2022 Managed Care Summit
The Future of Healthcare Delivery
October 17-18, 2022 * JW Marriott Orlando Grand Lakes *Orlando, FL

2022 On-Site and Near-Site Health Clinics Summit

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About the Conference:

Today, manage care is the predominant form of healthcare in the U.S. Efforts in managed care programs over the past decade have led to improved care delivery across the country. Advancements have empowered providers to focus on care quality over cost, helping to improve member engagement and outcomes while impacting costs at the same time. Healthcare leaders must expand their focus from merely data and measurement. It must be complemented by a focus on workforce development and increasing teams’ quality competencies. Additionally, leaders must clarify and validate the knowledge and skills that each healthcare role must learn to successfully shift to outcome-focused, value-based care. By developing specific competencies in quality, population health, care coordination, data analytics, governance and care delivery, MCOs can empower their workforces to meet the challenges and opportunities presented by this new model—and ultimately improve health care outcomes for all.

Today, consumers have more healthcare options and more control over them. Managed care has evolved into a more holistic part of the consumers’ world. It’s no longer just about copays, deductibles, and premiums, but has become part the overall quality of life for individuals and families. Members will be able to tailor their healthcare with more flexibility and ease. The care they receive should be whole-person centered, holistic, and integrated, accommodating the full range of their clinical, behavioral, social and spiritual health needs.

Another key to creating effective care delivery models is developing effective partnerships with key stakeholders. There is no one-size-fits-all solution in managed care. Nuances abound — across markets, regions, cultural competencies, geographies, and member populations — and each factor plays into how well any system can deliver care. There are significant opportunities to develop more effective managed care delivery models.

This conference will help you navigate this new world of managed care and bring you the education, networking, tools and resources to achieve improvements in both clinical and economic healthcare outcomes. Topics to be discussed will include health equity, member engagement strategies, payer-provider collaboration strategies, the impact of COVID-19 on managed care performance incentives, program integrity, leadership change management strategies, disruptive trends transforming healthcare, the adoption of emerging technologies, risk management, supplementing patient care coordination with telehealth, quality measurement and improvement, ways to boost Star ratings, patient safety, Medicare Advantage trends and more.

 

Who Should Attend?
C-Level Executives from Health Plans; ACO’s; Medical Groups; Government Agencies; Community Health Centers; Managed Care Organizations; Medicare; Medicaid; Star Ratings; Hospitals; Health Systems

  • CEO’s
  • CFO’s
  • VP’s
  • Patient Engagement
  • Quality Improvement
  • Risk Adjustment
  • Healthcare Operations
  • Performance Improvement
  • Clinical Services
  • Medical Directors
  • Managed Care Directors
  • Growth Officers
  • Social Determinants
  • Value Based Care
  • Population Health
  • Actuarial Services

 

Also of Interest to Vendors and Solution Providers

Conference Agenda

Day One - Monday, October 17, 2022
7:15am – 8:00am

Conference Registration & Networking Breakfast

 

8:00am – 8:15am

Chairperson’s Opening Remarks

 

8:15am – 9:00am

Keys To Realizing Health Equity

As the COVID-19 pandemic continues to widen existing health and health care disparities in the United States, the attainment of health equity looms large and is arguably our most pressing national priority to curb the pandemic. Social and economic vulnerabilities that have long preceded COVID-19 have perpetuated staggering challenges. Many in our nation now understand what public health experts have known for decades—underlying socioeconomic conditions in communities across the country predict health and health care outcomes more reliably than health care delivery itself. Eliminating health disparities has moved from a goal post for public health agencies, nonprofits, philanthropists, community-based organizations, and researchers, to a necessity for the private sector—including the nation’s health plans. Health plans assume the risk for millions of Americans and are responsible for the health of most Americans. In a healthcare delivery system that is highly fragmented, health plans are uniquely positioned to coordinate whole-person care across the lifespan. They are also poised to lead efforts in health equity that will address the systemic and structural factors that have perpetuated health inequities for too long. To succeed in achieving health equity in these companies, it is crucial that investments in health equity leadership be made, at the highest level, and that health equity is weaved into the organizational fabric, strategic plan, and business goals of every health plan. This session will explore how health plans can integrate health equity into their business model.

