agenda - ahip.org

@AHIPCoverage, #AHIPInstitute

® America’s Health Insurance Plans

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June 15-17, 2016

Las Vegas, NV

Agenda

Wednesday, June 15

7:00 am – 7:00 pm Registration and Information Desks Open (Registration Desks 1 & 2) Sponsored by Optum

11:45 am – 7:00 pm Exhibit Hall Open (Lafite and Latour Ballrooms)

11:45 am – 1:00 pm Luncheon in the Exhibit Hall (Lafite and Latour Ballrooms) Sponsored by GE Healthcare

1:00 pm – 1:30 pm Welcome and General Session

The Future of Health Care and Plans Leading the Way (Encore Ballroom)

Speaker:

Marilyn Tavenner, President and CEO, America's Health Insurance Plans (AHIP)

1:30 pm – 2:45 pm General Session

Better Health Care at Lower Cost: Is It Possible? (Encore Ballroom)

As you work daily to transform our health care system, lower costs, and build the path to sustainability, you know the answers aren’t easy. It takes bold ideas, unprecedented partnerships, and new ways of thinking for all stakeholders. Take a look at what’s working, what’s next, and how your organization can help lead the change.

Speakers:

David L. Bernd, CEO Emeritus, Sentara Healthcare

Senator William H. Frist, MD, Nationally-Acclaimed Heart and Lung Transplant Surgeon, Former

U.S. Senator and Senate Majority Leader

Bernard J. Tyson, Chairman and CEO, Kaiser Permanente

2:45 pm – 3:00 pm Coffee Break (Outside of Petrus, Mouton and Margaux Rooms)

3:00 pm – 4:00 pm Concurrent Sessions

AHIP Young Professionals Network Career Development Workshop

Millennial Game Plan for Success: Essential Advice for Today’s Young Professional (Lafleur 1)

As digital natives, Millennials have grown up with instant feedback and access to information. As employees, they are ambitious and hungry for success and open communication is key to this success. Whether you are a Millennial looking to succeed in the workforce or a manager determined to hold onto these exceptional employees, this session will help you learn the key ingredients to build your own/employee development plan.

Speaker:

Joe Judge, President, Clear Possibilities

Institute & Expo Moderator

Susan Dentzer, President and

Chief Executive Officer, The Network for Excellence in Health Innovation (NEHI)




June 15-17, 2016

Las Vegas, NV

Wednesday, June 15

3:00 pm – 4:00 pm Concurrent Sessions (continued)

Track: Industry Disruption & Transformation

Health Care Consolidation: Trends, Impact and Regulation (Margaux 2)

This session will address the driving forces behind the recent increase in consolidation; the scope and extent of consolidation among physicians, hospitals and insurers; implications for consumers and other stakeholders; and the roles of the Department of Justice and the Federal Trade Commission. The speakers will explore what the review process may look like, the potential competitive impact of these deals on health care markets and the health insurance industry, and the unique issues they present locally and nationally.

Speakers:

Mark J. Botti, Partner, Squire Sanders

Paul B. Ginsburg, PhD, Professor, Public Policy and Director of Public Policy, Schaeffer Center for

Health Policy and Economics, University of Southern California; Leonard D. Schaeffer Chair in Health Policy Studies, Senior Fellow and Director, Center for Health Policy, The Brookings Institution

Slava Zayats, PhD, Principal, Bates White

Track: Consumer Experience

Five Uncommon Choices of the Best Consumer Experience Companies (Margaux 1)

With one mouse click, you can have a package on your doorstep in a matter of hours or a dinner reservation for that evening. These experiences and others just like them are causing consumer expectations to skyrocket. Learn how the best-in-class consumer companies are making five uncommon choices to achieve market differentiation through consumer experience that run counter to everything you know. For the past two years, a leading health plan has been following the example set by these innovative companies and has some encouraging results to report about their consumer experience and culture transformation.

Speaker:

David Poole, Staff Vice President, Consumer Experience, Anthem, Inc.

Track: Federal Programs

How to Work with the Government as Your Largest Customer (Mouton 2)

The federal government is the largest single payer of health care in the United States, accounting for more than a quarter of all U.S. spending on health care. As the nation’s largest payer, the federal government is able to significantly shape and move the health care market. Whether it is the Centers for Medicare & Medicaid Services determining which treatments and technologies are worth covering and how much they are willing to reimburse for them; the Agency for Healthcare Research and Quality mandating quality and safety standards; or the Affordable Care Act Marketplace setting the standard for benefit packages throughout the health insurance market, it is clear that government agencies and their directives play a powerful role in guiding the provision of health benefits and the overall construct of the market. Speakers in this session will explore how to work effectively with the government as your largest customer and how to achieve the widely proclaimed goal of better quality health care at a more affordable cost.

Speakers:

Andrew Davis, Vice President and General Manager, Medicare Segment, Medica

Austin Ifedirah, DDS, MBA, Senior Vice President and Chief Business Development Officer, Gateway Health Plan




June 15-17, 2016

Las Vegas, NV

Wednesday, June 15


Track: Data Analytics & Insight

Using Data to Drive Better Health Care (Montrachet)

Health care “hotspotting” is a data-driven process for the timely identification of extreme patterns of health care use. It can be employed to guide targeted interventions and follow-up to better address patient needs, improve care quality, reshape ineffective utilization patterns and reduce costs. This session will examine resources a city-wide coalition of health care providers is developing to help other communities identify and care for their high-need, high-cost residents. Speakers will share perspectives on using the hotspotting approach to improve quality of care and reduce costs.

Speakers:

Matthew O. Hurford, MD, Vice President, Medical Affairs, Community Care Behavioral Health Organization, UPMC Insurance Services Division

Alice Rogot Pressman, PhD, MS, Director, Analytics and Evaluation Research, Development and Dissemination, Sutter Health of Northern California

Stephen Singer, Senior Manager, Data Analytics, Camden Coalition of Healthcare Providers

Track: Prevention, Health & Well-Being

Culture + Verifiable Results = Wellness Program Success (Palmer)

Many employers struggle to define a comprehensive wellness strategy that both meets their employee needs and is also attractive to leadership in the C-suite. Wellness programming can be a smart investment. But in order to justify that investment, you must be able to illustrate that your program quantifiably produces better employee health, generates long-term cost savings and increases overall employee productivity. You also want to be able to demonstrate the intangible values of creating stronger employee engagement and encouraging a culture of wellness. This session will highlight the key elements needed to build a successful wellness program, how to excite and engage employees in a way that gets them motivated to participate, and how to promote

program benefits to the C-suite.

Speakers:

Alisha DeMoss, MS, Leader, Health Promotion Consultants, Humana Inc.

Cameron Troxell, Director, Health and Wellness, Indiana State Personnel Department

Track: Digital Health

Where’s the Next Digital Health Unicorn? (Petrus 1)

Billions of dollars of venture funding have poured into digital health, but most investors are still waiting to see a return. Many of the recently public digital health companies have lost value since going public, and several high-profile private companies have hit major roadblocks. This session will explore the digital health landscape and how startups and health care organizations successfully partner to bring new technologies to the forefront. Speakers will discuss why they are excited about digital health, how investor sentiment has evolved in the last five years, and where all the promised unicorns are.

Speakers:

Lynne Chou O’Keefe, Partner, Kleiner Perkins Caufield & Byers

James Sinclair, Managing Director, Healthcare Services and Technology, Goldman, Sachs & Co.

Halle Tecco, Founder, Rock Health and Adjunct Professor, Columbia Business School




June 15-17, 2016

Las Vegas, NV

Wednesday, June 15


Track: Technologies & Business Solutions

Your Members are in the Pharmacy. Are You?! (Petrus 2) Powered by McKesson Health Solutions

Nearly ninety-five percent of all Americans live within five miles of a pharmacy and consumers, on average, visit their pharmacy two to three times per month. Learn how health plans are using a nationwide retail pharmacy network to tailor member engagement and member compliance in real-time when members pick up a prescription at the pharmacy. Speakers will discuss results of how health plans are collaborating with retail pharmacy to fill gaps in care, expand immunization coverage and drive adherence rates to improve their quality measures.

