2024 Value-Based Healthcare Congress

7:15am – 8:00am
Conference Registration & Networking Breakfast 

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

8:15am – 9:00am
Opportunities in Value-Based Care
For more than a decade, value-based care (VBC) has been positioned as healthcare’s next big thing. And while progress has been uneven until now, multiple forces are converging to inflect growth across an expanding set of risk-bearing models. Rising costs of care are putting pressure on stakeholders while key VBC enablers have matured—including data availability, analytics and care management models. Increased participation from other payers will be needed to unlock the full market potential. Physician interest in VBC is high, but risk appetite is still a work in progress. This session will explore all this and more opportunities in VBC. 

Karen Marie Wilding, MHA, CHCIO, FHIMSS
Vice President, Chief Value Officer
Nemours Children’s Health 

9:00am – 9:45am
Key Metrics to Gauge the Quality of Value Based Care
Metrics are vital to understanding how successful a business is in meeting key performance goals. In fee-for-service healthcare practices, those metrics tend to focus on quantity over quality: How many patients are being seen? How many billing codes have been processed? How much money has been made over a specific period? In value-based care, metrics prioritize quality over quantity. Quality is a much more important approach to use in determining how well your services are meeting patients’ needs, but it’s also more difficult to measure. This session will explore quality measures that matter for value-based care.

Marybeth Sexton, MD, MSc
Chief Quality Officer, The Emory Clinic and ESA
Epidemiologist, The Emory Clinic
Associate Professor, Division of Infectious Diseases
Emory Healthcare 

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

10:15am – 11:00am
The Value of Pharmacist Interventions to Patients, Providers, Health Plans, and Payers
The problems associated with prescribed medication like drug reactions, poor medication adherence, overprescribing, and medication errors, contribute to preventable patient injuries and treatment failures that cost $634B/year. Consider this – for every dollar spent on medication, there is an additional dollar cost for medication misadventures and treatment failures. The solution? Using more patient-centered and clinically deployed pharmacists – what one physician during a recent TED talk described as “the new disruptors of healthcare.” However, what is the evidence that highly trained and clinical deplored pharmacists make a significant difference in clinical improvement, patient safety, healthcare utilization, and quality of care? And, if these clinical pharmacists do make a difference, what is the value to patients, providers, health plans, and payers?

William N. Kelly, Pharm.D.
Professor
University of South Florida, Tampa 

11:00am – 11:45am
Engaging Providers in Value-Based Care
Implementing value-based care initiatives that result in improved health outcomes requires all factors needed to drive those changes are aligned. This ensures the informed decisions will result in higher margins and increased patient and provider satisfaction. Confirming that all data is meaningful and accurate is essential to optimizing overall improvement and engagement initiatives successfully. This session will explore how by putting performance management practices in place and elevating clinical and financial performance to deliver high-value care, managed care executives can equip their organizations to make informed decisions about what type of reimbursement risk to take on and how to manage it successfully. Topics to be discussed will include:

–            Exploring the population health transition framework

–            The importance of physician and provider engagement in the transition to value

–            Successful tools for gaining physician buy-in for VBC and alternative payment models

Michele Forgues-Lackie MBA, FACHE, CHFP, FACMPE
Senior Vice President/Chief Financial Officer
UW Medicine Valley Medical Center 

11:45am – 12:30pm
Value Based Care and Remote Patient Monitoring
Is it easier to make value-based care with remote patient monitoring? The answer is yes. Telehealth and RPM provide several avenues for providers to attain value-based care in their organization. This session will provide an overview of value-based healthcare and remote patient monitoring. In addition, we will outline easy ways that telehealth and remote patient monitoring can help providers prioritize care delivery, improve patient outcomes, and receive reimbursement for their efforts.  

