BMA ALLY BLOG: Innovations in Senior Care and Supports – Holding Gains and Accelerating Progress

The following article was published by the Better Medicare Alliance and was authored by Rose Maljanian, Chairman & CEO HealthCAWS and Chairman Emeritus at the Population Health Alliance. PHA is an active member of BMA’s Ally Network. The original posting can be found here.

– – –

May 20, 2020
Rose Maljanian, Chairman & CEO HealthCAWS

Even before the COVID-19 pandemic took hold in our communities earlier this year, change was already afoot in the American health care system as payers and providers increasingly move to demonstrate and reward value – better health, experience of care and reduced costs – rather than the volume of services delivered.

Population health management strategies deployed by Medicare Advantage plans, the managed care option in Medicare where over one-third of beneficiaries receive coverage today, have maximized fixed per-member, per-month payment for each beneficiary’s care to deliver such value.

According to independent research commissioned by Better Medicare Alliance, these strategies have resulted in a 94 percent satisfaction rating among beneficiaries, nearly $1,600 in annual consumer savings, access to an array of supplemental benefits and improved health outcomes and reduced hospitalizations.

As coronavirus continues to impact the entire health care ecosystem, we see pre-COVID gains in value-based care that must be preserved, new trends that are rapidly accelerated, and demands on our health care system that should be addressed. The Medicare Advantage model offers opportunities to do exactly this, individually and at scale. In fact, a new report from Better Medicare Alliance provides numerous examples of how Ally organizations are innovating to meet seniors’ needs in new ways – even now.

As we prepare to move beyond the initial surge of coronavirus with an eye toward long-term solutions to protect vulnerable seniors and enhance their wellbeing, here are some of the factors to consider:

Holding and Enhancing Pre-COVID Gains

1. Analytics Supporting Individualized Needs and Preference-based Care Supports: The 65-year cut point is just that: a cut point. If we look at five-year age bands as populations, the 65-70 group on average looks very different from the 85-90 group in terms of co-morbidity and frailty. Furthermore, individual health and wellbeing profiles vary widely despite chronological age, as do consumer goals and preferences, including aging at home as the preferred environment. Advanced analytics are creating population level insights and individual profiles to support tailored care and life planning.

2. Integrated Medical-Behavioral Care: When behavioral health accompanies a medical condition, especially chronic conditions such as diabetes, cardiac disease, kidney disease, and COPD, total costs are at least two to three times higher. This is compounded when underlying behavioral health issues go undetected or undertreated. Medicare Advantage enrollees benefit from care teams who work together to treat the whole person; offering coordinated care with an emphasis on primary care that can be brought to bear in behavioral health needs arise.

3. Continuity of Care: Significant reductions in avoidable readmissions, improved health and experience of care outcomes and expanded opportunities to enjoy everyday life for seniors, have been accomplished across numerous geographies. This has largely been the result of better discharge planning, care supports, medication reconciliation, and systematic follow-up. Transition of Care programs further support seniors as they progress from acute to post-acute to home-based service supports to full recovery and maintenance. Primary care and annual wellness visits provide an avenue to assess for relapses or emerging health concerns.

4. Addressing Social and Environmental Influences: Substantial investments in Social Determinants of Health (SDoH) initiatives e.g. food insecurity, transportation, housing and social isolation have been made over the last several years not only because it’s the right thing to do but because research supports the impact of these social issues on health and cost indicators, and reduction in cost when SDoH issues are addressed. Coordinating efforts across Community-based Organizations (CBOs) has been critical to this advancement as, like medical and behavioral issues, SDoHs come in clusters – often with the common denominator of financial instability. A recent independent study from the actuarial firm Milliman shows how Medicare Advantage plans leverage supplemental benefits to address SDoH – with nearly half of plans offering meal benefits for those with chronic conditions and 44 percent offering transportation between appointments.

Trends Further Accelerated by COVID:

1. Digital Triage, Coaching and Navigation: For seniors needing maintenance support for chronic condition prevention or management, technology-supported workflows assist in getting consumers to the best intervention for their fluid place in the health continuum at any given time. As social support issues are escalating, seniors may not only feel pressure on their own resources but also feel pressure to help struggling children or grandchildren requiring further support for seniors to prioritize their health needs.

2. Engagement in New Times: As social distancing becomes a new norm whether permanent or periodic, seniors may experience social isolation, fear, and loss of purpose. Thus far, creativity has at least partially eclipsed restrictions with virtual video visits, birthday parades, technology-enabled recreation, and asynchronous voice and image transmission. Better Medicare Alliance recently reported on how its Ally organizations are working to stem the effects of social isolation, with primary care providers like ChenMed calling patients at risk at least once a week. Likewise, Humana has made over 500,000 proactive calls to beneficiaries during this time.

3. Shift to Home-based Services: House calls and technology including telehealth for routine and follow-up care, remote patient monitoring of blood pressure, heart rate and rhythms, and weight have grown exponentially in adoption. Home test kits for lab studies have been distributed where possible. And, access to wellness activities and health coaching have greatly expanded. Today, nearly 90 percent of Medicare Advantage plans provide supplemental and health promotion benefits.