Speakers:

Dan Dragalin, MD, MPH, FAAP, Medical Director, McKesson Health Solutions

Jan Reed, Director, Health Plans Services, RelayHealth Pharmacy Solutions

Track: Value-Based Partnerships

The Business Case for Addressing Patients' Social Needs in Health Care Delivery

(Mouton 1)

Sociologists and public health researchers in recent years have learned much from studying the “social determinants” of health, that is, how lack of education, low income, and the characteristics of neighborhoods and social networks can harm health through complex pathways. Given the importance of social determinants on health and health equity and the new opportunities provided by the ACA, a range of initiatives to address social determinants of health are emerging at the federal, state, local and provider level. This session will address the social determinants of health and their role in reducing health disparities and building and sustaining healthy communities. Speakers will highlight frontline accounts of how health systems are striving to meet their patients’ social needs, especially in response to value-based payment and increasing accountability for quality, costs and outcomes.

Speakers:

Rocco Perla, President, Health Leads

Karin VanZant, Executive Director, Life Sciences, CareSource



Investing in Health Care Innovation in a Fast-Changing Market (Margaux 2)

In the face of drastic changes, incumbents are consolidating and new entrants are emerging to disrupt legacy health care models, due to a potent mix of new regulations, new technologies and fast-evolving consumer demand. For investors, this means navigating a complicated landscape to identify the sectors and models ripe for disruption. For plans, this means how they diversify their portfolio and distinguish themselves in a market where everyone offers the same core services. In this session, speakers will discuss what it takes for a startup to disrupt an incumbent, and for an incumbent to disrupt itself.

Speakers:

Terry Booker, Vice President, Corporate Development and Innovation, Independence Blue Cross

Rob Coppedge, President, Direct Health Solutions, Cambia Health Solutions




June 15-17, 2016

Las Vegas, NV

Wednesday, June 15


Track: Customer Experience

Reinventing the Health Plan: How Creating a Magnetic Offering is the Path Forward

(Margaux 1)

Today’s payers have the opportunity to re-invent the health product offering and play offense at a time when consumers are seeking more from their health and wellness benefits – more value, more convenience, more transparency, more relevancy and so on. They are ready to experience what permeates other aspect of their lives, from online shopping to finding a restaurant to helping a child with homework – a fully informed and magnetic experience backed by a broad set of offerings and big data that allows for not just personalization, but prediction; and in health care’s case, prevention. This session will explore how health plans can set the bar for a much more attractive and ambitious product and service offering on par with Google and Amazon. Learn how the payer can actively engage in vital partnerships that enable Health Plan 2.0, in which they become both a curator and an integrator of a truly magnetic offering. This session will also highlight one health plan’s ambitious approach to next generation product design as well as lessons learned.

Speakers:

Sukanya Soderland, Partner, Health & Life Sciences Practice, Oliver Wyman

Rebekah Gales Swain, Principal Strategic Advisor, Sales & Marketing, Blue Cross Blue Shield of North Carolina

Todd Van Tol, Partner and Head of Life Sciences, Oliver Wyman


Medicare Advantage: Delivering Value for Beneficiaries through Innovation

(Mouton 2)

Medicare Advantage (MA) plans play a critical role in providing high-quality, affordable coverage for nearly 17 million Americans. The success MA plans have achieved in improving health care quality, patient care and value is due in large part to innovations in health care delivery, care coordination, and disease management. This session will examine how changes to the MA risk adjustment system impact innovative approaches that are driving value and improving care for MA beneficiaries.

Speakers:

Eve Gelb, Senior Vice President, Healthcare Services, SCAN Health Plan

Thomas Kornfield, MPP, Vice President, Avalere Health

Dirk Wales, MD, PsyD, Senior Vice President and Chief Medical Officer, Cigna-HealthSpring


The Changing Path to Purchase and the Importance of ZMOT (Montrachet)

The Zero Moment of Truth (ZMOT) is fundamentally about getting closer to the customer. To do this, you need to understand them. What are they looking for? When? What information do they have already? What’s their state of mind? The consumer’s health insurance journey is no longer linear, and is rapidly transforming by the catalyst of technology. Through data, we’ll explore how and why the purchase path has expanded and what you need to know to stay relevant and engage with them. How do health plans win ZMOT and all of the subsequent real time, intent-driven, digital micro moments that follow? This session will offer insight for how to gain a competitive advantage.

Speaker:

Addie Braun, Head of Industry, Health Insurance, Google




June 15-17, 2016

Las Vegas, NV

Wednesday, June 15



Meeting Patients Where They Are: The Race to Re-Engineer How Care Is Delivered

(Mouton 1)

New reimbursement models are yielding new models of care – but it’s not yet clear which are best positioned to succeed at-scale. Will it be primary care-centered ACOs, or a host of new services entirely, such as retail clinics, telehealth offerings, or on-demand home care? Most importantly, what do these new models mean for patients in terms of quality, access and cost? This session will tackle what the future holds in terms of care settings, technology tools, and patient engagement tactics – and what it means for patients and physicians alike.

Speakers:

Ed Lehman, Senior Vice President, National Accounts & Channel Partnerships, Grand Rounds

Andrew Schutzbank, MD, MPH, Vice President, Product, Iora Health


Connecting Providers, Payers and Patients through Mobile Health (Petrus 1)

Mobile health, or mHealth, is a game-changer in the era of accountable care – from improving care delivery to streamlining operational efficiencies in health care organizations. For providers, payers and patients, mHealth is pushing the limits of how we track health, gather and store data, and analyze the information to deliver meaningful results. Speakers will engage in dialogue around both the possibilities and real-world applications of mobile in health care.

Speakers:

Sean Doolan, Network Associate, StartUp Health

Adam Pellegrini, Vice President, Digital Health, Walgreens

Leah Sparks, CEO, Wildflower Health

Harry Wang, Senior Director, Research, Parks Associates


The Payer’s Journey to Achieving Operational Excellence (Petrus 2) Powered by Optum

Now more than ever, payers must drive their operations to become as efficient, dexterous and agile as possible. Leading payers are leveraging business process solutions (BPM) to drive cost out of their organization, develop consumer-centric enterprises and deliver operational efficiencies that free up working capital. For payers to transform and optimize the enterprise, they must combine BPM processes and technology within a proper operational framework with an eye toward driving strategic business outcomes. Join our panel of experts to hear first-hand how they are helping to transform health plans into agile enterprises. You will learn how to determine if BPM solutions are right for your organization.

Speakers:

Jeff Carter, Vice President, Optum Payer Solutions

Bill Polston, Vice President, Consumer Experience, Optum Customer Care

Timothy M. Roty, Senior Director, Provider Operations and Technology, UnitedHealthcare

Ranga Valayaputhur, Associate Director, Consulting Services, Optum Payer Solutions




June 15-17, 2016

Las Vegas, NV

Wednesday, June 15



Public Exchange Realities: Why One Size Does NOT Fit All (and Why It Matters)

(Lafleur 1) Powered by Accenture

Public health insurance exchanges are in their third coverage year with three open enrollment cycles completed. In each cycle the process matures and consumer expectations and behaviors adjust. The keys to sustainability for exchanges and payers include enrolling harder to reach consumers, keeping consumers from dropping out and effectively assisting consumers to purchase coverage that meets their expectations. This session will present the latest Accenture research that illuminates the key factors that affect consumers’ satisfaction with the process and their ability to select the most appropriate plan for themselves – including how strategies such as live assistance, digital tools, standardization and other approaches impact consumer engagement. This discussion will also feature the perspective of a Public Exchange executive regarding the key factors to success in the exchange market in the future.

Speakers:

Mila Kofman, Executive Director, DC Health Benefit Exchange Authority

Loren McCaghy, Director, Consumer Engagement and Product Insight, Accenture

Phil Poley, Managing Director, Accenture


The Future of Wearables (Palmer)

Wearable technology is providing us with an unprecedented view of people’s everyday behavior and lifestyle. Data produced by fitness trackers, clothing, accessories, lifestyle apps and other sources have the potential to help consumers gain better control over their own health and related health care costs, and help health care organizations revolutionize and personalize the health care experience. How is the wearable technology landscape evolving in complexity? How will wearables impact population health and wellness and help shape the new health economy? Our speakers will share perspectives on the opportunities and challenges facing wearable technology today and what the future may hold.

Speakers:

Karen Lee, Leader, Wellness Innovation and Strategic Partnerships, Humana, Inc.

