Breakfast Symposiums

Collaborating in a global economy to improve engagement in the evolving health care landscape.

Health care is changing in dramatically. In response, the health care industry must also change to meet the consumer where they are in their health journey. Both the consumer and health care providers must account for three key components of health care: access, high quality and affordability. The presentation will follow a consumer from identification to engagement addressing those three key components.

  • Utilization of an evidence-based approach to member engagement
  • Leveraging collaboration to reach and engage populations
  • Understanding how effective navigation of the health care system impacts outcomes
  • Looking ahead to the intersection of health care and the consumer experience

Presenters

James D. Cross, MD

Head of National Medical Policy and Operations, Aetna

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Daffany Walker, RN, BSN

Director, Aetna Special Programs, Aetna

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Betsy Farrell, RN, BS

Director, Performance Management, Aetna

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Gerald Osband, MD

Chief Medical Officer, EXL Service Holdings

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Stan Nowak, MBA

Chief Executive Officer and Co-Founder, SilverLink

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Putting the patient first: Innovative care models and patient engagement.

Practical Application: Learn principles that will help you connect population health management with patient engagement.

  • Describe patient risk segmentation methods to determine care needs, from healthy to catastrophic.
  • Define a consumer-centric approach that is grounded in a deeper understanding of human behavior.
  • Discuss the motivational connection between people and purpose.

Presenter

Cynthia Kilroy, MBA

Senior Vice President, Solution Strategy and Business Development, Optum

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Value on Investment: Making It Relevant in the Marketplace

Communicating value is a strategic business imperative. Today, population health managements programs provide a number of positive outcomes, in addition to the financial savings traditionally used to report program success. In this breakfast briefing, attendees will discuss the Value on Investment (VOI) construct, be briefed on the progress made by the PHA-HERO VOI Workgroup, and provide input via a group discussion about messaging VOI to population health management purchasers.

Practical Application: Understand Value on Investment (VOI) and latest industry thinking about how to measure and communicate VOI

  • Learn about the PHA-HERO VOI Workgroup’s progress and charter.
  • Define the VOI construct and review diverse perspectives on this construct.
  • Discuss future steps for communicating VOI throughout the industry.

Presenters

Michael Connor

Alere Health

Craig Nelson

American Specialty Health

Adam Kaufman

DPS Health

Paulo Machado

United Preference

Improving population health through better understanding of individual consumers

Traditional care management approaches are not designed to systematically address many of the entrenched challenges impeding the delivery of high quality and efficient care today. This discussion will highlight the importance of understanding the individual health care consumer – including their behaviors, preferences, support network and resources – in order to more consistently provide the support required and desired by individuals, while improving the health of your population and the business performance of your organization.

At the end of this session, you will have learned how consumer preferences, engagement, and conditions can be derived from data elements, spanning consumer, demographic, financial, and clinical sources. You will also understand how these consumer-level insights can be used to predict health risk and individual likelihood to engage, in order to guide more effective and measurable interventions.

Presenter

Chris Coloian

President & CEO, Predilytics, Inc

Shared Decision Making: A Process to Improve the Health of Your Population.

Practical Application: Apply best practices in shared decision making to engage people, support clinicians, and positively impact the Triple Aim.

  • Learn how shared decision making is key to engaging patients in their health care.
  • Discover why shared decision making is a process, not a tool, and how to make it a reality.
  • Apply best practices to gauge your organization’s readiness to implement a shared decision making program.

Presenter

Michael Barry, MD

Chief Science Officer, Healthwise

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Chronic Disease Management: A Recipe for Success and for Validating Your Results.

Practical Application: Enhance ability to create, launch, and grow a successful remote care program.

  • Discover what you need to know before you launch a tele health program.
  • Learn how to engage key stakeholders to make your program successful.
  • Plan for how you will evaluate success of your program and be sure of your ROI.

