Social Determinants of Health: A Payer’s Strategic Advantage

Thursday, November 7th, 2019 11:00am PT / 2:00pm ET

Payers and providers must innovate and share data to improve quality and lower costs
Social determinants of health (SDoH) hold much promise for payers, providers and patients, but few understand how to develop and operationalize a collaborative approach and solution. Most payers and providers are not regularly screening for SDoH factors or recommending community resources to help, and most consumers are unaware of their available benefits.
Yet some innovative payers, providers and community resources are forming partnerships with exemplary results. Typically, these organizations are leveraging diverse data sources, implementing value-based payment models and adopting technology that helps improve collaboration and workflows.
Register to join Constance Sjoquist of HLTH, Kim Ingram and Harry Merkin of HealthEdge as they debut the results of HealthEdge’s 2019 independent survey, share examples of SDoH in practice and provide guidance for how to get started addressing and overcoming challenges organizations face with regards to SDoH. Get an exclusive preview of key survey insights and tangible recommendations on how to leverage SDoH for your organization.

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Panelist

Constance Sjoquist

Chief Transformation Officer at HLTH

Kim Ingram

Director of Marketing, Surescripts

Harry Merkin

Chief Technology Officer, Surescripts

We Can Stop Diseases, But Can We Stop The Fax?

Thursday, October 17th, 2019 11:00am PT / 2:00pm ET

Did you know…the fax machine was invented in 1843, telephone in 1876, internet in 1969 and the first e-prescriptions were sent in the early 2000’s. Yet 175 years after its invention, the fax machine is still used billions of times a year to ultimately deliver patients their prescriptions.

There is a better way. Not only can we get rid of faxes, but we can arm both prescribers and pharmacists with data and insights to make the optimal decision for the patient. Technologies exist that enhance prescribing and inform care decisions, to get patients the right prescription at the right cost, the first time. It began with E-Prescribing, but now includes such technologies as Real-Time Prescription Benefit, Electronic Prior Authorization and Clinical Direct Messaging.

These technologies support electronic, secure, in workflow communications across the entire healthcare ecosystem. Join us to learn more about how healthcare IT is moving out of 19th century and into the 21st century.

Agenda

  1. Hear about the history of prescription technology
  2. Understand today’s prescription experience
  3. Explore tomorrow’s prescription experience
  4. Learn about key technologies advancing the prescriber, pharmacist and patient experience
  5. Discover what it takes to create a reliable, secure and scalable platform to support the transition

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Panelist

Ashley Fifield

VP Key Accounts, Surescripts

Ashley works with our Health Plan clients and prospects to ensure they have a clear understanding of Surescripts solution portfolio. She has worked in the health care industry for over 10 years, primarily focused on health information technology in hospitals and physician practices. She holds a BA in Economics with a Concentration in Biomedical and Management studies from St. Olaf College.

Melissa Warnke

Director of Marketing, Surescripts

Melissa Warnke is the Director of Marketing at Surescripts focused on Pharmacy, PBM and Health Plan markets. She has worked in the health care industry for over 15 years including time in supply chain, medical device and health information technology. She holds an MBA from DePaul University, Kellstadt Graduate School of Business and a BA in Finance from the University of Illinois, Urbana-Champaign.

Jeff Sponaugle

Chief Technology Officer, Surescripts

Jeff Sponaugle is the Chief Technology Officer at Surescripts with more than 20 years of experience in the healthcare technology industry. He was previously the co-founder and CTO of Kryptiq Corporation, a provider of secure healthcare information exchange platforms. Jeff has a BS in Electrical Engineering and Computer Engineering from Purdue University, and has extensive experience in both hardware and software design, network engineering, and information security.

The Doctor Can’t See You Now: New Ways to Speed Up and Improve Provider On-Boarding

Thursday, October 3rd, 2019 11:00am PT / 2:00pm ET

Many healthcare payers and providers struggle to onboard and credential providers quickly, but delays mean reduced physician revenue, provider directory inaccuracies, denials and fines. Ultimately, this affects patients and member outcomes, with cancelled appointments, increased wait time to get an appointment, and customer dissatisfaction.

