wichita association of health underwriterswichita association of health underwriters presents the...

Wichita Association of Health Underwriters

7th Annual Healthcare Symposium

April 6, 2017

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Presents the 7th Annual

HEALTHCARE SYMPOSIUM

7:30 am – 7:55 am Registration and Breakfast

7:55 am – 8:00 am Welcome – WAHU President, Jennifer Elliott

8:00 am – 9:00 am Pam Mitroff, Senior Director of Health Reform Compliance with NAHU

Legislative and regulatory update, and presentation on compliance changes concerning

penalties, affordability measures, timelines, HRAs, cash in lieu of affordability, and reporting

requirements.

9:00 am – 10:00 am Jared Estes – Keynote Speaker & Ethics Perspective

“Fire Back”

10:00 am – 10:15 am Break & Visit Exhibitor Booths

10:15 am – 11:15 am Jason Lacey, Partner with Foulston Siefkin, LLC - Legal Perspective

Legislative & compliance update regarding Healthcare and the ACA

11:15 am – 12:00 pm Edward J. Hett, MD, Medical Director, New Models of Care, Via Christi Health

“Transforming the Primary Care Practice”

12:00 pm – 12:45 pm Lunch & Visit Exhibitor Booths

12:45 pm – 2:20 pm How ACOs are Changing Healthcare - Carrier Perspective

Health insurance carriers will discuss the impact of Health Care Reform on their businesses,

ACO Implementation and Performance Based Payments. Participants include:

Ramona (Mona) Burt, R.N., M.S.A., Population Health Management

Tracy E. Bassett, VP of Network Strategy & Innovation, UnitedHealthcare

John Stockton, Market Head of Sales, Aetna

2:20 pm – 2:40 pm Break & Visit Exhibitor Booths

2:40 pm – 3:25 pm Francie Ekengren, MD, Medical Director of Wesley Medical Center &

Lindy Garvin, MPA, CPHRM, Division VP Quality Improvement & Patient Safety,

HealthOne/HCA Continental Division

“Quality Outcomes in Today’s Healthcare Market”

3:25 pm – 4:10 pm Mark Fendler, President, MedTrakRx – PBM Perspective

“The Future of Rx and Managing the High Cost of Prescriptions”

4:10 pm – 4:15 pm Closing Remarks – WAHU President, Jennifer Elliott

Conference Agenda

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Board of Directors

President/ HUPAC Chair Jennifer Elliott HUB International Mid-America

Director/Communications Chair Kristen Hoffman Delta Dental of Kansas/Surency Life & Health

President Elect Lindsay Smith Hays Companies of Kansas

Treasurer Jack Graham USI Insurance Services

Secretary/ Education Chair Gaylee Dolloff Health Partners of Kansas

Director/ Legislative Chair Doug Dixon Insurance Resources, Inc.

Director/ Media Relations Chair Sarah Sampson Fee Insurance

Director/ Membership Co-Chair Bob Langhofer Ridge Consulting Group, Inc.

Director Sean Bateman Delta Dental of Kansas/Surency Life & Health

Director/Membership C0-Chair Kylie Hurtig Arthur J. Gallagher & Co.

Director Mike Wise Wise & Associates

Director Courtney Hurley Blue Cross Blue Shield of Kansas

Director/Past President Dallas Scrip Benefit Management Inc. (BMI)

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Pam Mitroff, MBA, Senior Director of Health Reform Compliance with NAHU

Pamela Mitroff joined the staff at the National Association of Health Underwriters in March of 2011 as a Director of State Affairs. She was promoted to the new position of Senior Director of Health Reform Compliance in November 2013. In that role, Mitroff has provided NAHU members consultative compliance assistance, answering more than 1000 inquiries in 2015 alone!

She has more than 30 years in the health care and workers’ compensation insurance and cost control field. Mitroff is a licensed Illinois insurance producer and has held positions with a major insurance company and a third-party administrator of benefit plans for self-funded companies. She was a lobbyist for the Illinois State Chamber of Commerce, lobbying on health insurance, employee benefits and workers’ compensation issues.