4. Expanded Use of Well-trained High-touch and High-tech Care Team Members: With primary care provider and geriatrician shortages growing, care extenders skilled at assessing and managing special needs of the senior population, including falls prevention, polypharmacy and avoidable or manageable declines in cognitive status have been mobilized. Further, the use of tools including artificial intelligence, remote monitoring devices, smart mattresses, GPS trackers, and voice alerts from two-way personal speakers are beginning to mimic 24-hour surveillance by a care team member.

While there are many lessons still to be learned from the recent changes in service delivery and consumer behavior, there are positive developments all around us that point to a brighter health care future for seniors and those with disabilities – even amid the deep challenges posed by COVID-19 – with Medicare Advantage leading the way.

As health care continues to evolve, new concepts show promise of staying power. Using telehealth in behavioral health settings, for example, has been of increasing interest because of costly numbers of undetected and undertreated individuals, provider shortages, stigma in seeking care, and the growing numbers of individuals experiencing symptoms of anxiety, depression, and emotional trauma resulting from the coronavirus pandemic. Alignment of need and demand with regulatory requirements and payment models, and removing consumer barriers to adoption such as cost, access, and training are key takeaways from which to expand.

In addition to telehealth, the shift to better supporting seniors in their home environments with individualized, comprehensive care through integrated medical, behavioral, and social services will continue to be a top priority. After all, home is the environment that most seniors and their children prefer. The expanded shift to home will entail home care team visits and use of technology to promote health and monitor vital signs, symptoms, and activity could provide early warning signals of trouble to prevent avoidable complications, ER visits, and hospitalizations. Supporting seniors and providing every possible convenience in the home will require balance. Maximal life enjoyment is the endgame across the full continuum of health. Perhaps we all now better appreciate the value of getting outside to enjoy everyday activities, such as a trip to the store, exercise class, or a family member’s house.

No doubt the next phase of coronavirus recovery will be wrought with challenges as the economy and individual healthcare businesses suffer a decline and then stabilize, perhaps in a new form. Certainly, for years to come, the learnings from this period must continue to spawn further innovation on behalf of the growing senior population who desire quality, safety, convenience, and affordability as they live life to their fullest potential.

Rose Maljanian is the Chairman and CEO of HealthCAWS Inc. and is the Chairman Emeritus of the Population Health Alliance.
Better Medicare Alliance

Olio Joins the Population Health Alliance

Indiana startup becomes latest member of national coalition committed to advancing results in value-based care

Washington, DC, April 16, 2020 — Population Health Alliance (PHA), the industry’s only multi-stakeholder professional and trade association solely focused on population health, today announced that Olio (olio.health) has joined the organization as a new member. Olio’s leading technology is a post-acute care solution for population health managers in provider, health systems, and plans, designed specifically for optimal results in value-based care settings.

Olio’s post-acute technology is a direct response to a market necessity driven by the move from volume to value.” said Brent Ling, Executive Director at PHA. “In recent weeks their platform has proven to be a vital tool that assists nursing homes managing the COVID19 pandemic, and Olio’s team has responded in such a way that has undoubtedly helped optimize care. We are honored to welcome their team to our membership.” he added

Every member of our team has been focused on building solutions to help patients and clinicians during this pandemic. We are confident that we found a better way for health systems to engage with their post-acute partners and this public health crisis only magnifies that.” said Ben Forrest, CEO of Olio. “We are excited to join such an esteemed group of population health leaders at PHA who are committed to advancing the utilization of innovative solutions like the Olio platform.

Olio is now fully operational in 22 hospitals and 186 nursing homes providing care for 1,632 patients in the state of Indiana. Most of those installments have occurred in recent four weeks and are dedicated to helping providers triage patients with COVID19.

– – –

About the Population Health Alliance:

PHA represents stakeholders from across the health care ecosystem that seek to improve health outcomes, optimize medical and administrative spend, and drive affordability. Learn more at PopulationHealthAlliance.org.

About Welldoc:

Founded in 2018, Olio’s technology platform enables the highest level of post-acute engagement for health systems. A central component to those efforts is to create digital post-acute networks for health systems that encapsulate 90% of the hospitals discharge footprint. Olio’s health system customers are innovating beyond traditional preferred post-acute networks and have realized a more comprehensive approach to patient care and post-acute engagement. Learn more at olio.health.

Population Health Alliance
Brent Ling
202.737.5476
bling@populationhealthalliance.org
www.populationhealthalliance.org

HealthCAWS FOUNDER’S CIRCLE: Please COVID responsibly … and if you see something say something

The following article was published by HealthCAWS and was authored by Rose Maljanian, PHA Chairman Emeritus and Chairman & CEO at HealthCAWS. The original posting can be found here.

– – –

April 14, 2019
Rose Maljanian, Chairman & CEO HealthCAWS

In this time of COVID 19 crisis, many consumers are confused and afraid for their health and futures. It is no wonder. The airwaves have been flooded with information, sometimes with inconsistent messaging. For the heroic providers caring for the populations on the front lines, stress could not be higher. Guidelines are evolving as our experience with this virus in a global pandemic scenario is in its infancy; we don’t know how much worse it will get in various locations; if or when there will be another wave or waves; or if this is one of many pandemics we will face in the coming years. To effectively empower consumers to take positive actions, they need the best up to date information.

