Payer Issues Virtual Summit

August 24, 2021 | 1 - 3 PM CT

payer issues virtual summit

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Stephanie Signore, Vice President of Payer Relations at North Shore Healthcare

Dr. Robert Vissers, President and CEO of Boulder (Colo.) Community Health

Dr. Shiva Chandrasekaran, Chief Population Health Officer and ACO Executive Director at Einstein Healthcare Network

Richard Isaacs, CEO and Executive Director of The Permanente Medical Group and President and CEO of The MidAtlantic Permanente Medical Group

Matthew Cox, Chief Financial Officer of Spectrum Health System

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Amy J. Khan, MD MPH Executive Medical Director, Regence Health Plans

Dennis Matheis Executive Vice President of Sentara Healthcare and President of Sentara Health Plans

Shara McClure Divisional Senior Vice President, Texas Health Care Delivery, Blue Cross and Blue Shield of Texas

Gracelyn McDermott Executive Director, Kaiser Permanente

Becker's Payer Issues Virtual Summit | August 2021

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The past year revealed clear imperatives for health systems and payers: more telehealth, digital transformation, mental health and higher-value care. Payer and health system executives are coming together for critical conversations about what patients need and where healthcare is headed. The panelists will engage in focused, fast-paced discussions tackling the big questions facing health plans and systems today. Don't miss this unique opportunity for peer-to-peer insight on where the industry is headed.

J. William Wulf, MD Chief Executive Officer, Central Ohio Primary Care Physicians

Nisha Sikder Vice President of Payer Strategies, Valley Health System

Bob Sarkar President and Chief Executive Officer, Arkansas Health Network

Denise Prince Senior Vice President and Chief Operating Officer, Population Health, Mount Sinai Health Partners

special thank you to our corporate partner

Lori Kostoff Director of Quality Performance, Aledade

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How HCM realized a 441% ROI with a shift to cloud communications

Healthcare Claims Management (HCM), a revenue cycle management company, deployed RingCentral Contact Center and RingCentral MVP™ due to the flexibility within the platform allowing for the integration of future technology as well as the reliability of a cloud-based solution. As HCM adopted a cloud first approach, the team needed a platform to meet the integration needs of future projects. RingCentral helped the company save $1.2 million in annual operational costs and just over $1 million annually in personnel costs. In the end, the company realized a 441 percent ROI and recovered its initial investment in just 3 months after implementation.

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Mark Hite, Managing Director, Healthcare, Alithya Brian Kelsey, Product Manager, Analytics, Alithya

Understanding Patient Scheduling Tendencies in a New Virtual World

2:30 PM CT | Featured Session

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Amy J. Khan, MD MPH, Executive Medical Director, Regence Health Plans

Digital Transformation, Consumerism and What It Really Takes To Put the Patient First

1:00 PM CT | Panel discussion

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Discussion Topics: • We have millions of patient data points - Now what? • How to win big with data analytics and drive innovation • Build vs. buy: Key strategies for hospital data management on a budget • Predictive analytics, precision medicine and more: The tech and mindset to achieve top results • Best ideas to build a strong data science team Full agenda and speakers coming soon!

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Nisha Sikder, Vice President of Payer Strategies, Valley Health System Gracelyn McDermott, Vice President, Marketing, Sales & Business Development, Kaiser Permanente Mid-Atlantic States Dennis Matheis, Executive Vice President of Sentara Healthcare and President of Sentara Health Plans

The Payer’s Role in Population Health and Closing the Gap in Health Equity

1:45 PM CT | Panel discussion

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Denise Prince, Senior Vice President and Chief Operating Officer, Population Health, Mount Sinai Health Partners Shara McClure, Divisional Senior Vice President, Texas Health Care Delivery, Blue Cross and Blue Shield of Texas Lori Kostoff, Director of Quality Performance, Aledade

The Next Iteration of Value-Based Care

2:30 PM CT | Panel discussion

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payer industry company to know

Hyland Healthcare provides a content services platform that serves as a foundation for payer digital transformation. It helps connect disparate content to core systems to simplify workflows, streamline processes and better serve providers, members and employers. Solutions built in the platform allow healthcare payers to: automate business processes, expedite appeals and grievances, automate accounts payable, streamline human resources workflow, collaborate with providers and simplify the processing of claims.

Dr. Richard Embrey , Medical Director, BCBS Alabama Dr. YiDing Yu, Chief Medical Officer, Olive

Reimagining Utilization Management with Artificial Intelligence

1:45 PM CT | Featured Session

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Featured Whitepaper

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How can you influence Age-Ins? Understand the factors contributing to Medicare decision-making.

MDRG's study focuses on understanding consumer attitudes and behaviors as they pertain to: • Awareness and influence of Medicare advertisements • Learning more about Medicare • Deciding on a Medicare plan • Factors that predict selection of Medicare Advantage and Medicare Supplement

Ed Hafner, AVP Payer Strategy, Change Healthcare

Government Mandates: Deadlines Are Approaching; It’s Time to Act!

