Picture of Medicare Chronic Care: A Payer/Provider Complete Guide to Improving Care & Cutting Costs

Medicare Chronic Care: A Payer/Provider Complete Guide to Improving Care & Cutting Costs


Insurance Exchanges, Meaningful Use, ACOs, PCMHs, Star Ratings, HCC & P4P
August 5-7, 2013
Hyatt Regency Orange County
Garden Grove, CA

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Conference Details
The latest in our 'collaborative care' line-up, our annual Anaheim conference is the only conference to expose Medicare Shared Savings success stories: Clinical integration models, strategies for controlling costs & boosting quality!

With over 200 attendees at our launch event, our Medicare Chronic Care Summit has established itself as one of the premier Medical Management conferences. Our 2013 program will continue to provide the "next generation" medical management tactics that Health Plans, Hospitals and Physician Group's require in the current economic climate.

As the chronically ill make up more of the Medicare Advantage population, hospital readmissions have become a signAificant financial challenge. Plans must have a medical management strategy that is grounded in:
  • Evidence-based clinical practices
  • Predictive outcomes modeling
  • Member engagement
  • Multi-disciplinary professional collaboration
Our event will discuss:
  • Accountable Care Organizations
  • Medical Homes
  • Transitional Care
  • And more!
Some of the Key Topics to be Covered:
  • Designing patient-centric strategies
  • Initiating provider communication
  • Strategies for changing reimbursement methodologies to better align incentives around primary care & chronic disease management
  • Transitioning to Medical Homes and ACOs

Who Will Attend:
This unique event has been researched and developed specifically for executives from Health Insurance firms, IPA Physician Groups, Hospitals and Community Hospitals.

Chief Medical Officers, Chief Clinical Officers and Medical Directors.

Also, Vice Presidents, Directors, and Managers of:
  • Care Management
  • Utilization Management
  • Chief Actuaries
  • Inpatient Nurse
  • Observation Management
  • Disease Management
  • Quality Management
  • Case Management
  • Quality Improvement
  • Outreach Management
  • Care Coordination
  • Clinical Program Management
  • Medical Management
  • Health Promotion
  • Wellness
  • Compliance
  • Clinical Research
  • Medical Affairs
  • Health Economics
  • Patient Engagement
  • Network Contracting
  • Network Management
  • Provider Relations
Audience Demographics:
Hotel Info:
Hyatt Regency Orange County
11999 Harbor Blvd.,
Garden Grove, CA 92840
Tel: 714-750-1234

We are pleased to announce that the Opal room block is open and we are accepting reservations. Please click on the ONLINE HOTEL RESERVATION link to book your room. The hotel will not accept individual call-ins.

Online Hotel Reservation
  • Rooms are available only to those participants who are registered conference attendees.
  • Rooms will not be guaranteed without a credit card.
  • Rooms are allocated on a first come first serve basis. Room types/rates are subject to availability.
  • The name on the form will be the name of the guest room.
Conference Registration Prices:
Earlybird Rate
Standard Rate
Medicare/Medicare Advantage/Medicaid Health Plans*, Physician Group, Hospital, Government Employees
Complimentary
$995
Behavioral Health, Vision Plans, Dental Plans, Radiology, Vascular Access, Rehabilitation Services, Diagnostic Laboratory Testing Services
$995
Service Providers
$1895
Register Now!
Group Discounts:
Register 3 people and receive 10% off ***
Register 4 people and receive 15% off ***
Register 5 people or more and receive 20% off ***

If you'd like to be invoiced, please submit your contact details on the registration page and select "Please invoice me" at the bottom of the page.

If you are interested in sponsorship, exhibiting, or speaking opportunities, please call 212-532-9898 or email information@opalevents.org
* TERMS & CONDITIONS
Subject to approval. To qualify you must be currently employed by a non-vendor company. Eligibility will be verified by conference producer. Opal reserves the right to allocate places and to refuse applications.

* Health plans must be CMS approved as Medicare, Medicare Advantage or Medicaid health plans

***Registrations must be made online on the same date. Discount will be applied after all registrants have been received.


