May 3, 2021 • 12:30 PM - 1:30 PM ET

For many providers, the pandemic spurred the move to value-based reimbursement arrangements with health plans, as they recognized the shortcomings of the fee-for-service model and benefits that moving into risk-based contracts could offer them. Yet, while there is more willingness, many providers still admit they are unprepared to take on risk.

During this discussion, hear how health plans are helping their providers transition gradually into value-based care models by meeting them where they are in their journey.

• Discuss how plans and providers can work together on focused solutions that address immediate needs, early wins and ROI, and alignment on value-based and clinical goals
• Highlight new value-based programs or initiatives developed during the pandemic, including those focused on primary care
• Walk through common challenges plans face (and solutions to overcome them) when working with their provider partners on value-based care arrangements
• Examine ways to provide more insight into pandemic deferred care and how to help providers find and prioritize those patients

Webinar Speaker

Karen Amezcua
Senior Director, Provider Partnerships
Blue Cross Blue Shield of Minnesota

Lori Logan
Chief Product and Client Officer
Geneia

Oraida Roman, MHA
Vice President, Value Based Strategies
Humana

Brian Wheeler
Vice President, Provider Collaboration and Network Transformation
CareFirst BlueCross BlueShield

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Karen Amezcua

Karen Amezcua Senior Director, Provider Partnerships Blue Cross Blue Shield of Minnesota

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Karen Amezcua is the Senior Director of Provider Partnerships at Blue Cross and Blue Shield of Minnesota where she oversees the overall management of statewide provider relationships including strategic partnerships, payment arrangements and value-based and innovative contracting for both commercial and government markets. Ms. Amezcua assisted in the development and rollout of new value-based payment methodologies including total cost of care and quality incentives. Karen has almost 20 years’ experience in health care with time spent on the care delivery side where she held positions in Payer Contracting, Quality Improvement and most recently was the Senior Director of Accountable Care. Ms. Amezcua earned her B.A. in Philosophy from the Metropolitan State University.

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Lori Logan

Lori Logan Chief Product and Client Officer Geneia

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Oraida Roman

Oraida Roman, MHA Vice President, Value Based Strategies Humana

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Oraida Roman, MHA, is Vice President of Value Based Strategies for Humana, leading the organizational advancement of innovative payment models that enable Humana to support providers as population health managers in value-based care relationships. The Value Based Strategies organization develops, supports and deploys the best programs, practices and capabilities that assist Humana’s provider partners and internal customers to successfully achieve enterprise value based goals. Roman’s career with Humana spans more than 18 years, holding various management roles, including Regional President, Director of Operations, and Director of Provider Contracting. Prior to being Vice President for Humana, Roman worked for several years with DaVita Medical Group as the Chief Operating Officer of Florida and Market President of Colorado. Roman holds a Master’s in Health Administration from University of South Florida and an undergraduate degree in Biology from Florida State University.

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Brian Wheeler

Brian Wheeler Vice President, Provider Collaboration and Network Transformation CareFirst BlueCross BlueShield

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Brian Wheeler is responsible for leading the overall provider and network-related business functions, which includes the Practice and Payment Transformation Group, as well as Provider Contracting and Network Strategy, Network Operations, and Provider Relations and Engagement for CareFirst BlueCross BlueShield. In this role, he is responsible for leading CareFirst’s five-year transition from “Volume to Value.” He is supported in this effort by a team of experts in value- based payment models, practice transformation, data analytics, contracting strategists, and provider-relationship collaborators, dedicated to making healthcare more affordable and accessible for the communities CareFirst serves. He gained experience in various areas of the healthcare sector for over 20 years, working in in various management roles, ranging from small provider organizations to start-ups to a multi-national Fortune 500 company.

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Sponsored By:

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Geneia

Geneia is a healthcare analytics and services company. We work to improve collaboration between healthcare organizations to better support personalized, patient-centered care. Through advanced technology, education and training, insights and clinical services, we help clients better identify and actively manage risk, improve quality measurement and outcomes, and strengthen revenue. Rooted in deep clinical experience and leading-edge data science, our client-centric, phased approach to population health simplifies the transition to risk and value-based care. We are located in Harrisburg, PA and Manchester, NH. To learn more, visit Geneia.com (https://www.geneia.com) or connect with us on Facebook, Twitter and LinkedIn.

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