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Health Datapalooza - Payer and Provider Risk Owner Track

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Series of sessions at Health Datapalooza, sponsored by The Department of Health and Human Service (HHS), the Robert Wood Johnson Foundation and RowdMap, Inc. dedicated to health plans, government payers and providers in risk arrangements and using public data to succeed in the transition from Fee for Service (FFS) to value based care.

OWNING RISK IS TOUGH, BUT IT’S WHERE THE ACTION’S AT

Once upon a time plans had large group commercial populations with years of consistency and providers simply delivered services for a fee. But government programs like Medicare Advantage, Marketplace / Exchange and Medicaid, have populations changing every year, or even every month and providers managing a population's health over time.
 
Changing populations and dynamic payment models may make it tough to predict and achieve member outcomes in a financially sustainable way precisely when providers are getting in the game to take on risk.
 
Public health data are providing solid case studies of achieving member health and happiness with sustainable financial models for all players in this new game.
 
If you are managing risk, considering taking on risk, or investing in or providing products or services to anyone bearing risk, camp out in these sessions to learn how to use public data and internal resources to:
 
Effectively leverage analytic approaches to manage risk

Accurately assess risks and project costs

Effectively align providers and incentivize care delivery


7 sessions dedicated to the value public data brings payers and risk owners by:

1. Optimizing Population Health and Containing Costs

2. Designing and Curating a Pay-for-Value Ready Network

3. Facilitating Payer and Provider Partnerships for New Care Delivery

4. Coordinating Care and Sharing Risk between Health Plans, States and CMS

5. Projecting and Managing Costs, Risk and Disease Burden

6. Aligning Strategy and Delivery with Member Outcomes and Experience

7. Transforming Delivery Systems, Measurement and Payment Models

Published in: Health & Medicine
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Health Datapalooza - Payer and Provider Risk Owner Track

  1. 1. Payer and Risk Owner Track Organizers Jonathan Blum, EVP, CareFist and Former Principal Deputy Administrator, CMS Joshua Rosenthal, PhD, RowdMap Inc. and NCHVS Data Group Paul Wallace, MD, AcademyHealth Senior Scholar in Residence OWNING RISK IS TOUGH, BUT IT’S WHERE THE ACTION’S AT Once upon a time plans had large group commercial populations with years of consistency and providers simply delivered services for a fee. But government programs like Medicare Advantage, Marketplace / Exchange and Medicaid, have populations changing every year, or even every month and providers managing a population's health over time. Changing populations and dynamic payment models may make it tough to predict and achieve member outcomes in a financially sustainable way precisely when providers are getting in the game to take on risk. Public health data are providing solid case studies of achieving member health and happiness with sustainable financial models for all players in this new game. If you are managing risk, considering taking on risk, or investing in or providing products or services to anyone bearing risk, camp out in these sessions to learn how to use public data and internal resources to: § Effectively leverage analytic approaches to manage risk § Accurately assess risks and project costs § Effectively align providers and incentivize care delivery 7 SESSIONS DEDICATED TO THE VALUE PUBLIC DATA BRINGS PAYERS AND RISK OWNERS BY: 1. Optimizing Population Health and Containing Costs 2. Designing and Curating a Pay-for-Value Ready Network 3. Facilitating Payer and Provider Partnerships for New Care Delivery 4. Coordinating Care and Sharing Risk between Health Plans, States and CMS 5. Projecting and Managing Costs, Risk and Disease Burden 6. Aligning Strategy and Delivery with Member Outcomes and Experience 7. Transforming Delivery Systems, Measurement and Payment Models Chair & Vice Chair Kavita Patel, MD, Brookings Institute and Former Director of Policy, The White House Niall Brennan, Chief Data Officer, CMS “The value propositions for public data either disintermediate or innovate owning risk – either way they can’t be ignored.”
  2. 2. 1. FINDING UNTAPPED VALUE THROUGH SHARING AND USE OF MULTI-SECTOR DATA Value Proposition: Optimizing Population Health and Containing Costs Moderator: Peter Eckart, Illinois Public Health Institute; Alison Rein, AcademyHealth Panelists: Craig Brammer, HealthBridge; Nikki Olson, Center for Outcomes Research and Education; Bren Manaugh, The Center for Health Care Services; Chief J. Scott Thomson, Camden County Police Department 2. CREATING A VIRTUOUS CYCLE: DESIGNING NETWORKS TO MITIGATE NO-VALUE CARE FROM FEE FOR SERVICE AND CREATE VALUE- BASED WINS FOR BOTH PAYERS AND PROVIDERS USING CMS BENCHMARK DATA Value Proposition: Designing and Curating a Pay-for-Value Ready Network Moderator: Joshua Rosenthal, RowdMap Panelists: Jonathan Blum, CareFirst Blue Cross BlueShield; Sachin Jain, CareMore; Steve Ondra, Health Care Service Corporation 3. BANKING ON DISRUPTION: NEW DELIVERY MODELS AS COMPETITIVE ADVANTAGE IN A PAY FOR VALUE WORLD Value Proposition: Facilitating Payer and Provider Partnerships for New Care Delivery Moderator: Maureen Sullivan, BCBS Panelists: Lynn Banaszak Brusco, Disruptive Health Technology Institute, Carnegie Mellon University; Jonathan Mathieu, Center for Improving Value in Health Care; Eric Armbrecht, Midewest Health Initiative; Elizabeth Mitchell, Network for Regional Healthcare Improvement; Farzad Mostashari, Aledade, Inc. 4. HOW STATES AND OTHERS ARE USING MEDICARE DATA TO MANAGE POPULATIONS Value Proposition: Coordinating Care and Sharing Risk between Health Plans, States and CMS Moderator: Sharon Donovan, Centers for Medicare & Medicaid Services Panelists: Mylia Christensen, Oregon Health Care Quality Corporation; Doris Lotz, New Hampshire Department of Health and Human Services; Patricia Murphy, Illinois Department of Healthcare and Family Services 5. SOCIAL DETERMINANTS AND WHAT TO DO WITH THEM: IMPROVING COST PROJECTIONS AND NAILING RESOURCE ALLOCATION Value Proposition: Projecting and Managing Costs, Risk and Disease Burden Moderator: Dianne Munevar, Avalere Health (Moderator) Panelists: Jim Sorace, US Department of Health and Human Services; Sandeep Wadhwa, Noridian Healthcare Solutions; Eric Williams, Omada Health; Gui Woolston, NunaHealth 6. FROM POLICY TO WAREHOUSE TO BEDSIDE: USING PUBLIC AND PRIVATE DATA TO IMPROVE TRIPLE AIM GOALS Value Proposition: Aligning Strategy and Delivery with Member Outcomes and Experience Moderator: Paul Wallace, AcademyHealth Panelists: Paul Bleicher, Optum Labs; Helen Burstin, The National Quality Forum; Kate Goodrich, Centers for Medicare & Medicaid Services 7. HOW STATES ARE USING NEW DATA SOURCES FOR SYSTEMS TRANSFORMATION Value Proposition: Transforming Delivery Systems, Measurement and Payment Models Moderator: Rachel Block, Milbank Memorial Fund Panelists: David Mancuso, Washington State Department of Social and Health Services; Áron Boros, Massachusetts Center for Health Information and Analysis; Richard Shonk, HealthBridge

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