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1 NG Healthcare Payers June 10 th 12 th, 2015 JW Marriott Miami, Florida Day One June 10 th 16:30 18:00 Roundtable 1: Split-Streams Track 1: Healthcare becoming a Digital Business Track 2: Transformation of Population Health Management Track 3: Big Data, Big Investments 18:10 19:00 Cocktails and Roundtable Feedback 19:00 22:00 Gala Dinner and Keynote Speech 07:00 08:00 Breakfast and Registration 08:10 08:50 Opening Keynote Panel Discussion Day Two June 11 th 09:00 09:40 Session 1 Private Exchanges and Regional Health Plans: Matching Strategy to Opportunity Dennis Bolin, Chief Marketing Officer/Member Engagement with Health Plan Alliance Regional health plans continue to develop and implement partnerships with private exchanges. These partnerships take various forms. And exchanges are taking a variety of approaches to the marketplace. Regional plans must match their strategies and the dynamics of their marketplace with the strengths of private exchange. In this session we will discuss: 1. Overview of private exchange marketplace 2. Questions regional plans might ask when developing a strategic direction 3. Factors regional plans might use when evaluating private exchanges 09:45 10:25 Session 2 HIE s Role in Payer-Provider Collaboration Health care reform initiatives sponsored by the Affordable Care Act depend on timely availability of data, the ability to assimilate and aggregate data from many sources, and the ability to convert data to actionable information. HIEs, established or augmented in every state and territory through HITECH funding, are well positioned to be the neutral broker of data sharing and value added services around the data. This presentation will describe the role that the Delaware Health Information Network is playing in health care reform initiatives in Delaware. Key takeaways: -Nobody has all the data they need - clinical and administrative, in and out of network; HIEs serve a valuable role in data aggregation, normalization, and accessibility

2 -A robust and rich health information ecosystem creates synergy for all participants -Non-information resources held by HIEs (provider directory, provider portal, etc.) can also be leveraged in improving provider-payer collaboration 10:30 11:10 Session 3 Tobacco Control in Managed Care Dr. Edward Anselm, Medical Director with Health Republic of New Jersey Tobacco Use remains the single greatest public health challenge in the United States creating an extraordinary burden of death, disease and health care cost. Unlike obesity, a close second, we have strong evidence based interventions that will, over time reduce the impact of tobacco use. Many people believe that the pandemic is resolved, but in fact smokers have become so marginalized that they are scarcely visible. They tend to cluster among the poor, less educated, those with mental illness as well as immigrant and LBGT populations. With 420,000 preventable deaths each year, smoking is the single most significant driver of death, disease and health care costs. Ironically, smoking cessation interventions are effective, cost-effective and produce a return on investment. What are these interventions and what are the barriers to their implementation? What are the best methods for health plans and Accountable Care Organizations to leverage this knowledge? 11:15 11:55 Session 4 Future of Health IT in a Consumer-Centric World The Healthcare industry is in the midst of unprecedented change as the traditional group based business model shifts to a consumer based model. The shift brings two major challenges; meeting service expectations set by consumer centric industries such as retail, travel and financial services, as well as, capturing increased market share from first time buyers. These new buyers have little to no understanding of health insurance products and the benefits of signing up with established market leaders. Leading Health Insurance companies will require deep consumer insights and will need to develop advanced levels of analytics for segmentation, targeting, outreach to overcome these two challenges. Many of these capabilities are driven by the five digital forces and Health Insurance companies must harness a combination of these forces through the effective and efficient use of emerging digital technologies. 12:00 12:45 Session 5 Meetings & Networking 12:50 13:50 Lunch 13: Session 6 Consumer Intimacy in the Post Reform World: Strategies for Success Using Social CRM Tim Gilchrist, Columbia University Health Innovation Lab

3 The trend towards consumerism in healthcare is irreversible. Customer Intimate companies will be more likely to win in the post reform world as they secure the support of their own members, drive word of mouth advertising and outsource care management and customer service to their own members. Healthcare organizations will start to realize the true value of their customer base not only for delivery of core services but as the center of a network delivering the most important household service-wellness. Takeaways include: - Healthcare s journey into social media and how social changed the way companies see themselves and their members - How social natives will change internal business structures to survive in the always on, mobile and transparent new world - Combining social, listening, CRM and clinical data to build a 360 view of the member 14: Session 7 Pharmacy & Specialty Pharma Cost Management: The Woes, Realities and Strategies The rate of increase in spending on generics as well as specialty pharmaceuticals is outpacing by far the rate of increase in spending for other drugs. Specialty pharmaceuticals represent the fastest growing segment of drug spending due to new product approvals, high unit costs, and increasing use. Health care payers are faced with significant challenges related to coverage, cost, clinical management, and access. A variety of short- and long-term strategies have been employed to address these challenges. The objective in this workshop is to explore the strategies payers are using in response to challenges related to coverage, cost, clinical management, and access of specialty pharmaceuticals and to describe the potential implications for key stakeholders, including patients, physicians, and health care purchasers. 15:25 16:05 Session 8 A Bolder Approach To Digital: Coming From Behind The Curve Daniel Newton, Staff VP Product Solutions Development and Behavioral Economics Due to regulation and risk concerns, the health industry has been a bit behind the curve in terms of Digital Adoption. However, as healthcare takes on a more customer-centric approach, customer demands will dictate that healthcare organizations adapt by embracing digital trends and and techniques that consumer marketers have deployed for the past decade. Its no secret that the healthcare sector has struggled to adapt to the digital and social media age, with regulatory skepticism about anything that looks like marketing leading to a conservative, risk-averse digital and social strategy from the pharma industry. But that may be about to change. Healthcare organizations are challenged with The benefits of participating in these online patient communities included better managing their condition and the facilitation of a strong patient-physician partnership.