James Marcin, MD, MPH
Vice Chair, Pediatric Clinical Research
Professor, Department of Pediatrics
Director, Center for Health and Technology
UC Davis 

12:30pm – 1:30pm
Lunch 

1:30pm – 2:15pm
Asynchronous Provider Care Models to Effectively Manage Our At-Risk Population and Reduce TME
Boston Children’s launched an enterprise-wide eConsults (online, written provider-to-provider consults) program in 2021 to help centralize and triage lower acuity consults while increasing access and alleviating capacity constraints in a compliant method. The program continued to expand to additional specialties and internal primary care sites through 2022. In 2023, the state of Massachusetts included eConsults criteria into their Medicaid (Masshealth) ACO requirements and those participating offices would achieve greater PMPM for having access to this service.  Within six months, the Boston Children’s eConsult program scaled their eConsult offering to their affiliated primary care network across the state of Massachusetts which included more than 100 offices and 600 providers at a 6x growth rate since the beginning of the year. Successful outcomes to date have shown that 60% of eConsults can stay local without the need for a referral to a specialty outpatient visit, 92% influenced the care plan, and 80% of requests are made in specialties with higher appointment lead times.

Heather M. Meyers, MBA
Director, Virtual Care
Innovation & Digital Health Accelerator
Boston Children’s Hospital 

2:15pm – 3:15pm
Panel: Transparency and Value-Based Care Collaborations Between Providers and Payers
Succeeding at value-based care isn’t just about the numbers. Success depends as much, if not more, on the trust between providers and payers. Both sides share the same goal: providing more value—better clinical outcomes for less cost—to patients and members. Yet, unless both sides trust each other, collaborating to achieve that common goal can be difficult. As healthcare consumerism grows and patients pay more of their medical bills out of pocket, trust will become a big competitive differentiator in the market as patients select their providers, exerting even more margin pressure on hospitals, health systems and medical practices across the country. This session will explore transparency and VBC collaborations between providers and payers.

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

Stephanie Turner, RN, MSN
Vice President, Population Management
UNC Health 

Byron Scott, MD, MBA
Lecturer
Jefferson College of Population Health
Board Vice-Chair
Rady Children’s Hospital-San Diego
Board Director
Providence Health Plan

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

3:45pm – 4:30pm
Value-Based Care Best Practices for the Best Patient Experience
More and more healthcare organizations are shifting to value-based care (VBC), an approach that prioritizes patient health outcomes and rewards physicians accordingly. VBC focuses on the whole person, not just a person’s specific condition. With value-based care, better patient outcomes go hand in hand with better patient experiences and satisfaction. This session will explore numerous factors that contribute to the patient experience and strategies that a primary care physician and their staff can use to improve care and increase patient satisfaction.

Francis Balucan, MD, MBA, FACP
Section of Hospital Medicine, Division of General Internal Medicine & Public Health
Vanderbilt University Medical Center

4:30pm – 5:15pm
How to Achieve Medicare’s VBC Goals of 100% by 2030: Growth Tactics and Strategies for Healthcare Providers
In January 2021, the Centers for Medicare and Medicaid Services (CMS) announced its goal to have all Medicare beneficiaries with Parts A and B in a care relationship with accountability for quality and total cost of care by 2030. CMS plans to achieve this goal by growing its current programs and creating new ones to entice providers to participate. CMS expects that new policies taking effect in 2024 will drive growth in participation, promote equity, better align accountable care initiatives and add another 4M assigned beneficiaries over the coming years. So what does this mean for providers, health systems and ACOs? Why is it still difficult to grow your accountable care lives within your practice even within the models that exist? This session will dive into both operational tactics and growth strategies for providers to be able to take advantage of the capabilities they build for population health at scale.

