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ACO Provider Forum
How to Navigate Risk-Sharing and Care Coordination
Friday, June 24, 2011 • Hyatt Regency Chicago • Chicago, IL
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The advent of ACOs is forcing providers to develop new skill-sets to successfully navigate emerging risk-sharing arrangements with health plans and to address the challenges of coordinating care to achieve improved outcomes at a lower cost.
This means understanding how to structure risk-sharing contracts with health plans, develop meaningful and achievable quality measures, and reengineer care delivery.
But there's a whole lot more. Success will also require access to actionable financial and clinical data, the ability to accurately assign and track ACO patients in both HMO and PPO benefit settings, and the ability to work with managed care organizations in a mutually beneficial partnership. There's also the need for flexibility, commitment and the type of resources that suggests true management buy-in.
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Sponsored by:
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During Corporate Research Group's ACO Provider Forum,you'll get a frank assessment of what's working and what isn't as physician organizations, group practices, health systems and hospitals ramp up ACO initiatives. You'll also hear about innovative provider payment and revenue models and get a glimpse of what the future may hold as risk continues to shift from payers to providers.
Top Five Reasons to Attend:
- Get an update on ACO initiatives among leading physician organizations, group practices, health systems and hospitals and find out who's ahead of the curve in making accountable care work.
- Learn about new and innovative provider-payment models, risk-sharing initiatives and efforts to make capitation succeed despite past failings.
- Find out how physician organizations and health plans are entering into ACO arrangements aimed at increasing member share and patient volume without sacrificing much - if anything - in the way of total provider compensation.
- Assess ACO-related care coordination strategies aimed at meaningfully driving improved patient outcomes and reducing cost.
- Learn how ACOs are dealing with tricky variables like pricing at community hospitals, benefit design, drug formularies and payer-sponsored disease management programs - i.e., things that may fall outside an ACO's purview but still impact ACO performance, cost and quality
Preliminary Agenda Topics and Panels
7:00-8:00 Registration and Continental Breakfast
8:00 - 8:30 Introduction: The Outlook for ACOs
Corporate Research Group welcomes attendees to the ACO Provider Forum and sets the stage with its unique take on the outlook for accountable care organizations.
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Carl Mercurio
President and Managed Care Analyst
Corporate Research Group |
8:30 - 9:30 Morning Keynote: Destination ACO
Health systems, physician organizations and providers face a wide variety of challenges in establishing an ACO. These include preparing physicians to deliver coordinated care, reengineering clinical and administrative systems, and navigating risk-sharing contracts with health plans and employers. In this keynote address, you'll hear how one of the nation's leading health systems is making it all work. Advocate Health Care has been a leader in establishing an ACO. Learn how the right preparations and proper execution can make all the difference.
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William K. Faber, MD, MA, MHCM
Medical Director for Credentials, Peer Review and Quality Improvement Collaborative
Advocate Physician Partners
(View Biography) |
9:30 - 10:30 The Role of Population Management in ACOs
For ACOs to work, providers and health plans must come to an understanding on how to work together toward a common goal - better quality care at a lower cost. Population management will be a critical part of this joint effort - including care coordination, risk management, evidence-based medicine, disease management, wellness initiatives and analytics-based population management efforts. On this panel, you'll hear how health plans are partnering with providers to better manage populations of patients, share resources and develop trust in a shared-risk environment.
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Scott Saran, M.D.
Chief Medical Officer
Blue Cross Blue Shield of Illinois
(View Biography) |
10:30 - 10:45 Coffee Break
10:45 - 12:00 How Health Plans Can Forge a Successful ACO Strategy
Health plans are working hard to develop a working strategy for involvement in ACOs - one that allows plans to change with the times while also remaining relevant in a world where risk is shifting to providers. Plans are investing in information technology and care coordination capabilities, entering into a variety of shared-risk contract arrangements, and even in some case acquiring clinics. In this keynote address, you'll hear from a health plan that is doing all of the above.
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Tom James, M.D.
Medical Director, Kentucky Operations
Humana Inc.
(View Biography) |
12:00 - 1:00 Lunch
1:00 - 2:30 Launching an ACO - Lessons from the Field
Providers across the nation are in various stages of ACO development. Some have full-blown ACOs in place and have already begun to take risk contracting. Others are just beginning to get physician buy-in and establish ACO network. Still others are somewhere in between. On this panel, you'll hear case studies from ACOs at every stage of development. Learn how to address key issues around building a network, implementing technology, winning your first payer contracts, and managing risk.
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Keith Pugliese
Vice President of Accountable Care and Public Policy
Brown & Toland
(View Biography) |
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Raj Behal, M.D.
Associate Chief Medical Officer, Senior Quality & Patient Safety Officer
Rush University Medical Center |
2:00 - 3:30 Innovative Provider Care Delivery and Revenue Models
Even before ACOs became the latest buzzword in healthcare, a variety of providers have been implementing or experimenting with innovative revenue models. These include everything from capitation from payers to monthly membership fees paid by patients for unlimited access to primary care services. Other market-based solutions include retail clinics that provide routine care at low cost, and various programs that offer bonuses and incentives for reaching quality benchmarks. On this panel, you'll learn about some of the latest provider payment innovations from the real world.
3:30 - 4:00 Coffee Break
4:00 - 5:00 The Challenges of Establishing an ACO in a Self-Insured PPO Environment
Before ACOs can reach widespread adoption, they must prove they can work in a self-insured PPO environment. The challenges to such as arrangement are many, including how to identify the primary care physician of a PPO member (HMO members are typically required to name a PCP). In addition, there is the challenge of tracking claims and costs in a PPO environment. In this session, you'll hear from a health system that has been on the front lines in offering an ACO to populations of self-insured employees in a PPO setting.
Pricing
Pricing for this conference is not yet available. Please check back soon for updates.
Team Discount:
Register 3 team members from the same organization at the same time and the 4th team member attends FREE! (Valid only at regular registration rate.)
Register Online or call 800-647-7600
Organized by:
Corporate Research Group has been serving the healthcare marketplace for 14 years as the industry's leading source for breaking news, strategic intelligence, market research and custom consulting.
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