Richard Kerslake, Director, Product Management & Strategy, Wearables, Intel Corporation

Carrie L. Rief, MBA, MHA, Strategic Partnerships, Health Plans, Fitbit Wellness

Halle Tecco, Founder, Rock Health and Adjunct Professor, Columbia Business School

5:30 pm – 7:00 pm Opening Night Reception (Lafite and Latour Ballrooms)

Sponsored by IBM Corporation




June 15-17, 2016

Las Vegas, NV

Thursday, June 16

6:45 am – 5:15 pm Registration and Information Desks Open (Registration Desks 1 & 2) Sponsored by Optum

7:30 am – 8:15 am Breakfast Briefings


Consumer Engagement and Outcomes-Based Payments: How Stakeholder Collaboration Can Help (Margaux 1) Powered by Payspan, Inc.

These days, payers and providers are collaborating more than ever. As the health care industry continues to transform, consumers need to be engaged on a more personal level. This session will explore how industry stakeholders can work together to effectively achieve this level of engagement, and how this collaboration can also create value for the consumer. The speaker will also discuss how payers and providers can align their strategies to aid in the shift to outcomes-based payment models.

Speaker:

Bill Nordmark, Chief Growth Officer, Payspan, Inc.

Track: Data Analysis & Insight

The Evolution of Provider Data Management – Moving Beyond Compliance to Enterprise Value (Montrachet) Powered by LexisNexis

®

Providers are at the heart of health care and new delivery models call for health plans to find more ways to collaborate, manage, and foster the relationships they keep with their networks. Historically, the upkeep and use of provider information has been viewed as vehicle to drive compliance. But when leveraged appropriately, provider data can become a key enabler for better operational efficiency, informed contract negotiations, and improved member satisfaction and health outcomes. This session will revisit the evolution of provider data and its role within the health plan, explore the untapped potential this data set has to drive enterprise-wide benefits and identify future provider data trends that require health plans to act now.

Speaker:

Josh Schoeller, Vice President, Client Engagement, LexisNexis® Health Care


Bundled Payments: Evaluating the Opportunities for Your Business (Mouton 1) Powered by Truven Health Analytics

Bundled payments are one of the most promising fee-for-service alternatives, and have gained increased traction with health care reform. These arrangements provide a workable solution for providers and payers by focusing on care transformation, and offer real promise for improving care and controlling costs. But payment bundling is complex and requires deep understanding and analysis of your data and effective provider relationships to facilitate care transformation. In this session, attendees will learn about the experiences of payers and providers in various stages of implementing bundled payments. The speakers will discuss methods used to determine preparedness, how to evaluate opportunities and risks, and key metrics for measuring success.

Speakers:

David Jackson, Senior Consulting Manager, Payer Analytics, Truven Health Analytics

Kevin Ruane, Senior Consulting Scientist, Payer Analytics, Truven Health Analytics




June 15-17, 2016

Las Vegas, NV

Thursday, June 16

7:30 am – 8:15 am Breakfast Briefings (continued)


Leveraging Customer Experience Technology to Become a Trusted Brand (Palmer) Powered by Zipari, Inc.

While the ACA presents significant challenges there is also tremendous opportunity. Health insurers can differentiate themselves by offering a superior, data-driven customer experience to become a trusted brand. Carriers require tools that will offer a deep understanding of their consumers and allow them to guard against the volatility introduced by public and private exchange marketplaces. Health care payers can utilize real-time customer data and analytics and advanced CRM capabilities to evaluate and improve upon member interactions to maximize membership and lifetime member value. During this session, speakers will discuss how health plans can leverage data and consumer-friendly technology to realize the benefits of creating strong member brand affinity.

Speakers:

Tracy Faigin, Chief Marketing Officer, Canopy Health Insurance

Mark Nathan, Chief Executive Officer, Zipari, Inc.

Kristina Park, Partner, Optimity Advisors


Using Digital Technologies to Drive Member (or Consumer) Engagement: Are You Prepared to Compete? (Petrus 1) Powered by Cognizant Technology Solutions

Welcome to the world of the engaged, aware and empowered health care consumer. Transformative market forces, coupled with rapid advances in digital technologies, are placing consumers at the center of an increasingly virtualized, personalized and delocalized health care system. Responding to this transformation is an existential challenge for traditional health care organizations – one they must master if they hope to thrive in the new digital economy. Health plans are struggling to identify how to best meet the needs of their members across digital channels, while balancing competing priorities for technology investments. During this session, gain insights into recent research focused around member expectations, and whether or not they are aligned with the C-Suite’s perspectives on the adoption of digital technologies to drive member engagement.

Speaker:

Joel Gleason, Senior Vice President, Health TranZform, Cognizant Technology Solutions


Business Transformation: Creating a Competitive Advantage in the Market (Petrus 2) Powered by PA Consulting Group

This session will highlight a health plan’s recent journey to transform its business, restructure its operations to be competitive in the market, and reinvent traditional business functions into strategic business assets. Attendees will learn about the results of a transformational initiative a large payer recently completed which identified operating model changes resulting in substantial year over year cost savings. The speakers will also review lessons learned that other organizations can use to apply to their organization’s transformational initiatives.

Speakers:

Jeff Cameron, Member of PA Consulting Group’s Management Team, PA Consulting Group, Healthcare Practice

Douglas Cowieson, Senior Vice President of Operations, EmblemHealth




June 15-17, 2016

Las Vegas, NV

Thursday, June 16



Agility, Efficiency and Transparency: Stories from Industry Leaders at the Forefront of the Health Care Revolution (Margaux 2) Powered by HealthEdge®

This session will focus on the agility that’s required to compete in today’s health care marketplace, and explore the models that will have the most significant market impacts both today and tomorrow. The panelists will also explore strategies and key concepts related to the topic of efficiency, and discuss ways that health plans are leveraging new approaches to become more efficient and reduce administrative costs. Finally, the session will review experiences and insights related to transparency, and talk about ways that data transparency and analytics are being used to drive new levels of insight, efficiency and success, particularly in today’s consumer-focused world.

Speakers:

Tim Bartholow, MD, Vice President and Chief Medical Officer, WES Trust

Ray Desrochers, Executive Vice President, HealthEdge

Robert J. Murphy, MBA, MHS, Managing Director, Accenture


Next Generation Payers: Influencing Care Quality in Collaboration with Providers

(Mouton 2) Powered by GE Healthcare

Payers are looking for higher quality and value, provider assumption of risk, and greater adherence to care protocols at a lower cost. Providers are facing new payment challenges and models and are increasingly looking for ways to manage the care of patient populations in a value-focused environment, seeking to improve quality, reduce costs and eliminate waste. Patients need to be more active participants in decisions about their health care and more conscious of costs. This session will highlight the importance of creating a system that generates insights from population health management initiatives, and automatically turns them into evidence-based guided actions to deliver optimal patient and business outcomes.

Speaker:

Jon Zimmerman, General Manager, GE Healthcare IT

8:30 am – 9:30 am General Session

The Health Insurer of the Future: How Disruptive Innovators are Reimagining Health Care (Encore Ballroom)

New health insurers are entering the market, thinking differently about the consumer and focusing on innovative disruption that is reshaping our health care system. From technology to telemedicine, innovative care models and transparency, learn firsthand how they are helping to reimagine health care.

Speakers:

Vivek Garipalli, Co-Founder and CEO, Clover Health

Kyle Rolfing, Co-Founder and President, Bright Health, Inc.

Mario Schlosser, Chief Executive Officer, Oscar Insurance Corporation

Tom Vanderheyden, Co-Founder and Chief Executive Officer, Harken Health




June 15-17, 2016

Las Vegas, NV

Thursday, June 16

9:30 am – 7:00 pm Exhibit Hall Open (Lafite and Latour Ballrooms)

9:30 am – 10:30 am Coffee Break in the Exhibit Hall (Lafite and Latour Ballrooms)

10:30 am – 11:45 am Signature Series


The Disruptors: Consumerization of Health Care (Mouton 1)

The number of companies with a vision to improve consumers’ health care experiences are exploding. From population health management to consumer decision support to technology infrastructure, they are rethinking the health insurance customer relationship throughout the lifecycle. The pace of change is mindboggling. This C-suite panel of entrepreneurs will discuss how their value proposition is intended to disrupt and disintermediate markets, and bring an enhanced value exchange (and better health) to tomorrow’s health care consumers.