Presenter

Karissa Price-Rico, PhD

Chief Marketing Officer, Intel-GE Care Innovations

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Bios

James D. Cross, MD

Head of National Medical Policy and Operations, Aetna

James D. Cross, MD is the head of National Medical Policy and Operations where he oversees teams that develop and maintain clinical policy as well as reimbursement and coding methodology. He is also responsible for all national Aetna Health ConnectionsSM programs, including Disease Management, Precertification Operations, Women’s Health, Beginning Right, Infertility, National Medical Excellence, Informed Helpline, Healthy Lifestyle Coaching, and Clinical Claim Review operation, the National Clinical Appeals Unit, External Review, and the Oral and Maxillofacial Surgery Unit, as well as the International Care Management Center. Jim's background includes key leadership roles over the past 23 years with several private payer organizations.

 

 

Daffany Walker, RN, BSN

Director, Aetna Special Programs, Aetna

Daffany Walker is the Clinical Director of Aetna’s Special programs with operational oversight for Women’s Health, National Medical Excellence and the International Care Management Center. She has over 13 years of experience in managed care. Daffany is a registered nurse, a certified case manager and holds BS in Nursing from Auburn University in Auburn Alabama. Daffany is also the 2015 President-elect for CMSA, Atlanta Chapter.

 

 

Betsy Farrell, RN, BS

Director, Performance Management, Aetna

Betsy A. Farrell, RN is Director of Performance Management at Aetna where she oversees teams of professionals who deliver strategic development for care management programs, process excellence, and change management. She also holds a Bachelor of Science from Charter Oak State College and a Master Black Belt in Six Sigma and Lean from Villanova University.

 

 

Gerald Osband, MD

Chief Medical Officer, EXL Service Holdings

Dr. Osband currently serves as the corporate Chief Medical Officer for EXL Service Holdings where he is responsible for setting clinical strategies, clinical process oversight and engaging clients in portfolio based opportunities. He is a seasoned physician executive whose senior level positions include Chief Medical Officer and Chief Operational Officer for nationally recognized health care management and technology organizations.

 

 

Stan Nowak, MBA

Chief Executive Officer and Co-Founder, SilverLink

Stan's vision is to help health plans, pharmacy companies, and other key healthcare stakeholders become trusted health advisors, as they improve health, reduce healthcare costs and build loyalty with their members. His innovation is to bring the power of consumer marketing methodologies to healthcare communications. This vision has helped 21 of the top 25 health plans better engage their members and drive improved outcomes. Under Stan's leadership, Silverlink has developed a flexible communications technology, proprietary analytics capabilities and a team with deep industry expertise. Stan's background includes over 22 years of general and executive management in technology services. He held executive roles with StorageNetworks, GTE and InterGen (Bechtel). Stan is often quoted by the healthcare and business press, and is a frequent keynote speaker at industry events. Stan holds a Master’s degree from Harvard Business School and a Bachelor’s degree from Harvard College.

 

 

Michael Barry, MD

Chief Science Officer, Healthwise

Michael J. Barry, MD is a champion of shared decision making. As a physician-researcher, Dr. Barry has spent his career studying various aspects of shared decision making and putting into practice the knowledge that he’s gained. As chief science officer at Healthwise, Dr. Barry is responsible for ensuring the highest level of clinical accuracy in Healthwise decision-support solutions.

 

 

Cynthia Kilroy, MBA

Senior Vice President, Solution Strategy and Business Development, Optum

Ms. Kilroy is senior VP of solution strategy and business development at Optum, where she is accountable for defining client strategies in the areas of consumer health, financial management and population care management. Her expertise is focused on helping providers transition to value-based care to improve quality and reduce costs.

 

 

Karissa Price-Rico, PhD

Chief Marketing Officer, Intel-GE Care Innovations

Dr. Price brings to healthcare a deep background in successfully developing and launching new products and services for consumers and businesses that improve people’s lives and provide a sound ROI. Dr. Price is sought after as a speaker at Home Health Care, Multicultural Marketing and Digital Health conferences where she blends her diverse background into actionable insights on how to create and deliver a winning consumer experience. She is passionate about connecting the care continuum to people at home through technology and services that allow people to age gracefully and in better health where they want to be while simultaneously reducing our overall healthcare costs.

 

Top 10 Reasons to Attend

In 2014, PHA Forum will focus on the role of collaboration and communication to increase engagement at all levels of the implementation of population health models and strategies from development to delivery.

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