HEDIS & QUALITY IMPROVEMENT Summit

Transcription

1 Healthcare Education Associates and RISE (The Risk Adjustment Initiative & Society for Education) Proudly Present T h e 3 r d A n n u a l HEDIS & QUALITY IMPROVEMENT Summit u xpertise Yo Gain the E r ximize You Need to Ma! ormance HEDIS Perf Nov 18-19, 2013 Aria Resort & Casino, Las Vegas Strategies to Reach and Exceed Your Healthcare Quality Improvement Goals Learn innovative techniques that strengthen quality initiatives and advance your plan s success. NEW THIS YEAR This program is eligible for up to 11.5 CPE credits! You must attend both days for full credit. (Day One=7.5 CPE credits; Day Two=4 CPE credits.) Hold On for the HEDIS Revolution: What Developments are Ahead in Healthcare Quality for Plans, Providers, and Consumers? Case Studies: Our Journeys to Excellence - How We Built Strong HEDIS Scores Follow these Guidelines to Improve Your Scores on the Essential HEDIS Measures Case Study: Leveraging Electronic Health Records to Boost HEDIS Scores Incorporating CAHPs & HEDIS Into Your Quality Improvement Efforts Provider Education & Incentives are Key to Elevating HEDIS Results Creating Toolkits They ll Actually Use In-House or Outsource? Analyzing Who Should Conduct Your Quality Measurement Program Metrics That Matter: Establishing Collaborative Relationships with Providers to Increase HEDIS Scores Getting Home Care Right: Addressing Quality in the Home Taking Data Collection and Reporting Beyond the Conventional HEDIS Season Navigating a HEDIS Audit How to Survive and Thrive Data-Driven Strategies to Improve HEDIS Scores This event is Co-Located with the 2nd Annual Health Insurance Exchange BRONZE SILVER PLATINUM SPONSORS

2 Health plans must clearly demonstrate their quality quotient in today s ultra-competitive marketplace. With new, tighter timeframes for data submission and a higher bar for overall performance, only those with the strongest HEDIS scores will be positioned to prosper. So come to Las Vegas for a healthcare quality improvement intensive that has it all top-rated plans, insightful case studies, and numerous actionable approaches for your organization s success in 2014 and beyond. Please join us for: The 3rd Annual HEDIS & Quality Improvement Summit, November 18-19, 2013 Engage with our seasoned faculty as they detail successful methods used to elevate HEDIS status at their own organizations. You ll leave this event with a playbook of strategies to enhance HEDIS performance, boost STAR Ratings, lift members healthcare status, reduce unnecessary costs and optimize your plan s financial outlook. Here are just a few conference highlights: The state-of-the-state of healthcare quality HEDIS in the broader context of the Triple Aim Ways to pinpoint essential measures that are key to developing effective intervention priorities ICD-10 s impact on HEDIS The role of analytics in HEDIS prioritization Approaches that best incentivize physicians Using HEDIS & CAHPs member outcome, access, and satisfaction measures to strengthen your MCO s Quality Management Plan The benefits of interim reporting What critical information HEDIS auditors always look for Elements of successful provider collaborations that boost HEDIS performance Don t miss this opportunity to network with the healthcare industry s quality improvement elite and learn the latest about HEDIS from experts in the know. Register today! Call or register online at Sincerely, Michele Chandler, Conference Director HEALTHCARE EDUCATION ASSOCIATES P.S. You ll definitely want to hear NCQA s Kathleen Mudd s up-to-the-minute address Hold On for the HEDIS Revolution: What Developments are Ahead in Healthcare Quality for Plans, Consumers, and the Exchanges? Our Renowned Speaking Faculty Kathleen Mudd, NCQA Stephen Perkins, UPMC HEALTH PLAN Violeta Rabrenovich, KAISER PERMANENTE Bernard Cohen, WELLCARE HEALTH PLANS Lori Kramer, MEDICAL ASSOCIATES HEALTH PLANS Jill Kasel, MEDICAL ASSOCIATES HEALTH PLANS Ramesh Jayasuriya, OPTUM Kristian Marquez, INOVALON Kate Eshelman, INOVALON William Runyon, WELLPOINT Beth Foley, FALLON COMMUNITY HEALTH PLAN Sarah Bussmann, HEALTHCARE PARTNERS NEVADA Christopher Radley, HEALTHCARE PARTNERS NEVADA Jane Elliott, HEALTH ALLIANCE Pat Fowler, AMERIGROUP MARYLAND Nathan Goldstein, CENSEOHEALTH Who Will Attend? From Medicare and MA health plans, payer and provider groups, directors and managers of: HEDIS Quality Improvement Analytics Quality Management Pharmacy Administration HEDIS Audit HEDIS Data Analysis Product