Health Plan Alliance. Overview for Business Sponsors
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1 Health plans, hospitals and physicians working together Overview for Business Sponsors
2 COMMITTED TO THE SUCCESS OF REGIONAL HEALTH PLANS Improving knowledge Increasing resources Leveraging our network 10/5/2015 Copyright
3 What will be covered Our vision, mission, and focus Our membership Our programs and services Our business sponsors Our team 10/5/2015 Copyright
4 Who we are Founded by 8 regional plans in 1996 Our Vision We exist to inspire and support health plans to deliver exceptional service, drive transformational care, and champion health and well being Our Mission The brings together health plans with similar values in collaborative ways to improve their performance and succeed in their markets 10/5/2015 Copyright
5 Focus on helping regional health plans succeed Supporting health plans: Improving clinical performance Improving financial performance Improving operational performance Improving customer experience Improving market position No political lobbying or advocacy activities 10/5/2015 Copyright
6 Our membership roster 1. Adventist Health Plan (CA) 2. Alliant Health Plans (GA) 3. Aspire Health Plan (CA) 4. Avera Health Plans (SD) 5. AvMed (FL) 6. Baptist Health Plan (KY) 7. Chinese Community Health Plan (CA) 8. Community First Health Plans (TX) 9. Community Health Options (ME) 10. Community Health Plan of Washington (WA) 11. Concert Health Plan (FL) 12. Cook Children s Health Plan (TX) 13. Cox HealthPlans (MO) 14. Fidelis Care New York (NY) 15. FirstCarolinaCare Insurance Company (NC) 16. Geisinger Health Plan (PA) 17. Gundersen Health Plan (WI) 18. Health Alliance Medical Plans (IL) 19. Health Alliance Plan (MI) 20. Health First Health Plans (FL) 21. Health New England (MA) 22. Health Partners Plans (PA) 23. Health Plan of San Joaquin (CA) 24. Health Plan Select (GA) 25. Indiana University Health Plans (IN) 26. Johns Hopkins Healthcare (MD) 27. Medical Associates Health Plans (IA) 28. MetroPlus Health Plan (NY) 29. Mount Carmel Health Plan (OH) 30. Network Health Plan (WI) 31. New West Health Services (MT) 32. Paramount Health Care (OH) 33. Parkland Community Health Plan (TX) 34. Passport Health Plan (KY) 35. Physicians Health Plan (MI) 36. Physicians Plus Insurance Corporation (WI) 37. Presbyterian Health Plan (NM) 38. Prominence Health Plan (NV) 39. Providence Health Plans (OR) 40. Rocky Mountain Health Plans (CO) 41. Samaritan Health Plans (OR) 42. Santa Clara Family Health Plan (CA) 43. Scott & White Health Plan (TX) 44. SelectHealth (UT) 45. Sentara Health Plans (VA) 46. Sharp Health Plan (CA) 47. SummaCare (OH) 48. Western Health Advantage (CA) 10/5/2015 Copyright
7 Our members cover the country 10/5/2015 Copyright
8 Our members represent various ownership models all regional plans with strong provider ties Plan ownership Government owned Cooperative 2 1 Multiple owners 3 Independent 2 10/5/2015 Copyright Single owner-ids or provider entity 40
9 Our members range in size less than 50K 9 Plan s covered lives 500K K-500K 10 50K-100K 11 10/5/2015 Copyright K-250K 14
10 Our members are in all business lines Number of plans in each product line Commercial 10 Medicaid Medicare 3 10/5/2015 Copyright
11 How members stay involved and connected Value Visits Multidisciplinary face to face sessions with a focus on the 9 key priorities and trends Two Leadership Conferences each year Value Calls, Webinars, Executive Briefings, and Vendor Spotlights Operational topics designed for specific peer groups and/or topics of interest Listservs, for questions and knowledge-sharing 28 peer/topic groups 10/5/2015 Copyright
12 Key 2015 programming priorities Our members tell us what is important 1. Clinical Integration. Assessing effectiveness of population health strategies and exploring alternative reimbursement models as plans transition to value based reimbursement 2. Exchanges. Building brand identity, customer loyalty, infrastructure and compliance capabilities in a consumer-centric marketplace on public and private exchanges 3. Government Programs. Leveraging the market opportunity around government -sponsored health care and successfully managing the risk 4. Health System Relationships. Collaborating to strategically leverage the value of your plan with your provider delivery systems 10/5/2015 Copyright
