Developing & Managing ACOs Ensuring Financial and Operational Success, and Incorporating an Innovative Medical Management Approach

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1 Developing & Managing ACOs Ensuring Financial and Operational Success, and Incorporating an Innovative Medical Management Approach The premier conference for ACOs, Payers, Providers and Physician/Medical Groups to successfully develop and manage ACOs! October 26 27, 2015 Treasure Island Hotel & Casino Las Vegas, NV KEY CONGRESS TAKEAWAYS Transforming Healthcare Delivery: Strategies and Operational Challenges in Laying the Foundation for ACO Formation, Implementation and Success Creating a Quality-Driven Structure for Accountable Care Organizations that Enhances Patient Satisfaction and Maintains Costs Establishing an ACO that is Attractive to Current and Potential Members Creating Consumer Value within an ACO Creating Viable Patient Engagement Strategies for ACOs How to Educate Medicare Beneficiaries and the Community-at-Large about an ACO Network Development within an ACO Laying the Foundation for Success by Establishing an Effective Payer & Provider Collaboration Model Essential Building Blocks of an ACO: Incentivized Provider Network, Patient Centered Medical Homes, Integrated Care Coordination, and Data Analytics Successful Payer-Provider Collaboration: Demonstration of Impact at the Intersection of Quality and Cost Care Management Strategies for Vulnerable Patient Populations within ACOs Establishing a Physicians-Based Accountable Care Organization Engaging Providers in a Value Based Health Care Environment for ACOs Incorporating an Innovative Medical Management Approach to Ensure Financial and Operational Success for Accountable Care Organizations Advanced Care Management Strategies for Patient-Centered Medical Homes in ACOs Building Effective Models for Accountable Care to Serve Rural Communities Lessons Learned from Medicare Shared Savings Program (MSSP) ACO Pioneers and Prospects for Growth Thomas Raskauskas, MD CEO & President St. Vincent s Health Partners, Inc. Scott Berkowitz, MD, MBA Senior Medical Director, Accountable Care Alliance for Patients, LLC Renae Pemberton ACO Program Director Centura Health Kirk Gillis Vice President, Accountable Care Renown Accountable Care Renown Health Keely Smith Sierra Nevada Medical Associates Medical Benefits Administration ACO Jeffrey Farber, MD, MBA, FACP Mount Sinai Care, LLC Mount Sinai Health Partners, LLC Vice President, Hospital Services Utilization Mount Sinai Health System FEATURED CONGRESS SPEAKERS Venu Kondle, MD Sierra Nevada Medical Associates Medical Benefits Administration ACO charles Chodroff, MD, MBA, FACP Senior Vice President, Population Health & Chief Clinical Officer WellSpan Health Jeffrey Tucker, EFPM President & Integrity Health Network Integrity Health Innovations ACO Jordan Asher, MD, MS Chief Clinical Officer & Chief Innovation Officer MissionPoint Health Partners A Subsidiary of Ascension Health Larry Allen, MD, FAAFP Indiana Lakes ACO IU Health Goshen Beth Maynard, CMPE Director of Operations, Value-Based Care Summit Health Solutions ACO Summit Medical Group MAIN Conference WORKSHOP SESSION Jonathan Gluck, JD Senior Executive & General Counsel Heritage California ACO Heritage Provider Network Pam Halvorson Vice President, Regional Clinic Operations Executive Sponsor, Trinity Pioneer ACO UnityPoint Health navneet Kathuria, MD, MPH, MBA Vice President, Population Health & Clinical Quality Meridian Health Meridian Health Accountable Care Organization, LLC Vikram Saini, JD, MHA Vice President, Operations & Legal Florida Accountable Care Services, LLC Vice President, Legal Services Florida Physicians Trust ACO Gary Jacobs Managing Director, Health Advisory Practice PriceWaterhouseCoopers (PwC) Effectively Managing Long Term Care within Accountable Care Organizations: The Next Generation of Long Term Care Services and Supports - PriceWaterhouseCoopers (PwC) Organized by: How to Register: Phone: Fax: Online:

2 Developing & Managing ACOs Ensuring Financial and Operational Success, and Incorporating an Innovative Medical Management Approach Accountable Care Organizations represent a critical component of healthcare reform and have been targeted by the White House for major expansion this year, with several new Medicare Shared Savings ACOs starting up this year alone. In addition to the Medicare ACOs, commercial payers are adapting the government model into a more flexible effort appealing to a wide range of providers facilitating increased access and care delivery to rural areas and innovations in health insurance exchanges. The main goal of ACOs is to offer a healthcare delivery system that achieves the triple aim of lowering cost, enhancing quality of care and improving outcomes. Under this new model we are moving from paying a fee-for-service to paying a fee-for-performance where performance involves multiple resources, partners and more. This annual event offers strategic advice on ACO design and implementation strategies, case studies on cutting-edge programs, information on how to select and implement the best technology for population management, outcome analysis, and more! The 2015 Congress on Accountable Care Organizations