Development STARS Performance Management Provider Outreach and Network Management Top Ten Reason to Attend Get an insider s view of what lies ahead for HEDIS from NCQA s Kathleen Mudd Zero in on which interventions reduce healthcare disparities Discover what can be done to better prepare for your annual HEDIS audit a mission-critical mandate that s now more stringent and less forgiving than in the past Learn the impact of ICD-10 on HEDIS Uncover how off-season reporting can enrich your HEDIS scores Determine the most effective strategies to ensure data integrity Gain insight to the critical role analytics plays in HEDIS prioritization Find the methods that best incentivize physicians - and motivate members Explore approaches to create action plans for difficult patient measures Network with numerous health plans and providers identify how they re preparing for the upcoming year Sponsorship & Exhibit Opportunities Enhance your marketing efforts through sponsoring a special event or exhibiting your product at this event. We can design custom sponsorship packages tailored to your marketing needs, such as a cocktail reception or a custom-designed networking event. To learn more about sponsorship opportunities, please contact Kevin Weigel at or kweigel@healthcare-conferences.com

3 DAY ONE: November 18, :00 8:45 Registration & Breakfast sponsored by 8:45 9:00 Chair s Welcome & Opening Remarks Chair: TBD 9:00-10:00 Hold on for the HEDIS Revolution: What Developments are Ahead in Healthcare Quality for Plans, Consumers, and the Exchanges? What s the state of healthcare quality for health plans? Is NCQA exploring new topics for measures? Have MRRV updates resulted in HEDIS indicator changes? Laying out the impact of ICD-10 on HEDIS What s the latest on health plan rankings? How will the use of HEDIS evolve for Medicare Advantage? Are there implications for Stars ratings? For the Exchanges? Kathleen Mudd, BSN, MBA, Vice President for Product Delivery NCQA 10:00 10:45 Case Study: Leveraging Electronic Health Records Data to Collaborate on Care and Lower Costs Strategies to extract a richer data set from EHR records Leveraging information not included on claims to improve administration rates Perfecting the data collection process Beyond the once-a-year data feed Pat Fowler, R.N., Vice President of Quality Management AMERIGROUP MARYLAND 10:45 11:00 Morning Break sponsored by 11:00-12:15 Follow these Guidelines to Improve Your Scores on the Essential HEDIS Measures Creating action plans for difficult patient measures: Boosting medication adherence & reducing preventable medication errors Breast and colorectal cancer screenings Osteoporosis management in women who ve experienced a bone fracture Diabetes management What are the best ways to motivate patients to comply with their doctors treatment recommendations? Considerations when establishing treatment goals Stephen Perkins, MD, Vice President of Medical Affairs UPMC HEALTH PLAN Christopher Radley, Director, Quality Management HEALTHCARE PARTNERS OF NEVADA Kristian Marquez, Vice President, Clinical and Quality Outcomes INOVALON Kate Eshelman, MD, MPH, Senior Medical Director INOVALON 12:15-1:30 Networking Luncheon 1:30 2:15 Getting Home Care Right: Addressing Quality in the Home Right according to whom? The members. Funding home-based care management programs Medication Therapy Management in the home Addressing beneficiary behavior and self-management Nathan Goldstein, Chief Strategy Officer CENSEOHEALTH 2:15 3:15 Incorporating CAHPs & HEDIS Into Your Quality Improvement Efforts Using HEDIS EOC/CAHPs performance to set priorities and drive your MCO s quality improvement efforts Utilizing the HEDIS Measure Rotation approach to identify and achieve the MCO s performance improvement goals Performing analyses and identifying meaningful interventions to reduce health disparities Violeta Rabrenovich, MHA, CHIE, Director of PMG Performance Improvement, The Permanente Federation, L.L.C. KAISER PERMANENTE 3:15 3:30 Afternoon Break sponsored by 3:30 4:15 Provider Education & Incentives are Key to Elevating HEDIS Results Creating Toolkits They ll Actually Use Compensation programs that drive engagement Volume-based compensation models Value-based incentives Strategies to maximize data accuracy Proper coding Provider visits Network optimization Relative HEDIS comparisons Identifying non-par, high-performing providers Tiering, sculpting, and education strategies Reporting for your audience Education focus Network continuation decisions