overview
Healthcare payment models continue shifting from volume-based to value-based arrangements. Accountable Care Organizations (ACOs) now serve over 44 million lives nationwide, bundled payments expand across specialties and health plans push risk-sharing models on providers. Yet many healthcare leaders feel underprepared for value-based transition. Financial risk management requires different operational infrastructure than fee-for-service medicine. Population health demands capabilities most organizations still lack. Data analytics must drive clinical and operational decisions. Primary care must be strengthened as foundation for managing risk. Social determinants of health — housing instability, food insecurity, transportation barriers — increasingly drive outcomes and costs yet healthcare organizations struggle to address them.
Business Research Intelligence Network’s Value-Based Care and Population Health Management Summit brings together health system leaders, medical directors, ACO executives and operational leaders navigating value-based transformation. Sessions will explore financial risk management strategies and actuarial modeling, building population health analytics capabilities, strengthening primary care as risk foundation, addressing social determinants through practical strategies, designing measurement and reporting frameworks and leading organizational transformation toward value. Attendees will hear from health systems and ACOs successfully managing risk while improving quality and outcomes, learn about technology and data platforms enabling value-based care and discover practical frameworks for navigating federal programs, contracting with payers and managing downside risk.
7:15am – 8:00am
Conference Registration & Networking Breakfast
8:00am – 8:15am
Chairperson's Opening Remarks
8:15am – 9:00am
TBD
Farrukh N Jafri, MD, PhD, MS-HPEd, FACEP
Medical Director, WPH Cares
White Plains Hospital
9:00am – 9:45am
Aligning Payment and Care Transformation to Reduce Health Disparities
Marshall Chin, MD, MPH
Richard Parrillo Family Distinguished Service Professor of Healthcare Ethics
Department of Medicine
University of Chicago
9:45am – 10:15am
Networking & Refreshments Break
10:15am – 11:00am
Risk Adjustment and Coding: Maximizing Accurate Risk Capture
Risk adjustment determines financial performance in capitated and shared savings arrangements. Inaccurate or incomplete coding leaves money on the table and understates patient complexity. Organizations succeeding in value-based care have sophisticated risk adjustment strategies operating prospectively, concurrently and retrospectively. Learn how to build coding teams and processes capturing patient complexity accurately, implement concurrent review identifying missed opportunities before reconciliation and conduct retrospective analysis identifying coding improvement opportunities.
Stina Redford
Director of Payment Innovation and Risk Accuracy
Blue Cross of Idaho
11:00am – 11:45am
Quality Programs and Stars Ratings: Aligning Metrics with Outcomes and Incentives
Quality metrics drive financial performance in value-based arrangements. Medicare Advantage Stars ratings impact quality bonus payments and member selection. HEDIS measures assess clinical quality. Member experience metrics reflect care satisfaction. Organizations must understand which metrics matter most, how they're measured and calculated and how to design programs improving performance. In this session you will learn about major quality frameworks and metrics in different value-based programs, how quality performance impacts financial results, member engagement programs improving satisfaction and health outcomes and operational approaches to quality improvement including workflow redesign and provider engagement.
Ria Paul MD
Clinical Associate Professor, Section of Geriatrics
Division of Primary Care and Population Health
Department of Medicine
Stanford Health
11:45am – 12:30pm
Population Health Analytics: Data as Foundation for Value-Based Success
Population health requires data infrastructure most healthcare organizations lack. Organizations thriving in value-based arrangements invest heavily in analytics platforms, data governance and clinical integration. They profile populations identifying high-risk and high-cost patients, understand drivers of cost and utilization, model clinical and financial impact of interventions before deployment and measure outcomes across multiple dimensions. In this session you will learn how to build analytics infrastructure consolidating claims, clinical and social determinants data, identify populations and patient cohorts requiring intervention and design dashboards providing visibility to clinical and operational leaders. We’ll also explore how to translate analytics into action using predictive models to intervene before patients become high-cost and measuring whether interventions improve outcomes and reduce costs.