Registration price reflects $100 online discount
Gold Sponsors:
Health IntegratedPWC
Silver Sponsor:
Home Instead Senior CareWalgreens
Exhibitor Sponsor:
Practice IQ
Media Partners:
Advantar LaboratoriesKong Push Medical News Today PharmaPhorum
2013 Attendees & Agenda
Care/Case/Management Director, ACCESS HEALTH CARE PHYSICIANS, LLC
Chief Compliance Officer, ACCESS HEALTH CARE PHYSICIANS, LLC
Medical Director, ACCESS HEALTH CARE PHYSICIANS, LLC
CEO, ACCESS HEALTH CARE PHYSICIANS, LLC
Medical Director, ACCESS HEALTH CARE PHYSICIANS, LLC
Case Management Supervisor, ALTAMED HEALTH SERVICES
HCC Coder/Auditor/Educator, ARCH HEALTH PARTNERS
Director IT, Projects Delivery, APRIA HEALTHCARE
Director of Patient Care, BELLA VIDA HOSPICE
Chief Administrative Officer, BELLA VIDA HOSPICE
Director of Patient Care, BELLA VIDA HOSPICE
Chief Operating Officer, BELLA VIDA HOSPICE
Administrator, BELLA VIDA HOSPICE
MD, BELLEVUE BONE & JOINT PHYSICIANS
Director, BLUE CROSS BLUE SHIELD OF TENNESSEE
Manager, Case Management, BLUE CROSS BLUE SHIELD OF TENNESSEE
Medical Director, BLUE CROSS BLUE SHIELD OF TENNESSEE
Manager, Medicare Advantage UM/CM, BLUE CROSS BLUE SHIELD OF TENNESSEE
VP, Government Affairs, CALIFORNIA ASSOCIATION OF PHYSICIAN GROUPS
Executive Faculty, CALIFORNIA STATE UNIVERSITY, DEPT. HCA
Director of UM/CM, CENTRAL HEALTH PLAN
Sr. Compliance Counsel, CENTRAL HEALTH PLAN OF CA
QM Director, CENTRAL HEALTH PLAN OF CA
Executive Vice President, CENTRAL MASS. INDEPENDENT PHYSICIAN ASSOCIATES
Project Director, CHOC CHILDREN’S
Clinical Program Manager, CIGNA MEDICAL GROUP
QM Manager, CITIZENS CHOICE HEALTHPLAN HMO
Contract Performance Monitor, Government Programs, COLORADO DEPT. OF HEALTH CARE POLICY & FINANCING
Quality Program Coordinator, EASY CHOICE HEALTH PLAN
QI/CM Manager, EASY CHOICE HEALTH PLAN
IPA Administrator, FAMILY CARE SPECIALIST IPA
Accounts Receivable Manager, FAMILY HEALTH CENTERS OF SAN DIEGO
Manager, FAMILY PHYSICIANS GROUP
CEO, FOUNDATION FOR POSITIVELY KIDS
CEO, GLENNER MEMORY CENTER
Senior Vice President, GORMAN HEALTH GROUP, LLC
Vice President, GORMAN HEALTH GROUP, LLC
Vice President, Operation, HARDEN HEALTHCARE
Vice President, Finance, HARDEN HEALTHCARE
Vice President of Clinical Services, GORMAN HEALTH GROUP, LLC
Chief Medical Officer, Government Programs, HEALTH CARE SERVICES CORPORATION
Chief Medical Officer, HEALTH INTEGRATED
Director, QI Medicare, HEALTH NET
Program Manager SNP, HEALTH NET
Senior QI Specialist, HEALTH NET
Senior Quality Improvement Specialist, HEALTH NET
Director, QI, HEALTH NET
QI Manager, Medicare, HEALTH NET
Health Care Analysis, Medicare, HEALTH NET
Senior QI Specialist, HEALTH NET
Director, Health Services, HEALTH PLAN OF SAN MATEO
Front Line Lead Quality Nurse, HUMANA
Delegation Compliance Manager, HUMANA
Medical Director, HUMANA
Director, Quality-STARs/HEDIS, HUMANA
Senior Medical Director in Care Management/Quality Improvement, INLAND EMPIRE HEALTH PLAN
Director of Care Management, INLAND EMPIRE HEALTH PLAN
Medical Services Executive Director, INLAND EMPIRE HEALTH PLAN
Care Management Manager, INLAND EMPIRE HEALTH PLAN
Senior Director, Medical Management, L.A. HEALTH PLAN
Senior Biostatician, L.A. HEALTH PLAN
UM/CM Specialist, L.A. HEALTH PLAN
CM Director, L.A. HEALTH PLAN
Regional Officer Manager, LAS VEGAS SKIN & CANCER CLINICS
Senior Vice President, MENTAL HEALTH SYSTEMS
Senior Vice President, MENTAL HEALTH SYSTEMS
Medical Director, Healthcare Business, NATIONAL NAVAL MEDICAL CENTER, INTERNAL MEDICINE
Captain, NATIONAL NAVAL MEDICAL CENTER, INTERNAL MEDICINE
Senior Director of Care Management, NORTH TEXAS SPECIALTY PHYSICIANS
Business/Program Management, PALOMAR HEALTH
Vice President, Operations, PARADIGN HEALTH
CEO, PRECISION HEALTHCARE SYSTEM
Medical Director, RIVERSIDE PHYSICIAN NETWORK
Care Manager, RIVERSIDE PHYSICIAN NETWORK
VP, Medical Director, SCAN HEALTH PLAN
Medical Management Program Specialist, SCAN HEALTH PLAN
Director, Education and Training, SCAN HEALTH PLAN
Director, Complex Care Management, SCAN HEALTH PLAN
Health Education Specialist, SCAN HEALTH PLAN
Practice Administrator, SC INTERNAL MEDICINE ASSOCIATES AND REHABILITATION, LLC
Managing Partner, SC INTERNAL MEDICINE ASSOCIATES AND REHABILITATION, LLC
Managing Partner, SC INTERNAL MEDICINE ASSOCIATES AND REHABILITATION, LLC
Assistant Practice Administrator, SC INTERNAL MEDICINE ASSOCIATES AND REHABILITATION, LLC
Program Director, SENIOR HEALTH INSURANCE ASSISTANCE PROGRAM
Manager Network Development/Provider Support, SHARP HEALTH PLAN
Network Development/Provider Support, SHARP HEALTH PLAN
Director of Coding Services, ST. JOSEPH HERITAGE HEALTH
Certified Coder, ST. JOSEPH HERITAGE HEALTH
Director, TEXAS DEPARTMENT OF INSURANCE
Program Specialist, TEXAS DEPARTMENT OF INSURANCE
Psychologist, THE LANDING OF NEWPORT BEACH
Psychologist, THE LANDING OF NEWPORT BEACH
Psychologist, THE LANDING OF NEWPORT BEACH
SVP Marketing Services, UNIVERSAL AMERICAN
Vice President Health Services, SW Region, UNIVERSAL AMERICAN
Geriatric Nurse Practicioner, HSR, VA GREATER LOS ANGELES
Clinic Manager, VA GREATER LOS ANGELES
Clinical Director, Geriatric, VA GREATER LOS ANGELES
Program Manager, WELLPOINT
Program Director Network Strategy Medicare Programs, WELLPOINT
2013 Agenda (current as of 5/14/13)
Conference Day One: Tuesday, August 6, 2013
7:00 am
Continental Breakfast & Registration
8:10 am
Opal Events' Welcome
8:15 am
Chair's Welcome & Audience Demographics