 

9:00am – 9:45am

High-Impact Member Engagement Strategies

The healthcare industry is no stranger to its share of changing variables, so Medicaid plans should be prepared to optimize their engagement strategies as trends across the industry—and among enrollees—shift. Member engagement is a powerful tool for Medicaid plans and managed care organizations. When members are actively engaged, everyone involved benefits. Increased engagement compels members to focus on high-value activities, making them more likely to take actions that prevent serious or chronic conditions. This leads to healthier members and populations, improved health outcomes, stronger plan performance and a better overall health care system. That said, many Medicaid members deal with real social factors that impact care and make it challenging for plans to engage. Social determinants, such as unstable living conditions or uncertainty about where the next meal or paycheck will come from, are concerns that often take precedence over dealing with health care. Medicaid engagement programs need to factor in the social determinants of health that affect members. Understanding and acknowledging uncertain circumstances helps plans and managed care organizations communicate with their members more effectively. This session will explore look strategies plans can take to actively engage members.

 

9:45am – 10:15am

Networking & Refreshments Break

 

10:15am – 11:00am

Payer and Provider Collaboration: The Key to Improving Long-Term Outcomes

When it comes to managing the care of a patient or health plan member, each interaction provides a new piece to the puzzle of helping him or her get healthy and stay healthy. When it comes to health plans and providers, collaboration is critical to this success. By enabling effective communication between the provider and the health plan there are more resources available to ensure care tasks are completed and that the patient is well taken care of. Together, they can establish who is responsible for post-discharge follow up, for reminding the member of upcoming preventive screening eligibility, for educating the patient on how to manage their condition. This session will explore strategies to enable more effective collaboration, including sharing information, assigning care tasks, and incentivizing success.

 

11:00am – 11:45am

Impact of COVID-19 on Managed Care Performance Incentives

As the COVID-19 pandemic continues to evolve and significantly alter care delivery, managed care organizations and providers are considering the impact on health care quality and spending. They are examining their value-based payment programs and evaluating modifications to their quality measurement and quality and cost performance policies, particularly those arrangements that hold entities financially accountable for performance. This session will explore quality and cost performance issues related to managed care performance incentives and discuss policy options for consideration.

 

11:45am – 12:30pm

Building and Evolving Your Program Integrity Compliance Program

Program integrity activities are meant to ensure that federal and state taxpayer dollars are spent appropriately on delivering quality, necessary care and preventing fraud, waste and abuse. Like other administrative activities, program integrity responsibilities are shared between states and the federal government. This session will explore contracted managed care organizations program integrity responsibilities.

 

12:30pm – 1:30pm

Lunch Break

 

1:30pm – 2:15pm

Leadership Change Management Strategies

Whether change involves a merger, acquisition, or reorganization, healthcare leaders must constantly evaluate the circumstances of the changes they face so that they can effectively make the right decisions. It is imperative that leaders determine how they respond so that they can help their organizations prepare, manage, and navigate the sometimes violent turbulence of organizational disruption. This session will explore change management strategies and takeaways for managed care executives as the changing face of leadership continues to proliferate.

 

2:15pm – 3:15pm

Panel: Disruptive Trends Transforming Healthcare

Spiraling costs, poor quality outcomes, and inequities in access to care are driving significant and long overdue changes to the way healthcare is administered and managed in the U.S. And while the U.S. spends more on healthcare per person than other wealthy countries, its health outcomes are no better than those in other developed countries. In fact, it performs worse in several health metrics, including life expectancy, infant mortality, and unmanaged diabetes. These types of poor clinical outcomes are often driven by inequitable access to good healthcare in low-income neighborhoods. And a growing body of evidence suggests that an individual’s U.S. ZIP code—where people live—is a more accurate predictor of future health outcomes than genetics or medical care. This session will explore disruptive health care trends that will intensify in the coming year and ultimately improve healthcare in America.