will examine specific strategies and action steps you can take to design and manage an ACO program. Don t miss this discussion-filled event filled with a variety of Accountable Care Organization leaders and team members who will share their up-to-date experience and enriching insights. The more you hear, the better prepared you and your team will be to profit and thrive in this new healthcare paradigm and build solid strategic programs. Register today to reserve your seat at the conference and take advantage of early bird discounts. Call or register online at We look forward to seeing you in Las Vegas! Sincerely, 2015 Accountable Care Organizations Team WHO SHOULD ATTEND Senior Executives from ACOs, Hospitals, Medical Groups, Physician Practices, PHOs, IPOs, PCP Groups, Multispecialty Groups Responsible for: Managed Care Patient Financial Services Reimbursement Government Relations Operations Contracting Revenue Cycle Management Payer Relations Finance Quality Senior Executives from Health Plans Responsible for: Network Management Provider Relations Finance Reimbursement Compliance Risk Management Care Management Compliance Healthcare IT Companies Health Services Researchers Third Party Administrators Also of Interest to: Medicaid Managed Care Directors Patient Advocates Purchasers (such as Public/Private Employers) Program Integrity Directors Political Leaders Network Development Medicare Strategy Medical Management Auditing Claims Management Utilization Management Government Healthcare Consultants Healthcare Academics Law Firms Pharmacy Directors State Budget Officers State Inspector Generals Solution Providers Actuaries How to Register Phone: 80

3 Day One Monday, October 26, :15 Conference Registration & Morning Breakfast 8:00 Chairperson s Opening Remarks 8:15 Transforming Healthcare Delivery: Strategies and Operational Challenges in Laying the Foundation for ACO Formation, Implementation and Success This featured session will examine the strategic elements involved in developing Accountable Care Organizations. The presenter will provide attendees with an examination of the current landscape as it relates to the delivery of healthcare for ACOs, and how to develop a viable structure. Thomas Raskauskas, MD President & St. Vincent s Health Partners, Inc. 9:00 examining the Accountable Care Organization Model at (JHM) has embarked on many aspects of delivery system transformation. Among them, JHM has created an accountable care organization, known as Johns Hopkins Medicine Alliance for Patients (JMAP), which includes the JHM faculty and community physicians, hospitals, community private practices, and over 36,000 Medicare beneficiaries. It has also received a CMMI Health Care Innovation Award for its Johns Hopkins Community Health Partnership (J-CHiP) program, which seeks to improve care coordination across the continuum with specific focus on JHM clinical sites in East Baltimore. Beyond these, there are many other efforts underway to help prepare JHM for the future. Dr. Berkowitz will focus primarily on the JMAP and JCHiP programs as well as additional context regarding these efforts. Scott Berkowitz, MD, MBA Senior Medical Director, Accountable Care Alliance for Patients, LLC 9:45 Networking Break & Refreshments 10:15 incorporating an Innovative Medical Management Approach to Ensure Financial and Operational Success for Accountable Care Organizations Renown Health is an integrated healthcare network based in Reno, Nevada, and has embarked on a journey to consolidate and integrate all of its disparate care management assets into an enterprise population health management organization. Kirk Gillis, VP of Renown Accountable Care will discuss the clinical integration transformation occurring at Renown Health, and share the company s plans for achieving scalable and sustainable Triple Aim performance improvement. Kirk Gillis Vice President, Accountable Care Renown Accountable Care Renown Health 11:00 creating Viable Patient Engagement Strategies for ACOs How to Educate Medicare Beneficiaries and the Community-at-Large About an ACO This session will highlight how to establish an ACO that creates consumer value. The presenter will provide attendees with effective patient engagement strategies and how it is important to the success of an ACO. This session will examine the importance of engaging the patient towards the adaptation of an Accountable Care Organization. Renae Pemberton ACO Program Director Centura Health 11:45 aco Network Development: Enhancing Care Delivery and Quality of Care This session will examine the fundamentals of developing an effective and viable ACO network. It will highlight the key elements and participants involved in an ACO network, and how to enhance care delivery and quality of care. Keely Smith Sierra Nevada Medical Associates Medical Benefits Administration ACO Venu Kondle, MD Sierra Nevada Medical Associates Medical Benefits Administration ACO 12:30 Luncheon for All Attendees & Speakers 1:30 advanced Care Management Strategies for Patient- Centered Medical Homes in ACOs WellSpan Health has experience with 3 commercial ACO arrangements and the MSSP. This session will examine advance care management strategies for patient-centered medical homes as it relates