It’s not surprising that Operational Effectiveness is ranked #8 on the 2019 HCEG Top 10 list of challenges, issues, and opportunities facing healthcare payers and providers.

In this webinar, attendees will learn best practices and tools to automate and standardize provider onboarding while minimizing risk to the revenue cycle and operations. They’ll see live examples and hear customer stories of provider onboarding improvement. They will also discover how provider onboarding could be a key step in the journey toward enterprise automation using robotic process automation and AI

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Panelist

Ryan VanDePutte

Associate Director at Bits In Glass

Ryan VanDePutte, Associate Director at Bits In Glass where he is responsible for managing and executing the full delivery and implementation of custom Appian solutions for Bits In Glass’ clients. He has nearly a decade of experience providing project and portfolio management as well as strategic guidance and advisory services for some of the nation’s largest healthcare companies.

Kirsten Prucha

Global AVP Digital Enterprise, Luxoft, a DXC Technology Company

With over 25 years in the healthcare industry, Kirsten’s experience has included working for health plan payers, a Third Party Administrator (TPA), and for both a regional, and national PPO network. This background has given her a unique perspective, enabling her to see first-hand the impact that proper, timely and accurate provider credentialing can have on a health plan’s operations and how it contributes to plan member and provider satisfaction. Kirsten attended Virginia Tech, located in Blacksburg, Virginia, and resides in Northern Virginia today.

Fritz Haimberger

Vice President, Global Industry Lead – Healthcare Provider

Fritz Haimberger is a healthcare consulting, sales, and management executive with more than eighteen years of HIT, clinical operations, and revenue cycle experience. With a strong background in healthcare administration and operations, business development and IT systems design, he has extensive experience focusing on provider solutions both in the U.S. and internationally, including Canada, Ireland, and the UK. Having been with Appian for four years and leading the company's healthcare provider industry vertical, Mr. Haimberger holds a B.E. in Biomedical Engineering from Vanderbilt University and resides with his family in Nashville, Tennessee.

Cate McConnell, MBA, CPHIMS

Appian Global Industry Leader, Healthcare Payer

Cate McConnell is an experienced healthcare executive whose work focuses on making healthcare more effective and efficient through thoughtful application of technology. She currently serves as Vice President & Global Industry Leader for Healthcare Payers at Appian. Cate earned an MBA from Duke University’s Fuqua School of Business, holds the CPHIMS certification from HIMSS, and serves on the Board of Directors of the Healthcare Executive Group (HCEG.) She lives in Atlanta, GA.

Using People, Process & Technology to Grow Your Business

Thursday, July 25th, 2019 11:00am PT / 2:00pm ET

People, process and technology are at the core of every business. Each one is its own science to be mastered, but the art is found where the three intersect. The intersection of these three essentials is where efficiency and value are realized. With their optimization, a health plan is poised for successful growth. Communication, collaboration and planning are the building blocks to formulating and understanding the strategy for growing a health plan’s business. Whether the organization seeks to enter a new geography, start a new line of business, or create an entirely new plan, health insurance leaders need to be confident that they have the right people, process and technology in place.

During this webinar, attendees will hear from two industry leaders who leveraged the art and science of people, process and technology to successfully grow their respective health insurance businesses both from the ground up as well as within an established organization.

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PANELISTS

Sal Gentile

CEO, Friday Health Plans

Sal Gentile founded Friday Health Plans to transform the health insurance market. With more than 30 years of experience in high growth, innovative companies, Sal brings deep experience in operational leadership, market strategy, and business development. Prior to founding Friday, Sal was CEO of HealthX, a software company which built online portals and tools for the health insurance industry. From 2004 to 2013, Sal led markets at TriZetto Corporation, the leading provider of enterprise software and services for the health insurance industry, where he became an expert at using technology to drive efficiency and automation in health insurance. Sal led a number of sales, marketing and business development functions at high growth technology firms. Sal is a graduate of Pace University where he majored in math and computer science.