Case studies Bernard Cohen, MD, MBA, Vice-President, Quality Management WELLCARE HEALTH PLANS 4:15 5:00 In-House or Outsource? Analyzing Who Should Conduct Your Quality Measurement Program How to identify key abilities required to oversee quality measurement and collection initiatives in-house Outsourcing vs. internal management: what to consider Once you outsource how do you artfully select and manage vendors? Ways to maintain clear, regular and on-going communications with your vendors Stephen Perkins, MD, Vice President of Medical Affairs UPMC HEALTH PLAN 5:00 End of Day One 5:15-6:15 Cocktail Reception Immediately Following Sponsored by: Contact Kevin Weigel for more information on about our sponsorship opportunities at

4 DAY TWO: November 19, :00-8:30 Continental Breakfast 8:30 8:45 Chair s Recap of Day One Chair: TBD 8:45 9:45 Improving HEDIS Scores: A Two- Part Discussion PART ONE: Metrics That Matter: Establishing Collaborative Relationships with Providers to Increase HEDIS Scores HEDIS in the broader context of the Triple Aim Review elements of successful provider collaborations that improve HEDIS performance A program for transformation of primary care practices to become a PCMH; the promise to impact quality/hedis outcomes Using data and reporting in the context of provider collaboration to impact quality and HEDIS scores William G. Runyon, MD, FAAFP, National Medical Director, Provider Services Organization Government Business Division WELLPOINT PART TWO: Data-Driven Strategies to Improve HEDIS Scores Creating action plans for: Member prioritization using claims data, lifestyle data and risk groupers Provider prioritization Use of pre-adjudicated claims and real-time tracking of campaigns to maximize return on investment Ramesh Jayasuriya, Senior Director, Clinical & Quality Solutions OPTUM 9:45 10:45 Case Studies: Our Journeys to Excellence: How We Built Strong HEDIS Scores Using HEDIS data to identify opportunities for clinical improvement Designing critical success factors What role does analytics play in HEDIS prioritization? How our plan benefitted from continuous measurement and reporting Beth Foley, RN, M.Ed., CHES, Vice President, Quality and Wellness FALLON COMMUNITY HEALTH PLAN Lori Kramer, BSN, RN, Quality Improvement Coordinator MEDICAL ASSOCIATES HEALTH PLANS Jill Kasel, BSN, RN Quality Improvement Nurse Auditor MEDICAL ASSOCIATES HEALTH PLANS 10:45 11:00 Morning Break 11:00-11:45 Taking Data Collection and Reporting Beyond the Conventional HEDIS Season How much of a need is there for interim reporting, and why? In what ways can off-season reporting enrich your HEDIS scores? The utility of a full-time HEDIS team to increase capture of difficult measures, feed repository databases, and maximize STARs potential Sarah Bussmann, RN, BSN, CRNI, Quality Manager HEALTHCARE PARTNERS NEVADA 11:45-12:30 Navigating a HEDIS Audit How to Survive and Thrive What are HEDIS auditors looking for anyway? What kind of data is acceptable? Changes for HEDIS in 2014 How to assemble your team so they re prepared to deliver what auditors are seeking Team structure to ensure success Creating a cohesive plan that engages multiple departments to meet audit expectations When is it too soon to start preparations? What can be done to better prepare for your annual HEDIS audit? Jane Elliott, MS, CPHQ, Director of Quality and Medical Management HEALTH ALLIANCE 12:30 HEDIS & Quality Improvement Summit concludes The Conference Organizers Healthcare Education Associates is a division of Financial Research Associates, LLC. HEA is a resource for the healthcare and pharmaceutical communities to improve their businesses by providing access to timely and focused business information and networking opportunities in topical areas. Offering highly targeted conferences, Healthcare Education Associates positions itself as a preferred resource for executives and managers seeking cutting-edge information on the next wave of business opportunities. Backed with over 26 years of combined conference industry experience, the producers of HEA conferences assist healthcare professionals, actuaries, attorneys, consultants, researchers and government representatives in their professional endeavors. See for more information on upcoming events. RISE began as the first national association totally dedicated to enabling healthcare professionals to meet the challenges of risk adjustment. Now, RISE has expanded its focus in recognition of the fact that risk adjustment, quality, revenue