Speakers:

Ann Mond Johnson, CEO, Zest Health

Lindsay Resnick, Chief Marketing Officer, Wunderman Health

Jennifer Schneider, MD, MS, Chief Medical Officer, Livongo Health

Jeff Smedsrud, Chief Executive Officer and Co-Founder, Healthcare.com


From Volume to Value: New Frontiers in Payer-Provider Collaboration (Mouton 2)

As payers and providers tackle the shift from volume to value, established players are collaborating on new reimbursement and care delivery models – while new entrants are emerging to enable the market’s transformation. What are the bounds of competition and collaboration? Which models are actually succeeding at generating savings and improving outcomes? What strategies are being used to effectively integrate providers and evaluate risk tolerance among hospitals, primary care doctors and specialists? How well are strategies for transferring risk, increasing specialist involvement and distributing shared savings working? Hear the pros and cons of different models, and which value-based strategies are optimal for creating a win-win model for plans, providers and patients. Speakers will address the lessons learned from existing payment reform initiatives, the challenges that remain, and new health plan efforts for reaching the goals of the HHS initiative.

Speakers:

Jan Berger, MD, MJ, President and Chief Executive Officer, Health Intelligence Partners

Andrea Gelzer, MD, MS, FACP, Senior Vice President and Corporate Chief Medical Officer, AmeriHealth Caritas

Beth Ginzinger, Vice President, Provider Joint Ventures, West Region, Anthem, Inc.

Scott Sarran, MD, MM, Chief Medical Officer, Government Programs, Health Care Service Corporation

Frank L. Urbano, MD, MBA, FACP, Senior Medical Director, Clinical Services, AmeriHealth New Jersey

Charlton Wilson, MD, FACP, FACHE, Chief Medical Officer, Mercy Care Plan




June 15-17, 2016

Las Vegas, NV

Thursday, June 16

10:30 am – 11:45 am Signature Series (continued)


Measuring Success: Which Consumer-Focused Initiative Is the Right One?

(Margaux 1)

You’ve gone beyond segmentation and have done some qualitative research to understand what consumers really need and want from your organization. You’ve used those research insights to envision an improved consumer journey that will alleviate pain points and even deliver delight. The team is on the same page that this vision will result in a fundamentally improved experience, but there are many aspects of the journey. Many changes will need to be made, some large and some small. Which are more important? Which will get you the most results? What should be done first, second, and third? Where should limited investment dollars be spent? The speakers will explore key considerations for measuring consumer engagement, deciding which metrics are important to your organization, and setting up guiding principles that support your organization’s purpose as a framework for decision making.

Speakers:

Amy Cueva, Founder and Chief Experience Officer, Mad*Pow

Melinda Karp, Senior Director, Member Experience Innovations, Blue Cross and Blue Shield of Massachusetts


RAPS to EDS Transition Collaboration: Data Driven Analysis (Margaux 2) Powered by Inovalon

In the Final Calendar Year (CY) 2016 Medicare Advantage Rate Announcement, CMS proposed for the first time to calculate 2016 risk scores for health plans, which reflects data from 2015 dates of service, by weighting risk scores from diagnoses submitted through the Risk Adjustment Processing System (RAPS) by ninety percent, and the risk scores from diagnoses obtained through the Encounter Data System (EDS) by ten percent. The Final CY 2017 Medicare Advantage Rate Announcement increases the EDS weighting to twenty-five percent. As health plans undergo this transition, a collaboration of over nine diverse payers was designed to provide insight, driven by aggregate data, to compare the impact this change will have on health outcomes and risk scores. Attendees will learn the results of this robust collaboration and the quantifiable data on the leakage issues for RAPS submission when compared to EDS.

Speakers:

Thomas Kornfield, MPP, Vice President, Avalere Health

Gabriel Medley, Senior Director, Gateway Health Plan

David Meyer, Vice President, SCAN Health Plan

Alan Miller, Manager, Risk Adjustment, Blue Cross Blue Shield of North Carolina Kevin Mowll, Executive Director, Resource Initiative and Society for Education

Jason Z. Rose, Chief Strategic Development Officer, Inovalon




June 15-17, 2016

Las Vegas, NV

Thursday, June 16

10:30 am – 11:45 am Signature Series (continued)


The New Rules of Patient Engagement: Innovations and Strategies for Effectively Managing 100% of a Population (Petrus 1 & 2) Powered by Health Dialog Services Corporation

Patient engagement is the “holy grail” for any organization implementing population health management programs. Understanding risk, realigning financial incentives, and increasing access to care are all critical components to success, but without effectively motivating people to change their behaviors and improve their health, these initiatives are likely to fail. Payers and self-funded employers are often challenged with engaging certain segments of the population, especially those that can’t be easily identified using claims or other traditional methods. This session will focus on these challenges and provide insight on how we can use advancements in analytics, mobile technology, digital health, and behavioral science to deliver more personalized, cost-effective, and measurable patient engagement programs.

Speakers:

Houman Arasteh, President and Chief Operating Officer, H2 Wellness

Ken Black, Group Vice President, Compensation, Benefits and Shared Services, Rite Aid

Peter Goldbach, MD, CHIE, Chief Medical Officer, Health Dialog Services Corporation

Karen Staniforth, Chief Operating Officer, Health Dialog Services Corporation


Do Current Business Process Outcomes Have You Singin’ the Blues? (Montrachet) Powered by Dell

In every industry, senior leaders are looking at new ways to radically improve operational outcomes and significantly reduce costs, thereby improving customer experience and freeing up funds for investment in digital and analytics initiatives. Leading industries have adopted a business process as a service model, giving them the flexibility to focus on their higher-value initiatives. Learn how other organizations have achieved greater operational and customer results by embracing an innovative service model. You will hear a living case study of one health plan’s journey.

Speakers:

Andy Arends, Managing Principal, Health Plan Innovation & Consulting, Dell Services

Lee Fontaine, Insurance Services Senior Consultant, Dell Services

Mike Hudson, Chief Financial Officer, Blue Cross & Blue Shield of Rhode Island

Randy Wiele, Managing Director, KPMG

Shashi Yadiki, Executive Director & Global Head, Health Plans, Dell Services

11:45 am – 1:15 pm Lunch in the Exhibit Hall (Lafite and Latour Ballrooms)



Realizing the Promise of Digital Health Technology for Complex Patients (Petrus 1)

Speakers will share perspectives on the current health technology landscape, challenges and opportunities, and how to bring entrepreneurs, providers, investors, payers, and patients together to develop meaningful tools.

Speakers:

Wen Dombrowski, MD, MBA, Aging, Healthcare, Technology and Social Media Advisor, Resonate Health LLC

Andrey Ostrovsky, MD, CEO and Co-Founder, Care at Hand

Mike Payne, MBA, MSci, Chief Healthcare Development Officer, Omada Health




June 15-17, 2016

Las Vegas, NV

Thursday, June 16



Helping Consumers Navigate Health Care: How to Win the Hearts and Minds of the New Consumer (Margaux 1)

When it comes to navigating health care, we are just beginning to scratch the surface of what is needed to create a patient-centered, consumer-centric health care system. Consumers today face a complicated task: from selecting a plan, to finding care, staying healthy, and more. Incumbents are certainly evolving to adapt; but just as quickly, new entrants are entering the market with the goal of becoming consumers’ trusted health care advisors. And yet, many questions remain. What is working? What can we do better? What can we learn from other industries? How can we own or drive the consumer relationship and experience more effectively? How do we build consumer credibility? This session will feature a panel of leaders from across the continuum of consumer health care organizations to explore what the future holds for consumer-focused models. Speakers will share what it takes to win the hearts and minds of consumers so that we earn their trust and in return gain what every business covets, satisfied and repeat customers.

Speakers:

Veer Gidwaney, CEO and Co-Founder, Maxwell Health

Marcus Osbourne, Vice President, Health and Wellness Transformation, Walmart

Sally Poblete, CEO, Wellthie


Operationalizing in a Dynamic and Expanding Regulatory Environment (Mouton 2)

Medicaid’s role in the health care delivery system has expanded significantly. With the passage of the ACA, Medicaid now provides health insurance to almost 80 million Americans or about 1 in 4 individuals. The majority of those enrolled are insured by private health plans which must comply with both state and federal regulations, many of which are newly issued. For example, the recently finalized “mega-reg” modernizes and touches on all aspects of health plan operations and finance. This session will focus on the implications, opportunities and challenges arising from the dramatic increase in regulations for Medicaid managed care programs. Speakers will share strategies that harmonize these new standards with efficient business operations and assist governmental payers with broader health system transformation goals.

