Payer’s Summit on Clinical Integration

For those organizations thinking about or in the early stages of integration, this workshop explores considerations that lead to initial success when designing an integrated system. Content includes changes to structures, processes, and strategies centered on increased care coordination and delivery of care. Learn from systems that have established programs and integrated initiatives as to how best begin the path toward full integration.

• Explore the attributes to look for when identifying the best partners for your hospital, health system, plan, or medical group to better coordinate care
• Learn what steps are necessary to begin integration operations with payer or provider counterparts in terms of HIT to improve data sharing and care coordination
• Create interoperable EMR and claims data to improve transparency and care transitions
• Implement population health management systems to improve care coordination
• Understand how legislation and the current geopolitical environment is impacting physician alignment, care management, and population health abilities
• Discover solutions and financial incentives such as risk assumption or shared savings to improve physician alignment and engagement in any part of the country
• Improve outcomes and contain costs by integrating and aligning inpatient care with outpatient care teams and locations in terms of staff and clinical standards
• Define a care management strategy and assign a navigation team to better coordinate patient care

For those organizations already working in an integrated setting, this workshop focuses on strategies to improve risk assumption and adjustment to support more efficient, affordable, and quality care. In this comprehensive workshop, learn ways to further leverage the advantages of integration and additional opportunities afforded to organizations with this structure in place.

• Enhance network alignment through improved management of a large system of acute, primary care, and post-acute groups within the system
• Learn the challenges associated with risk assumption from a clinical, financial, and operational standpoint
• Identify steps and strategies to assume risk gradually in order to lessen losses while improving morale and clinical support
• Start with upside only programs such as shared savings to incur less potential loss
• Gradually adjust risk structures to include wider risk corridors and downside risk to create larger possible gains and better focus value
• Evaluate the adoption of a health plan or provider organization to manage assumed risk
• Hear how integrated systems are adjusting risk to better align incentives, gaming, and protect organizational interests
• Discover how to integrate risk adjustment programs system-wide for Medicare, Medicare Advantage, Marketplace, and Medicaid programs
• Outline the resources needed to integrate risk adjustment programs in terms of technology, staff, and information to better improve the adjustment process as well as health models and capitated payment programs