2023 Value-Based Healthcare Congress

8:00am – 8:15am
Chairperson’s Opening Remarks 

8:15am – 9:00am

What Value-Based Care Means for Providers
Value-based care is a form of reimbursement that ties payments for care delivery to the quality of care provided and rewards providers for both efficiency and effectiveness. This form of reimbursement has emerged as an alternative and potential replacement for fee-for-service reimbursement, which pays providers retrospectively for services delivered based on bill charges or annual fee schedules. In order to transform how healthcare providers are reimbursed for services rendered, CMS introduced an array of value-based care models. Private payers have, in turn, adopted similar models of accountable, value-based care. As the healthcare industry transitions to this new way of delivering care, many healthcare providers are left wondering how value-based care differs from the traditional model, what programs are available, and how successful it has been? This session will explore the basics of value-based care and help providers understand how the model works. 

9:00am – 9:45am
Payer-Provider Collaboration and the Value-Based Care Continuum
As the healthcare industry continues to move toward value-based delivery and payment models, payers must rethink the way they engage with provider partners. Building new payer-provider collaborations is critical to success in a value-based healthcare world where both parties share financial risk for achieving health outcomes. Under such models, payers and providers have incentives aligned around providing the right care to the right patient at the right time, ultimately achieving better outcomes at lower cost. Developing such partnerships can ultimately serve as the basis for a new business model that is sustainable in the increasingly competitive and cost-conscious healthcare environment. This session will explore successful pay-provider collaboration strategies.

Scott Flinn, MD
Regional Medical Director
Blue Shield of California 

9:45am – 10:15am
Networking & Refreshments Break 

10:15am – 11:00am
Integrating Social Determinants of Health into Value-based Care
The movement toward value-based care provides a significant opportunity to address social determinants of health (SDoH) while improving value and quality of care. Value-based care can allow greater flexibility in terms of what services are delivered while providing accountability for long-term sustainability and population health improvements. Although federal, state, and commercial payers are launching innovative new payment models addressing SDoH, questions remain regarding best practices for implementation, impact on cost and outcomes, and ability to scale and spread across different contexts under current policies. This session will explore the current landscape of payment reform initiatives addressing SDoH, challenges and opportunities related to implementation, policy implications and next steps so that states and payers can use value-based payment to encourage and promote addressing social needs.

11:00am – 11:45am
The Role of Population Health in Value-Based Care
As value-based care gains momentum, healthcare systems and insurers are looking at care with a new lens. Reimbursement is dependent on positive patient outcomes, not the volume of services rendered. As a result, providers must take a team-based approach to care that focuses on the whole person, not just the conditions that patients present at a given point in time. Value-based care organizations recognize that a significant key to success is getting the treatment plans right the first time for the right individuals. However, delivering the right care to the right people at the right time, requires providers to have comprehensive knowledge about their patients. To deliver true value-based care, healthcare providers need insight into the characteristics of both individuals and larger groups of patients. This session will explore how population health management replaces “one size fits all” care with tailored, cost-effective interventions based on patients’ risk levels, and is well aligned with the goals of value-based care.

Lindsay Jubelt, MD
Chief Population Health Officer and Chief Medical Officer
Mass General Brigham 

11:45am – 12:30pm
Key Considerations for Value-Based Care Strategies
The healthcare industry is under extreme pressure with escalating costs, an aging population, healthcare delivery disruption and increased regulatory demands. Organizations of all sizes are feeling squeezed by the everchanging pressures of an unsustainable system. As we aim to actively move the healthcare ecosystem away from siloed processes, cumbersome data and misaligned incentives to one where information, people and processes are connected, organizations are struggling to strategize their diversification from fee-for-service to value-based care. This session will explore what should healthcare organizations consider when adopting value-based care strategies aimed to improve outcomes for individuals and populations and lower the total cost of care, including:

–            Organizational structure and proper governance

–            Unified technology platforms backed by a health IT partnership

–            Optimizing and expanding the venue of care

–            Consumer engagement

–            Health and prevention strategies

12:30pm – 1:30pm
Lunch 

1:30pm – 2:15pm
Leveraging Digital Health to Realize Value-Based Care
It is estimated that nearly half the population suffer from at least one chronic illness. From a cost perspective, chronic illnesses account for 75 percent of healthcare costs in the U.S. each year. The COVID-19 pandemic has also made disparities and inequities in the American healthcare system even more apparent than ever before. Given these staggering statistics, it’s more important than ever that our healthcare system shifts from the traditional approach of paying for discrete services in a fragmented manner, with gaps in payment for many high-value services, to one that supports value and improved health outcomes, but this goal remains far from realized. Digital healthcare technologies provide an essential major means for advancing value-based care, yet they remain underutilized or completely unused. The time is now to truly incent the use of digital healthcare innovations so that a transition to value-based care happens. This session will explore key challenges to the responsible use of digital health technologies in advancing value-based care, and recommendations on how to overcome them.