Speakers:

John Kaelin, Senior Advisor, Centene Corporation

Susan Montgomery, Vice President, Medicaid and Regulatory Affairs, MVP Health Care

Michael P. Radu, Senior Vice President, Clinical Operations and Business Development, WellCare Health Plan


The Biopharmaceutical Dilemma? (Margaux 2) Powered by AMGEN Inc.

This session will provide a snapshot of how health care innovations both enhance and challenge the U.S. health care system. You will learn about the effects of competition and consolidation on innovation. The speaker will also examine the Affordable Care Act and its effects on health care innovation. Finally, payers and employers will learn about some key considerations when evaluating new innovations for patients.

Speaker:

Amitabh Chandra, MD, Chief Scientific Officer, Precision Health Economics




June 15-17, 2016

Las Vegas, NV

Thursday, June 16



Scaling Alternative Payment Models: Expanding Global Budget Contracts to Include PPO Members (Mouton1)

Rethinking how the U.S. health care system pays for care is critical to achieving better outcomes at lower costs. As health care stakeholders explore new ways to achieve this goal, existing payer models can provide valuable guidance. This session will explore an innovative payment model developed by a leading regional health plan to promote quality and reward positive health outcomes. The speaker will share lessons learned to date, as well as explore the potential for their payment model and other successful commercial ventures to serve as templates for pilots that engage the Medicare program and other government payers, with the potential to transform health care delivery and spending.

Speaker:

Matthew Day, FSA, MAAA, Senior Vice President, Network Payment Innovation and Contract

Management, Blue Cross Blue Shield of Massachusetts


Personalization: The Must-Have Capability for Population Health Managers

(Montrachet) Powered by Welltok

The one-size-fits-all approach to health care is no longer acceptable. To survive, organizations must evolve from using traditional population segmentation approaches that serve the “sickcare” system, to creating a holistic, personalized experience that guides consumers to optimized health. How can health plans connect with consumers at an individual level, and serve up the right resources, at the right time? The secret is to fully understand and engage with consumers – both within and outside of the health care system through a new combination of applied analytics, cognitive computing and consumer inputs. This session will explore how industry innovators are leveraging data and enterprise-level technologies to create a truly personalized experience for their consumers.

Speaker:

Jeff Margolis, Chairman and CEO, Welltok


Disruption without Disenfranchisement (Palmer)

One of the most pressing challenges facing the health insurance industry today is meeting the expectations that consumer-driven health care demands, including enabling people to access all their health care information in one place – easily and securely. To do this, employers, health plans and providers must leverage digital solutions and drive innovative disruption without disenfranchising the health care system – and the people it serves. In this session, speakers will discuss how they are embracing the new frontier of health care innovation to better serve the health needs of their populations and scale for the future.

Speakers:

Jeff Arnold, Chairman and CEO, ShareCare

Ken Goulet, President, KRG Advisers LLC

Teri Wisness, Director, Benefits, Google




June 15-17, 2016

Las Vegas, NV

Thursday, June 16



Reduce Improper Payments with End-to-End Risk Mitigation (Lafleur 1) Powered by Change Healthcare

Tackling fraud, waste and abuse can be a daunting task for payers. It typically requires significant resources, access to sophisticated data and high levels of expertise. An effective risk mitigation program takes an end-to-end look at health care cost containment and savings opportunities at every stage of the claim lifecycle. This includes savings in a stage often overlooked – pre-submission. Learn more about an innovative approach to cost avoidance strategies and recommended best practices for developing an end-to-end risk management program to help reduce unnecessary losses.

Speakers:

Dave Cardelle, RPh, Senior Vice President, Post Payment & Advisor Solutions, Change Healthcare

James McCall, AHFI, Director, Fraud Analytics, Change Healthcare


Disrupting Traditional Paradigms in the PBM Industry: A Fresh and Innovative Perspective (Petrus 2) Powered by RxAdvance

The PBM industry, which manages over $300 billion in prescription drug spending, provides limited and fragmented services, forcing plan sponsors to outsource critical functions to multiple vendors, thus making it difficult for health plans to manage avoidable drug-impacted medical risk. This decentralized practice has led to a lack of a “single-point-accountability,” introducing an additional $350 billion of avoidable drug-impacted medical costs into the health care delivery system. In addition, $100 billion in poorly managed “buy and bill” specialty drug spend needs to be converted to an “authorize and manage” model. In this session, learn how a health plan has effectively reduced overall pharmacy costs, specialty spend, and avoidable drug impacted costs.

Speaker:

Christine Lounsbery, PharmD, Director of Medical Management, Avera Health Plans



New Approaches in an Increasingly Crowded and Competitive Marketplace: Innovative Plan-Provider Joint Ventures (Margaux 2)

As the payment and care delivery landscape evolves, dynamic partnerships between health plans and providers become even more imperative, and robust strategies and seamless execution are critical. Some payers and providers are launching joint ventures that aim to take the strongest parts of both industries to both provide and pay for health services. By integrating payer and provider capabilities, there is greater potential to more effectively manage population health, a central capacity in a value-based system. This session will explore the key opportunities, challenges and lessons learned in developing joint ventures between providers and health plans. The speaker will discuss a value-based health plan-provider partnership, lessons learned, practical recommendations and experience to date.

Speaker:

Michael Sherman, MD, Senior Vice President and Chief Medical Officer, Harvard Pilgrim Health Care




June 15-17, 2016

Las Vegas, NV

Thursday, June 16



How to Set Your Customer Experience Strategy – Credibility, Competency, and Culture (Margaux 1)

How mature is your customer experience strategy? How do you start or jump start your strategy? How do you know where your company is on the journey? Delivering a superior experience to customers is a powerful – arguably the most powerful – differentiation that a business can deploy. This session will explore building a differentiating customer experience strategy – both the business and cultural road maps necessary to become customer centric. Our speaker will highlight a proven framework of the three Cs of customer experience strategy and transformation – culture, competency and credibility – to transform your company’s customer experience strategy.

Speaker:

Ingrid C. Lindberg, Customer Experience Officer, Chief Customer, LLC


Behavioral Economics: Nudge the Unengaged and Why We Eat Chocolate Cake

(Palmer)

Extensive work in behavioral economics has demonstrated that people act in irrational ways, yet these actions are often predictable. In this session, speakers will share an evidence-based overview of how this science is being applied to drive health behavior change, increase wellness program engagement and improve outcomes. Speakers will review a detailed case-study on the design, delivery and impact of behavioral economics based incentives on health plan members. Their examples will include specific metrics such as doubling program participation rates, increasing tobacco cessation quit rates by twenty-five percent and lowering incentive costs by over forty percent. This session will also feature a “Top 10 List” of actions attendees can take to apply this science to their organizational challenges.

Speakers:

Karen Horgan, Co-Founder and President, VAL Health

Angie Kalousek, Senior Manager, Wellness Market Solutions, Blue Shield of California


Integrating the Local Care Coordination and the Delivery System in Your Care Programs to Derive Greater Value (Mouton 2) Powered by Optum

What care models are delivering the best quality of care and most value for Medicare, Medicaid and Exchange populations? Our industry continues to focus on the challenge of escalating medical spend while resources are limited to engage and deliver the spectrum of care required to manage populations at risk. This forces a new collaboration across payers, providers and consumers, with significant financial incentives to reduce costs and improve clinical and quality outcomes. This session will explore care models that derive value by integrating care programs with local resources and the delivery system. You will learn how specific care models are wrapping around the consumer and provider to achieve results.

Speakers:

Bernie Elliott, MD, Chief Clinical Officer and Senior Vice President, Clinical Alignment, Optum, Inc.

Angela Perri, Vice President, Medicaid Programs, Optum, Inc.




June 15-17, 2016

Las Vegas, NV

Thursday, June 16



The Power of Real-Time Analytics at the Point-of-Care (Montrachet) Powered by Quest Diagnostics

As health care continues to transition to a value-based care model, clinical solutions that combine data and advanced analytics to provide targeted insights at the point-of-care are critical to improve outcomes for health systems, providers and patients. This session will highlight how the need for patient-specific data analysis is shaping the health care industry, and how one company is helping providers to deliver on-demand data within their existing workflows.