Prior to joining NAHU’s staff, Mitroff had been an active NAHU member on federal, state and local levels. Mitroff established the professional lobbying role for the state association (ISAHU). She was Associate Chairman for Employee Benefits of NAHU’s Legislative Council from 2007 to 2010.

Mitroff previously had a Wheaton, Illinois based consulting firm, Pamela D. Mitroff Consulting, Inc. The firm provided services to insurance companies, employers, brokers and associations in the public policy, government relations, employee benefits compliance, marketing and training areas.

In 2012, Mitroff was awarded the prestigious Edward H. O’Conner Memorial Distinguished Service Award from the Chicago & Northeastern Illinois Association of Health Underwriters. She received NAHU’s Distinguished Service Award in 2006 and the NAHU Region 3 Distinguished Service Award for Legislative activities in 2007.

Pam will review the political landscape as well as legislative and regulatory updates in her presentation

“Politics, Compliance and Thriving in 2017”. She will cover the following subjects:

President Trump’s Healthcare Policies & the new congress

Repeal and replacement of ACA

Compliance Issues for 2017

Reporting Requirements

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Keynote Speaker – Jared Estes

Presents “Fire Back”

As newlyweds at age 25, Jared, his wife Paige, and two friends were driving home from a hockey game when they were struck by a drunk driver going over 120 mph. This horrific moment changed the course of Jared’s life in ways he could have never imagined. Jared barely escaped death as he suffered 2nd and 3rd degree burns on half of his body. As he began to endure more than 50 surgeries, doctors delivered devastating diagnoses, including a lifetime of pain and loss of functionality. Even worse, his bride of only six months was killed in the crash. Jared began to sink into a deep depression - he had trouble recognizing himself in the mirror and battled feelings of resentment towards the person who caused this situation. He was truly at a crossroad in his life... torn between giving up and surviving. With the love and support of his family and friends, Jared was able to find a new perspective that helped him emerge from the darkness. He realized the value of gratitude and forgiveness, and became determined to recover beyond the doctors’ diagnoses. His character was molded as he maintained an optimistic attitude throughout his physical therapy and numerous complex surgeries. Jared had a realization that he could decide to surpass mere survival… he could FIRE BACK. Jared’s perseverance paid off - he is clearing his bucket list by checking off marathons and sitting in tankers swapping stories with soldiers. His endurance has allowed him to discover his life mission – to help others by sharing his amazing story of tragedy and triumph. Jared realizes that trials and the need for perseverance is not unique to him, rather is it something that we all must deal with in life. His mantra is that there will be times when life will get us down, and kick us while we are down. When that happens, we must not only get back up, but we must FIRE BACK.

Sponsored By:

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Jason Lacey, Partner with Foulston Siefkin, LLC

Jason Lacey practices primarily in the areas of income taxation, ERISA, employee benefits, and executive

compensation. He assists both taxable and tax-exempt employers with a wide variety of employee benefit and

executive compensation issues, including design and administration of welfare benefit plans and qualified and

nonqualified pension, retirement savings, and deferred compensation plans. He also represents clients with

respect to the tax and business aspects of entity formation, tax-advantaged exchanges and reorganizations,

and tax controversies, and has significant practice experience in the areas of estate administration, estate and

gift taxation, and the federal tax aspects of municipal finance transactions. He has been selected by his peers

for inclusion in The Best Lawyers in America, the Missouri & Kansas Super Lawyers Rising Star list, and

Chambers USA as a leading business attorney in the United States. He was recognized by Best Lawyers as the

2014 and 207 Wichita Employee Benefits (ERISA) “Lawyer of the Year”.

Jason will present on topics including the IRS memorandum on specified disease taxability, EEOC activities on

non-discrimination and DOL audit examples and outcomes.

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Edward J. Hett, MD, Medical Director, New Models of Care, Via Christi Health

Presents, “Transforming the Primary Care Practice”.