Tori Bratcher, MHA
President
Trinity Integrated Care, LLC 

5:15pm
End of Day One

7:15am – 8:00am
Conference Registration & Networking Breakfast 

8:00am – 8:15am
Chairperson’s Recap 

8:15am – 9:00am
The Future of Value-Based Payment
A decade after the passage of the Affordable Care Act, the vision of moving the U.S. health care system “from volume to value” has been partially realized, with few value-based payment initiatives systematically reducing spending or improving quality. While participation in value-based payments continues to grow, the adoption of advanced forms of value-based payment through alternative payment models lags. Furthermore, the complexity of the current suite of alternative payment models and allure of traditional fee-for-service prevent the widespread adoption of full risk-bearing contracts. The high costs of care with the impending insolvency of the Medicare trust fund, persistence of poor quality of care and health disparities along racial and socioeconomic lines, and mixed success of alternative payment models indicate the need for a revamped vision. There is a need for a new strategy that moves from a short-term focus on testing new payment models to a long-term focus on expanding models that are most likely to generate substantial savings and improve quality. This session will explore the transition to a healthcare system that pays for value and reduced health disparities, rather than high volumes of services.

William Riley, Ph.D
Director of the National Safety Net Advancement Center
Professor, Science of Health Care Delivery, College of Health Solutions
Arizona State University (ASU) 

Cameron Adams, MPP
Program Administrator
Arizona Health Cost Containment System

9:00am – 9:45am
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.

Karen L. Fortuna, PhD, LICSW
Assistant Professor of Psychiatry
Geisel School of Medicine at Dartmouth
Research Health Scientist Specialist
VA White River Junction Healthcare System 

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

10:15am – 11:00am
Innovative Approaches to Leverage Care Team Members to Succeed in Value-Based Care
This session will discuss innovative approaches that were developed at University of Michigan Health to leverage care team members to be successful in value-based programs and contracts while improving patient outcomes.  The talk will review various ways to support the care team to enable them to practice at the top of their license.  Attendees will learn how to form partnerships with community pharmacies to support and extend primary care.  This session will also discuss improving Annual Wellness Visits (AWV) by integrating care team into the process.  

Hae Mi Choe, PharmD
Chief Population Health Officer
University of Michigan Health
Chief Executive
Physician Organization of Michigan ACO (POM ACO)
Executive Director
Michigan Institute for Care Management & Transformation (MICMT)
Associate Dean & Clinical Professor, College of Pharmacy
University of Michigan 

11:00am – 11:45am
How Value-Based Care Supports Workforce Well-Being
Value-based care (VBC) focuses on achieving the outcomes that matter to patients, but how does it impact the health care workforce? VBC supports the professionalism of clinical practice by returning health care to its purpose of health and healing. Health systems currently face accelerated levels of staff burnout and moral distress, leading to disengagement and high turnover that affects both patient care and financial viability.  VBC aligns what matters to patients with what matters to the workforce along with a financial model aimed at achieving both. Using case studies from US and international settings, this session will demonstrate how VBC reengages the clinical workforce and builds high-performing health care teams.

Alice Andrews, PhD
Assistant Professor, Department of Medical Education
Dell Medical School
Clinical Associate Professor, Department of Management, McCombs School of Business
The University of Texas at Austin 

11:45am – 12:30pm
How to Successfully Deploy Digital Health in Value-Based Care
This session will explore how digital health tools can support financial and clinical success under value-based care arrangements. Learn how to successfully demonstrate value within the value-based care framework and hear how value-based care models have successfully leveraged digital health tools.

Anthony Roggio, MD
Assistant Professor
Department of Emergency Medicine
University of Maryland School of Medicine
Interim Chair
Department of Emergency Medicine
UMMC – Midtown Campus
Medical Director, Center for Telehealth
University of Maryland Telemedicine and Access Center 

12:30pm
Conference Concludes

Workshop: Strategies to Implement and Improve Value-Based Care
Value-based care (VBC) is a provider payment model based on incentivizing high-quality healthcare, rather than quantity of services. Overall, the goal is to improve the lives of patients while reducing cost of care. This session will explore key strategies to implement and improve value-based care, including:

• How to identify patients with the highest risk
• Addressing patients who need care
• Encouraging annual wellness visits
• Keeping open communication with provider-relation reps
• Being open-minded to succeed at VBC

 Greg L. Smith
Managing Director
Accenture