to Accountable Care Organizations, and provide attendees within an understanding of what has worked and what hasn t in the implementation of the patient-centered medical home model. The presenter will provide a unique insight into utilizing the medical neighborhood to accelerate patient-centered medical home within an ACO. Charles Chodroff, MD, MBA, FACP Senior Vice President, Population Health & Chief Clinical Officer WellSpan Health Panel Discussion 2:15 Surviving and Thriving in this New World of Care Delivery Innovations in Care Coordination and Quality Improvement within ACOs Some of the topics this interactive panel discussion will examine include: Integrating technology with care management Increasing compliance Population management to promote appropriate self-care and preventive care Identifying and managing high-risk patients Using data analytics to learn more about patients Jeffrey Tucker, EFPM President & Integrity Health Network Integrity Health Innovations ACO Jordan Asher, MD, MS Chief Clinical Officer & Chief Innovation Officer MissionPoint Health Partners A Subsidiary of Ascension Health Beth Maynard, CMPE Director of Operations, Value-Based Care Summit Health Solutions ACO Summit Medical Group 3:15 Networking Break & Refreshments Fax: Online: w

4 3:45 essential Building Blocks of an ACO: Incentivized Provider Network, Patient Centered Medical Homes, Integrated Care Coordination, and Data Analytics Some of the topics to be examined in this session include: Incentivizing the Provider through ACO contracts: How shared savings, Management Fees, and Capitation impact both Primary Care and Specialty Providers Streamlining Care Coordination: The need to reduce the redundancies and improve efficiency in care coordination between payers, hospitals, ACOs, and physician offices (examples from the efforts we are making here) Developing the PCMH: What types of Certifications are available and are they necessary? What are the key elements of PCMH development and how should they function within the ACO? ED Utilization in an ACO population: Where is the overutilization and how can it be impacted by feedback loops to the physicians Larry Allen, MD, FAAFP Indiana Lakes ACO IU Health Goshen 4:30 establishing an Effective Payer & Provider Collaboration Model for Accountable Care Organizations Summit Health Solutions ACO has developed a robust project charter and action plan that addresses 5 major areas that directly impact their success under a Medicare Advantage contract. This session will examine how to establish an effective payer and provider collaboration model for ACOs. Beth Maynard, CMPE Director of Operations, Value-Based Care Summit Health Solutions ACO Summit Medical Group 5:15 End of Day One Day Two Tuesday, October 27, :15 Morning Breakfast 8:00 Recap of Day One 8:15 accountable Care Organizations What s in it for the Consumer and Why Should They Care Beneficiaries cannot be expected to engage with an ACO if they believe it only benefits the ACO. How can we help the beneficiary understand that they will experience better health if they participate together with the ACO in their care? This session will discuss what has proven successful at Heritage California ACO when engaging beneficiaries, and also those ideas that have not worked. Jonathan Gluck, JD Senior Executive & General Counsel Heritage California ACO Heritage Provider Network 9:00 Building Effective Models for Accountable Care to Serve Rural Communities Rural communities are uniquely challenged to perform well within an ACO model. Physician and APP performance reporting calls for significant administrative investment in quality reporting, investment in patient satisfaction tools and robust EMR platforms. Typically challenged by size and reimbursement disincentives to align with ACO performance, each community, CAH and RHC must evaluate its appetite and capacity to perform in these opportunities. Economy of scale becomes important in finding resources to align, modify and adjust care delivery. This session will focus on one pioneer s experience that developed a rural delivery model including the challenges, successes and work ahead. Pam Halvorson Vice President, Regional Clinic Operations Executive Sponsor, Trinity Pioneer ACO UnityPoint Health 9:45 Networking Break & Refreshments 10:15 engaging Providers in a Value Based Health Care Environment for ACOs In this session, discuss ways to collaborate with providers to improve quality of care, communication, and clinical outcomes. Some takeaways include: Understand the clinical and financial importance of embedding personnel in provider offices Utilize data to align plan incentives with provider goals to improve quality of care and HEDIS measures Navneet Kathuria, MD, MPH, MBA Vice President, Population Health & Clinical Quality Meridian Health Meridian Health Accountable Care Organization, LLC 11:00 care Management Strategies for Vulnerable Patient Populations within ACOs Dr. Farber will share the Mount Sinai Health System s experiences with a transitional care program targeted at reducing readmissions, its expansion to an ambulatory ICU model, and linkage to a home-based primary and palliative care program. He will also examine a CMMI-funded mobile acute care