13 Key 2015 programming priorities Our members tell us what is important 5. Informatics. Identifying sources, collecting and using information for business & clinical decision making 6. Member Experience. Creating an organizational wide approach to delivering superior customer experience 7. Operational Excellence. Implementing a customer focused business model through an engaged workforce and a culture of continuous quality improvement 8. Risk Management. Managing governance, financial, operational and compliance risks 9. Work Force Management. Hiring, developing, engaging, rewarding and retaining employees in a complex business environment & highly competitive job market 10/5/2015 Copyright
14 A concentrated program designed to support Medicare Advantage Health Plans The Medicare Advantage Collaborative (MAC) is designed to support Alliance member plans that are: Launching new MA plans, Expanding their existing MA market, or Beginning a joint venture in a new market This concentrated program focuses on the foundation our member plans must have in place to successfully launch or grow in the MA marketplace. Educational content, virtual meetings, and face-to-face networking opportunities are dedicated to topics relevant to the start up or expansion phases. 10/5/2015 Copyright Medicare Advantage Collaborative participants: Aspire Avera AvMed Chinese Community Community WA Fidelis First Carolina Care Geisinger Health Alliance Health Alliance Plan Health First Health New England Health Partners Health Plan of San Joaquin Health Plan Select IU Health Plans Johns Hopkins Medical Associates Metroplus Mount Carmel Network New West Optima Passport Physicians Plus Presbyterian Providence Prominence Rocky Mountain Samaritan Santa Clara Scott & White SelectHealth Sharp
15 Health plans, hospitals and physicians working together A program supporting strategies with your Health System Owner Intersection Points: Programming / Networking: 10/5/2015 Copyright
16 Business sponsorships Website posting Available to All Sponsors Name Description Contact Clients Links Best Practices and/or Capabilities Webinars or Presentations at Events minutes With or without Members as co-presenters Fit with agenda or hot topics 10/5/2015 Copyright
17 Business sponsorships (cont d) Sponsorships Build relationships Meals, speakers or in-kind Marketing support includes newsletter and recognition at events Umbrella Contracts Driven by member need Consensus among members Bring value not possible in individual contract Member makes own business decision Administrative fee negotiated Marketing and access to members 10/5/2015 Copyright
18 Ways to get more engaged online: Home Page (Public) Click on VENDOR PORTAL link to access our vendor section of the site. 10/5/2015 Copyright
19 Alliance staff Leadership Team Specialists Team Cathy Eddy President Dennis Bolin Membership Engagement/ Chief Marketing Officer Jaime González, DrPH Business Development/ Chief Financial Officer CEO and senior leadership Alliance governance relations System/health plan relations Annual member strategic conversations/priorities Member orientation oversight Peer group support for: Operational Areas such as Claims, Customer Service and Administrative Areas such as Marketing and Workforce, & Topics such as Health Care Reform, Exchanges and ICD-10 Alliance membership growth Products/services Financials/budget CFO support Multicultural initiatives oversight Vendor relations Kristin Rodriguez Chief Knowledge Officer/ Knowledge Management & Communication Medicare Advantage Collaborative oversight Knowledge management and content delivery infrastructure Member and vendor communications Donna Dixon Membership Specialist Keri Bloomer Program Specialist Patrice Snowden Program Specialist Rosecelia (Roe) Carson Business Specialist Member onboarding Member database management Newsletter management Programming support Member engagement support Programming support Meeting logistics Website maintenance and support Medicare Advantage Collaborative support Programming support Meeting logistics Support to Alliance Board of Directors & Subcommittee Alliance staff support Sponsor database management Programming support Sponsor engagement support Accounting and financial support Sara Neese, RN Learning & Innovation/ Chief Operating Officer Programming oversight Peer group support for: CMOs, Medical Directors, Clinical, Quality, Pharmacy, Fraud & Abuse, Medicare & Medicaid & Compliance Program teams Alliance operations General Web site: 10/5/2015 Copyright
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