2016 HCEG Webinar Series

Directly derived from key critical issues outlined in HCEG’s Top 10, HCEG Webinars are designed to address the main issues faced by healthcare organizations in today’s evolving landscape. Led by industry leaders and experts from across the spectrum, each webinar enables members to further dive into key and trending topics, as identified by peer organizations at the HCEG Annual Forum, and further analyzed in the annual HTMS Industry Pulse.

Hosted quarterly, HCEG webinars are free to members, and allow for convenience in learning and participation.

Attendees are encouraged to engage with presenters and fellow peers; asking questions and driving constructive dialog on critical topics and relevant themes that dominate health care.

Sign up for an upcoming webinar or subscribe to our HCEG newsletter.

I am text block. Click edit button to change this text. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Ut elit tellus, luctus nec ullamcorper mattis, pulvinar dapibus leo.

Sponsored by:

Retail Health Care: We shop for everything else, why can’t we shop for health care? Using Incentives to Drive Shopping Behaviors

Helping people make smarter health care choices is a relatively new phenomenon.  While almost all health plans offer their members some type of transparency tools or assistance, an average of only 1-3% of those members actually use the tools.

Rewards programs are increasingly used in health care to help close that member engagement gap.  During this webinar you will:

  1. Learn when – and when not – to use rewards to encourage transparency tool use
  2. What level of rewards you should offer
  3. Who you should offer rewards to for the greatest success

John Surie -Webinar Presenter

Customer Insights Director, M Health, LLC

A full-service advertising agency based in Philadelphia serving global, national and regional clients. John began as a medical representative with Merck Sharp & Dohme before moving into advertising and brand development.

John, a board director with Saatchi & Saatchi before founding his own businesses, has worked on countless innovation and strategic brand development for major consumer packaged goods manufacturers such as Procter & Gamble. John has also done product and corporate brand development for various healthcare, life science and pharmaceutical firms such as Siemens Healthcare, Pfizer, BMS, AstraZeneca, Novartis, Schering-Plough, Johnson & Johnson and Boehringer Ingelheim.

Retail Healthcare
Tue, Dec 13, 2016

10:00 AM – 11:00 PM PST

Sponsored by:

Payment Reform: Exploring Technology Implications for Health Insurers

Payment reform is much talked about, often written about and now becoming real in today’s world. The move to value-based reimbursements and other new business models is an inevitable reality that is dramatically reshaping the US healthcare system. The underlying technology systems health insurers are using to run their businesses must have the agility to change as new business models are introduced. Otherwise, there is tangible risk of those health plans being left behind.

This webinar will explore the technology implications for health insurers as they face the swelling wave of payment reform. Using the recent MACRA rule as a case study, executives from Medica and HealthEdge will discuss how:

  • health plans must be ready to capture data related to new quality and performance measures
  • to leverage a technology infrastructure with the agility to manage new benefit and payment models quickly and efficiently
  • health plans can adjust the way services delivered are reimbursed while embracing new models

Presenters

Andrew Davis, VP & GM, Medicare Segment, Medica

AndrewAndrew Davis is the Vice President and General Manager of the Medicare Segment. Medica serves over 175,000 Medicare beneficiaries in Minnesota, North Dakota, South Dakota and Wisconsin. Andrew joined Medica in January of 2013 with more than 20 years of diverse healthcare leadership experience. He most recently was a vice president at Express Scripts, Inc where he was part of the leadership team that oversaw the UnitedHealth Group account. He has also held leadership roles related to corporate business development, health care reform strategy and has led a national Medicare Part D Prescription Drug Plan. Early in his career, he held positions with the Minnesota Departments of Health and Commerce as well as served as a legislative assistant to U.S. Rep. James Oberstar.

Andrew received a Bachelor of Arts degree in Political Science from The George Washington University.

Harry Merkin, Vice President of Product Marketing, HealthEdge

3bf5dd8Harry Merkin has worked with both payers and providers through many dynamic changes in healthcare for a number of years. He is currently responsible for Product Marketing at HealthEdge and previously had similar responsibilities at Evariant and NaviNet. Merkin has collaborated with many transformative entities across the healthcare landscape. He has helped introduce and promote enterprise software solutions that enable payers to improve their competitive effectiveness, as well as perform valuable communications between payers and providers, and allow providers to effectively collaborate with patients and consumers as well as with each other. He received a BA in economics from Brandeis University.

Click on the above video player to view the entire recorded webinar

Provider and Payer Integration: the Eight Questions You Should Be Asking Yourself

Payers and providers are being challenged to achieve the heady task of improving the quality of patient care while managing to rising costs of delivering that care. Fortunately, CMS is supporting the health care industry through the investment of millions of dollars to help providers acquire systems to promote the creation of environments to enable interoperability across organization boundaries.

Organizations will need to have patience to address both organizational and technical barriers while recognizing the need to push forward as an industry to make progress. These efforts are not for the faint of heart, nor will they be addressed in a short-time frame.