Speakers:

Keith R. Dunleavy, MD, Chief Executive Officer and Chairman of the Board, Inovalon

Lidia L. Fonseca, Senior Vice President and Chief Information Officer, Quest Diagnostics


Market Update: New Research Insights on Reimbursement Models (Mouton 1) Powered by McKesson Health Solutions

With an evolving health care system comes the need for innovative ways to deliver and pay for health care. Speakers in this session will share exciting new insights from a 2016 national research study that reveals the current state of value-based reimbursement models. Learn how the market has evolved since the 2014 study, which models have gained the most traction, what payers and providers say are their greatest challenges, what tools they say are needed to succeed, and where the market is headed.

Speakers:

Dana Benini, Vice President, ORC International

Andrei Gonzales, MD, Director, VBR Initiatives, McKesson Health Solutions

Carolyn Wukitch, Senior Vice President and General Manager, Network and Financial Management, McKesson Health Solutions


Five Trends to Put People First in the Age of Digital Health (Petrus 1) Powered by Accenture

Winners in the digital age know success comes from more than just completing a checklist of technology. It hinges on people. Keeping up with changing technology is vital. But today, it’s just as important to evolve the consumer experience, career development opportunities for the health care workforce and methods of care delivery. Technology can enable innovation across health care organizations, but people will lead the real evolution. This session will provide for an insightful look at how five trends behind a “people-first” approach to digital transformation are impacting health care: intelligent automation, liquid workforces, the platform economy, predictable disruption and digital trust.

Speaker:

Kaveh Safavi, MD, JD, Senior Global Managing Director, Accenture Health




June 15-17, 2016

Las Vegas, NV

Thursday, June 16



Are You Paying a Data Integration “Tax”? (Lafleur 1) Powered by MarkLogic Corporation

Savvy healthcare leaders have started to ask their IT leaders why everything is so hard to do. They don’t want to pay a “tax” in time, money and resources every time they start a new project or initiative. As data volumes and complexity increase due to competitive pressures, regulation and consolidation, senior leadership is shifting its focus from one off downstream-use cases (e.g. predictive analytics, pop health, business intelligence tools) to how to better and more efficiently integrate all of their data – the data they have now – and the data they know is incoming. This session will introduce participants to emerging trends in the database world and demonstrates the business value for healthcare organizations to critically evaluate the platform that they rely on to operationalize their data. Drawing on representative examples from leading health care payers, participants will learn how taking a more strategic approach to enterprise data integration can generate business value both in the near-term and in the future, as the enterprise adapts to an unpredictable and evolving health care landscape.

Speaker:

Bill Fox, Vice President, Healthcare and Life Sciences, MarkLogic Corporation


Engagement Re-Imagined: An Integrated Care Search Experience to Drive Effective Utilization of the Health Care Ecosystem (Petrus 2) Powered by Rally Health

The consumerism trend is challenging health plans to provide a better cost transparency and search experience for their members. Connecting with the right care is too often complicated, financially confusing, and frustrating for consumers. Health plans, physicians and health care systems – focused on providing quality care in a fractured ecosystem – don’t always have the technology or consumer expertise needed to effectively target, engage, and guide members during important care decisions. This session will focus on how an integrated search and transparency experience, coupled with care paths, can drive effective utilization of the health care system with improved consumer engagement/attitude.

Speakers:

Adam Bernstein, MD, Chief Medical Officer, Rally Health

Shawn Mobley, Chief Revenue Officer, Rally Health

Karl Ulfers, Vice President, Product, Rally Health

3:00 pm – 3:45 pm Wellness Break in the Exhibit Hall (Lafite and Latour Ballrooms)


Balancing Innovation and Affordability of High Cost Drugs: A New Path Forward

(Encore Ballroom)

The debate about the cost of pharmaceuticals continues. How can our health care system sustainably pay for breakthrough drugs, while balancing the tradeoffs between value, innovation, outcomes, accessibility and affordability? This session will delve into how all stakeholders can work together to foster a health system that leads in innovation, delivers the most affordable, highest quality medicines and results in healthier people.

Speaker:

David M. Cordani, President & CEO, Cigna Corp.




June 15-17, 2016

Las Vegas, NV

Thursday, June 16


Corporate America’s Role in Reducing Chronic Illness and Delivering Better Health

(Encore Ballroom)

The statistics are alarming. Three out of every four dollars is spent on chronic illness, and the number is growing. One-half of all Americans suffer from one or more chronic diseases. Chronic diseases have become a national epidemic. What is corporate America’s role and what bold steps are there to intervene early, keep people healthy and provide coordinated care for chronic conditions?

Speaker:

Larry J. Merlo, President and CEO, CVS Health

5:45 pm – 7:00 pm Wine & Cheese Reception in the Exhibit Hall (Lafite and Latour Ballrooms)

Sponsored by eviCore Healthcare

Friday, June 17

6:45 am – 12:30 pm Registration and Information Desks Open (Registration Desks 1 & 2)

Sponsored by Optum

7:30 am – 8:15 am Breakfast Briefings


Health Care Disruption for Care Delivery – Examining the Advantages of Telehealth (Mouton 1) Powered byTeladoc, Inc.

This session will examine the market disruption and opportunity created by the rapid growth of telehealth from a provider’s prospective. Learn how telehealth’s business and service implications can impact health plans, from helping to deliver increased access and convenience, to affecting positive ROI. This session will also discuss the importance of balancing clinical quality, security, resolution and continuity of care with operational scale. Learn about the rapid growth and important results consumers have experienced using telehealth to help save time and costs.

Speaker:

Henry DePhillips, Chief Medical Officer, Teladoc, Inc.


Analytics for Health Plan & Provider Interventions in the Risk-Adjusted Environment (Montrachet) Powered by Episource LLC

This session will review analytics applied to various types of patient data, and how those analytics are employed to target specific patients, diagnoses and providers for key interventions. Topics for discussion will include intervention options, key strategies, and historic rates of success. Attendees will also learn steps and options for employing these strategies at the level of their own health plan, medical management service, medical group, IPA, or other organization.

Speaker:

Tim Buxton, MBA, CPC, CIC, COC, CRC, CCS, CHP, Director of Coding Services, Episource LLC




June 15-17, 2016

Las Vegas, NV

Friday, June 17



Collaborating for the Consumer (Margaux 1) Powered by InterSystems Corporation

Collaborating for the consumer requires that insurers and providers work together to analyze and share claims, clinical and patient data. This panel will present three stories of successful collaborations among health plans and providers that place patient/consumer needs at the center. The panelists will discuss how consumers receiving end-of-life care have their preferences known and respected when everyone shares care plans, leading to a better patient experience and economic savings; how patients can achieve improved outcomes when insurers and providers assemble a more complete patient picture combining claims data and clinical data; and how a consumer’s desire for a seamless continuum of care is easier to meet when providers and insurers use technology solutions such as provider directories to safely and securely share comprehensive patient information.

Speakers:

Kathleen Aller, Director, HealthShare Business Development, InterSystems Corporation

Dominick Bizzarro, RPh, MBA, Executive Vice President for Business Development and Informatics, MVP Health Care

Alok Gupta, PhD, MBA, Chief Operating Officer and Chief Information Officer, Rhode Island Quality Institute


Market-Driven Approaches to Managing the Rise in Drug Prices (Mouton 2) Powered by CVS Health

In the last year, drug prices have risen to double digits in the United States, and the increases are larger and are occurring more frequently than in previous years. This issue dominated national media through much of 2015, led to increased congressional scrutiny, and has even pushed drug pricing into the presidential campaign. But there are market-driven approaches that can help moderate the rise in prices. In fact, now more than ever, health plans and large employers need a comprehensive approach to managing rising drug prices that both improves patient care and reduces unnecessary spending.

Speaker:

Troyen A. Brennan, MD, MPH, Executive Vice President and Chief Medical Officer, CVS Health


How Are You Planning for the Millennial Generation? (Petrus 1) Powered by Glenridge HealthCare Solutions

The millennial generation is now the largest generation in the workforce and they will soon be the primary influencer/decision maker for health care choices for their parents, the Baby Boomers. This generation will be game changing and will demand a different health care experience from payers and providers as a purchaser, consumer and patient. How will our traditional legacy industry transform? Speakers in this session will explore what the industry (payers, providers and employers) is doing and should do to prepare. Will you be ready?