1:00 PM CT | Featured Session

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Data Activation company to know

Innovaccer Inc. is a leading San Francisco-based HealthTech company committed to helping healthcare care as one. It leverages its Health Cloud to unify member data across systems, and empower healthcare organizations to develop interoperable applications to improve outcomes. Its solutions have been deployed across 1,000+ care settings in the U.S., enabling 37,000+ providers to transform care delivery. Innovaccer is recognized as a Best in KLAS vendor for 2021 in population health management and a No. 1 customer-rated vendor by Black Book

How technology is enabling providers and payers to achieve the Quadruple Aim

Reimagining Utilization Management with Artificial Intelligence

Data Activation company to know

payer industry company to know

Achieving success under the Star Rating System is a critical part of doing business today. The quest for success has led health insurers, PBMs and retail pharmacies to work together to formulate strategies to achieve top ratings. To effectively do this, they need access to trusted information and educational resources to deliver patient-centric care and to engage members in managing their own care. In this podcast, Brad Wilson, the founder of Wilson Strategic Consulting and former CEO Emeritus with Blue Cross Blue Shield of North Carolina, discusses star ratings and the value of trusted knowledge.

Star Ratings and the value of trusted knowledge

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COVID-19, consumerism, and increased technology are really transforming how patients receive the care they need to remain healthy or continue their care coverage. Reporting solutions need to be more robust than ever and not only give the flexibility required to analyze data in varying ways, but also add key functionality like artificial intelligence and machine learning options to help predict tendencies and behavior. Analytics that can provide visual cues in an easy to digest way are more important than ever for health systems to respond to changing patient populations. Join this educational session to understand: • How you can leverage your current scheduling data for better analysis • Traverse the scheduling workflow to understand different stages of your patients and where sessions are trending • Leverage AI/ML concepts to provide some predictive measures for patient populations and what appears to be working for them or will work for them • Leverage self-service concepts to bring the data and decision-making into the hands of the users

Understanding Patient Scheduling Tendencies in a New Virtual World

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Mark Hite Managing Director, Healthcare Alithya

Brian Kelsey Product Manager, Analytics Alithya

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Explore the changing relationship between payers, providers and members, and how new technology solutions for prior authorization can unlock new opportunities to achieve the Quadruple Aim. Health plans around the country are focused on reducing medical and operating costs, growing membership and being the plan of choice for both members and providers. Executives are addressing these priorities by deploying technology solutions that can finally align payers and providers together towards the Quadruple Aim. Utilization Management and prior authorization is a key area where new innovation is making a difference. Join a panel of health plan executives as they discuss their evolving relationship with providers, the shared challenges around prior authorization and utilization management, and how new technology solutions like automation and artificial intelligence are bridging the gap across payers, providers, and members. Learning Points: 1. The changing nature of the payer-provider relationship Learn how the relationship between payers and providers has evolved in recent years and how they have aligned towards the Quadruple Aim. Hear from the panel about how their perspectives have changed as a result of moving from provider organizations over to commercial health plans. 2. The friction caused by utilization management and prior authorization An area where there is misalignment and a source of friction between payers and providers is with prior authorization. Utilization Management was intended to help improve the prior auth processes, but has largely resulted in cost cutting measures that have created even more challenges. Learn about the challenges UM is facing to reduce medical and operating costs, increase plan membership and improve both the satisfaction of members and network providers. 3. Programs and technology solutions to reimagine utilization management Learn about the key initiatives and how new technology solutions and platforms like automation and artificial intelligence can help health plan executives reimagine utilization management and transform the payer enterprise. Hear from the panel on how they plan on solving these challenges and the programs they have developed to solve these challenges for both providers and their members.

Reimagining Utilization Management with Artificial Intelligence

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Dr. Richard Embrey Medical Director, BCBS Alabama

Brian Kelsey Product Manager, Analytics Alithya

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How technology is enabling providers and payers to achieve the Quadruple Aim

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Dr. YiDing Yu Chief Medical Officer, Olive

Deadlines for three critical government mandates are looming on the horizon, so payers need to act quickly to assess their paths to compliance. The first phase of the Transparency in Coverage final rule requires payers to post machine-readable files with healthcare cost information on a website by Jan. 1, 2022. Also with a Jan. 1, 2022, deadline, the No Surprises Act requires, among other things, that payers make advanced explanations of benefits (EOBs) available to members. A bit farther down the road, the CMS Interoperability and Prior Authorization rule takes effect Jan. 1, 2024. In this webinar, participants will hear key insights about all three rules. And the speaker will discuss solution options payers can consider as they chart their courses to compliance and strive to enhance their digital strategies. Learning Points Increase awareness of how you can better manage your organization’s preparations for achieving mandate compliance. Following this presentation, participants will: • Know more about the impact and timing of the No Surprises Act • See enhancements to interoperability and transparency solution options • Understand future CMS prior authorization mandates and opportunities to comply

Government Mandates: Deadlines Are Approaching; It’s Time to Act!

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Ed Hafner, AVP Payer Strategy, Change Healthcare Hafner provides strategic direction to help health plans derive value from the electronic document exchange, including the pre-adjudication platform, machine learning, interoperability, and solution integrations with payment integrity, risk adjustment, and clinical network. Hafner is a seven-term board member of WEDI and is the organization’s chair-elect. He also is an officer on the EHNAC Board’s Criteria Committee.

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Session description Attendees will learn about how virtual health can: • Expand consumer and clinician access • Improve clinical outcome • Enhance consumer experience

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Session description Attendees will learn about how virtual health can: • Expand consumer and clinician access • Improve clinical outcome • Enhance consumer experience

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