2019 Agenda

The RISE National Population Health Summit 2019 had a jam-packed agenda featuring a Population Health Track and Addiction Treatment & Prevention Track, more than eight networking opportunities, and over six case studies. Our hand selected expert speakers and thought-provoking educational sessions provide evidence-based strategies for population health management and combatting substance abuse disorder.

November 12, 2019

8:00-9:00 AM
Registration and Networking Breakfast

9:00-9:10 AM

Welcome Remarks

Darcie Robran-Marquez, MD, MBA, CPE, Executive Medical Director
Presbyterian Healthcare Services

9:10-9:55 AM

Regulation and Accreditation Update on Population Health

• Analyze the NCQA population health standards that are a cornerstone of health plan accreditation
• Examine the importance of population health in Long-Term Services & Support, Case Management, and Patient-Centered Medical Home standards
• Discuss the population health goals in CMS’ future Merit-based Incentive Payment System (MIPS) Value-based Pathways (MVPs).

Paul Cotton, Director, Federal Affairs
National Committee for Quality Assurance

9:55-10:40 AM

The Crucial Roles of Risk Adjustment and Quality Measurement to Improve Population Health

  • Strategies to ensure a specific, accurate, and complete representation of the population illness burden to ensure appropriate financial support for care 
  • Enable complete insight on every member to maximize population health, enhance individual care, and lower overall cost 
  • Utilize quality measures as a vehicle to reduce overall costs and maximize member health and satisfaction 
  • Obtain Medicare Advantage Quality Bonus Payment for additional support for care of your members 

William Jonakin, MD, CPC, CRC, Medical Director, Medicare Advantage and Risk Adjustment
St. Luke’s Health Partners
Principal, Clinical Discernment, LLC 

 

10:40-11:00 AM
Networking Break

11:00-11:45

How Payment Reform Can Drive Results: Taking Advantage of the Move to VBP to Deliver Population-level Change

  • The move from fee-for-service to value-based payment is accelerating, opening new doors of opportunity to address populations health
  • The work will be more place-based and cross-sector, requiring health care to become a convener and collaborator 
  • Mindset shifts such as the use of design thinking and systems thinking are key to being successful in the new ecosystem

Jason Helgerson, Chief Solutions Officer
Helgerson Solutions Group
Former New York State Medicaid Director

Juliette Price, Solutions Architect for the Social Determinants of Health
Helgerson Solutions Group

Sander Koyfman, MD, Behavioral Health Medical Director- New York
WellCare

11:45-12:30 PM

Taking Big Data and Narrowing It Down to Actionable Items Within A Population

  • Analyze what it takes to process available data narrow it down for the right intervention at the right time 
  • Understand how data regarding opioids is  a single variable within a population management strategy is only 
  • Learn how to look at population who may have depression, chronic pain, diabetes etc., and how to manage that population when opioids are part of that mix 

William Jonakin, MD, CPC, CRC, Medical Director, Medicare Advantage and Risk Adjustment
St. Luke’s Health Partners
Principal, Clinical Discernment, LLC

Sander Koyfman, MD, Behavioral Health Medical Director- New York
WellCare

Saeed Aminzadeh, CEO
Decision Point Healthcare Solutions

12:30-1:30 PM
Networking Lunch

12:45-1:20 PM

Bonus Lunchtime Roundtable Session

NCQA- Question & Answers Roundtable

An exclusive opportunity to meet face to face with the Director or Federal Affairs at the NCQA to obtain information that can improve your current health plan operations.

Paul Cotton, Director, Federal Affairs
National Committee for Quality Assurance

1:30-2:30 PM

Concurrent Tracks

1:30-2:30 PM

Track A: Innovative Approaches for Providing Care in your Members Home Setting

  • Initiate coaching strategies in order to prepare members for changes in lifestyle to eliminate falls and injuries 
  • Maximize SDoH to interact with members through technology, transportation and food services to improve care 
  • Understand policies required for a successful member in home service program 

 

Lois Simon, Executive Vice President of Policy and Programs
Seniorlink

Jessica Kinowski, MPH, Clinical Program Director
National Health Services – Cigna Medicare 

 