management and Star ratings are inexorably linked and that education in each of these areas is essential for plan and provider success. We strive to serve our members on three fronts: networking, education and industry intelligence via meaningful networking opportunities, roundtables, cutting-edge conferences and webcast presentations. RISE brings together multiple perspectives and facilitates highly interactive discussion between professionals and provides our members with the crucial information they need to stay ahead of the curve. To learn more about RISE, or to join, visit us online: About the Venue The ARIA is the ultimate luxury Las Vegas Hotel and Casino Resort offering 4,004 guest rooms, 568 luxury suites, 4 pools, and 150,000 feet of gaming. Go to for more information.

5 TO REGISTER: Fax: Mail: Healthcare Education Associates NE Cedar Drive Battle Ground, WA Phone: Online: The 3rd Annual HEDIS & Quality Improvement Summit November 18 19, 2013 Aria Resort & Casino Las Vegas 3730 Las Vegas Blvd. Las Vegas, NV (702) We have a limited number of hotel rooms reserved for the conference. The negotiated room rate of $119 per night will expire on 10/18/13, although we expect the block to sell out prior to this date. To ensure you receive a room at the negotiated rate, please book well before the expiration date. Upon sell out of the block room rate, availability will be at the hotel s discretion. Fees and Payments: The fee for attendance at the 3rd Annual HEDIS & Quality Improvement Summit is: Health Plans $1395, Providers $1195, and Service Providers: $1895 Please make checks payable to Healthcare Education Associates, and write code H190 on your check. You may also pay by Visa, MasterCard, Discover, or American Express. Purchase orders are also accepted. Payments must be received no later than November 11, Team Discounts: Three people will receive 10% off Four people will receive 15% off Five people or more will receive 20% off In order to secure a group discount, all delegates must place their registrations at the same time. Group discounts cannot be issued retroactively. For more information, please call Whitney Betts at or WBetts@ healthcare-conferences.com. Cancellations: If we receive your request to cancel 30 days or more prior to the conference start date, your registration fee will be refunded minus a $ administrative fee. Cancellations occurring between 29 days and the first day of the conference receive either a 1) $200 refund; or 2) a credit voucher for the amount of the original registration fee, less a $ administrative fee. No refunds or credits will be granted for cancellations received after a conference begins or for no-shows. Credit vouchers are valid for 12 months from the date of issue and can be used by either the person named on the voucher or a colleague from the same company. Please Note: For reasons beyond our control it is occasionally necessary to alter the content and timing of the program or to substitute speakers. Thus, the speakers and agenda are subject to change without notice. In the event of a speaker cancellation, every effort to find a replacement speaker will be made. CPE CREDITS Healthcare Education Associates is registered with the National Association of State Boards of Accountancy (NASBA) as a sponsor of continuing professional education on the National Registry of CPE Sponsors. State boards of accountancy have final authority on the acceptance of individual courses for CPE credit. Complaints regarding registered sponsors may be submitted to the National Registry of CPE Sponsors through its website: Sponsored learning activities are measured by program length, with one 50-minute period equal to one CPE credit. One-half CPE credit increments (equal to 25 minutes) are permitted after the first credit has been earned in a given learning activity. Please note that not all state boards adopted this rule. Some participants may not be able to use one-half credit increments. This course is offered as a group-live course and does not require prerequisites or advance preparation. We offer advanced level courses. Although no prerequisite courses, experience, or advance preparation is required to participate in this program, working knowledge of Healthcare is required, as well as, prior knowledge of the program topic. For specific learning objectives and program description, please refer to the individual conference sessions topics in the conference brochure located on our website SPONSORS Inovalon is a healthcare technology