Opal Events - Medicare Advantage Strategic Business Symposium

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4th Annual Medicare Advantage Strategic Business Symposium:

Creating a 2012 Survival Strategy for Your Health Plan

September 2012

Arlington, VA

	VIEW CONFERENCE DETAILS
	(Agenda current as of 9-22-11)

2011 Attendees:

Doctor, Acuity Vision Care National Medical Director, Retiree Markets, Aetna Administrator, Albany Medical Center National Director of Quality, Alliance Healthcare Services Quality Improvement Support Specialist, Alliance Healthcare Services Director of Quality Improvement & Patient Safety, AltaMed Health Services Corp Director of Network Operations American Health Chief Operating Officer, American Health Alliance Vice President, American Health Lawyers Association Case Specialist, Amerigroup Director of Hospital Contracting, Amerigroup Doctor, Anne Arundel Medical Center Executive Director, Arch Health Partners Manejadora de Casos y Condiciones, Asociacion De Maestros De Puerto Rico Practice Administrator, Associated Pathologists, P.A. Director, BlueCross BlueShield of Florida Vice President, BlueCross BlueShield of Florida CFO, Bronx Lebanon Hospital Center Medical Director Care Integration, Carilion Clinic Medicare Resources Chief Executive Officer, Capital Area Pediatrics Chief Operating Officer, Capital Area Pediatrics Director of Billing Services, Capital Area Pediatrics Director Clinical Operations, Capital Area Pediatrics Director, Centene Corporation Interim Medicare CEO, Centene Corporation SVP, Centene Corporation Administrative Assistant, Children's Hospital Los Angeles Director, Clinical Quality, Cigna Medical Group CEO, CINA Director Operational Compliance, Coventry Health Care Senior Director, Coventry Health Care VP Medicare Quality, Coventry Health Care Policy Analyst, Congressional Research Service Senior Business Solutions Leader, Dean Health Plan Department of Health Administrator, Digestive Health Women Care Assistant General Counsel, Dimensions Healthcare Systems CEO, Fairfax Urology Center Compliance Director First Medical Compliance Coordinator, First Plus Chairwoman, Flushing Hospital Medical Center Independent Contractor, formerly Kaiser Foundation Physician, Franklin Square Hospital Center VP of Medicare Revenue Management, Freedom Health Inc. CEO, Gorman Health Group SVP, Gorman Health Group Director Managed Care, HCR ManorCare Senior Case Manager, HCR ManorCare Medical Billing Auditor, Henry Ford Health System Manager, Research Dept., Highmark BCBS Sr. Director of Revenue Cycle HIS, Howard University Hospital Administrative Fellow, Johns Hopkins Health SystemAdministrative Fellow, Johns Hopkins Health System Administrative Fellow, Johns Hopkins Health System Clinical Data Specialist, Kaiser Permanente		Regional Vice President of Business Development, Leprechaun Sr. Clinical Training Specialist, Leprechaun Vice President & Controller, MAPFRE Life Insurance Company Director Client Services, Matrix Medical Network EVP, Matrix Medical Network VP Sales, Matrix Medical Network SVP, Matrix Medical Network Clinical Case Manager Medstar Georgetown University Hospital Senior Health Services Scientist, MedStar Health Vice President, Medicare Products, Mercy Care Plan CEO, Mid Coastal IPA VP, Health Solutions, MyHealthDirect Senior Vice President, MunichRe Senior Consultant, National Research Network/DARTNet, American Academy of Family Physicians Physician, Omni Medical Group Physician, Optum Director, Corporate Program Development, Physicians United Plan RAC Coordinator, Corporate Responsibility, Providence Hospital VP-Managed Care & Outreach, Roswell Park Cancer Institute Director of Compliance, Rothman Institute Regional Executive Director, Secure Horizons President & CEO, Insurance Services, Seton HealthCare Family Revenue Cycle Manager, Shriners Hospital for Children Philadelphia Senior Vice President, Sales, Social Service Coordinators Vice President Operations/CEO, Specialty Hospital of Washington- Hadley VP Systems Management, Specialty Hospital of Washington Director, Sunovion Pharmaceuticals Director of Quality, Texas Health Physicians Group Student, Tulane School of Public Health Student, University of California, Irvine Chief Director, International Health Management, The University of Hong Kong Chief Business Development Officer, UPMC Health Plan SVP, Universal American Director Strategy & Support, UnitedHealthcare SVP and GM Client Services, URAC Senior Information Security Analyst, VCU Medical Center Director of Managed Care, Virginia Cancer Specialists Associate Director of Financial Planning, Visiting Nurse Service of New York Sr Account Executive, VSP CEO, Whittier Hospital Medical Center Chief Government Affairs Officer, XLHealth / Care Improvement Plus Director of Clinical Initiatives, XLHealth / Care Improvement Plus XLHealth / Care Improvement Plus Administrator, Yalobusha General Hospital Assistant Administrator, Yalobusha General Hospital