 

3:15pm – 3:45pm

Networking & Refreshments Break

 

3:45pm – 4:30pm

Managed Care and the Evaluation and Adoption of Emerging Technologies

New technologies —medical devices, pharmaceuticals and procedures — often allow great improvements in the outcomes of medical care, but they are also widely believed to be a major cause of increasing costs. Selective adoption of new technologies is crucial in the quest to control healthcare costs while preserving or enhancing the quality of care. This session will explore the evaluation and adoption of innovative procedures and medical devices by managed care organizations, including:

  • Developing better information before market introduction
  • Learning more from experience after market introduction
  • Evaluating and synthesizing clinical information
  • Disseminating information

 

4:30pm – 5:15pm

Look Before You Leap: Enterprise Risk Management for Managed Care Plans

Risk is ubiquitous in healthcare. And that reality makes it imperative for finance leaders of both provider organizations and health plans to make effective risk management a top priority. The best way to take on risk and mitigate its effects—particularly in this time of transition to value-based care—is through a comprehensive approach that accounts for all risk across the organization. A piecemeal approach to managing risk can provide only limited benefits, no matter how well-managed each part might be. This session will examine how an enterprise risk management program can provide an unparalleled means to safeguard a healthcare organization’s financial position.

 

5:15pm

End of Day One

Day Two – Tuesday, October 18, 2022
7:15am – 8:00am

Networking Breakfast

 

8:00am – 8:15am

Chairperson’s Recap

 

8:15am – 9:00am

Supplementing Patient Care Coordination with Telehealth

Today, telehealth platforms allow patients to self-monitor their vitals daily and answer questions on how their symptoms are progressing. Moreover, it allows clinicians to receive alerts if there are any high-risk readings and to be proactive about addressing them. The use of telehealth in managed care coordination and operations empowers a patient to learn more about their condition, promotes self-monitoring, augments a patient care coordinator’s reach, and allows for more actionable interventions by the patient’s primary care team to prevent unnecessary healthcare spend and improve quality of life. This session will explore the benefits of telehealth in managed care and how to leverage it to supplement patient care coordination.

 

9:00am – 9:45am

Quality Measurement and Improvement in Managed Care

In recent years the number of Americans receiving healthcare services through some sort of managed care organization has increased greatly. While managed care has been heralded as a means to reduce costs associated with the delivery of healthcare services, there has been much concern that this cost saving will be achieved by sacrificing the quality of care. Because of this, measuring and assuring the quality of care in managed care settings has become a priority. Government agencies, nonprofit organizations, and consumer groups have all begun to focus on the two major aspects of this issue: measurement and improvement. Measurement efforts include developing tools, collecting data, determining indicators of health care quality, analyzing the data and reporting it. After this is done, steps must be taken to ensure that the quality of care is up to par, and to make improvements, where necessary, through education initiatives. Information on the quality of care provided under managed care plans is useful to consumers and employers when trying to chose the best plan to purchase, and also to the plans themselves to determine where improvements need to be made. This session will provide tools about quality measurement and improvement in managed care.

 

9:45am – 10:15am

Networking & Refreshments Break

 

10:15am – 11:00am

Why Managed Medicaid/Medicare Health Plans Need Analytics to Improve Outcomes

Managed care organizations that provide healthcare services to Medicare/Medicaid members are dedicated to improving the health and wellness of these underserved populations, especially those living in rural areas.

With this patient- and member-centric mission, health plans are continually under pressure to improve the quality of care, grow access to healthcare services, and boost chronic care programs. To be successful with these programs, health plans must use data analytics to monitor healthcare access and outcomes success, all while monitoring expenditures to help ensure new healthcare services for the underserved can be rolled out. This session will explore how analytics give health plans with Medicare/Medicaid populations the ability to combine quality, cost, utilization management, enrollment and eligibility into a 360-degree member view.

 

11:00am – 11:45am

Ways to Boost Star Ratings and Retain Members

The Five-Star Quality Rating System isn’t just a mechanism to improve the patient experience; it has also changed the industry from an insurer’s perspective. A distinct correlation has been found between the number of complaints about Medicare Advantage plans and the number of customers withdrawing from these plans. This session will explore steps health plans can take to reduce customer complaints, improve Medicare star ratings, and lower member attrition rates.

