Transcript

Payer and Risk Owner Track Organizers

Jonathan Blum, EVP, CareFist and Former Principal Deputy Administrator, CMS

Joshua Rosenthal, PhD, RowdMap Inc. and NCHVS Data Group

Paul Wallace, MD, AcademyHealth Senior Scholar in Residence

OWNINGRISKISTOUGH,BUTIT’SWHERETHEACTION’SAT

Onceuponatimeplanshad large groupcommercial populationswithyearsofconsistencyandproviders simplydelivered services forafee. Butgovernment programs likeMedicareAdvantage, Marketplace /Exchange andMedicaid, havepopulationschangingevery year, orevenevery monthandprovidersmanaging apopulation'shealthover time.

Changingpopulationsanddynamicpayment modelsmay make it toughtopredictandachievemember outcomes ina financially sustainableway preciselywhenprovidersare getting inthegame totake onrisk.

Publichealthdataareprovidingsolidcasestudiesofachieving member healthandhappinesswithsustainable financialmodels forallplayers inthisnewgame.

Ifyouare managing risk,considering takingonrisk,orinvesting inorprovidingproductsorservices toanyonebearing risk, campoutinthesesessionstolearnhowtousepublicdataandinternal resourcesto:

§ Effectively leverageanalyticapproachestomanagerisk

§ Accuratelyassessrisksandprojectcosts

§ Effectively alignprovidersandincentivizecaredelivery

7 SESSIONS DEDICATED TOTHEVALUE PUBLICDATABRINGS PAYERS ANDRISK OWNERS BY:

1.OptimizingPopulationHealthandContainingCosts

2.DesigningandCuratingaPay-for-ValueReadyNetwork

3.FacilitatingPayerandProviderPartnershipsforNewCareDelivery

4.CoordinatingCareandSharingRiskbetweenHealthPlans,StatesandCMS

5.ProjectingandManagingCosts,RiskandDiseaseBurden

6.AligningStrategyandDeliverywithMemberOutcomesandExperience

7.TransformingDeliverySystems,MeasurementandPaymentModels

Chair & Vice Chair

Kavita Patel, MD, Brookings Institute and Former Director of Policy, The White House

Niall Brennan, Chief Data Officer, CMS

“Thevaluepropositionsforpublicdataeitherdisintermediateorinnovateowningrisk– eitherwaytheycan’tbeignored.”

1. FINDING UNTAPPED VALUE THROUGH SHARINGANDUSEOFMULTI-SECTOR DATA

ValueProposition: Optimizing Population Health and Containing Costs

Moderator: Peter Eckart,Illinois Public HealthInstitute; Alison Rein, AcademyHealth

Panelists: CraigBrammer, HealthBridge; NikkiOlson, Center for Outcomes Research and Education; BrenManaugh, The Center forHealthCare Services; Chief J.ScottThomson, Camden County Police Department

2.CREATING AVIRTUOUS CYCLE: DESIGNING NETWORKS TOMITIGATE NO-VALUE CAREFROMFEEFORSERVICE ANDCREATE VALUE-BASEDWINS FORBOTH PAYERSAND PROVIDERSUSING CMS BENCHMARK DATA

ValueProposition: Designing andCurating aPay-for-Value ReadyNetwork

Moderator: Joshua Rosenthal, RowdMap

Panelists: Jonathan Blum, CareFirstBlue Cross BlueShield; Sachin Jain,CareMore; SteveOndra, Health CareServiceCorporation

3.BANKING ONDISRUPTION: NEWDELIVERYMODELS ASCOMPETITIVE ADVANTAGE INAPAY FORVALUEWORLD

ValueProposition: FacilitatingPayerandProvider Partnerships forNew CareDelivery

Moderator:Maureen Sullivan, BCBS

Panelists: Lynn Banaszak Brusco, Disruptive HealthTechnology Institute, CarnegieMellon University; JonathanMathieu, CenterforImproving ValueinHealth Care;EricArmbrecht, Midewest HealthInitiative;ElizabethMitchell, Network forRegional HealthcareImprovement; Farzad Mostashari, Aledade, Inc.

4.HOW STATESANDOTHERSAREUSING MEDICAREDATATOMANAGE POPULATIONS

ValueProposition: Coordinating CareandSharing RiskbetweenHealth Plans, StatesandCMS

Moderator: Sharon Donovan, Centers forMedicare &Medicaid Services

Panelists: Mylia Christensen, Oregon HealthCareQuality Corporation; DorisLotz, NewHampshire Department of Healthand HumanServices; PatriciaMurphy, Illinois Department ofHealthcare and FamilyServices

5.SOCIAL DETERMINANTS ANDWHAT TODOWITH THEM: IMPROVING COST PROJECTIONS ANDNAILING RESOURCE ALLOCATION

ValueProposition: Projecting andManagingCosts, Risk andDisease Burden

Moderator: DianneMunevar, Avalere Health(Moderator)

Panelists: JimSorace, USDepartment ofHealth and Human Services; SandeepWadhwa, Noridian Healthcare Solutions; EricWilliams,Omada Health;Gui Woolston, NunaHealth

6.FROMPOLICY TOWAREHOUSE TOBEDSIDE: USING PUBLIC AND PRIVATE DATA TO IMPROVE TRIPLE AIMGOALS

ValueProposition: AligningStrategyandDeliverywithMemberOutcomes and Experience

Moderator: PaulWallace, AcademyHealth

Panelists: Paul Bleicher, Optum Labs; Helen Burstin, TheNational QualityForum; KateGoodrich, Centers forMedicare&MedicaidServices

7.HOW STATESAREUSINGNEWDATA SOURCES FORSYSTEMS TRANSFORMATION

ValueProposition: Transforming DeliverySystems,Measurement and PaymentModels

Moderator: Rachel Block,MilbankMemorial Fund

Panelists: DavidMancuso, Washington StateDepartment of Social andHealth Services;Áron Boros,Massachusetts Centerfor HealthInformation andAnalysis; Richard Shonk, HealthBridge


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