Tuesday, October 27, 2020: 10 a.m. – 12:00 p.m. ET
The Increasing Importance of Data & Technology Now and Post Pandemic | |
10:00 |
ChairpersonJim Milanowski,CEO,Genesee Health Plan |
10:05 |
Telehealth and Our ‘New Normal’: Using Digital Platforms to Support the Care of Medicaid and Medicare MembersTelehealth has emerged as a requisite tool for supporting access to needed health care services while reducing the risk of exposure to and spread of COVID-19. Specifically, in response to the coronavirus pandemic, both the Federal government and States have issued emergency orders to increase access to and utilization of telehealth services in lieu of in-person care. According to recent data from Forrester Research, virtual health care visits could top more than 1 billion this year, including more than 900 million visits related to COVID-19. State Medicaid leaders and managed care organizations are actively considering the long-term possibilities of these new flexibilities and the long-term opportunities to integrate digital platforms long term into the Medicaid system.
Kersten Burns Lausch, MPP,Director, Policy & Strategy,UnitedHealthcare Community & State |
10:25 |
Care Coordination in the Post-Covid-19 World: Addressing Gaps in Care, Chronic Illnesses, Exacerbated Conditions & Behavioral Health
Dirk Wales, MD,Chief Medical Officer,axialHealthcare |
10:45 |
Case Management Automated Assessment Tools – Prioritizing and Providing Access to CareThe Complexity Assessment Grid (CAG) is a tool utilized to enhance Case Manager practice. It allows for clear illustration of a member's needs and opportunity for prioritization of Case Manager short-term and long-term care plan goals. This session will highlight how to incorporate the Complexity Assessment Grid into Case Manager workflow and the benefits of automating this through electronic platforms. Michelle Squire, Director of Case Management,Affinity Health Plan |
11:05 |
Leveraging Data & Technology to Proactively Target Care Coordination Efforts and Outreach During a Pandemic
Summer Sweet, Triage and Data Integration Manager of Population Health,CareOregon Karissa Smith, Director of Care Coordination,CareOregon |
11:30 |
Reactive to Proactive: COVID-19 & Population Health
Saeed Aminzadeh,Chief Executive Officer,Decision Point Healthcare Solutions Dr. Jerry Frank,Former Chief Medical Officer (CMO),Emblem Health Dr. Rich Petrucci,Former Chief Medical Officer (CMO),WellCare NY Corporate Chief Medical Director, Quality,WellCare |
12:00 |
Making Every Member Encounter Count: Building Care Coordination PartnershipsNavigating the pathways between the multiple silos in our healthcare system can be daunting for individuals and their family members. Difficult, fragmented, and duplicative processes between Medicaid and Medicare, between Managed Care and FFS, confound members at every turn. We will explore how fostering health plan collaborative agreements while using supportive technology to coordinate care and services in a manner that is agnostic to payer source and integrates paid services with community supports can improve the healthcare experience for our most vulnerable members while addressing cost savings with reduced service duplication and earlier identification of care gaps. James Henderson,Chief Innovation Officer,Independent Living Systems Hilda Perea,VP Care Management,Independent Living Systems |
12:20 |
Close of Module #1 |
Tuesday, October 27, 2020: 2 p.m. – 4:00 p.m. ET
2:00 |
ChairpersonLisa Holden,Vice President, Accountable Care,iCare |
2:05 |
The Maryland Model & Care ManagementThe Maryland Health Care Commission (MHCC) supports advanced care delivery and quality improvement initiatives to improve health outcomes and reduce the total cost of care. This session will present a care management readiness tool under development for ambulatory practices aimed at improving patient care and reducing the need for medical services by helping patients and caregivers more effectively manage health conditions: The tool was informed by MHCCs Care Management Focus Group. The focus group consists of diverse health care stakeholders including payers, health systems, hospitals, state agencies, long term care providers, accountable care organizations, managed care organizations, consumers, and ambulatory care providers.