Speaker:

Ellen Brown, Executive Vice President, Strategy and Advisory Services, Glenridge HealthCare Solutions




June 15-17, 2016

Las Vegas, NV

Friday, June 17



Mastering the Complexity of Value-Based Care through Plan-Provider Collaboration

(Margaux 2) Powered by DST Health Solutions

The Affordable Care Act (ACA), Medicare Access and CHIP Reauthorization Act (MACRA) and other health policy provisions are rapidly accelerating the shift from volume- to value-based reimbursement models. Moving toward alternative payment models and emerging risk-based contracts are top priorities for government and employers alike. How can health plans meet these demands while navigating a responsible path to care delivery and payment transformation? This session will explore how comprehensive data — beyond claims — can be analyzed, shared and visualized to support plan-provider collaboration on behalf of the consumers they serve. Speakers will address core competencies in operations, financial management, leadership and health care innovation. Learn how to achieve higher quality care delivery and better patient health outcomes by blending data and innovation with population health, provider stratification and care planning for true value-based design.

Speakers:

Adele Allison, Director, Provider Innovation Strategies, DST Health Solutions

Deirdra Yocum, Vice President, Quality and Performance Outcomes, CareSource


Virtual Centers of Excellence: Changing the Face of Obesity-Related Illness

(Petrus 2) Powered by Real Appeal, Inc.

This session will provide an overview of the impact of one company’s unique approach to delivering an online, interactive weight loss center of excellence. Attendees will learn how to drive deep population enrollment and engagement, reduce medical spending and increase compliance with the United States Preventive Services Task Force (USPSTF) guidelines. The speaker will also share the impact of how some of the key learnings can be applied to improve the scalability and outcome of other condition management programs.

Speaker:

Steve Olin, Chief Executive Officer, Real Appeal, Inc.


Fastest Path to Lower Employer Trend: Full-Replacement HSAs with a Safety-Net for Lower-Wage Employees (Palmer) Powered by ConnectYourCare

Speaker:

Allen Pease, Chief Business Development Officer, ConnectYourCare




June 15-17, 2016

Las Vegas, NV

Friday, June 17

8:30 am – 9:15 am Concurrent Sessions


Health System Innovation for Health Care Delivery and Payment Reform (Margaux 2)

As a result of this combination of cost pressures and the lack of effective tools to deal with them, U.S. employers are looking for creative means to improve the health of their employees and the families of those employees, generating sustainable long term savings. Proactive large employers are exploring direct contracting agreements with hospitals and health care providers. This session will explore the key opportunities, challenges and lessons learned in developing a direct contracting arrangement between an employer and a health delivery system. Speakers will discuss their innovative direct-to-employee ACO benefits model that is aimed at coordinating high quality patient care for employees while reducing costs.

Speaker:

Angi Frary, Senior Client Manager, Accountable Care Services, Providence Health & Services


Meeting the Needs of Complex Patients through Collaborative Models (Mouton 2)

As innovative models continue to emerge, policymakers, payers and providers are eager to identify and scale effective strategies for serving the small subset of individuals who account for the majority of health care spending as one component of broader efforts to build more efficient and sustainable systems of care. How can health plans, population health managers, and risk-taking providers alike identify the most complex patients? How can they partner effectively with innovators, providers, and broader support services to meet the needs of complex patients? This session will explore promising approaches ranging from pilot projects to statewide efforts to drive outcomes, reduce disparities, and bring down the cost of health care for high-need, high-cost patients. Speakers will discuss how to provide complex patients with the care they need, where and when they need it.

Speakers:

Sachin H. Jain, MD, MBA, President and Chief Executive Officer, CareMore Health System

Lisa Price-Stevens, MD, MPH, Vice President, Medical Affairs, Fallon Health


Attitudes and Preferences of the Engaged Health Care Consumer (Margaux 1) Powered by Deloitte

Health care consumers’ needs and expectations are changing, similarly to how their expectations are changing for all services and digital experiences. Strategies that worked before are seeing decreased impact, and it is becoming apparent that what it takes to acquire, retain, and engage consumers with their health care can differ widely across an increasing number of consumer segments. Organizations that do not anticipate “consumerism” trends risk being left behind, as capabilities which currently provide market differentiation may become “normal” in the next three years. A better understanding of recent consumer sentiments and trends can provide critical considerations for how organizations can engage the increasingly tech-savvy and empowered health care consumer. And knowing the specific preferences of your target members could provide the contextual insight for what it will take to win in an evolving consumer health care ecosystem.

Speakers:

Matt Kaye, Senior Manager, Deloitte Consulting LLP

Leslie Read, Principal, Deloitte Consulting LLP




June 15-17, 2016

Las Vegas, NV

Friday, June 17

8:30 am – 9:15 am Concurrent Sessions (continued)


Patient-Centeredness, Comparative Effectiveness and Value: Realizing the Full Value of CER (Mouton 1)

This session will explore how comparative effectiveness research can support efforts to enhance value in health care, as well as when it cannot. The speaker will discuss the importance of collaborative partnerships and stakeholder engagement through innovative initiatives. The session will also address the need to identify and shape research questions early on and the challenges associated with doing so.

Speaker:

Joe V. Selby, MD, MPH, Executive Director, Patient-Centered Outcomes Research Institute

(PCORI)


How Accountable Care Organizations Can Harness the Power of Health Data and Analytics (Montrachet)

Recent advances in health IT adoption and interoperability are a key enabler of new value-based payment and delivery models. However, to really succeed with population health, Accountable Care Organizations serving independent physicians must cope with the reality of enabling data integration across dozens of EHR systems, access to hospital event (ADT) data, clinical quality and HCC coding reporting, EHR interfacing and optimization and many other challenges. This session will explore what is needed to support small, independent practices to address these challenges, so they can effectively harness health data and analytics to improve patient outcomes and drive down health care costs.

Speaker:

Farzad Mostashari, MD, ScM, CEO, Aledade, Inc.


Population Health Management: The Value of Palliative and Hospice Care Services

(Palmer) Powered by VITAS Healthcare

The health care industry is now firmly focused on using big data to improve the patient experience and clinical outcomes while enhancing efficiency and reducing costs through prevention. The challenge for health plans is how to develop sound clinical practice guidelines for patients with advanced illness, particularly near the end of life. Speakers will incorporate case-based examples and highlight approaches of collaboration between payers, providers and physicians. Literature supporting palliative and hospice care interventions will be incorporated and include its effect on the reduction of ED utilization, acute hospital days, ICU use, and re-admissions among patients near the end-of-life. Attendees will learn how to re-examine their strategies towards identifying appropriate patients for palliative care transitions to ensure appropriate care is delivered at the right place and at the right time.

Speakers:

Rodrick Hurt, MD, Medical Director, Sound Physicians

Geeta Nayyar, MD, MBA, Chief Medical Information Officer, Femwell Group Health, Inc.

Richard Payne, MD, Esther Colliflower Professor of Medicine and Divinity, Duke University

Joseph Shega, MD, Regional Medical Director, VITAS Healthcare




June 15-17, 2016

Las Vegas, NV

Friday, June 17



Member Engagement Strategies in the Digital Age (Petrus 1) Powered by Teleperformance

Health care is not immune to changing consumer expectations. Between increased marketplace competition, new digital channels of interaction, and consumer decisions on how and when to engage, payers must adapt their customer management practices. This call for better service requires a demand-driven customer interaction strategy in order to satisfy the instant, seamless, and personal needs of consumers. This session will help health plans better understand consumer behaviors, learn how consumers engage, and what channels they engage through. This session will also share a practitioner’s point-of-view on how to win the hearts and minds of digital consumers.