Vladimir G. Manuel, MD
Vice Chair for Clinical Affairs
UCLA Health
12:30pm – 1:30pm
Networking Lunch
1:30pm – 2:15pm
TBD
Michael D. McCann, MD, MBA, SFHM, FACP, FAAP
Assistant Professor of Clinical Medicine
Section of Hospital Medicine
Division of General Internal Medicine & Public Health
Department of Medicine
Vanderbilt Interdisciplinary Care Program, Medical Director
Discharge Care Center & Post
Discharge Clinic, Medical Director
Founding Director, Clinical Care Model & Care Design
Vanderbilt Health
2:15pm – 3:15pm
Panel Discussion: Leading Organizational Transformation to Value-Based Care
Health system and ACO leaders navigating value-based transformation discuss strategic and operational challenges. Panelists share how they built organizational readiness for financial risk, managed resistance from physicians and staff accustomed to fee-for-service incentives and maintained financial performance during transition. Hear about unexpected obstacles, what worked and what didn't and how leaders maintain momentum through multi-year transformation journeys. Topics to be discussed will include:
- Building organizational alignment on value-based strategy
- Managing physician and staff concerns about financial risk
- Interdepartmental alignment and governance structures
- Maintaining financial performance through value-based transition
Marc Newell, MD
Senior Consulting Cardiologist and Vice President
Allina Health Minneapolis Heart Institute
Celina M. Sullivan, JD, BSHCM
Senior Director, Program Management
Kaiser Permanente
3:15pm – 3:45pm
Networking & Refreshments Break
3:45pm – 4:30pm
Payer-Provider Collaboration: Aligning Across the Value-Based Continuum
Value-based care success requires strong payer-provider collaboration. Misaligned payers and providers create friction, inefficiency and missed opportunities. Organizations excelling at value-based care develop strategies strengthening collaboration with health plans. Learn how to approach payer negotiations strategically, build data-sharing arrangements enabling clinical engagement, align quality and financial incentives and structure partnerships that work for both parties. Understand payer perspectives and constraints helping you negotiate more effectively. Explore emerging models of collaboration going beyond traditional arrangements.
Gerald Hautman, MD, MBA
Chief Medical Officer, Senior Vice President
National Accounts
United Healthcare
4:30pm – 5:15pm
Value Based Care and Measurable Outcomes
Arvind Dr. Goyal, MD, MPH, MBA, FAAFP, FACPM
Medical Director
Illinois Medicaid, Department of Healthcare and Family Services
Clinical Associate Professor
Chicago Medical School
5:15pm
End of Day One
7:15am – 8:00am
Networking Breakfast
8:00am – 8:15am
Chairperson's Remarks
8:15am – 9:00am
Community-based primary care: The Engine of Value-Based Health
Strong primary care is the highest-return investment in value-based healthcare because it improves outcomes while reducing avoidable costs through prevention, continuity, and coordinated care. This session will explore practical strategies for building trust in underserved communities, integrating behavioral health and social care into primary care practice, and engaging medical students as meaningful members of interdisciplinary care teams. Drawing on lessons from the UTHSC Health Hub, participants will learn how community-centered primary care can improve health outcomes while creating sustainable value. The session will also examine how success should be measured beyond traditional RVU-based metrics by emphasizing patient outcomes, equity, community impact, and long-term population health.
Austin Dalgo, MD, MA
Medical Director
University of Tennessee Health Science Center Health Hub Soulsville
Medical Director
Tennessee Population Health Consortium
Co-Medical Director, Wellness and Stress Clinic
Associate Professor of Internal Medicine
University of Tennessee Health Science Center
9:00am – 9:45am
Building Population Health Culture: From Clinical Care to Prevention and Wellness
Value-based healthcare requires different culture than fee-for-service medicine. Fee-for-service rewards treating sick patients. Value-based rewards keeping patients healthy. This fundamental difference requires reshaping how clinicians think about their role and how organizations allocate resources. In this session we’ll explore how to shift organizational culture toward population health and prevention, align incentives with value-based goals, engage clinicians and staff in transformation and measure culture change.
Jeanine Bulan, MD, FACP
Associate Chief Population Health Office
Mass General Brigham
9:45am – 10:15am
Networking & Refreshments Break
10:15am – 11:00am
Care Coordination and Chronic Disease Management: Keeping Patients Healthy and Engaged
Patients with chronic conditions like diabetes, heart disease, COPD and depression drive disproportionate costs. 5% of patients generate roughly 50% of costs. Effective care coordination and disease management keep these patients stable, prevent acute exacerbations and reduce emergency utilization. Yet many healthcare organizations lack systematic approaches to chronic disease management. We’ll explore how to identify highest-risk highest-cost patients, design care coordination programs targeting complex patients, involve patients as partners in their care and measure whether interventions reduce utilization and costs while improving quality of life. Learn how to use data and predictive analytics to target resources toward patients who benefit most.
