AHIP’s Summit on Payment Reform and Delivery Transformation, March 5 in Washington, D.C., spotlights efforts across the country to transform the payment system and care delivery. The Summit showcases initiatives where providers and health plans are partnering with success. The sessions will demonstrate the many lessons learned from these partnerships including gaining provider buy-in, governance issues, and strategies for changing the paradigm for health plans, providers and consumers.
The Summit’s sessions include:
Collaborative Quality Improvement Programs: Blue Cross Blue Shield of Illinois and Advocate Health System. This innovative partnership showcases a changing paradigm — new partnerships and shared savings with providers. This session will illustrate how Blue Cross and AdvocateCare have constructed PPO and HMO arrangements that reduce cost trends and clinically integrated care.
- H. Scott Sarran MD, MM, Vice President and Chief Medical Officer, Blue Cross Blue Shield of Illinois
- Lois Elia, MBA, Vice President, AdvocateCare
Performance Improvement: Demonstrating Results with Humana and Norton Health System Partnership. Focusing on Accountable Care Organizations, learn about this successful ACO Pilot Project between Humana and Norton Health System — active physician participation and financial modeling, as well as the performance reporting and shared savings.
- Marcia Guida James, MS, MBA, CPC, Director, Provider Engagement, Humana, Inc.
- Kenneth C. Wilson, MD, MS, CPE, System Vice President – Clinical Effectiveness & Quality, Norton Healthcare
Harvard Pilgrim Health Care’s Payment Reform Initiatives. This session will showcase lessons learned from a suite of products and services that drive volume to high performing providers and present innovative care models aimed at improving the delivery and coordination of medical care.
- Richard Weisblatt, PhD, Senior Vice-President for Provider Network and Product Development, Harvard Pilgrim Health Care, Inc.
- Roberta Herman, MD, Chief Operating Officer, Harvard Pilgrim Health Care, Inc.
Physician Partnerships and Patient-Centered Medical Homes: Capital District Physicians’ Health Plans’ (CDPHP) Successful Initiative. CDPHP’s patient Centered Medical Home pilot is designed to improve the quality of care provided members while improving the efficiency in which care is delivered. Learn how this model improves provider reimbursement and focuses on payment for value (vs. payment for volume) under risk-adjusted capitation. Hear about how to gain provider trust and buy-in to successfully operationalize the payment model.
- Lisa Sasko, MA, MBA, Director of Clinical Transformation, Capital District Physicians’ Health Plans (CDPHP)
- Holly Cleney, MD, Latham Medical Group, Community Care Physicians
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