We invite you to listen and discuss how we as organizations move forward with these business ventures and ask, What are the critical success factors that need to be addressed to help mitigate risks and improve the likelihood of success.

Agenda:

  1. The Business Strategy Perspective
    1. Business impact of various novel payment models
    2. Macro trends driving the market towards payment models
  2. The Technology Perspective
    1. First understand the business drivers and strategies and the new ecosystem you must navigate
    2. It is all about the data and who needs access to it and in what form
    3. Next define the requirements for technology strategies for payer and provider integration it is all about interoperability and access to data
    4. Align business requirements with the overall technology strategy and architecture
    5. Create a program approach that establishes governance and aligns incentives
    6. Use standards and get others to use these standards
    7. Establish interim goals

If you are interested in joining this cutting-edge conversationClick Here to Register

Sponsored by:

Ensuring Your Meaningful Use Funding and Avoid the Ticking Time Bomb

HighPoint Solutions delivers practical solutions that solve strategic problems. They partner with their clients in the healthcare and life sciences industries to provide direct access to the people and technology that get things done. On every project, with every client, their objective is to build a better way of doing business.
During this webinar HighPoint Solutions executives Jim Slubowski and Jay Fisher will discuss Meaningful Use Audit, from the perspective of an auditor and present best practices for evaluating provider attestation (pre-submission) against the potential of being selected for CMS audit. The team will provide insights and industry expertise on:

  • The characteristics of documentation to provide a sound audit defense
  • Discuss mock audit, from engaging independent third parties, to the creation of strategies that enable internal audit teams to effectively deliver mock audit
  • Educate on preparations for attestation through 2021 with retroactive auditing and increased scrutiny
  • Discuss where Meaningful Use fits in over time
  • Discuss a broader overview of CMS compliance requirements, with an eye towards the impact on providers and potentially on payers

If you are interested in joining this cutting-edge conversation click here to register.

Moderator

Panelist

Jim Slubowski

Jim Slubowski

SVP, Healthcare at HighPoint Solutions, LLC

Jim is Senior Vice President of Healthcare Solutions at HighPoint Solutions. Jim is responsible for business and financial growth, new product/service development, strategic planning, business partnerships, and staff development across our healthcare practices.
Prior to joining HighPoint, Jim spent 14 years as CIO and VP of Enterprise Operations at Priority Health. He has also held senior positions as JS Advisory Services, Ernst & Young, and Henry Ford Health System. His academic credentials include a B.A. in Computer Science from Wayne State University.

Jay Fisher

Jay Fisher

Partner, HighPoint Solutions LLC

Jay Fisher is an accomplished leader, organizer and teacher when deployed by his clients in a project or program management role. His education as a CPA fosters a predisposition toward objectivity and metrics-based management, which results in clear, concise communication to all involved a primary key to success on any large endeavor.
He led a team of developers and auditors in the creation of a software tool for Meaningful Use administration, which today supports over 40 hospitals and 5,000 physicians in creating efficiencies around Meaningful Use Management. His team also manages compliance help desk around these complex regulations, and supports annual Mock Audits of Meaningful use.

Sponsored by:

From Concept to Reality: Practical Considerations of Implementing Alternative Reimbursement Models

Various ways of reimbursing medical providers have come in and out of fashion over the last 20 years and many thousands of words have been written on the topic but often from a theoretical, what if perspective.

From Concept to Reality: Practical Considerations of Implementing Alternative Reimbursement Models will do just that present and discuss concrete, real world experiences of payers and providers seeking to reengineer the way we pay for care with the goal of driving value in place of volume. We will eschew theory and talk only about on-the-ground efforts: what works, what does not, overcoming barriers, and developing payer-provider relationships that align incentives. After listening to our panelists you should have information on which to base a realistic approach with which to design and implement reimbursement which supports the volume-to-value revolution.

David DiLoreto, MD -Chief Executive Officer at Presence Health Partners – will talk about how delivery systems are responding to new reimbursement models and provide his perspective on ways payers can work more effectively with their networks.

Dan Tuteur – Chief Strategy Officer at Colorado HealthOP – will share his lessons from developing innovative reimbursement methods in a startup health plan forging brand new provider relationships.

Craig Samitt, MD, MBA – Partner and Global Provider Practice Leader – will talk about actualizing the vision of changing physician behavior by aligning incentives based on his personal experience.

After their respective brief presentations the panel will take your questions and engage in a lively discussion.

How to Participate

No Registration is Required.

Before The Event:

  1. Download the Meeting Planner (Above): It contains the dial-in number required for the event.

On The Day Of the Event:

  1. Dial-in to Conference Line 877.345.2580,622.61.750#
  2. Listen in and ask your questions at the end

Moderator

Panelist

Catherine Roth

Catherine Roth

Vice President at HTMS

Catherine Roth, a vice president at HTMS, has over 25 years of experience working with both health plans and healthcare providers. Her background includes co-founding and serving as president and COO of a major payer systems software company, serving as CEO of a for-profit subsidiary of the California Medical Association, and developing the business plan and leading operations of a messenger model PPO. She has a masters in public policy from the Goldman School, University of California, Berkeley.