Sofia Warner, MD
Associate Chief of Value Based Care and Internal Medicine Physician
Boston Medical Center
11:00am – 11:45am
TBD
Alexander Koster, MA, CHCIO, CDH-E
Senior Director, Special Projects
Nemours
11:45am – 12:30pm
Your Value-Based Care Journey: Building Sustainable Competitive Advantage
Value-based transformation requires multi-year commitment and sustained organizational alignment. Leaders who navigate transformation successfully maintain momentum through obstacles and resistance. Learn how to align executive teams on strategy, build clinical leadership buy-in essential for implementation and measure whether transformation delivers intended results. Hear from leaders about obstacles encountered and how they recovered course. Leave with clarity on your strategic direction and specific commitments for implementation.
Gregory Esper MD, MBA
President
Emory Health Plan
Professor and Vice Chairman of Clinical Affairs for the Department of Neurology
Vice President of Lean Promotion and Associate Chief Medical Officer
Emory Healthcare
12:30pm
Conference Concludes
12:45pm – 2:45pm
Workshop: From Assessment to Action: Building Your Value-Based Transformation Strategy
This workshop guides leaders through honest assessment of organizational readiness for value-based care across financial infrastructure, population health analytics, primary care strength, care coordination effectiveness, measurement infrastructure and physician engagement. You'll identify gaps and prioritize improvements based on your organization's specific context and constraints. Participants work through actual contract scenarios understanding implications for operations and develop accountability structures ensuring transformation implementation. Leave with clear assessment of current state, prioritized initiatives for year one and two and specific action items ready for deployment.
Learning objectives:
- Assess your organization's readiness across dimensions of value-based care
- Understand contract models and their operational implications
- Identify highest-impact priorities for your organization
- Create accountability plan ensuring transformation implementation
R. Kyle Kramer, FACCA, FAAMA
Chief Executive Officer
Day Kimball Health
From Hospitals/Health Plans/Health Systems/Gov’t Agencies
• CFO’s
• Network Operations
• Chief Medical Officers
• Chief Quality Officers
• Value-Based Care
• Accountable Care Organizations
• Chief Marketing Officers
• Population Health Management
• Medical Management
• Community Health
• Medicare
• Behavioral Health
• Senior Products
• Medical Directors
• Reimbursement
• Contracting
• Claims Management
• Government Programs
• Health Reform
• Patient Quality & Safety
• Readmissions
• Innovation
• Nursing Director
• SDOH
• Auditing
• Compliance
• Data Analytics
• Managed Care
• Care Management
• Operations
• Finance
• Strategy
• Business Development
• Regulatory Affairs
• Risk Management
• Utilization Management
• Network Management
• Clinical Director
• Revenue Cycle
• Quality Management
Also of interest to: Vendors; Solution Providers; Population Health Management Organizations; Home Health Care; Physician Groups; Healthcare C
Featured Speakers
Farrukh N Jafri
Medical Director, WPH Cares
White Plains Hospital
Marshall Chin
Richard Parrillo Family Distinguished Service Professor of Healthcare Ethics, Department of Medicine
University of Chicago
Stina Redford
Director of Payment Innovation and Risk Accuracy
Blue Cross of Idaho
Ria Paul
Clinical Associate Professor, Section of Geriatrics Division of Primary Care and Population Health Department of Medicine
Stanford Health
Vladimir G. Manuel
Vice Chair for Clinical Affairs
UCLA Health
Michael D. McCann
Assistant Professor of Clinical Medicine Vanderbilt Interdisciplinary Care Program, Medical Director Discharge Care Center & Post Discharge Clinic, Medical Director
Vanderbilt Health
Marc Newell
Senior Consulting Cardiologist and Vice President
Allina Health Minneapolis Heart Institute
Celina M. Sullivan
Senior Director, Program Management
Kaiser Permanente
Gerald Hautman
Chief Medical Officer, Senior Vice President National Accounts
United Healthcare
Arvind Dr. Goyal
Medical Director Illinois Medicaid, Department of Healthcare and Family Services
Clinical Associate Professor, Chicago Medical School
Austin Dalgo
Medical Director, Co-Medical Director, Wellness and Stress Clinic
University of Tennessee Health Science Center Health Hub Soulsville, Tennessee Population Health Consortium, University of Tennessee Health Science Center
Jeanine Bulan
Associate Chief Population Health Office
Mass General Brigham
Sofia Warner
Associate Chief of Value Based Care and Internal Medicine Physician
Boston Medical Center
Alexander Koster
Senior Director, Special Projects
Nemours
Gregory Esper
President, Vice President of Lean Promotion and Associate Chief Medical Officer
Emory Health Plan, Emory Healthcare
R. Kyle Kramer
Chief Executive Officer
Day Kimball Health
Hyatt Regency Austin
208 Barton Springs Road
Austin, TX 78704
512-477-1234