Dr. Edward J. Hett started in 1981 as a Family Medicine resident at St. Joseph Medical Center, which became part of Via Christi Health when the system was formed in 1993. While he still maintains a family medicine practice as an employed physician within the Via Christi Clinic, Dr. Hett assumed an administrative role in 2012 as Medical Director for New Models of Care and later became the Chief Executive Officer for Via Christi Health’s accountable care organization. As the physician leader for the health systems’ population health initiatives, Dr. Hett is responsible for new and redesigned models of care, the integration of cost with quality network performance, patient centered medical home transformation, clinical integration across ACO care sites, and leading the subsidiary company in its’ efforts to expand the physician network regionally. Dr. Hett has responsibility for ensuring that the Via Christi Health ACO remains consistent with clinical models implemented by Ascension Health’s National ACO, MissionPoint Health Partners.

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Carrier Perspective Attendees

Ramona (Mona) Burt - Blue Cross Blue Shield of Kansas

Tracey E. Bassett – United HealthCare

John Stockton – Aetna

Discussion Outline

These presentations allow the State’s largest health insurance carriers to provide their perspectives “How

ACOs are Changing Healthcare”. Each presenter has been asked to address:

Their ACO Activities: Locally Nationally How are Physicians Being Measured? What are the Reimbursement Methodologies being used to reimburse physicians? What should self-funded employers expect to pay in additional reimbursement on average per member? What specific outcomes are you expecting for the patient, the provider and expected costs? If applicable do you have a timeline for full Kansas market implementation

Each representative will speak for 30 minutes on the topics identified above.

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Ramona (Mona) Burt, R.N., M.S.A.

Population Health Management Coordinator

Blue Cross Blue Shield of Kansas

Ramona (Mona)Burt has been a practicing registered nurse since 1979. She started at BCBS in 2001 as part of

the Medical Review team, and since 2013 has served as the Population Health Management Coordinator

where she is responsible for performing extensive clinical analysis to identify areas of risks and opportunities

for programs and processes to improve the total cost of care of the population. In this role, she delivers

information on the high-risk population, identifies gaps in care and understands utilization, costs and

associated trends to identify targeted opportunities to assist and support quality management programs to

improve the quality based activities and outcomes.

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Tracy E. Bassett

Vice President of Network Strategy & Innovation

UnitedHealth Network, UnitedHealthcare

Tracy has most recently been the Vice President of Network Strategy and Innovation for 12 states that make

up the Central Region of UnitedHealth Networks. In this role, she is charged with developing and deploying

successful network strategies for the diverse markets in the region. In her current role, she is at the forefront

of transforming provider relationships with UnitedHealthcare by negotiating innovative reimbursement

structures built on the Triple Aim to deliver higher quality healthcare more efficiently with better patient

outcomes. She utilizes the new reimbursement structures to support the development of innovative products

that provide UnitedHealthcare customers with options that offer higher quality and lower cost benefits to

their employees. Prior to this role, Tracy was the Regional Ancillary Lead for the Central Region where she

developed the ancillary contracting strategy and assured that UnitedHealthcare members had access to a wide

variety of high quality and efficient ancillary providers. Tracy’s first role at UnitedHealthcare was a hospital

contract negotiator in Indiana where she built strong relationships with hospital systems that helped produce

best in class rates.

Prior to joining UnitedHealthcare, in January 2005, Tracy was the Finance Manager of a group of Physician

Hospital Organizations (PHO) in Indianapolis where she developed reimbursement strategies and

implemented performance based measures for a risk-based HMO. She started her career in healthcare

managing the chargemaster for St. Vincent Health, the flagship hospital of Ascension Health.

Tracy completed a Bachelor of Science degree in Corporate and Institutional Finance with an emphasis in

International Business and later completed a Masters of Business Administration from Ball State University.

She is currently a member of the Advisory Board for the Economics Department of the Miller College of

Business at Ball State University.

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John Stockton

Market Head of Sales – Kansas, Nebraska, Western Missouri

Aetna

John Stockton has over 29 years of employee benefits and health insurance experience. John joined Aetna in

1999 and held market leadership positions over Kansas City, St. Louis, Oklahoma, and Colorado until 2012.