company that combines advanced data analytics with highly targeted interventions to achieve meaningful impact in clinical outcomes and financial performance across the healthcare landscape. Our unique achievement of value is delivered through the effective progression of Turning Data into Insight, and Insight into Action. Proprietary datasets, sophisticated analytics, deep subject matter expertise, and nationwide in-community personnel deliver a seamless, end-to-end platform of technology and operations. Driven by data, Inovalon uniquely identifies gaps in care, quality, data integrity and financial performancewhile also bringing to bear the resources to resolve them. This differentiating combination provides a powerful capability suite touching more than 120 million Americans, driving high-value impact, and improving million Americans, driving high-value impact, and improving the quality and economics for health plans, hospitals, physicians, patients, and researchers. CenseoHealth s mission is to facilitate meaningful connections between health plans and their members by providing tailored solutions resulting in high-quality, cost-effective health care at a historically underutilized site of care the home. The Company s suite of services is anchored by CareConsult, an in-home health consultation conducted by one of the Company s 10,000 licensed physicians that results in improved member engagement, more accurate diagnoses, and more informed primary care providers. CareConnect and CareCurrent expand CenseoHealth s breadth of support and subsequently assist health plans in their effort to close gaps in care and mitigate audit risk. For more information please visit ECS is the nation s largest and most secure provider of medical record retrieval services. ECS processes more than 2 million medical records retrieval requests from 65,000 physician offices annually. ECS s 2,000+ on-site retrieval personnel and 200 person call center leverage the industry s most proven and robust technology platform to ensure customer and provider satisfaction with the retrieval process. In addition to retrieving paper and electronic medical records for Medicare & Medicaid Risk Adjustment, HEDIS and RADV audits, ECS can distribute and retrieve any document from any provider office at any time. Optum is a health services company with more than 35,000 people dedicated to making the health system work better for everyone. Our solutions and services are used at nearly every point in the health care system, from provider selection to diagnosis and treatment, and from network management, administration and payments to the innovation of better medications, therapies and procedures. Our clients and partners include those who promote wellness, treat patients, pay for care, conduct research and develop, manage and deliver medications. With them, Optum is helping to improve the delivery, quality and cost effectiveness of health care. Co-Located Conference The 2nd Annual Health Insurance Exchange Summit November 18-19, 2013 The Aria, Las Vegas, Nevada Platinum Silver Bronze

6 The 3rd Annual HEDIS & Quality Improvement Summit Healthcare Education Associates 200 Washington St. Ste 201 Santa Cruz, CA To Register: Fax: (704) Call: (866) Online: Mail: Healthcare Education Associates Battle Ground, WA Attention Mailroom: If undeliverable, please forward to the Director of Quality Improvement NE Cedar Drive Please Mention This Priority Code When Registering Yes! Register me for the conference: Health Plan: $1395 Provider: $1195 Standard Service Providers: $1895 Please bill my: Please call me; I m interested in a group discount for my team. Please call me; I m interested in exhibition or sponsorship opportunities at this event. I wish to receive updates on HEA s upcoming events via fax, and phone. Signature: Name Title Company Dept. MasterCard Card number: Exp. Date: Signature: Check enclosed Visa Amex Discover Name on Card: Please bill me later Make checks payable to Healthcare Education Associates, and write H190 on your check. Please mention your priority code when registering: Address City State Telephone Fax: Zip Conference Code: H190 Healthcare Education Associates and RISE (The Risk Adjustment Initiative & Society for Education) Proudly Present T h e 3 r d A n n u a l HEDIS & QUALITY IMPROVEMENT Summit u xpertise Yo Gain the E r u ximize Yo Need to Ma ormance! HEDIS Perf Nov 18-19, 2013 Aria Resort & Casino, Las Vegas Strategies to Reach and Exceed Your Healthcare Quality Improvement Goals