1:30-2:00 PM

Track B: Federal Laws and Other Factors That Affect Access to Medications for Treating Opioid Use Disorder

  • Review a description of medications used in the treatment of opioid use disorder   
  • Examine federal laws and regulations that apply to these medications 
  • Analyze factors that affect access, such as practitioner availability, stigma, and costs/insurance coverage and the Federal efforts to expand access to treatment, and recommendations to better measure progress toward this goal       

Will Simerl, Assistant Director, Health Care Team
U.S. Government Accountability Office

2:00-2:30 PM

Track B: Understanding the Patient Journey from Childhood to Addict

  • Demonstration of data and how to utilize that for better addiction policies 
  • Review CDC’s newest guidelines for prescribing medication to kids  
  • Learn how to identify high-risk patients and how to intercede

Alanna Lavelle, Senior Principal, Life Sciences
MITRE

2:30-3:15

Concurrent Tracks

2:30-3:15 PM

Track A: Case Study: Illinois- Illinois Health and Hospital Association and Coordinated Care Alliance’s Statewide Population Health Initiative Targeting Older Adults

  • Examine the implementation process of a broad-spanning population health initiative in Illinois in order to replicate 
  • Identify key partners and SDOH areas of focus for population health programs for partnerships 
  • Evaluate critical quality improvement strategies to implement throughout population health initiatives 
  • Learn how to replicate this best practice in your state 

Jessica Grabowski, AM, LCSW, Executive Director
Coordinated Care Alliance

2:30-3:15 PM

Track B: Identifying High Risk Patients and How to Intercede: Trends in Pharmacy Data

  • Review how plans who have started to manage at-risk populations and have programs for tracking opioid prescriptions filled 
  • Analyze how those programs are looking at appropriate use of medication versus tipping over the edge and providing interventions before it becomes and addiction  
  • Define what are the different methods and processes to look at from a 30,000 ft level as a health plan 

Joseph Albright, PharmD | Pharmacist, Team Lead, Clinical Pharmacy Services
BCBSNC

Stacy Garrett-Ray, MD, MPH, MBA, Vice President, UMMS, Medical Director, Population Health Services Organization, President, Quality Care Network, President, Transform Health MD
University of Maryland Medical System

3:15-3:30 PM
Networking Break

3:30-4:15 PM

Concurrent Tracks

3:30-4:15 PM

Track A: Multicultural Systems of Care Approach

  • Evaluate the impact of the Flint water crisis and how it raised awareness of the health care coverage challenge 
  • Describe the process developed by the Genesee Health Plan to implement the Multicultural System of Care 
  • Discuss the usefulness and value of Community Engagement/Community Voices to enhance member satisfaction 
  • Examine the Conversation process for identifying cultural differences and challenges to bridge the gaps in care 

Jim Milanowski, President/CEO
Genesee Health Plan

3:30-4:15 PM

Track B: Transforming Opioid Use Disorder Data into Action: Creating a Regional Response to Opioid Overdoses

  • Review how to use OUD data to develop targeted strategies for high risk cohorts and patients not engaged in treatment 
  • Understand ways to support development of MAT programs in primary care through learning collaboratives, technical assistance, and alternative payment models 
  • Examine how to convene a multi-stakeholder task force to develop a regional strategy to reduce opioid-related harms 

Melissa Joy Brewster, PharmD, BCPS, Pharmacy Director, Columbia Pacific CCO                            CareOregon  

Keshia Bigler, Population Health Portfolio Manager                                                                        CareOregon 

4:15-5:00 PM

Concurrent Sessions

4:15-5:00 PM

Track A: Case Study: Commercial Populations with High Disease Burdens

  • Utilize in home face to face programs to drive medical cost savings and increase health for the most medically complex members 
  • Intensive chronic care coordination:  Program provides robust, multichannel care management related to diet, exercise, self-measurement, preventive care, and medication use offered in multiple settings.  Support and guidance to be delivered to help clients and their families acquire the skills, confidence, and problem-solving techniques to manage their chronic illness, resulting in enhanced peer-to-peer support, networking opportunities, goal setting and problem solving 
  • Encourage self-funded employers to take ownership of population health and use benefit design to influence appropriate care and SDoH strategies 