Melanie Cavaliere,Chief, Innovative Care Delivery,Maryland Health Care Commission |
2:25 |
Case Study: Integrated Complex Care Management – Using Technology to Engage Patients & Boost Quality of CareFind out how Kaiser Permanente is approaching moves to Integrated Care Management to provide better care for patients. This change moves Kaiser from care focused on specific chronic conditions such as Diabetes, Asthma or Depression to an integrated approach where the plan integrates a patient’ social needs into their care. This approach uses technology to enable care protocols and patient engagement. This presentation will discuss the process Kaiser has taken to affect the transition, review of care protocols and how they have enabled the EMR to provide care. Joseph Crimando,Population Health Solutions Leader, Information Technology,Kaiser Permanente |
2:45 |
Data Sharing, Patient Engagement & Cross Collaborations to Coordinate Care with
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Care Coordination & Social Determinants of Health – Closing Gaps in Care |
3:15 |
Home is Where the Health Is: Extended Home-Delivered Meals Programs to Support Vulnerable MembersHealth plans more frequently offer long-term meals programs as part of Medicaid LTSS or HCBS waiver programs or short-term meals programs as part of Medicaid and Medicare Advantage post-discharge programs. Now is the time for mid-term or extended meals programs that can help support vulnerable populations who need support managing a chronic or acute condition like diabetes, heart disease, high risk pregnancy or behavioral health condition or who may be facing pandemic-related needs, like food insecurity or illness. Extended programs may support members for six weeks to six months and can help members to avoid hospital and SNF utilization at a time when it is critical to help members stay healthy at home. Mom’s Meals will share snapshots of a variety of innovative mid-term meals programs and the outcomes they are helping managed Medicaid and Medicare Advantage plans to achieve. Policy flexibilities that allow health plans to offer these innovative programs will also be discussed. Melissa Hildebrand, MSW,Director of Healthcare Partnerships,Mom’s Meals |
3:35 |
Including Housing Stability Assistance for Pregnant Women to Boost Birth Outcomes, Reduce Infant Mortality and Decrease NICU UseAddressing the social determinants of health (SDoH) is essential to the provision of high quality care coordination. When a member faces housing instability, the level of services needed can be time consuming and require a significant level of expertise. Healthy Beginnings at Home in Columbus, OH demonstrates how Clinical Care coordination, Life Coach, and Housing Service Specialists working together can improve birth and housing outcomes. This session will:
Amy Riegel,Director, Housing,CareSource |
3:55 |
Close of Module # 2
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Wednesday, October 28, 2020: 10 a.m. – 12:00 p.m. ET
10:00 |
ChairpersonJim Milanowski,CEO,Genesee Health Plan |
10:05 |
Social Determinants of Health Data and Case Management Interventions: A Household PerspectiveDiscuss use of assessments of the Social Determinates of Health (SDoH) needs of a household to effectively assist members with these needs as well as their impact on medical care. UPMC collects SDoH information from providers, member interactions, and publicly available data sets. Information about SDoH needs is incorporated into all case management activities with the member as well as all members in their household.