team program that provides hospital level care to patients in their homes. Jeffrey Farber, MD, MBA, FACP Mount Sinai Care, LLC Mount Sinai Health Partners, LLC Vice President, Hospital Services Utilization Mount Sinai Health System 11:45 lessons Learned from Medicare Shared Savings Program (MSSP) ACO Pioneers and Prospects for Growth This session will examine an ACO that has been battletested and physician approved. Attendees will learn how to navigate the pitfalls and perils of the MSSP ACO program with one of the first successful 27 ACO groups in the county. Learn from their strategies for success as well as an outline of the failures in transforming the FFS to FFV. Vikram Saini, JD, MHA Vice President, Operations & Legal Florida Accountable Care Services, LLC Vice President, Legal Services Florida Physicians Trust ACO 12:30 Conference Concludes ww.2015observation.com

5 main Conference WORKSHOP SESSION Monday, October 26, :30 p.m. 7:30 p.m. Effectively Managing Long Term Care within Accountable Care Organizations: The Next Generation of Long Term Care Services and Supports The long term care services and supports market is a growing segment of the health care marketplace as the population ages. Individuals needing LTCSS are expected to increase from a current 15 million to 27 million by Current federal and state policies are attempting to redirect LTCSS away from costly facilities based settings and into home and community based settings where care is both more consumer friendly and less costly. And, concurrently, CMS and states are moving providers to value based payment models. Join Gary Jacobs, Managing Director, PwC, as he discusses: Value based care models for Long Term Care Services and Supports The role of home health and community based services in the market transformation Opportunities in Medicaid and the private sector ABOUT THE WORKSHOP LEADER: Gary Jacobs is the Managing Director of Health Advisory Practice at PriceWaterhouseCoopers (PwC). He has over 25 years of experience in healthcare, insurance and healthcare products for Medicare beneficiaries. Prior to joining PwC this year, Gary worked for Universal American Corporation. In his role as Senior Vice President of Corporate Development and Strategic Planning, Gary was responsible for implementing enterprise wide planning initiatives, strategic alliances, government affairs, and identification of acquisitions and new business opportunities. Gary has significant experience leading M&A engagements, including Universal American s acquisition of MemberHealth, a Part D company and virtual PBM with 1.1 million members. While at Universal American, Gary also led the acquisition of APS Healthcare, a population management company serving Medicaid populations with a particular emphasis on behavioral health and Managed Long Term Care. In addition to starting up a successful management company specializing in long-term care systems, Gary orchestrated the strategic direction at Universal American. During his tenure, Universal American rapidly expanded into Medicare managed care, Private Fee for Service, and Part D through new market initiatives and acquisitions. Gary is also on the Board of the Visiting Nurses Association of America. Sponsorship Opportunities Current sponsorship opportunities for the 2015 Congress on Accountable Care Organizations, range from speaking to exhibiting at the event. All sponsorship opportunities are on a first come first serve basis. For information on sponsorship and exhibiting opportunities, please contact Justin Sanders at or jsanders@globalmediadynamics.com VENUE Treasure Island Hotel & Casino 3300 Las Vegas Blvd South Las Vegas, NV *Mention Priority Code Global Media Dynamics to get the discounted rate of $79 /night Special Rate $79/night How to Register Phone: Fax: Online:

6 130 W. Pleasant Avenue Suite 253 Maywood, NJ Developing & Managing ACOs Ensuring Financial and Operational Success, and Incorporating an Innovative Medical Management Approach October 26 27, 2015 Treasure Island Hotel & Casino Las Vegas, NV GMD21015 registration Form mail Global Media Dynamics 130 W. Pleasant Avenue Suite 253 Maywood, NJ PHONE Hospitals/Health Systems/ Health Plans September 10, 2015 October 26, 2015 Conference Only $995 $1295 FAX Name 3. Name online Yes! Please register me for the 10th Annual Observation Patient Management Congress n Conference only n Conference & Workshop 2. Name 4. Name Conference & Workshop $1195 $1495 Vendors/Solution Providers September 10, 2015 October 26, 2015 Conference Only $1295 $1495 Company Address City State/Country Zip/Postal Code Conference & Workshop $1495 $1695 Venue: Treasure Island Hotel & Casino 3300 Las Vegas Blvd South Las Vegas, NV Special Rate $79/night *Mention Priority Code Global Media Dynamics to get the discounted rate of $79/night! Telephone Authorized signature n Payment Enclosed n Bill Me** Please Charge My Credit Card: n Visa n MasterCard n AmericanExpress n Discover Card Number Signature Fax Exp.Date **Cancellations received 3 weeks prior to the event will be refunded in full less a $175 processing fee. Cancellations received less than 3 weeks before the event will receive a credit towards a future event which is valid for one year from date of the event.