examine different organization’s risk financing strategy and why this strategy is used to fund losses
    • Explore risk-sharing arrangements with third parties who specialize in loss
Lawrence S. Green
Lawrence S. Green, AM, MBA
Director, Payer Strategy and ACO Operations
Affirmant Health Partners

Joseph Vasile
Joseph Vasile, MD, MBA
President and Chief Executive Officer
Greater Rochester Independent Practice Association (GRIPA)

3:00 pm

ESCOs are collectively effective at driving improvement and achieving savings for a complex, chronically-ill end-stage renal disease (ESRD) patient population.

  • Discuss the potential for specialized high-risk patient value-based models (e.g. ESRD)
  • Determine how experience in an ESCO can serve as a foundation to improve performance in other value-based models (i.e. ACOs)
  • Assess the care management strategies that drive clinical improvement and waste reduction
    • Why did these strategies work or not work?
  • Hear an ESCO share lessons learned to-date on shared savings and implications for other value-based programs
Nathan Lohmeyer
Nathan Lohmeyer
Vice President, Integrated Kidney Care and Government Programs
DaVita

4:15 pm

Pathways to Success is a new direction for the Medicare Shared Savings Program that redesigns participation options and encourages a faster move to performance-based risk.

  • Gain clarity and insight into regulatory changes and how the program has evolved
  • Understand factors to consider when deciding to continue with the program, to take downside risk and at what level, or to exit from the program
    • Weigh pros and cons of participating in the Basic Track and one of its levels, or in the Enhanced Track
  • Hear early adopters’ experiences and how they position themselves for success in the new model
    • Explore how participants are facing the next set of priorities and challenges
James M. Bock
James M. Bock, MD
Chief Medical Officer, HSHS ACO, LLC and Physician Clinical Integration Network, LLC;
Medical Director, HSHS Medical Group—Central Division

Kim Nunnally
Kim Nunnally
Director, Governmental Programs
Novant Health

5:00 pm

These roundtables provide an opportunity to discuss current challenges and opportunities for professionals engaged in value-based contracting and APMs. Attendees choose one of the below topics to address with peers led by a roundtable facilitator.

  • Bridge the Gap between FFS and PFV
  • ACO Pathways to Success
  • All other APMs (emerging models, PCMH, bundled/episode payments, payer/provider shared risk)

Facilitators:

James M. Bock
James M. Bock, MD
Chief Medical Officer, HSHS ACO, LLC and Physician Clinical Integration Network, LLC;
Medical Director, HSHS Medical Group—Central Division

Nicole Bradberry
Nicole Bradberry
Chief Executive Officer and Chairman of the Board
Florida Association of ACOs (FLAACOs)

Kim Nunnally
Kim Nunnally
Director, Governmental Programs
Novant Health

Tiffany Wandy
Tiffany Wandy
Executive Director, Clinically Integrated Network
LifeBridge Health