	Conference Day One, September 26, 2011

8:30a	Breakfast & Registration
9:25a	Opal Events Welcome & Introduction of Keynote Speaker
9:30a	Keynote Address: (with audience members from Medicaid CFO Forum) Overview of the Political Regulatory Environment in Washington... And How it Impacts You Campaign environment: What happens if budget issues dominate? How do we move forward with mitigating against un-due risk? Balanced billing issues: Role of care coordination Role of quality Speaker: SVP, UNIVERSAL AMERICAN FINANCIAL CORP.
10:30a	Networking & Refreshment Break
11:00a	Chair's Welcome & Audience Demographics Chair: Chief Government Affairs Officer, XLHEALTH / CARE IMPROVEMENT PLUS
11:15a	Managed Care 3.0 - Frontiers of Care Coordination by Payers and Providers P4P that works Technology that matters What ACOs can teach MA... and visa versa Speaker: CEO, GORMAN HEALTH GROUP
12:15p	Luncheon Combined lunch with participants and speakers from Medicaid CFO Forum
1:15p	Health Advocate Medicare Stars Platform: Driving Member Engagement to Maximize Reimbursement This talk will focus on Member engagement as the key to improving a plan's Medicare Stars levels. Motivating Medicare members to address their own health needs presents unique challenges and is not easy. Putting in place complementing services like paying for transportation, arranging for home monitoring and testing, and facilitating physician appointments builds success. Speaker: MD, Co-Founder, EVP, and Chief Medical Officer, HEALTH ADVOCATE, INC.
2:00p	Structuring Data to Maximize Interconnectivity, Collaboration and Efficiency for Patients, Providers and Plans Creating a standardized data platform that allows for the integration of clinical data with claims data to support PCMH and P4P programs - without breaking the Provider, the Plan, or the Bank! Using dynamic and robust clinical decision support tools as the backbone for quality improvement across the continuum of care Creating "Win-Win" partnerships: Patients - consistently-delivered, non-duplicative, quality-focused care; Providers - efficient process for completing the data “picture” necessary to becoming a PCMH; Plans - total cost of care savings through a data partnership model that aligns the goals of the Plan, the Provider, and the Patient Establishing a foundation for wide-scale CER to evaluate novel therapies, evolving guidelines; drug / device comparisons, workflow and behavior modifications resulting in clinically effective, cost efficient care Moderator: Sr. Consultant, AMERICAN ACADEMY OF FAMILY PHYSICIANS Panelists: Chief Clinical Officer, CINA CEO, CINA
2:45p	Star Ratings Spotlight, Part 1 Maximizing Your Star Rating Through Scheduling Connectivity Ensuring that members obtain the preventive services they need is essential to maximizing your Star Rating. Relying on members to schedule appointments themselves is hit or miss at best. Using the telephone to schedule appointments on their behalf is time consuming and inefficient. This session will explore how establishing web-based scheduling connectivity with providers in your network can lead to improvements in your Star Rating. Speaker: Vice President of Health Solutions, MYHEALTHDIRECT
3:30p	Networking & Refreshment Break
4:00p	Star Ratings Spotlight, Part 2 Getting Physician Buy-In Education tools Incentives Recognition Speaker: VP, Quality Improvement, PRECISION HEALTHCARE SYSTEMS
4:45p	ACO Spotlight: A Health Plan's Perspective on ACO Implementation Speaker: National Medical Director, Retiree Markets, AETNA
5:30p	Cocktail Reception Combined reception with participants and speakers from Medicaid CFO Forum

Conference Day Two, September 27, 2011

8:00a	Breakfast
8:50a	Chair's Welcome & Day One Re-Cap
9:00a	Pay for Performance Provider Panel
9:00a	The Importance of Being Educated: How Risk Adjustment Training Can Optimize Revenue The benefits of comprehensive training to all members of the team Key aspects of documentation that can make a difference The overall impact of education to the "bottom line" Speaker: Sr. Clinical Training Specialist, LEPRECHAUN
9:45a	SNP Status and Outlook: Quality Oversight, Care Management, and Payment Speaker: Chief Government Affairs Officer, XLHEALTH / CARE IMPROVEMENT PLUS
10:30a	Networking & Refreshment Break Hotel Check-Out
11:00a	Prospective Assessments: Emerging Opportunities to Create Value Speaker: Senior Vice President, MATRIX MEDICAL NETWORK
11:45a	Luncheon

12:45p

HCC Spotlight:
Coding Hot Button: Diabetes & Manifestations

Speaker:
Medical Billing Auditor, HENRY FORD HEALTH SYSTEM

1:30p

Networking & Refreshment Break

1:45p

Best Practices for Reducing Hospital Readmissions for High-Risk Populations

Participants learn and be able to:

State key components and benefits of the following proven Re- admission prevention strategies:
- Eric Coleman's model
- Boost
- Project RED (Re-Engineering Discharges)
- Define the key interventions/strategies related to lower re-admission rates
- Learn how to risk stratify admissions to appropriately deliver higher cost interventions to a sub-set of all admissions.
- Understand how to implement a Re-admission prevention program

Speaker:
INDEPENDENT CONTRACTOR, formerly Director of Case Management, Kaiser Foundation

2:30p

Transforming Practices into Patient Centered Health Care Homes

Understand the basics of the health care home
Identify how to transform any practice, regardless of size, environment or technological level
Learn about auditing of practices and options for recognition

Speaker:
SVP, General Manager of Client Services, and Chief Accreditation Officer, URAC

3:15p

Conference Adjourns

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