Dannette Coleman

Executive Vice President, Account Management & Business Development, HealthEdge

Dannette Coleman is a senior health insurance executive with more than 25 years of experience in the health insurance industry. She was previously Senior Vice President and General Manager for Individual Business at Medica, where she was responsible for the growth and development of all aspects of the business unit. Dannette joined Medica in 1992 and had roles in Customer Service, Consumer Affairs, Quality Improvement, Government Programs and Public Policy, prior to taking on P&L responsibility. Dannette served as the board chair of the TwinWest Chamber of Commerce, is a member of the MinneWomen’s Economic Roundtable, and is a board member of Fraser, an organization that provides services to children and adults with special needs. She also has been appointed to serve on numerous health care task forces including the Minnesota Exchange Advisory Task Force and the Minnesota Health Care Financing Task Force. Dannette holds a Bachelor of Arts degree from the University of Wisconsin – Madison, and a Masters of Business Administration degree from the University of St. Thomas.

Solving the Rubik’s Cube of Payer Data

Thursday, June 6th, 2019 11:00am PT / 2:00pm ET

For many health payers, making sense of their data is like trying to solve a Rubik’s Cube. They have all these individual data points. But the more they twist and turn them with their analytics, the further away from the goal they seem to get – and the more frustrated they get with the process.

Anyone who has learned to solve an actual Rubik’s Cube with regularity, however, knows the key is to understand and recognize the patterns that lead to success.

The Rubik’s Cube health payers are currently facing the mountain of incredibly rich data they’re sitting on right now. America’s Health Insurance Plans (AHIP) says the typical regional payer processes $8 billion in claims each year. Each of those claims houses a wealth of interesting data. Yet the challenge they face is how to aggregate and parse it in ways that enable them to take actions that will improve health outcomes and reduce costs.

Mayur Yermaneni, Chief Strategy and Growth Officer at eQHealth Solutions, alongside Marina Brown, Vice President of Clinical Programs at eQHealth Solutions, will discuss why it isn’t the volume of payer data that makes it so valuable – it’s the unique view it offers into member/patient health.

Predictive and prescriptive analytics, especially when supported by AI and machine learning, can help take those maddening twists and turns of data and create a complete, clear picture that helps drive healthcare quality and member/patient satisfaction up while driving benefit costs down.

PANELISTS

Sponsored by:

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Mayur Yermaneni, ME

Chief Strategy and Growth Officer, eQHealth Solutions

With a Master of Biomedical Engineering, Mayur Yermaneni is responsible for the organization’s vision and strategic direction, the continued development of eQHealth’s product and service lines while ensuring alignment with established corporate goals. Additionally, eQHealth’s current medical management services model was designed and developed under his leadership, and he maintains responsibility for end-to-end management of the model. Yermaneni has over 15 years of experience providing innovative, strategic technology solutions in the public and private sectors.

Marina Brown, RN BSN, CCM, CHC

Vice President of Clinical Programs, eQHealth Solutions

Brown joined eQHealth in 2009 and is responsible for our clinical program design and works with our Chief Medical Officer to develop and enhance new client programs. Brown is a registered nurse with a BSN and is a certified case manager and a certified health coach. Prior to joining eQHealth in 2009, she was responsible for designing and developing the disease management and medical management training program for Blue Cross Blue Shield of Louisiana.

The Pulse of the Healthcare Industry for 2019

Thursday, April 18th, 2019 at 2:00pm ET

For the past nine years, Change Healthcare has commissioned and published an annual survey of health plan leaders and other healthcare organizations reporting on the “pulse” of the healthcare industry. This latest study, produced in partnership with the HealthCare Executive Group (HCEG), aims to define and explain the issues facing healthcare, reveal how the industry is responding, and offer valuable resources and perspectives to help navigate the complexities of the rapidly evolving healthcare industry.