Anthony Roggio, MD
Medical Director of Telehealth
University of Maryland Medical System and Access Center 

2:15pm – 3:15pm
Panel: How Providers, Payer and Tech Can Collaborate to Drive Better Financial and Clinical Outcomes
As demand for value-based healthcare grows, the most innovative organizations are using analytics to develop standardized episodes of care at scale to optimize performance. Topics to be discussed include:

– How transparent episode analytics are driving value-based-care performance at leading organizations

– Overcoming obstacles to adoption

– Driving improved clinical and financial performance

Stuart L. Lustig, M.D., M.P.H.
National Medical Executive for Provider Partnerships
Evernorth Behavioral Health
Cigna 

3:15pm – 3:45pm
Networking & Refreshments Break 

3:45pm – 4:30pm
Emerging Trends in Value-Based Care
The COVID-19 pandemic has brought about many changes within the healthcare system. Most prominently, it has exposed the downfalls of the outdated fee-for-service healthcare model. This has prompted a renewed interest, and opportunity to fully invest, in value-based care. This session will explore emerging trends in value-based care to keep an eye on in 2022, including:

–            Adaptability

–            Accessibility

–            Innovation

–            Value

–            Equity

Jennifer Houlihan
Vice President Value Based Care & Population Health
Atrium Health Wake Forest Baptist 

4:30pm – 5:15pm

Managed Care and Value-Based Arrangements

Value-based care and alternative payment models represent an increasing share of payments to healthcare providers. In this session learn how to seize opportunities and overcome the challenges. Topics to be discussed will include:

–            Negotiating contracts with accountable care organizations and for bundled-payment arrangements, patient-centered medical homes and other pay-for-performance, value-based care, shared savings and risk-contracting models

–            The sharing of financial risk between and among providers and payer

–            The risks and rewards that these evolving payment models present

–            Maximizing the benefits for your health care organization

William Munley
Administrator
Shriners Children’s 

5:15pm
End of Day One

8:00am – 8:15am
Chairperson’s Remarks 

8:15am – 9:00am
Patient Engagement Strategies That Prevent Hospital Readmissions 

Carla Beckerle,DNP,APRN-BC
Vice President
Esse Health 

9:00am – 9:45am
Transforming Musculoskeletal Care: More than Just Virtual Physical Therapy
Musculoskeletal (MSK) conditions impact more than 1 in 2 adults and dramatically drive healthcare costs. The traditional health care system delivers a fragmented and expensive care-model for patients and payors. MSK patients are typically referred from their PCP to a spine or orthopedic surgeon which results in overutilization of advanced imaging and surgery. For example, 50% of low back surgeons and 34% of knee replacements are inappropriate and postoperative complications harm patients. This session will highlight the solution: a virtual first model in which patients are surrounded by a multi-disciplinary care team (physician, physical therapist, health coach, and registered dietitian) to leverage evidence-based whole-person care and optimize non-surgical treatments. Better clinical outcomes, high patient satisfaction, and lower healthcare costs are achieved with this model. Transforming MSK care is essential to achieving value in healthcare.

Mary I. O’Connor, MD
Chair
Movement is Life
Professor Emerita of Orthopedics
Mayo Clinic
Chief Compliance Officer
Co-founder and Chief Medical Officer
Vori Health 

9:45am – 10:15am
Networking & Refreshments Break 

10:15am – 11:00am
Transforming the Care Journey to Deliver Value-Based Care
The shift from volume-to-value-based is improving patient health outcomes and reshaping the relationship between patients and providers. With the increasing role of technology in the healthcare setting, patients extensively rely on digital sources to stay informed, engaged, and connected with the physicians and specialists involved in their treatment. This transformation is progressively gaining importance across all stakeholders in the healthcare value chain, from patients to health systems, and payers. The key reasons are qualitative treatment modules and improved patient care which also contribute to potential cost savings. The transition from volume to value is expected to expand, despite concerns about providers’ slow adoption of technology. This session will explore successful strategies to transform the care journey to deliver value-based care.

Francis Balucan, MD, MBA, FACP
Medical Director, VICP Program
Vanderbilt Health 

11:00am – 11:45am
Population Health and Value-Based Care at Johns Hopkins Medicine 

Scot Berkowitz, MD, MBA
Chief Population Health Officer and Vice President of Population Health
Johns Hopkins Medicine

11:45am – 12:30pm
The Rise of Value-Based Technology in Driving Value-Based Care

A system-wide transformation to value-based care is challenging and rewarding. It puts the patient at the center and rewards quality improvement over volume. A successful transition reduces medical errors and lowers costs while increasing patient satisfaction. However, a lack of integrated tools, outdated processes, and inaccessible data can halt progress. This session will explore how value-based technology helps healthcare leaders manage the risks of VBC, and how IT tools enhance workflows and interoperability, allowing executives to monitor and manage care. This session will explore how IT infrastructure can support value-based care delivery and contribute to its success.

12:30pm
Conference Concludes

As healthcare organizations seek more separation from fee-for-service, insurers continue to wrestle with delivery system change, consolidation, and value-based care. There is a need to create transparent, scalable and equitable programs that include quality and payment and bring value to members. These members, many who have avoided care and are now not only sicker but also have more advanced and complex illnesses, need to be flagged and identified for care management. Using risk adjustment can help. There are many tools that can measure performance but if not done on a risk-adjusted basis quality, financial and outcomes measures may not be truly reflective of value. This session will explore value-based payment programs that leverage equitable policy decisions and utilize risk adjusted methodologies that focus on population health improvements and keeping members healthier.