Provider-Payer Collaboration and the Impact on Population Health

Sep 14, 2016 12:00pm, CDT

Population health management (PHM) is a journey that requires a sound strategy, solid IT and data infrastructure and a clear understanding of continuous quality improvement efforts in order to make a significant and lasting impact on patients and communities. Increased provider-payer collaboration can have a lasting and positive impact on improving patient and population outcomes. The principles of population health management and their supporting technologies can help ease this shift to value-based care. They align the metrics, incentives, and interventions that guide decision-making for healthcare networks, clinicians, and patients. A population health framework supports collaboration among payers, providers, and community partners—a critical component to developing a program that can be implemented at scale and sustained over time. Attendees will learn how to optimize their provider-payer relationships in order to transform their current population health management strategy and achieve the best results possible during their transition to value-based care.

 

Overall Event Learning Objectives:

1) Identify best practices utilized in successful PHM strategies today
2) Integrate innovative analytic approaches to prepare for emerging trends
3) Discuss best practices for optimizing provider-payer relationships resulting in improved patient outcomes and satisfaction
4) Demonstrate the ability to measure and manage patient populations at risk and improve the quality of care
 

 

Program:

Sep 14, 2016 12:00pm, CDT
Innovation in Healthcare Delivery: the "Comprehensive Care Physician"

David Meltzer, MD, professor in the University of Chicago’s departments of medicine and economics, has undertaken one of the most potentially important projects in U.S. health care, work that may one day transform the way physicians and patients interact.

 

While standard medical practice typically offers care by a primary care physician in a clinic, and transfers the oversight of the patient to a different physician if hospitalization is required, Dr. Meltzer’s concept involves a “comprehensive care physician” (CCP) who oversees the patients’ needs both in clinic and in hospital.

 

The CCP model was developed by the University of Chicago Hospitals in July 2012 as a federally-funded, randomized controlled trial and has undergone a preliminary assessment, which suggests that it may significantly improve quality of care, health outcomes, and reduce cost. That assessment has encouraged other hospitals and health systems in Chicago and around the country to express interest in adopting the model.

 

In this session, Dr. Meltzer, who is widely known for his pioneering work on medical cost-effectiveness and the cost and quality of hospital care, explains the “comprehensive care physician” approach, and, importantly, reviews the outcomes, which, he said, produced a “double digit reduction in hospitalization for an intervention that is free.”

 

 

Speaker(s):

David Meltzer

AChief of the Section of Hospital Medicine

The University of Chicago

 

 

Sep 14, 2016 12:45pm, CDT
Revolutionizing the Provider-Payer Collaboration

Provider-payer relationships are evolving in the era of payment reform and value-based care. The “us versus them” mindset is starting to evolve into a collaboration built on trust and respect. Payers and providers must successfully align their goals in order for both to succeed and patients to benefit. This session will explore the challenges of transforming provider-payer relationships and how to overcome them.

 

Session Learning Objectives:

1) Identify successful collaboration models which result in financial benefits, increased market share and improved clinical outcomes
2) Manage and mitigate the risk associated with shared accountability and data transparency
3) Discuss best practices for meeting patient needs and enhancing consumer trust

 

Speaker(s):

Jamie Solak

Managing Director & COO

Arlington Health Group

 


 

 

Sep 14, 2016 1:30pm, CDT
A Population Health Framework Bridges Fee-for-Service and Value-Based Care

Healthcare providers balance multiple payment models in the trend toward value-based payment. What makes value-based payment such a hot topic is not just the growing level of reimbursement at risk, but the difficulty organizations face balancing multiple revenue models. The principles of population health management and their supporting technologies can ease the shift. They align the metrics, incentives, and interventions that guide decision-making for healthcare networks, clinicians, and patients.

 

Learning Objectives:

1) Define IT capabilities to support value-based payment reform and population health management
2) Identify the five principles behind successful provider-payer collaboration to sustain quality and cost improvements
3) Recognize how other organizations assess patient risk, measure health goals, design fair payment and motivate providers and consumers to management health differently

 

Speaker(s):

L. Gordon Moore, MD.

Senior Medical Director

3M Health Information Systems

 

L. Gordon Moore is senior medical director for Populations and Payment Solutions at 3M Health Information Systems. He is a national leader in improving healthcare in primary care and medical office practices. Dr. Moore helps governments, insurers and healthcare delivery systems prepare for total cost-of-care contracting and effective population health management. He serves as advisor, expert and faculty to numerous initiatives working to achieve better health outcomes while bending the cost curve. His work focuses on the intersection of population health outcomes and patient experience of care, and their impact on total cost-of-care. Dr. Moore has been a faculty member of the Institute for Healthcare Improvement in the domain of office practice redesign, and is a Clinical Assistant Professor with the University of Washington Departments of Family Medicine.


 

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