8:15 am
Jeff Henderson
Jeff Henderson
Vice President, Head of Market Access and Government Affairs
Sobi

8:30 am

Calling all health care stakeholders. Join us to hear a firsthand account of CMMI’s current initiatives, future program directions, and the role NQF is playing to ensure that performance measurement lives up to its potential to help organizations achieve the Quadruple Aim in the ever-changing, value-based landscape. Examples of where innovation is happening and lessons learned will be shared from both perspectives. Learn practical considerations that will help you spur the changes you need in multi-payer, value-based arrangements.

Shantanu Agrawal
Shantanu Agrawal, MD, MPhil
President and Chief Executive Officer
National Quality Forum

Sanjay Doddamani
Sanjay Doddamani, MD, MBA
Senior Advisor and Medical Officer
Center for Medicare and Medicaid Innovation, Centers for Medicare and Medicaid Services

Moderator:

Ceci Connolly
Ceci Connolly
President and Chief Executive Officer
Alliance of Community Health Plans (ACHP)

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:

Kathryn L. Lueken
Kathryn L. Lueken, MD, MMM, CPE
Associate Vice President, Market/Industry Insights, Chief Medical Organization
Humana

Alefiyah Mesiwala
Alefiyah Mesiwala, MD, MPH
Senior Medical Director, Value-based Care and Innovation
UPMC Health Plan

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

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, Quality and Payment
American Academy of Family Physicians

Panelists:

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

Gerald Rupp
Gerald Rupp, PhD
Chief Innovation Officer
Fusion5

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

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

12:00 pm
1:15 pm
Alefiyah Mesiwala
Alefiyah Mesiwala, MD, MPH
Senior Medical Director, Value-based Care and Innovation
UPMC Health Plan

1:30 pm

Severely ill Medicare Advantage patients are unable to travel for regular checkups. Without regular primary care, health care organizations run the risk of poorer outcomes and admissions. By determining the beneficiaries who can benefit from primary care at home, patients can receive the care they need where they are comfortable and health care organizations can limit costs.

  • Examine how health systems can grow a primary care-at home capability organically
  • Discuss how to best incorporate and negotiate primary care-at-home into MA plan design
Clive Fields
Clive Fields, MD
President, VillageMD Houston ACO;
Chief Medical Officer, VillageMD

Gary Jacobs
Gary Jacobs
President, Village@Home
VillageMD

Neil Wagle
Neil Wagle, MD, MBA
Chief Medical Officer
Devoted Health

2:15 pm

Health care providers and health plans share the same goal of lowering costs and improving care. However, challenges around streamlining quality measurement metrics and data-sharing platforms prevents them from tracking quality and outcomes in a meaningful way.

  • Learn how leading providers and private payers are partnering to establish benchmarks, metrics for success, and promote data transparency
  • Avoid duplication of care from providers and payers to develop a cost-saving network
Michele Fisher
Michele Fisher, MBA, FACHE, FACMPE, CSMC, CHFP
Chief Contracting and Payer Relations Officer
UW Medicine Health System

Emily Rose
Emily Rose
Manager, Provider Network Management & Strategic Initiatives
Premera Blue Cross

3:00 pm

Although risk models in value-based arrangements can empower caregivers to be more accountable for the care provided, the ability to monitor performance and exchange data are hindering the implementation of risk-bearing contracts.

  • Explore new models that meet risk thresholds and migrate existing models to include risk assumption
  • Discuss ways payers collaborate with providers to track patients throughout their care journey and improve value-based contracting goals
  • Collaborate with providers to promote data transparency and data-sharing, and integrate processes to drive decision making
  • Create cooperative strategies to monitor performance in terms of quality and cost, and effectively utilize data to identify and stratify individuals in value-based contracts

Moderator:

Gary Jacobs
Gary Jacobs
President, Village@Home
VillageMD

Panelists:

Harvey Littman
Harvey Littman
Senior Vice President, Chief Financial Officer and Treasurer Capital Blue Cross

Drew Sheinen
Drew Sheinen
Senior Director, Value-Based Solutions
Aetna

4:15 pm

Interoperability has long been a priority for policymakers looking to leverage EHR data to move forward value-based care. Discuss how recent HHS rules intend to advance value-based care and how it will impact stakeholders throughout the continuum of care.

  • Uncover key takeaways of the rules and how they affect patients, providers, and plans
  • Assess the impact of information blocking practices on value-based contracting
Danielle Lloyd
Danielle Lloyd
Senior Vice President, Private Market Innovations and Quality Initiatives
America’s Health Insurance Plans (AHIP)

5:00 pm

With the evolution of bundled payment programs, commercial insurers have further delved into specialty bundles that can have positive clinical and financial impacts. Explore commercial specialty bundles being adopted and different approaches used to manage these bundles.

  • Define the focus and duration of specialty bundles and how to attribute costs and services
  • Optimize risk stratification within specialty bundles and analyze how to profile and incentivize physicians in these types of bundles
Oraida Roman
Oraida Roman, MHA
Vice President, Value Based Strategies
Humana