Payer Issues Virtual Summit

August 24th, 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

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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

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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

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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

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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.

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Reimagining UM

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Deploying artificial intelligence to reduce medical costs, improve operational efficiency, accelerate clinical reviews and improve member satisfaction

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Featured Whitepaper

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MDRG's COVID Tracker: April 2021 Report

Market researchers at our core, MDRG is committed to understanding consumer behavior as it evolves post-pandemic. To that end, we have developed a national tracker and surveyed over 1000 consumers so that we can understand changes in consumer attitudes and behaviors as they pertain to: • Concern about COVID-19 • Vaccine acceptance and hesitancy • Leisure and business travel • Expectations for the US economy In addition, we leveraged our WHOLE MIND™ Approach to market research to uncover emotions associated with travel this summer. This is a great example of System 1 at work using Online Metaphor Elicitation.

Ed Hafner, AVP Payer Strategy, Change Healthcare

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

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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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Health plans around the country are focused on a set of priorities that include reducing medical and operating costs, increasing plan membership and improving both the satisfaction of members and network providers. Executives are addressing these challenges by reimagining utilization management and using automation as well as artificial intelligence (AI) to transform the payer enterprise. Join a panel of health plan executives as they discuss their challenges around prior authorization and utilization management and how they are using AI to solve them.

Reimagining UM:

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Mark Hite Managing Director, Healthcare Alithya

Brian Kelsey Product Manager, Analytics Alithya

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Deploying artificial intelligence to reduce medical costs, improve operational efficiency, accelerate clinical reviews and improve member satisfaction

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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

session title

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Speakers

Digital Content Hub

Agenda

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