Chair:

Vice President of Clinical Services, GORMAN HEALTH GROUP
8:30 am
Keynote Address:
The New CMS Medicare Chronic Conditions Dashboard: Did the Game Just Change?
  • Driving patient-centered accountable care in a way that identifies beneficiaries with multiple chronic conditions
9:15 am
Utilizing Care Management Systems Within a Context of Meaningful Use

Speaker:
Contract Performance Monitor, Government Programs, COLORADO DEPT. OF HEALTH CARE POLICY & FINANCING
10:00 am
Morning Refreshment & Networking Break
10:30 am
New Case Management Models Round Up
  • Tips for increasing physician support
Speaker:
Vice President, Medical Director, SCAN HEALTH PLAN
11:15 am
Innovative Care Management Strategies
  • Helping health plans care for their sickest, most vulnerable and fragile members by guiding them through the health care system and giving them the information, resources and social support they need to live healthier lives
  • Results - healthier, more satisfied members and lower costs for health plans
Speaker:
Chief Medical Officer, HEALTH INTEGRATED
12:00 pm
Luncheon
Track A - STAR RATINGS
Track B - HCC & P4P
1:05 PM
Star Performers Panel Discussion
  • Top rated plans
Speaker:
Medical Director, SCAN HEALTH PLAN
Meaningful Use, ACOs & Coding: How The Two Hottest Trends in Healthcare Will Affect HCC Coding... and Visa Versa
1:50 pm
Afternoon Refreshment & Networking Break
2:20 pm
The Physician Group's Role in Star Ratings: Taking Collaborative Care to the Next Step

Chief Executive Officer, PRECISION HEALTHCARE SYSTEMS
The CMS Final Rate Notice & the How the HCC Model is Affected

