“Specialty Networks and Risk Sharing at Scale” – A Session at HCEG’s Annual Forum

By | Annual Forum, Risk-Sharing, Value-Based Care | No Comments

“Specialty Networks and Risk Sharing at Scale” – Monday, September 18th at 3:15PM – 4:30PM

At this year’s 29th Annual Forum in Nashville, TN, Dr. Richard Popiel, EVP & Chief Medical Officer at Cambia Health Solutions, moderates a panel presenting and discussing the current needs, opportunities, and challenges associated with improving the appropriateness, outcomes and affordability of specialty care services; specifically the clinical decision support mechanisms and other solutions that risk-sharing, value-based environments need to simplify, encode and utilize complex clinical content into a standardized, repeatable, evidence-based system for making decisions supporting an organization’s clinical programs.

Dr. Popiel and other healthcare industry experts will present how we as a healthcare system can improve healthcare outcomes and reduce costs by shifting to value and risk sharing arrangements. Insight into how disruptive analytics and analytical approaches to cost trend monitoring and containment will be shared and interactive opportunities to engage will be available.

Healthcare Thought Leaders Share Valuable Insight at HCEG Annual Forum

Panel Moderator – Richard Popiel MD MBA 

Dr. Richard Popiel, Cambia Health Solutions

Richard Popiel, M.D., MBA, Executive Vice President, Healthcare Services & Chief Medical Officer, Cambia Health Solutions & Regence Health Insurance Company

Dr. Richard Popiel leads medical strategy for Regence health insurance plans and provides executive leadership on care initiatives and cost management activities across the corporation. He came to Regence from Horizon Healthcare Innovations, where he was president and chief operating officer. Dr. Popiel earned a B.S. in biology and his M.D. at The George Washington University in Washington, D.C. He also holds an M.B.A. from Northwestern University Kellogg School of Management. He is board-certified in internal medicine.

Panelists include: (Additional panelists are pending confirmation)

Brandon Cady

Brandon Cady – President/CEO at AIM Specialty Health

Brandon Cady is the President and Chief Executive Officer of AIM Specialty Health® (AIM). Brandon joined AIM in 2002 and executed top line growth initiatives that expanded the business into one of the largest and most successful specialty benefits management companies in the United States.

Brandon has held a variety of leadership positions within hospital systems, health plans, and emerging technology companies. Brandon earned his master’s degree in Health Services Administration from the University of Michigan in Ann Arbor and a Bachelor of Business Management from the University of Iowa.

Dunston Almeida

Dunston Almeida – Executive VP of M&A Strategy and Business Development at Evicore

Dunston Almeida serves as an Executive Vice President of M&A Strategy and Business Development at eviCore healthcare, LLC. Dunston focuses on new strategic initiatives and partnerships, driving inorganic growth via mergers and acquisitions (M&A) and working with the Board and Executive Team on the company’s Strategy Council. He also supports the formulation of eviCore’s public policy and regulatory efforts. He has more than 20 years of experience in technology.

 

The 2017 HCEG Annual Forum

The HCEG Annual Forum provides the setting and platform for senior level executives from across the healthcare spectrum to come together for 2-3 days each year to discuss the continuous innovation, evolution and transformation of the industry. Attendees are granted direct access to approximately 100 peers, thought-leaders and solutions providers from around the country; all facing similar obstacles and providing opportunities, while engaging in real, relevant and productive dialog.

This year’s 29th Annual Forum takes place in Nashville, TN on September 18th -20th. For more information on this years annual forum, see this page.

Highlights from Day 1 of 2017 AHIP National Health Policy Conference

By | AHIP, Healthcare Reform, Healthcare Revolution, payer, Risk-Sharing, Value-Based Care | No Comments

The 2017 AHIP National Health Policy Conference kicked off today in Washington, DC.

Political, business, and health care leaders from across the nation gathered to dive deeply into our nation’s top policy priorities in an effort to move forward in today’s uncertain healthcare environment.

What a period for healthcare reform in the United States!

In addition to some general comments about healthcare policy and politics, today’s sessions addressed topics such as the following:

  • Risk-sharing and Cost Control
  • Value-based Care
  • Pharmacy Costs
  • Medicaid Exchanges
  • Importance of Social Determinants of Health

Social shares from conference attendees

As is happening more and more at many of today’s top healthcare conferences, conference proceedings, insights and other information were shared on Twitter – among other social channels. Here’s a sample of some interesting shares from Day 1 of the 2017 AHIP National Health Policy Conference.

Thanks to all those noted below who took the time to share with those who were unable to attend the conference.

General Stuff

Handle Tweet
@ajmc_journal There’s still a basic misunderstanding of how health insurance works, says @AHIPCoverage’s Tavenner
@rpalme01 @MD_Insurance @al_redmer ACA “status quo is not an option, status quo is not a solution”  #ACA
@nancyrwise Newt Gingrich sure that SOME bill will be passed this session…  but no direction on what it will include.  #AHCA
@nancyrwise T. Nickel, thank you: “Association Health Plans are awesome… until they are not”  @NAIC_News

Cost of Healthcare & Risk-Sharing

Handle Tweet
@ajmc_journal The only cost containment strategy that works is cost sharing but it can be such a burden that it takes care away–@chipkahn
@avercloud Healthcare payers: Make the move from pilot to full-scale bundled payment adoption. Let’s discuss at #AHIPPolicy
@leah_a_brown The discussion a few years ago was about coverage, now healthcare 2.0 is about cost.
@mahphealth Good point by MD Comm. Al Redmer Jr on NAIC panel Can’t do anything on premiums unless moderate cost of delivering #healthcare
@nancyrwise Great quote: “Pay for value = transferring risk to providers.” M. Chernew
@nancyrwise If health orgs are bigger & more integrated, they are better positioned to own market power: unlikely to lower costs. M. Chernew
@suemontgomery2 Cost of premiums is all about the cost of delivering care. – Ted Nickel at #AHIPPolicy

Value-based Care & Reimbursement

Handle Tweet
@ahipcoverage Consumers want affordable coverage & high-quality care – that’s what value-based care delivers.
@avercloud Debate the policy, but value-based healthcare is here to stay. Let’s discuss bundled payment success at upcoming #AHIPPolicy

Pharmacy

Handle Tweet
@springstex Prescription drug costs pass physician services as biggest slice of health insurance premium
@rpalme01 Keep talking to your local pharmacist and sharing what he tells you.

Medicaid Exchanges, Access & Importance of Social Determinants of Health

Handle Tweet
@ajmc_journal Healthcare reform is a question of access vs true availability. The devil is truly in the details, said @AndyGurmanMD
@nancyrwise Interested in continuing conversations about potential intersection of #Medicaid and Exchange markets in #healthcare #simplicity
@ahipcoverage From transportation, housing & environmental health, plans are addressing social determinants of health

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