On April 18, leaders from Change Healthcare and HCEG will host a webinar to review the analysis of the latest Pulse survey, offer insights into the thoughts and opinions of surveyed healthcare leaders, and explore how these leaders are preparing for the future.

Please join us at 2 PM EDT on April 18.

PANELISTS

Watch the recorded webinar below:

Ferris Taylor

HCEG Executive Director

Ferris Taylor is executive director of the HealthCare Executive Group (HCEG), a national network of healthcare executives seeking to reshape the industry. He has more than 30 years of healthcare leadership, technology, and consulting expertise.

David Gallegos

Senior Vice President, Change Healthcare Consulting

David Gallegos is senior vice president of Change Healthcare Consulting Services. He is responsible for leading the Change Healthcare effort to engage clients for consulting services and has over 20 years’ experience in healthcare-related operations.

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HCEG’s 2019 Top 10 List & 9th Annual Industry Pulse Report

Thursday, March 28th, 2019 at 2:00pm ET

The HCEG Top 10 has been a pillar of the Healthcare Executive Group for over 10 years, providing extensive insight into primary opportunities, challenges and issues currently facing healthcare executives in the United States. And the Industry Pulse – an annual research report based on the HCEG Top 10 and co-sponsored by HCEG and its sponsor partner Change Healthcare – was recently released.

Join HCEG’s Executive Director Ferris Taylor and Digital Strategist Steve Sisko for an overview of the 2019 HCEG Top 10 list and how the 9th Annual Industry Pulse Research Survey builds upon specific items of the HCEG Top 10 list.

WEBINAR OUTLINE

  1. Creating HCEG’s Top 10 list
  2. 2019 HCEG Top 10 list
  3. Convergence and divergence in 2019 HCEG Top 10 list
  4. HCEG Top 10 over last decade
  5. HCEG Top 10 as basis for The Industry Pulse
  6. Industry Pulse insight on HCEG Top 10 items
  7. More about HCEG Top 10 & Industry Pulse

Watch the recorded webinar below:

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PANELISTS

Ferris Taylor

HCEG Executive Director

Ferris Taylor was recently chosen as the Executive Director of the Health Care Executive Group (HCEG), where he has served on the board for 14 years. HCEG is a national network of select executives from across healthcare coming together to continually learn, grow, share and reshape the industry. Taylor until recently was Chief Strategy and Chief Operating Officer at Arches Health Plan, a non-profit member-governed health insurance company that had been providing health plan options to 80,000 individual and group members throughout Utah. Unfortunately, Arches is one of the many CO-OPs who are being shut down by CMS and he is working as a consultant to wind down the Arches operations. Taylor brings more than 40 years of business leadership including 30 years in health care, technology and consulting services to his executive roles. Prior to Arches, he founded Pragmatic Health Care Solutions, a health care strategy and market positioning firm. From 2003 to 2008, he was VP of Strategic Marketing and Payer Market Strategy for Ingenix (now Optum), one of the industry’s largest health information technology companies and part of UnitedHealth Group. Additionally, Taylor served 12 years as the head of Marketing and Information Services for Harvard Pilgrim Health Care and 2 years as Vice President of Marketing and Planning for North Shore Medical Center, the six community hospital system of Partners Healthcare that includes Mass General and Brigham and Women’s Hospitals. A graduate of Brigham Young University in Nuclear Physics with a minor in Spanish, Taylor holds an MBA with an emphasis in finance and quantitative economics. He is also a graduate of the GHAA/AHIP Executive Program in Managed Care from the University of Missouri.

Steve Sisko

HCEG Digital Strategist

Steve Sisko is an independent healthcare consultant and blogger based in Phoenix, Arizona with over 25 years of experience serving the U.S. health care industry. Steve provides a range of service delivery, product marketing, information technology, and management advisory services to health plans, health systems, risk-bearing provider organizations, product/service vendors and consulting firms. Steve runs a popular, perennially high-ranking blog – The Healthcare Data, Technology & Services Blog – at www.shimcode.com and is a leading source of information on Twitter where he is known as @ShimCode.