David DiLoreto, MD

David DiLoreto, MD

Chief Executive Officer at Presence Health Partners

Dr. DiLoreto leads the strategic advancement and development of innovative population health capabilities for Presence Health Partners, Presence Healths physician-led, clinically integrated payor/accountable care organizations. In 2009, he joined the organization as the first Chief Medical Officer for the former Resurrection Health Care and later became the Chief Clinical Operations and Innovation Officer for Presence. Prior to joining Presence, he was Senior Vice President and Chief Medical Officer at Baptist Health Care in Florida. He received his doctor of medicine from the University of Florida and his MBA from Emory University.

Dan Tuteur

Dan Tuteur

Chief Strategy Officer at Colorado HealthOP

Dan Tuteur has 35 years of diverse experience in health care in Colorado, much of which has been centered on improving services to low income people. From 1980 to 1995, Dan held a variety of administrative and financial leadership positions at National Jewish Health, a national referral center and research institute for respiratory and immunologic disorders. Between 1995 and 1997, he was Chief Financial Officer at a fledgling nonprofit Medicaid health plan, Colorado Access. In 1997 he became the first Chief Executive Officer of the Colorado Community Managed Care Network (CCMCN), a shared services organization for Colorado's Federally Qualified Health Centers. CCMCN's scope included managed care contracting, quality improvement programs, electronic health record support and data aggregation. CCMCN grew from a startup to an organization of over 20 employees in 2012 serving 17 FQHCs along with client organizations beyond the FQHC domain.

Craig Samitt, MD, MBA

Craig Samitt, MD, MBA

Partner and Global Provider Practice Leader

Dr. Samitt is a Partner and the Global Provider Practice Leader in Oliver Wyman's Health & Life Sciences Practice. He has led turnarounds at major health systems for 20 years, most recently serving as the President & CEO of HealthCare Partners, a division of DaVita HealthCare Partners. From 2006 through 2013, Dr. Samitt was President & CEO of the Dean Clinic, one of the largest integrated delivery systems in the Midwest and one of the nation's leading examples of a high-performance Accountable Care Organization. Previously, he served as Chief Operating Officer at Fallon Clinic (now Reliant Medical Group), as Senior Vice President on the turnaround team of Harvard Pilgrim Health Care and as Chief of Medicine and Site Medical Director at Harvard Vanguard Medical Associates (now Atrius Health). Dr. Samitt is currently in his third year as an appointee on the Medicare Payment Advisory Commission (MedPAC).

Sponsored by:

HealthCare Security: The New Normal

Security attacks against healthcare companies is growing in number and velocity, is this the New Normal? What is driving this behavior? What can executive stakeholders do to mitigate risks?

Key takeaways

  • Nowcast of the healthcare industry landscape
  • Expected security threats
  • Best practices to secure your organization and customer’s data.
  • Best practices of where to begin

Moderator

Speakers

Mike Ragan

Mike Ragan

Senior Vice President of Life Sciences and Healthcare at NTT DATA

Michael Ragan is a Global IT Innovator delivering global technology-enabled services and solutions to clients around the world. In this role, Mr. Ragan oversees Sales, Alliances and Business Development for North America within the industry sub-sectors of Healthcare Insurance, Life Sciences, Hospital, and Healthcare Technologies.

Bruno Kelpsas

Bruno Kelpsas

Director of Cloud Healthcare & Life Sciences at NTT Data

Bruno Kelpsas mission is to assist clients in transforming the business of healthcare through Next Generation IT. Bruno's experience with enterprise security has ranged from the Navy Marine Corps Intranet (NMCI) to Microsoft's internal IT to Cloud. He also incorporates seven years of corporate governance experience and fiscal year planning into security decision-making.

Eric Sorenson

Eric Sorenson

CIO CISO at Arches Health Plan

Eric Sorenson has more than 15 years of experience in technology and security. He worked as Information Security Officer at HealthEquity, Inc., the nation's oldest and largest dedicated health savings trustee which manages just over $1billion. He is well experienced in enacting policies, procedures, and safeguards to ensure regulatory compliance around HITECH, HIPAA, PCI, and GLBA and instituted a vendor risk assessment program to identify and mitigate risks posed by third party service providers. Prior to HEQ, he worked for Zions Bancorporation and IBM.

Johnathan Hyler

Johnathan Hyler

Delivery Management at NTT DATA

Experienced in IS/IT Security & Risk Management. Sub domain specialties include compliance, eDiscovery, expert witness testimony, managing external audit engagements (E&Y) & responding to control deficiencies. Specialty skills include mastery of implementing reusable controls to satisfy both SOX 404 & HIPAA requirements, as well as consolidating technologies and/or bringing in new technologies & partners to streamline an organization's approach to IT Security.