Day 2 Agenda | November 18, 2016

*invited

7:30 – 8:30 a.m.

Continental Breakfast

8:30 – 9:45 a.m.

How to Develop a Compliant Contract for Shared Risk Ventures

Bob Markette, Attorney, Hall, Render, Killian, Heath & Lyman, P.C.

Participating in shared-risk payment models that reward providers for delivering high-quality care at lower costs requires careful consideration, and a well-crafted contract. Healthcare attorney, Robert Markette will outline the must-include contract elements that ensure your payments are protected and that your partnership agreement complies with Medicare regulations. Stark, anti-kickback and patient choice are just three of the many rules governing shared-payment partnerships. Be certain you know how to avoid those pitfalls.

9:45 - 10:00 a.m.

Networking Break

10:00 – 11:00 a.m.

Clinical Document Improvement (CDI) in Healthcare

Sheri Poe Bernard, CPC, COC, CPC-I, CCS-P, Principal Consultant, Poe Bernard Consulting

With the emphasis on care coordination and value, clinical documentation is more important than ever to your organization and to your bottom line. What lessons do years of honed, disciplined clinical documentation improvement processes in the acute care setting hold for cross-continuum best practices? Find out in this session and walk away with simple, effective strategies for improving clinical documentation at your hospital, practice or home health agency.

11:00 a.m. – 12:30 p.m.

From the Trenches: 30 Critical Lessons in 90 minutes

Participate in any 3 small-group roundtables during this high-energy session. Your peers will exchange the top solutions, tools and lessons learned in implementing patient-centered care initiatives. You’ll come away with strategies that have proven to yield positive outcomes and significant cost savings.

Lessons Learned in Drug Cost Management

Clear Health Alliance

Clear Health Alliance’s cost management strategy has reduced pharmacy costs by 10% for its almost 10 thousand members across the state of Florida. From utilizing and sharing/discussing simple pharmacy reports to all Primary Care Providers and IDs, you too can apply the same disciplined approach to your pharm-intensive chronic conditions that Clear Health uses to control drug costs in the HIV/Aids population it serves. Pharmacy reports include information such as, all medications picked up by each patient, pick up location, cost (per medication), and trends, i.e., frequency, PMPM, adherence, etc.

Take-home tool: Pharmacy Cost Management Report Template

Lesson Learned Securing PMPM Money in Medical Home Models

Adirondack Health Institute

Adirondack Health Initiative’s medical home secured $7 per-member, per-month (PMPM) payments from its seven commercial payers plus Medicare and Medicaid to support effective patient-centered medical home practices – which adds up to about $8.4 million every year for the 100,000 eligible patients. Learn what you need to evaluate, such as health IT investments and care management costs, to support your PMPM request from payers.

Lessons Learned in Transitions of Care: Identifying the Most Appropriate PAC Setting

Dignity Health

Implementing the Bundled Payment Care Improvement initiative across 37 hospitals covering three states presented unique challenges that forced this system to break age-old post-acute care discharge patterns. From utilizing a proprietary functional assessment tool to new reports tracking PAC utilization Dignity Health is now able to effectively transition patients from higher levels of care to lower levels of care as recuperative gains are made, reducing PAC costs per case and hospital readmissions.

Lessons Learned: How an HHA used disease specific assessment tool to reduce hospital readmissions

Assurance HealthCare

This Tucson-based agency has achieved a mere 2% readmission rate since July 2015 for patients involved in its joint replacement bundled payment initiative using a mix of data analytics, quality reviews and QI training to improve quality of care for joint replacement patients.

Take-home tool: Disease-specific rehospitalization assessment tool

Lessons Learned in Improving the Patient Experience

University of Chicago

The University of Chicago established a Patient Experience program that is integrated into the mission and goals of the medical center: PRIDE: participation; Respect; Integrity; Diversity and Excellence. The strategy incorporated various work streams: business optimization; growth and new payment models; care delivery transformation and service. Attendees will learn what tools demonstrated patient engagement successes utilizing technology; line staff involvement; training and data management.

12:30 – 1:30 p.m.

Networking Lunch

Power Workshop #2: Optimizing Resources & Technology

Patient centered care interventions demand a shift in decision making from length-of-stay based considerations to dynamic clinical content. To succeed, providers must match the right care to the right patient at the right time.

1:30 – 2:30 p.m.

Beyond the Clinician: Successful Leveraging of SWs, Care Coordinators, Navigators, and Technology to Achieve Patient Engagement

Ellen Fink-Samnik, Owner, SEFS Supervision Strategies, LLC.

Social media and mobile devices connect patients, family caregivers, and providers instantly. Interactive portals allow patients to share experiences and resources while promoting access to care. New apps drive prevention and wellness across the health and behavioral health domains. Successful outcomes have been realized for remote health monitoring, telemedicine, and telehealth. Yet, with technology’s promise comes a double-edged sword of ethical concerns to manage. Practitioners strive to balance ease of electronic communication while adhering to laws and professional boundaries. A new age of medical identity theft and ransomware attacks yield consumer anxiety for the safety of electronic health record data. Amid these realities, how do professionals leverage technology ethically, legally, and appropriately, while achieving patient engagement? Integrating the latest industry intel with real-world scenarios, professional standards, and ethical codes, this presentation will provide attendees strategies to master the power of the rapidly changing technology realm.

2:30 – 3:30 p.m.

Delivering on the “High-Touch” Promise: Building and Leveraging Community Services

Alina Orozco, Director of Managed Care Coordination, Clear Health Alliance
Sam Quintero, Statewide Program Manager, Community Relations, Clear Health Alliance

Patient-centered care forces providers and health plans to manage all aspects of the patient, not just what’s going on clinically. Learn how one health plan identified, engaged and leverages a network of community-based services – from housing to legal aid – to effectively delivery on the promise of high-touch care.

How to set up a community services network & assess the quality of community service providers
How to align community services providers to your outcomes improvements goal
How to involve community services contacts in your case management process

3:30 – 4:30 p.m.

Managing Patient Care Seamlessly In the Acute/Ambulatory/Home Settings

Joseph Ebberwein, BBA, MPS, Principal, Longitudinal Health

As the US healthcare system transitions from fee for service to value based care, telehealth will be a critical tool in transforming care delivery to provide high quality care at a lower cost. Utilizing direct experiences with various post-acute care settings and a primary care physician practice setting, Ebberwein will share specific strategies for deploying telehealth technology to increase access to specialized clinical expertise, improve care coordination processes across settings.

4:30 p.m.