Ann Giazzoni, MSW, LCSW, MBA,Program Manager, Physical-Behavioral Health Integration,UPMC Health Plan |
10:25 |
Organizing Community Collaboration through a Community Information Exchange PlatformAddressing social determinants of health is a community-wide effort. What is the role of managed care in the community and what inherent industry competencies can it contribute to addressing social needs? This session will present lessons learned from the ConnectIE program. ConnectIE is a two-county regional program that seeks to organize social care delivery through a common resource and referral platform that is used daily by clinicians, schools, churches, community based organizations and residents. At this session attendees will:
Gabriel Uribe,Director of Community Health,Inland Empire Health Plan |
10:45 |
Interventions to Integrate Behavioral Health and Physical Health for Members with Co-Morbid ConditionsAcross the United States, behavioral health care needs are on the rise. Now more than ever, strategies, interventions, and programs designed to provide quick and easy access to behavioral health care and services are critical to improving the lives of people living with behavioral health conditions. This presentation will discuss solutions Centene has implemented to support their care coordination team in ensuring timely access and delivery of care, such as:
Taib Dedic,Director of Product Development, Complex Care, Centene |
11:05 |
Coordinating Care for the Complex Medical and Behavioral Health Needs of Poverty and the Homeless PopulationLauren Easton,Vice President of Innovations, Commonwealth Care Alliance |
Care Management & Care Transitions – Ensuring Quality and Cost Control |
11:25 |
Avoidable Admissions and Readmissions – Technology and Analytics to Maximize Outcomes
Lisa Holden,Vice President, Accountable Care,iCare |
11:45 |
At Home Care Program: Cut Costs and Improve OutcomesGeisinger at Home provides team-based comprehensive and acute care in the home for Geisinger Health Plan’s most complex members across Northeast and Central Pennsylvania. Geisinger’s approach combines in-person, facilitated tele-medicine, telemonitoring, outbound care coordination, and nurse triage to improve quality and manage the total cost of care. Andrea Harding, Senior Director of Operations, Geisinger at Home,Geisinger Health |
12:05 |
Close of Module # 3 |
Wednesday, October 28: 2 p.m. – 4:00 p.m. ET
2:00 |
ChairpersonLisa Holden,Vice President, Accountable Care,iCare |
2:05 |
Accessing and Caring for Hard to Reach Populations
Jim Milanowski,CEO,Genesee Health Plan |
Pharmacy-based Interventions for Care Coordination |
2:25 |
Effective, Scalable Clinical Pharmacy Based Care CoordinationLearn how effective use of technology in pharmacies and call centers can drive enhanced care coordination. Appointment based medication synchronization coordinates safe and effective use of medications while creating ongoing, accountable relationships between health plan members and pharmacy staff. Custom surveys tailored to condition-specific chronic care programs can further enhance member health outcomes while improving associated health plan quality measures and reducing medical costs. Mark Gregory, RPH,Director, Pharmacy Consultant, Population Health Services,EnlivenHealth |
2:45 |
Using a Concierge Approach to Secure Medication Access for Medicare MembersGetting a needed prescription can be a challenge for many seniors on a good day and the COVID-19 pandemic made it all the more difficult in many ways. Excellus BlueCross Blue Shield used predictive analytics to identify our Medicare members at the highest risk for COVID-19. Excellus then conducted telephonic outreach to offer concierge service to convert members to 90-day supplies of medication supplies, resolve medication access issues, and offer member care management and other supportive resources.
Renee Sabin-Haggerty,Director of Medicare Part D Strategy and Operations,Excellus BlueCross BlueShield |
3:05 |
Medication Therapy Management (MTM) 101: Effective Collaboration StrategiesMedication Therapy Management (MTM) can be of great benefit to providers and members, but the concept is often not well understood. What is MTM? How does it work? Why is it important? This session will break down the basics of MTM and the pharmaceutical care model, and discuss strategies for collaboration with other health care professionals such as care coordination. Erika Bower, PharmD, BCACP,Pharmacy Quality Manager,UCare |
3:25 |
Medication Adherence--How to Help Your Members During the COVID Outbreak
Gary Melis,Clinical Pharmacist,Network Health |
3:45 |
Pharmacy Innovations to Ease the Impact of the PandemicCOVID-19 has changed the world in a matter of months, and Cigna knows that as our world changes, our patients have different challenges and needs. To meet our patients where they are during these difficult times, we have created creative solutions to address issues and ensure patients get the best care possible. Areas where Cigna's Pharmacy services have innovated include:
Jeremy J. Menninger, PharmD, BCACP,CMG-Sun City West Pharmacy Supervisor,Cigna Medical Group Kari Nimlos Ehm, PharmD,Clinical Pharmacist,Cigna Medical Group |
4:05 |
Close of Conference |