ON DEMAND: Evolving Payer-Provider Collaboration, What’s next on the Horizon?

Virtual Briefing

Jul 27, 2016 11:00am - 11:00am CDT
Member Cost: $
Non-Member Cost: $

Increased government involvement, changing and diverse patient populations, rapid technology advancements, and payment and care delivery reform are just some of the major changes the healthcare industry is experiencing today. Healthcare consumers now have more choices than ever before when selecting both provider and payer organizations based on quality of care, comprehensive service offerings, transparent continuity of care, accessibility and convenience, as well as innovation. Value-based care initiatives and corresponding reimbursement incentives are transforming the way in which healthcare is delivered. This virtual briefing will examine challenges and best practices healthcare and payer organizations face with current initiatives, as well as explore strategies for influencing and predicting future opportunities.



Overall Event Learning Objectives:

  1. Identify current and emerging trends in the healthcare landscape which impact care delivery and   payment reform

  2. Discuss potential futuristic models of care and corresponding strategies to prepare for such initiatives

  3. Describe innovative approaches which leverage data analytics to drive behavior and engagement


Jul 27, 2016 CDT
Converging Delivery and Emerging Payment Models

Innovative service and payment models have recently converged on our healthcare delivery system, focused on improving the quality of care and overall population health outcomes, while decreasing costs. This type of industry transformation can be both complex and overwhelming for healthcare organization executives and providers. Unlike the traditional fee-for-service reimbursement methods, alternative payment models support and promote shared savings as well as shared risks amongst the provider/payer relationship. Accountable Care Organizations, Medical Homes, Bundled Payments, Advanced Primary Care and Population-based initiatives promise a future of accountability for both cost and quality. This session will focus on dissecting the broad spectrum of emerging value-based care and payment incentive models converging on the provider and payer sectors, while leveraging information technology and data analytic solutions to enable those initiatives.


Learning Objectives:

  1. Differentiate the emerging care and payment reform initiatives designed to streamline performance and practice transformation

  2. Discover data analytic strategies and interventions to foster a new culture of care delivery



Joe Miller
Director of Strategy and Innovation
AmeriHealth Caritas


Joe Miller has over 20 years’ experience in healthcare IT working in the provider, payer and government sectors. He is currently Director of Strategy and Innovation at AmeriHealth Caritas where he develops innovative solutions for the delivery of administrative and clinical information sharing for health plans addressing the needs of the underserved. He has worked at the local and national levels on a wide range of industry topics including, health information exchange, 5010/ICD-10, and care collaboration. He currently serves as Delaware Valley HIMSS Chapter Advocacy Co-Chair, chaired the 2015 HIMSS Annual Conference, and is a frequent speaker at regional and national conference.


Jul 27, 2016 CDT
Predicting the Models of the Future

Payment and care reform models have experienced unprecedented change within the past few years as healthcare costs continue to rise. Pilot projects with the CMS Innovation Center (CMMI) are already in place around the United States to test the impact on improving quality of care for patients and communities, while reducing expenditures. From population health management to predictive and prescriptive analytics, healthcare organization executives contemplate what the future will bring for future payment and service delivery models, and even more so, how can they predict the somewhat unpredictable. Less than a decade ago, many healthcare organizations were still operating primarily on paper, health data exchange was mostly limited to claims data, and the concept of data warehouses and analytics was fairly new. In addition, the patient population has changed significantly, with millennials and baby boomers looking for opposite healthcare conveniences. Learn from thought-provoking leaders on changes in patient populations and healthcare reform they predict the next decade might bring to the industry and identify visionary strategies that can be implemented today in order to prepare for future change and growth.


Learning Objectives:

  1. Identify current landscape challenges, trends and opportunities which could drive further care delivery and payment reform initiatives

  2. Recognize innovative best practices and strategies which can be incorporated in the short-term in order to plan for long-term, sustainable and viable transformation


Travis Broome, MPH, MBA
Policy Lead, Executive Director
Aledade, Inc.


Travis Broome leads Aledade's policy efforts in both Medicare and the commercial space to ensure a viable financial model for Accountable Care Organizations and population health. A veteran of the Center for Medicare & Medicaid Services, Travis most recently served as a Regional Manager at CMS. In this role he oversaw Medicare Part A & B, EHR, and ACO operations across five states. Prior to this, he was Team Lead for the group responsible for policy and oversight in the Health IT Group at the Center for Medicare & Medicaid Services. Travis received Masters of Public Health, and of Business Administration in Health Care Organization and Policy from the University of Alabama at Birmingham.

Jul 27, 2016 CDT
Predictive Analytics: A Catalyst to Drive Behavior and Engagement in a Value-based World

This session will discuss how behavioral data is informing the next generation of actionable and predictive analytics to further support the evolving value-based care system. Understand how organizations can use this data to manage populations and drive engagement not only by predicted cost, but also by receptiveness to treatment. By coupling behavioral information with predictive analytics showing the impact on patient or population outcomes and the likelihood that the patient or population will become actively engaged in their own care, healthcare organizations can further refine programs to maximize the delivery of the highest quality, most cost effective care. Learn what technology and analytics solutions are needed to assess, engage and treat patients through this lens. Examine advanced analytics exemplars and proven best practices to better understand how to further optimize outcomes, drive engagement, and support collaboration in your risk-based programs.


Learning Objectives:

  1. Review how behavioral data can determine which interventions are the most effective in driving improved care

  2. Discuss best practices to leverage predictive analytics to drive behavior and engagement

  3. Identify the impact of behavioral data on payer and provider collaboration



Rose Higgins
SCIO Health Analytics


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