Jessica Culver, CHES, Senior Manager, Population Health
Moda Health

4:15-5:00 PM

Track B: Methodologies and Non-Opioid Pain Management

  • Discuss if we are under prescribing treatment when medically necessary and if/how this negatively impacts treatment 
  • Review new “toolbox” that can be brought in and considered for pain management 
  • Discuss doctor education on alternative plans including the language they use when discussing pain with patients 

Moderator:
Edward D Shanshala II, MSHSA, MSEd, CEO
Ammonoosuc Community Health Services, Inc (AHCS)

John M Ventura, DC,
Spine Care Partners, LLC
Clinical Instructor, Family Medicine, University of Rochester School of Medicine

Nicholas DeGregorio, MD, FACP, MMM, Senior Medical Director
UPMC for You 

 

 

5:00-5:10 PM
Closing Remarks
5:10-6:10 PM
Networking Cocktail Reception

November 13, 2019

8:00-9:00 AM
Networking Breakfast

7:45-9:15 AM

Population Health Executive Think Tank- Invitation Only

An invite only exclusive thought-provoking think tank attended by high level health care leaders from across the nation to delve into critical topics related to the opioid crisis and population health.

William Jonakin, MD, CPC, CRC, Medical Director, Medicare Advantage and Risk Adjustment
St. Luke’s Health Partners
Principal, Clinical Discernment, LLC

Jason Helgerson, Chief Solutions Officer
Helgersons Solutions Group
Former Medical Director of Medicaid NY

Lois Simon, Executive Vice President of Policy and Programs
Seniorlink

Jessica Grabowski, AM, LCSW, Executive Director
Coordinated Care Alliance

Darcie Robran-Marquez, MD, MBA, CPE, Executive Medical Director                                              Presbyterian Healthcare Services 

Abner Mason, Founder and CEO
ConsejoSano, Inc.

Robran-Marquez, MD, MBA, CPE, Executive Medical Director
Presbyterian Healthcare Servicesner Mason, Founder and CEO
ConsejoSano, Inc.

Jim Milanowski, President/CEO
Genesee Health Plan

Nicholas Degregorio, MD, FACP, MMM, Senior Medical Director
UPMC for You

Karen DePasquale, LSW, Associate Vice President Clinical Affairs & Clinical Business Operations
UPMC Health Plan

Edward D Shanshala II, MSHSA, MSEd, CEO
Ammonoosuc Community Health Services, Inc (AHCS)

Stacy Garrett-Ray, MD, MPH, MBA, Vice President, UMMS, Medical Director, Population Health Services Organization, President, Quality Care Network, President, Transform Health MD
University of Maryland Medical System

 

9:15-9:25 AM

Opening Remarks

Darcie Robran-Marquez, MD, MBA, CPE, Executive Medical Director
Presbyterian Healthcare Services

9:25-10:15 AM

Case Study: Maximize Data to Accomplish Exceptional Population Health Outcomes

  • Capitalize on analytics to target specific member populations for specialized interventions 
  • Obtain actionable real time data to increase member care and reduce unnecessary costs 
  • Monitor member outcomes to achieve optimal performance and reduce readmission 
  • Take away tools and processes for implementation 

Darcie Robran-Marquez, MD, MBA, CPE, Executive Medical Director
Presbyterian Healthcare Services

10:15-11:10 AM

One Size Does Not Fit All- Member Engagement Strategies for Unique Member Population

  • Strategies to break down barriers to better serve your multicultural member population
  • Educate members on lifestyle changes to increase member ownership of health care 
  • Increase positive experiences for low income members through introduction of SDoH 

Moderator:
Stacy Garrett-Ray, MD, MPH, MBA, Vice President, UMMS, Medical Director, Population Health Services Organization, President, Quality Care Network, President, Transform Health MD
University of Maryland Medical System

Panelists:

Abner Mason, Founder and CEO
ConsejoSano, Inc.

