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

1:30 pm

Patient attribution and data sharing between payers and providers within value-based contracts are keys to long-term success. Evaluate how payers can assess potential participants and their role in setting providers up for success.

  • Improve the credentialing process to support value-based contracts and analyze available data to project financial impact and measure performance
  • Discuss how payers can help providers develop the infrastructure needed to enhance patient attribution and data-sharing
Jeffrey Park
Jeffrey Park
Senior Director, Value-Based Programs
Gateway 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

Chuck Levine
Chuck Levine
Vice President, Provider Network Management and Solutions
Premera Blue Cross of Washington and Alaska

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:

Brian Donovan
Brian Donovan
Vice President, Network Management
Health Partners Plans

Panelists:

Michael Hamilton
Michael Hamilton
Associate Vice President, Contracting
Cigna Medicare Advantage

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