4 16:10 16:50 Session 9 Successfully Managing the Data Challenges of the Affordable Care Act 16: Session 10 Telehealth Join us for our session as participants learn how maturing and expanding the use of traditional data quality and analytics can improve operational processes, reduce losses and greatly improve their book of business. This session will also explore the practical realities of embedding a useful and usable core data integrity and analytics capability throughout the organization. Key Takeaways: -Leveraging data integrity and analytics to meet challenges imposed by the Affordable Care Act -Addressing barriers to developing a robust enterprise data integrity and analytics capability -Articulating the value of data integrity and analytics Although Telehealth capabilities have been around for years, the year of 2014 was a big year for telemedicine. This year, with the proliferation of wearable devices, and providers starting to embrace seeing patients through video chat, telehealth will take on an even bigger role in healthcare. Technologies like Google s new talk with a doctor now video chat service, have changed the face of medicine. Even pharmacies got into the act, with remote medical kiosks popping up in Walgreens, CVS, and Walmart. Telemedicine and virtual healthcare have the ability to deliver significant financial benefits and efficiencies for both payers and providers. 18:45 19:30 Cocktails and Networking 19:30 22:00 Gala Dinner 07:00 08:00 Breakfast Day Three June 12 th 08:10 08:50 Session 11 Content-Based Testing: Is Now the Time? As the healthcare industry continues to evolve, it requires everyone to adjust. Mostly, the new environment necessitates that all the players find different ways of doing business in certain circumstances. For example, the relationship with providers and payers and how they interact needs to be re-examined in light of the various mandates, transitions and health care implementations. This session will look specifically at content-based testing as a vehicle to create a two-way educational environment between payers and providers that is inexpensive and easily accessible

5 and useable by health care providers. We will show how one payer used the ICD-10 mandate as an entry into this type of interaction. Key Takeaways: 08:55 09:35 Session 12 Meetings and Networking -How and why payers and providers need to find different ways to interact in an everchanging healthcare environment -How to use the changes in order to create new ways of working together between payers and providers -The ICD-10 and content-based testing case study of this approach 09:40 10:25 Roundtable 2: Split-Streams Track 1: Healthcare becoming a digital business Track 2: Transformation of Population Health Management Track 3: Big Data, Big Investments 10:30 11:10 Improving Healthcare One Connection at a Time: Integrated Care Management Healthcare delivery is all about connections: patients to doctors, members to caregivers and systems to systems. Integrated, multi-disciplinary care coordination which supports a holistic approach to managing individuals and populations across the healthcare continuum is the future of care management. But today in healthcare, the right information is not always easily available or at a caregiver s fingertips. Integrated care management (ICM) supports a multi-disciplinary approach to the management of a member's care with all care team participants having access to the same care information. The goal is to improve the lives of each individual with a focus on member-centered care. The care information needs to include not only clinical and care management data but also nonmedical services and behavioral health data. To support this efficient care team work environment, managed care organizations need to utilize open platforms that enable mobility and integrate with all the relevant clinical systems to effectively coordinate care. Achieving ICM will enable multidisciplinary teams to manage a member s entire health journey for the best outcomes at an affordable cost. Learning Objectives: Discuss the changes in care management delivery Discuss the principles of integrated care management Learn how data aggregation enables integrated care management Learn how mobility solutions enable better care coordination in a member s preferred setting Learn how coordinated clinical and community-based services enable

6 effective integrated care management, improve outcomes and reduce cost 11:15 11:55 Closing the Healthcare Information Gap at the Point of Care through Consumer-Controlled Personal Health Information Exchange 12:00 13:00 Lunch This session will provide a look into how health plans are leveraging chip-enabled membership cards, smartphones and other media to get essential data and analytics past portals and into the treatment room. Attendees will learn how some plans are using innovative approaches to data exchange as a way to improve quality metrics, risk adjustment factors, and ultimately improve health outcomes. The speakers will review the various data types that can be leveraged using point of care delivery so that when the patient arrives for care their vital health information arrives with them. 13:05 13:45 Session 15 Meetings and Networking 13:50 14:30 Session 16 Wrap Up and Feedback

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