Lauretta Converse Director of Payment Reform 
Rhode Island Medicaid Program

Jessica Kinowski, MPH, Clinical Program Director
National Health Services – Cigna Medicare

11:10-11:30 AM
Networking Break

11:30-12:30 PM

Concurrent Sessions

11:30-12:30PM

Track A: Embedding SDoH into an Existing Population Health Model

  • Develop a true integration of technology to improve operation 
  • Identify and implement training tools to advance workflow 
  • Recruit and educate the best staff members for your team to increase member satisfaction 
  • Introduce assessments across all products and lines of business to improve efficiency 

Terrie Hottle, Social Determinants of Health Strategy Lead
CareSource

11:30-12:30 PM

Track B: Medication Assisted Therapies: A Discussion on Efficacy and Process

  • Review of data on what works and what doesn’t 
  • Examination of case studies and lessons learned  
  • Examine immediate applications to various types health plans  

    Nicholas DeGregorio, MD, FACP, MMM, Senior Medical Director                                                              UPMC for You

    Case Study:  UPMC Health Plan’s Pilot Program Rapid Emergency Dept Outreach (REDO) 

     

    • Learn about REDO and why UPMC Health Plan implemented the program and why other plans may want to use this model 
    • Review data that indicates success of program 
    • Understand how UPMC Health Plan implemented billables and can reimburse paramedics 

      Karen DePasquale, LSW, Associate Vice President Clinical Affairs & Clinical Business Operations  UPMC Health Plan 

12:30-1:30 PM
Networking Lunch

12:45-1:30PM

Bonus Lunchtime Roundtable Session - Effective Strategies to Reduce Rehospitalization 

  • Maximize transportation services to increase attendance at regular health care appointments 
  • Utilize food delivery services to ensure that members are eating healthy meals for a time period post hospitalization 
  • Integrate member education and commitment to improve living a healthy lifestyle 
  • Strategies to coordinate social determinants referrals from primary care to benefit beneficiaries 

Noreen Hurley, Program Manager, Star Quality & Performance
Harvard Pilgrim Health Care

Jim Milanowski, President/CEO
Genesee Health Plan

 

1:30-2:15PM

Concurrent Sessions

1:30-2:15PM

Track A: Case Study: Segmentation of Medicare Member Population to Improve Quality Measures

  • Identify members of your population with the most need for education and guidance 
  • Generate a tailored approach to the segmented population to increase medication adherence and colonoscopy screenings 
  • Maximize population health tools and strategies to increase quality ratings 

Jessica Culver, Senior Manager, Population Health
Moda Health

1:30-2:15 PM

Track B: Case Study: Creating a Health Care Model to Reduce Chronic Opioid Use by Utilizing Pharmacy Data for Early Intervention with the Opioid Naïve Population

    • Develop a reporting mechanism to identify members recently prescribed opioid medication 
    • Create a case management program with outreach to members for timely intervention following a medical event 
    • Provide education about the risks of opioid utilization and the importance of safe storage and disposal of opioid medication 

     Ruth Boubin, MA, Restricted Recipient Program Case Manager                                                       South Country Health Alliance 

2:15-3:00 PM

Concurrent Sessions

2:15-3:00 PM

Track A: Case Study: Impact of Incentives on Member Behavior

  • Create incentives in Medicare Advantage population to achieve optimal success 
  • Develop a program to improve engagement and Stars performance 
  • Formulate segmented member communication based in risk stratification to improve outcomes 

Noreen Hurley, Program Manager, Star Quality & Performance
Harvard Pilgrim Health Care

2:15 - 3:00 PM

Track B: CAMPFIRE SESSION: Exploration of Innovative Partnerships and Continuum of Care for Addressing Substance Use Syndrome

  • Review ACHS continuum of prevention, diagnosis, treatment and recovery for Substance Use Disorder and the programs you can take back to your organization 
  • Work with your table to understand different organizations greatest challenges and how as a group you can move towards solving some of those problems 
  • Review challenges and solutions from the entire group for actionable items you can take back to your organization 

Edward D Shanshala II, MSHSA, MSEd, CEO
Ammonoosuc Community Health Services, Inc (ACHS)

https://ammonoosuc.org/ , Board President of the North Country Health Consortium, (NCHC) http://www.nchcnh.org/, Board Trustee of the Littleton Regional Healthcare (LRH), http://www.littletonhospital.org/, and Board Director and Treasurer of the Bi State Primary Care Association https://bistatepca.org/.

 

3:00 - 3:10 PM
Closing Remarks