8:00 am
Anu Banerjee
Anu Banerjee, PhD, MS, MHM, FACHE
System Vice President, Chief Quality and Innovation Officer
Arnot Health

8:10 am
  • Gain insight as to where HHS is in the process of gathering information and rulemaking to reform regulations that may be impeding coordination among providers to deliver better, lower-cost patient care
  • Learn about efforts around the Stark Law, the Anti-Kickback Statute, 42 CFR Pt. 2, and HIPAA and potential changes to allow better coordination of care
  • Discover ways HHS is seeking to improve information sharing, allow new value-based entities to create value-based arrangements, define new safe harbors around EHRs, and address cybersecurity concerns
Eric D. Hargan
Eric D. Hargan
Deputy Secretary
Department of Health and Human Services

9:00 am

NQF assembled the support and leadership of nearly 100 health care organizations and experts to form the National Quality Task Force to create a report of national recommendations to improve alignment throughout the health care delivery system to achieve better health value and outcomes by 2030.

  • Learn about the Task Force committee’s makeup, representing multiple perspectives across providers, payers, patients, consumers, employers, and more
  • Explore key trends being addressed by the committees, such as the move to population health, new care delivery settings, how emerging technologies such as AI and virtual care are being implemented, and competencies to embrace care redesign and payment models that support keeping people well
  • Gain insight into what the Task Force has considered, what’s being weighed, and the direction of the report
  • Learn how your role in care coordination contributes to advance system-wide changes to drive alignment
Shantanu Agrawal
Shantanu Agrawal, MD, MPhil
President and Chief Executive Officer
National Quality Forum

9:45 am

A: Adapt Care Teams to Coordinated Care Models

  • Simplify the transition from acute case management to coordinated care
  • Identify the ideal personnel to aid care teams – from care navigators, to social workers, and others – to design more effective and efficient care coordination
  • Assess processes and patient outcomes to enable continuous improvement
Mary McLaughlin-Davis
Mary McLaughlin-Davis, DNP, ACNS-BC, NEA-BC, CCM
Senior Director, Care Management, Main Campus and Cleveland Clinic Akron General Hospital
Cleveland Clinic

Julianna S. Sellett
Julianna S. Sellett, DNP, MBA, RN, CPHQ, CENP
Vice President, Community Health Initiatives
Carle Health System

B. Build a Comprehensive Care Technology Framework to Promote Population Health Initiatives

  • Incorporate design thinking to promote ease of use
  • Build workflows to integrate technology with population health tools
  • Develop governance structure to promote seamless integration across the enterprise
  • Discover how technology can be used to track quality metrics and create performance dashboards to give real-time feedback to clinicians and ultimately improve provider engagement
  • Improve patient satisfaction by allowing primary care physicians and specialists access to each other’s chart, and hospitals and medical groups to share records so that care managers can coordinate care between departments
Priscilla Stilwell
Priscilla Stilwell
Executive Director, Population Health
Genesis Health System

C: Align Quality Reporting in Care Coordination to Optimize Contract Performance

  • Create strategies to develop viable, collaborative relationships with community partners
  • Design patient identification strategies to create payeragnostic care coordination and ensure that all patients have access to the highest possible standard of care
  • Explore strategies for quality reporting alignment and efficiency
  • Develop care coordination process and outcome dashboards
Katie Doyle
Katie Doyle, MS, RN
Director, Ambulatory Care Coordination
Northwestern Memorial Health Care

Kimberly Zukowski
Kimberly Zukowski, LMSW, CCM, LSSGB
Director of Care Coordination
Wellstar Cobb Hospital

11:15 am
Lauren Williams
Lauren Williams, MPH
Director of Population Health
AU Health System, Inc.

11:30 am
  • Explore successful approaches to gain leadership buy-in for community health and SDOH investments by communicating their value to outcomes and your organization
  • Create community partnerships to impact SDoH and prevent SDoH-related readmissions by strategically investing in resources for your community
  • Effectively advocate for and allocate funds to form and preserve community partnerships
Linda Dunbar
Linda Dunbar, PhD, RN
Vice President, Population Health
Johns Hopkins Health Care LLC

Mouhanad Hammami
Mouhanad Hammami, MD
Senior Vice President, Safety Net Transformation, Community Health and Well-Being
Trinity Health

Debra Hickman M. Div.
Rev. Debra Hickman M. Div.
President, CEO Population Health
Sisters Together and Reaching, Inc. (STAR)

12:10 pm
  • Learn how a multidisciplinary stakeholder group was convened to identify areas of opportunity to improve delivery of care coordination services.
  • Learn about the development of Johns Hopkins’ guiding principles for new care coordination framework.
  • Understand design and implementation of embedded care coordination model to improve care team function.
Arielle Alvaro
Arielle Alvaro, MHSA
Senior Program Administrator, Population Health
Johns Hopkins HealthCare, LLC

12:50 pm
2:00 pm
  • Learn how a model of applied population health management reduced readmissions by 28 and 34%, some of the lowest rates in the state, for Lifebridge Health’s two safety net hospitals
  • Use a data-driven approach to understand the root clinical and social drivers of readmissions, re-evaluate ‘avoidable’ vs. ‘unavoidable’ readmissions, and identify specific patient populations who can be most impacted by readmission analyses
  • Explore the impact of adequate nonclinical care coordination, in comparison to clinical gaps in care, on SDoH initiatives to reduce readmissions
  • Hear tried and true strategies to improve interdisciplinary community integration and data-driven resource management by promoting a culture shift from health care to health
Susan Mani
Susan Mani, MD, FACC
Vice President, Clinical Transformation and Ambulatory Quality
LifeBridge Health

2:40 pm
  • Engage external partners to assess community health needs and drive collective impact
  • Align community health needs with organizational strategy
  • Develop SDoH screening initiatives and a network of community partners to better meet patient’s non-medical needs
  • Utilize lay health workers to extend the health system’s reach in the community
Leslie Marshburn
Leslie Marshburn
Executive Director, Strategy and Population Health
Grady Health System

Shannon Sale
Shannon Sale
Chief Strategy Officer
Grady Health System

3:50 pm
  • Relate to gaps and barriers to transitions of care for Heart Failure Patients
  • Assess the impact of social determinants of health on adherence and readmissions
  • Discuss 7 key elements for improving transitions and care coordination for patients and their family caregivers
  • Evaluate the importance of quality improvement studies on improving transitions for patient populations with heart failure
Cheri Lattimer
Cheri Lattimer, RN, BSN
Executive Director
National Transitions of Care Coalition

4:30 pm
  • Understand the impact of new regulatory reform on interoperability and health information technology, particularly as they impact delivery of patient care
  • Ensure interoperable design is scalable and flexible enough to withstand heavy utilization across diverse users and needs
  • Promote more effective information sharing that can lead to data capture for complex population health initiatives
  • Discuss other regulatory reforms that may impact interoperability and coordinated care
Will Brady
Will Brady
Chief of Staff to the Deputy and Senior Advisor to the Secretary
Department of Health and Human Services