Speakers:

Jo Anne Anderson, Executive Vice President, Healthcare Practice, Teleperformance

Ryan Petrizzi, Vice President, Consumer Markets and Product Development, AmeriHealth

New Jersey

Shayna Schulz, Vice President, Customer Care, Blue Shield of California

Amit Shankardass, Executive Vice President, Marketing, Teleperformance


Medicine Use and Costs: Looking Beyond the Headlines (Petrus 2) Powered by IMS Health

This session will provide perspective to health plans on the current landscape for medicines, including specialty and traditional, biologics and small molecules, and retail and non-retail segments, as well as key therapeutic areas. Analysis of drivers of spending growth over the past five years will be shared, including estimated net price trends for branded drugs. Prescription volume trends by payer type will be explained, and the uptake of new medicines – those on the market for less than two years – will be quantified. Patient cost exposure – with and without the use of coupons – will be discussed. Finally, the outlook for medicine costs through 2020 will be shared, based on the pipeline of new drugs expected to be launched, and overall utilization and cost trends.

Speaker:

Murray Aitken, Senior Vice President, IMS Health and Executive Director, IMS Institute for Healthcare Informatics, IMS Health

9:30 am – 10:15 am Concurrent Sessions


Health Plans’ Cost Comparison Tools: Helping Consumers Navigate the Health Care System (Margaux 1)

As consumers take a more active role in their health decisions, health plans are providing enhanced cost and quality comparison tools for individuals and families to make informed choices about their care. Through these price comparison tools, health plans are supporting patients as they navigate the health care delivery system and improving access to affordable, high-quality care. Speakers will discuss characteristics of price estimator tools offered by health plans to their members and explore potential trends, challenges, and opportunities for advancing the utility of these tools in the marketplace.

Speakers:

Charlie Kirksey, Senior Director, Marketing and Strategy, Florida Blue

David Newman, PhD, JD, Executive Director, Health Care Cost Institute

J. Darren Rodgers, Senior Vice President and Chief Marketing Officer, Health Care

Service Corporation




June 15-17, 2016

Las Vegas, NV

Friday, June 17



Would You Like Your Health Care for Here or to Go? (Margaux 2)

Over the past fifteen years, Internet technology has significantly changed the landscape of public health surveillance and epidemic intelligence gathering. Disease data is disseminated not only through formal online announcements by government agencies, but also through informal channels such as social networking sites, blogs, chat rooms, web searches, local news media and crowd sourcing platforms. These data streams have been credited with decreasing the time between an outbreak and formal recognition of an outbreak, allowing for an expedited response to the public health threat. Collectively, these online sources create an image of individual and population health that is fundamentally different from the one produced by traditional health data. This session will explore the current capabilities and future directions in the use of non-traditional technologies for the purposes of population health monitoring and improving health care access. The speaker will also discuss the burgeoning field of on-demand health services and its potential to enhance health care delivery, improve health outcomes and disrupt the market as we know it. Learn about the latest on-demand technologies and how on-demand transportation is poised to further change and consumerize health care.

Speaker:

John Brownstein, PhD, Chief Innovation Officer, Boston Children’s Hospital and Professor, Harvard Medical School


Health Plans Engage with Providers and Members to Promote Safety, Prevention of Opioid Abuse (Mouton 2)

Prescription drug abuse and overdose is a serious public health challenge with 2 million Americans addicted to prescription opioids and another 500,000 addicted to heroin. Health insurance plans have developed a targeted suite of services to assist members and their physicians in managing opioid abuse and abuse-related conditions and protect against overprescribing. This session will feature health plan leaders describing how they engage with consumers and clinicians to encourage evidence-based approaches to managing pain, safe prescribing of opioids, and educating consumers and physicians to ensure an understanding of the benefits and risks of opioids.

Speakers:

Jim Lancaster, MD, Senior Medical Director, Cigna Corp.

Jonas Thom, MA, PCC, Vice President, Behavioral Health, CareSource

Phiyen Tra, PharmD, Director, Clinical Pharmacy Programs, Health Care Service Corporation


Transforming Oncology Care: Lessons Learned from the Joint Replacement Bundled Payment Model (Mouton 1)

While the United States health care system is quickly shifting focus from volume to value, bundled payments have emerged as a promising lever for containing costs and improving quality of care. This model, designed to offset some of the downfalls of traditional fee-for-service payments, reimburses providers based on a predetermined cost of an episode, or group of related services. The model calls for providers to take on some financial risk while meeting quality standards, especially in areas of well-defined procedures. This session will explore episode-based bundled payments as a promising strategy for oncology services.

Speakers:

Lili Brillstein, MPH, Director, Episodes of Care, Market Innovations, Horizon Blue Cross Blue Shield

of New Jersey

Andrew Pecora, MD, FACP, CPE, President, Regional Cancer Care Associates




June 15-17, 2016

Las Vegas, NV

Friday, June 17



Separating Signal from Noise: Harnessing Analytics for New Patient Insights

(Palmer)

With the sheer amount of data now contained in electronic health records and the shift to value-based payment models, the ability to transform clinical data into meaningful insights has never been more vital. This has touched off a race between large and small organizations alike, as they compete and collaborate to draw new insights from a deluge of sources – patient records, genomic sequencing, social media, biometric trackers and more. This session will explore how players are separating signal from noise to deliver new models of care.

Speakers:

Carolyn Bradner Jasik, MD, Vice President, Medical Outcomes, Mango Health

Susan L. Moore, PhD, MSPH, Assistant Director, Center for Health Systems Research, Denver Health and mHealth Core Lead, ACCORDS, University of Colorado

Maggie O’Keefe, Associate Director, Product Development, Health Catalyst


Health Plan Provider Directory Initiative (Petrus 1)

Today, health plans employ a variety of approaches to maintain and update provider directory data, including scheduled phone calls, follow-up faxes, emails, and in-person visits. However, given the diversity of providers in health plans’ networks, data can quickly become out of date. Moreover, not all providers rely on the same method of communication, which often leads to delays in updating pertinent provider information. This session will highlight a new initiative to improve the accuracy and efficiency of data reporting with provider partners. Speakers will explore solutions to proactively address these issues.

Speakers:

Mark Martin, Director, Health Plan Portfolio, Availity

Tapio Tolvanen, Co-Founder and CTO, BetterDoctor

Ari Tulla, Co-Founder and CEO, BetterDoctor


Advancing Population Health Management (Petrus 2) Powered by ODH, Inc.

Risk adjusted-based registries showing separate behavioral health and physical health risk allow advancements in population health management beyond the traditional gap-in-care disease registry models. Learn how a new multifunctional enterprise system for the transformation of population health management can dramatically advance patient care management and provider network management.

Speaker:

John Docherty, MD, Senior Vice President, ODH, Inc.




June 15-17, 2016

Las Vegas, NV

Friday, June 17



Program Integrity Updates for the Centers for Medicare & Medicaid Services

(Montrachet) Powered by the Centers for Medicaid & Medicaid Services (CMS)

This session will explore current CMS program integrity initiatives and updates to improve the detection and prevention of healthcare fraud. The speaker will discuss the latest trends that affect both public and private healthcare organizations. The session will also highlight the work of the Healthcare Fraud Prevention Partnership (HFPP), the national public/private partnership dedicated to detecting and preventing healthcare fraud.

Speaker:

Shantanu Agrawal, MD, MPhil, Deputy Administrator for Program Integrity and Director, Center for Program Integrity, Centers for Medicare & Medicaid Services (CMS)

10:15 am – 10:30 am Coffee Break (Encore Ballroom Pre-Function)

10:30 am – 11:30 am General Session

Election 2016 and What it Means for the Future of Health Care (Encore Ballroom)

It’s an election season few would have predicted. While we can’t predict who will become our 45th President, we can be certain that the 2016 election stands to determine the fate of health care in America. With our industry front and center, you’ll need to be prepared for the impact on your organization. This up-to-the-minute session will certainly leave you thinking as you head back to your office.

Speakers:

Stephanie Cutter, Top Political Strategist, Senior Advisor to President Obama, and Media Commentator

Nicolle Wallace, Political Analyst, New York Times Best-Selling Author, and Former White House

Director of Communications

11:30 am – 12:30 pm Closing Keynote Session

Addressing the Key Challenges Facing America (Encore Ballroom)

Speaker:

Jeb Bush, Governor of Florida (1999-2007)

12:30 pm Adjourn

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The content presented at this conference is solely attributable to the speakers and does not represent an endorsement by America’s Health Insurance Plans (AHIP) of the accuracy of the information presented at the conference or any opinion expressed by the speakers. As content continues to evolve up until a conference, the materials included in this agenda are subject to change. AHIP—All Rights Reserved: © AHIP 2016

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