 

11:45am – 12:30pm

Managed Care and Patient Safety: Risks and Opportunities

Patient safety practices have primarily focused on providers, such as hospitals and ambulatory or long-term care. Based on the premise that most medical errors and patient safety problems arise from system issues, and that managed care constitutes the largest, most integrated system in healthcare, this session will examine the role of managed care in making patient care safer.

 

12:30pm – 1:30pm

Lunch Break

 

1:30pm – 2:15pm

Strategies to Grow Your Managed Care Organization

In recent decades, the healthcare delivery system has undergone significant and rapid changes. For managed care organization within this highly competitive marketplace, finding ways to distinguish your operation and grow your business is no simple task. But with an aging American demographic, experts predict that it will become an even larger factor, what with the continued growth of Medicare and Medicaid. This session will explore how to take advantage of this rising demand for high-quality care at competitive prices, and strategize ways to promote growth.

 

2:15pm – 3:15pm

Panel: Trends in Medicare Advantage

Over the last decade, the role of Medicare Advantage, the private plan alternative to traditional Medicare, has grown. In 2021, more than 26 million people enrolled in a Medicare Advantage plan, accounting for 42 percent of the total Medicare population, and $343 billlion (or 46%) of total federal Medicare spending (net of premiums). The average Medicare beneficiary in 2021 has access to over 30 Medicare Advantage plans, the largest number of options available in the last decade. This session will explore trends in Medicare Advantage.

 

3:15pm – 3:45pm

Networking & Refreshments Break

 

3:45pm – 4:30pm

Managed Care’s Effect on Outcomes

While much research has been conducted on whether managed care delivery systems result in better outcomes than traditional fee for service, there is no definitive conclusion as to whether managed care improves or worsens access to or quality of care for beneficiaries. This session will explore outcomes associated with managed care delivery systems, including aspects of Medicaid managed care that may affect access to and quality of care, and the relationship between managed care, access and quality.

 

4:30pm – 5:15pm

Managed Care Disputes and Litigation

The rollout of the administration’s healthcare and enforcement priorities combined with transparency measures, surprise billing legislation and pressure from the pandemic is churning up a new set of challenges and potential risks. This session will examine these new developments and their profound impact on MCOs, and practical insights on how to protect your organization.

 

5:15pm

Conference Concludes

Workshop - Tuesday, October 18, 2022
Workshop: HCC Coding: Best Practices to Implement in Medicare Advantage

A hot topic in healthcare right now, especially in the medical coding world is the Hierarchical Condition Category (HCC) risk adjustment model and how accurate coding affects healthcare organizations’ reimbursement. With almost one third of Medicare beneficiaries enrolled in Medicare Advantage plans, it’s more important than ever for healthcare organizations to pay attention to this model and make sure physicians are coding diagnoses appropriately to ensure fair compensation. This workshop will walk through basics of the risk adjustment model, why coding accuracy is so important, and five action items for interdisciplinary work groups to take, including:

  • Having an accurate problem list
  • Ensuring patients are seen in each calendar year
  • Improving decision support and enterprise risk management optimization
  • Widespread education and communication.
  • Tracking performance and identifying opportunities

 

Venue
VENUE

JW Marriott Orlando Grand Lakes
4040 Central Florida Pkwy
Orlando, FL 32837
407-206-2300

** Mention BRI Network for a discounted rate of $279/night **

Sponsors and Exhibitors
FAQ

Are there group discounts available?

  • Yes – Register a group of 3 or more at the same time and receive an additional 10% off the registration fee

Are there discounts for Non-Profit/Government Organizations?

  • Yes – please call us at 800-743-8490 for special pricing

What is the cancellation policy?

  • Cancellations received 4 weeks prior to the event will receive a refund minus the administration fee of $225. Cancellation received less than 4 weeks prior to the event will receive a credit to a future event valid for one year.

Can the registration be transferred to a colleague?

  • Yes – please email us in writing at info@brinetwork.com with the colleague’s name and title

Where can I find information on the venue/accommodations?

  • Along with your registration receipt you will receive information on how to make your hotel reservations. You can also visit individual event page for specific hotel information. The conference fee does not include the cost of accommodations.

What is the suggested dress code?

  • Business casual. Meeting rooms can sometimes be cold so we recommend a sweater or light jacket
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