From 2013 through most of 2016, John held the position of Regional Head of Sales for Aetna Accountable Care

Solutions (ACS) and served as the national Director of Distribution for ACS. He had oversight for the sales

strategy of the Mid America Region for membership growth into an Aetna Whole Health product model ACO

(Accountable Care Organization) solution. John worked closely with Aetna ACO partners such as Memorial

Hermann Accountable Care Network (Houston), Baylor Scott & White Quality Alliance (North Texas), Seton

Health Alliance (Austin), Baptist/Health Texas (San Antonio), CHI in Omaha and Des Moines, INTEGRIS Health

Partners (Oklahoma City), St. John (Tulsa), Texas Health Resources in DFW, and Advocate/Rush in Chicago. In

late 2016, John has returned to a local market role to lead Aetna in Kansas, Nebraska, and Western Missouri.

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Francie Ekengren, MD

Chief Medical Officer

Wesley Healthcare

Presents “Quality Outcomes in Today’s Healthcare Market”

Francie Ekengren, MD, received her medical education from University of Kansas School of Medicine in 1987.

She returned to Wichita and completed her medical residency in Family Practice at Wesley Medical Center

through the University of Kansas School of Medicine-Wichita. For over twenty years, she has worked as an

Emergency Department physician with Emergency Services, PA. She has served as the Chief Medical Officer at

Wesley Medical Center since 1999. She is also the President and CEO of Mid-Kansas Wound Specialists that is

located at Wesley.

She has served or is serving on: Wichita Eye Bank Board, the American Heart Association Board, and the

Cerebral Palsy Research Foundation, City-Wide Quality Health Collaborative, Kansas Health Ethics Board, WSU

AEGD Advisory Council Cabinet member, and KMS Kansas Healthcare Collaborative Steering Committee

member.

She has received the Kansas Health Ethics Award and HCA Frist Humanitarian Award.

She has provided a number of presentations to professional and community audiences.

Her community activities have included volunteer physician at Good Samaritan Clinic, Church Elder at Grace

Presbyterian, Medical Missionary Volunteer-Dominican Republic, and Susan G Komen Race for the Cure as a

survivor.

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Lindy Garvin, MPA, CPHRM Division VP Quality Improvement and Patient Safety

HealthONE/HCA Continental Division

Presents “Quality Outcomes in Today’s Healthcare Market”

A seasoned leader with over 35 years of Experience in healthcare administration. Directed as Clinical Director

and Chief Nursing Officer, overall delivery of safe effective patient care while maintaining financial and

operations efficiencies. Coached and led organizations in Clinical, Quality and Patient Safety Improvement

Initiatives. Lindy has worked at several Denver area hospitals as Clinical Service Line Director, Chief Nursing

Officer and Quality, Patient Safety and Risk Management Leader. She has been the Continental Division Vice-

President of Quality, Risk and Patient Safety for eight years. Lindy is certified in Healthcare Risk Management.

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Mark Fendler, President

MedTrakRX

Mark Fendler is the President of MedTrakRx, his most recent role since joining the company in 2011. His previous roles

included General Counsel and Chief Operating Officer. In all of these roles, Mark has drawn on 17 years of health care

industry experience: first, as a health care attorney in private practice, and then working for a national Fortune 50 PBM

before joining MedTrakRx. Mark’s new role as President will allow him to oversee the continued growth and expansion

of MedTrakRx’s brand to the national middle-market PBM segment, while leading the company’s 100+ employees and

also serving on the EnvisionRxOptions executive committee. Mark received his law degree from Saint Louis University

School of Law, and has a Bachelor of Journalism degree from the University of Missouri.

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Thanks to our Sponsors!

Aetna – Lunch Sponsor Allstate Blue Cross Blue Shield of Kansas Beneflex HR Cigna Companion Life Delta Dental of Kansas Empower Guardian – Snack Sponsor Health Partners of Kansas Hinkle Law Firm MetLife

Mutual of Omaha National General Surency Life & Health United Healthcare – Breakfast Sponsor UNUM Vision Care Direct Wesley

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Thank you for attending our symposium!

Visit our web site for coming events at

www.mywahu.org

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