Senior Vice President, GORMAN HEALTH GROUP
3:05 pm
Trying to Hit a Moving Target: What We Know Will Drive Your Score
  • Tips for low-rated plans: How to maintain CMS coverage
Coding for Medicare/Medicaid Dual Eligibles: Bringing Undercoded Risk Scores Up to Snuff
3:50 pm
Readmissions Report: The Effectiveness of Home Care
This presentation will report on the results of a demonstration project testing the hypothesis that in-home care is effective in reducing unnecessary hospital readmissions. The demonstration, initiated in May 2012 and to be concluded in January 2013, involves 60 high-risk CHF patients discharged into home care. Clients are voluntary participants each receiving between 80and 100 hours of non-medical care delivered over 30 days. This program will offer the following information as developed and applied in the test:
  • Impact on readmission rate: Goal was to reduce readmissions by a minimum of 6 percent. (Mid-point result: 40% reduction in readmissions for all causes.)
  • Care model applied: Description of the care model utilized.
  • Care management model followed: Discussion of the care management process followed by participating hospital and care provider.
  • Caregiver training & engagement: Implication for and response to providing readmissions care for caregivers
Speakers:
Marketing Director, HOME INSTEAD SENIOR CARE
HOME INSTEAD SENIOR CARE
4:20 pm
Health IT Spotlight
Interoperability and Exchange: Promoting Security and Compliance While Using Devices for Healthcare Information
  • Learn about effectively communicating healthcare information between technology devices and settings
  • Medical devices are subject to multiple standards that are not always in accordance with one another: Learn how to effectively navigate these criteria
  • Out of the box: There's more than EMRs and hospitals systems when it comes to healthcare IT
Speaker:
CEO, GLENNER MEMORY CARE CENTERS, Chairman Emeritus, SHARP HEALTHCARE FOUNDATION; Board of Directors, SO CAL HIMSS
5:05 pm
Day One of the Main Conference Closing Remarks and Cocktail Reception in the Exhibit Hall
Conference Day Two: Wednesday, August 7, 2013
7:00 am
Continental Breakfast & Registration
8:10 am
Opal Events’ Welcome
8:15 am
Chair's Day Two Welcome Back

Chair:
Vice President of Clinical Services, GORMAN HEALTH GROUP
8:20 am
Keynote
Plan/Provider Contracting & Relationships in Accountable Care: Lessons Learned from Medical Homes, ACOs, and HMOs

Speaker:
Chief Medical Officer, Government Programs, HEALTH CARE SERVICE COORPORATION
9:05 pm
The Dual Demos: What is the Business Model?

Speaker:
Former President, AARP ARIZONA
Track A - ACO
Track B - PCMH
10:00 AM
ACO Development Case Studies
2 30-min case studies from ACOs with various state dates
  • Case Study #1: “Improving Physician Engagement in an Accountable Delivery System”
Executive Vice President, CENTRAL MASS. INDEPENDENT PHYSICIAN ASSOCIATION

Moderator:
Vice President, GORMAN HEALTH GROUP
The Nationwide Experiment to Restructure PCMH Payers Payments: Update on Current Trends
  • Per-member, per-month care-management fees: The solution?
  • Different incentive programs
10:45 AM
Clinical Spotlight: ACOs & Oncology, Diabetes & Obesity
PCMH Provider Case Study: National Naval Medicine Center

NATIONAL NAVAL MEDICINE CENTER [invited]
11:30 am
Morning Refreshment & Networking Break; Hotel Check Out
11:50 pm
Member Engagement Spotlight:
Lessons on Shared Decision Making and Patient Decision Aids for ACOs
  • The promise of shared decision making and patient decision aids
  • State legislation to promote their use
  • Lessons learned from the Group Health Demonstration Project
Associate Professor of Law, UNIVERSITY OF CALIFORNIA, HASTINGS [invited]
The PCMH & Diabetes

Associate Professor, GRAND VALLEY STATE UNIVERSITY [invited]
12:30 pm
Aligning PCMHs and ACOs
1:15 pm
Conference Closing Remarks & Conclusion
Register:
Service Providers
$1,895.00
:
Behavioral Health, Vision Plans, Dental Plans, Radiology, Vascular Access, Rehabilitation Services, Diagnostic Laboratory Testing Services
$995.00
:
Medicare/Medicare Advantage/Medicaid Health Plans*, Physician Group, Hospital, Government Employees - First 100 FREE
Regular Price: $995.00
Price: $0.00
:
Pending Registrations
You have 1 registration pending.
Sub-Total: $537.00
    register now
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