As some well-meaning organizations have tried to quickly develop solutions or just contribute something, there have been some great support solutions as well as those that are less than helpful, including potentially harmful messaging or omissions. Two occurrences last week resulted in my coining the term “please COVID responsibly”. One was an okay start on a COVID APP but one that before release needs more testing, more clinical content review and a rigorous process for updates. The second was a headline of an email blast directed to individual decision making with a subject header that discouraged COVID 19 testing, albeit with some caveats for the consumer to read on and discern.

Clearly, the potential for missing information, misinformation or misinterpreted information leading to the continued spread or a life-threatening delay in treatment is real. Everything must be read and re-read through the eyes of a consumer and what action they may take or not take as a result of receiving the information. Collectively healthcare leaders can help. Look, listen and take the time to provide feedback for course correction if you believe such a risk exists. Your thoughtful feedback will go a long way in helping to protect and empower consumers while researchers continue to advance progress on vaccines, treatments and antibody testing, the CDC aggressively disseminates updated guidance, and the heroes battle the big fight on the front lines.

#COVID-19 #population health management #healthcare quality #CDC

R Maljanian HealthCAWS

Welldoc Joins the Population Health Alliance

Digital health leader joins national coalition to highlight the power of virtual consumer engagement in population health management

Washington, DC, April 14, 2020 — Population Health Alliance (PHA), the industry’s only multi-stakeholder professional and trade association solely focused on population health, today announced that Welldoc (welldoc.com) has joined the organization as a new member. Welldoc, a digital health solutions provider for clinicians, plans, and employers is best known for creating the BlueStar platform, the first FDA-cleared digital health solution that guides individuals through the complicated journey of living with diabetes.

We are pleased to welcome Welldoc to PHA. Welldoc has been leading the way to scale digital health innovation for individuals with chronic care needs including those with diabetes, hypertension and other cardiometabolic conditions, a need even more critical today as healthcare faces unprecedented industry-wide challenges” said Rose Maljanian, Chairman & CEO at HealthCAWS and PHA Chairman Emeritus. “Further, we are delighted to have Anand K. Iyer, PhD, MBA, join our Board of Directors. Anand was selected for the Board due to his vast industry experience and skills in strategic planning which are so vital at this important growth stage for PHA” added Maljanian.

Digital health and therapeutic solutions offer much needed accessibility to and scalability for the management of chronic conditions at the population level” said Anand Iyer, Chief Strategy Officer at Welldoc. “Now more than ever in light of COVID-19 and the inevitability of remote care, clinically-validated, FDA-cleared digital health solutions have the opportunity to help improve population outcomes while reducing total cost of care.”

Welldoc enhances the coaching provided for individuals living with diabetes, empowering self-care through expert, precise, and personalized guidance for managing their chronic condition, thereby naturally following social distancing guidelines in response to the COVID19 pandemic.

– – –

About the Population Health Alliance:

PHA represents stakeholders from across the health care ecosystem that seek to improve health outcomes, optimize medical and administrative spend, and drive affordability. Learn more at PopulationHealthAlliance.org.

About Welldoc:

Welldoc® is a pioneer in revolutionizing chronic disease management to help transform lives. BlueStar® was the first FDA-cleared digital health solution that guides individuals through the complicated journey of living with diabetes. By helping individuals with chronic disease self-manage their conditions and connecting them to their own healthcare team, Welldoc streamlines payers, employers and healthcare systems resources by focusing on a digital health solution to help better manage their populations living with multiple and costly chronic diseases. For more information, visit www.welldoc.com

Population Health Alliance
Brent Ling
202.737.5476
bling@populationhealthalliance.org
www.populationhealthalliance.org

TapCloud Joins the Population Health Alliance

Chicago-based remote patient engagement provider joins national effort dedicated to bridging communication gaps, improving information flow, and empowering the patient experience with health care

Washington, DC, April 9, 2020 — Population Health Alliance (PHA), the industry’s only multi-stakeholder professional and trade association solely focused on population health, today announced that TapCloud (tapcloud.com) has joined the organization as a new member. TapCloud provides a new approach to remote patient engagement and monitoring, connecting patients, caregivers and clinicians in real time to share crucial information that is often unknown or overlooked.

We are excited to welcome TapCloud’s innovative team to PHA’s family of members and their unique perspective to our work” said Jaan Sidorov MD, President & CEO for the PA Clinical Network at the Pennsylvania Medical Society and President of the Population Health Alliance. “Clear communication and optimized information flow are the digital bedrock of population health management in 2020 and user experience, where TapCloud specializes, is perhaps the most critical piece to get right for patients, providers and payers.” Sidorov added.

The need for virtual patient care has never been clearer than it is today” said Phil Traylor, CEO at TapCloud. “We are thrilled to engage in the kind of industry collaboration that PHA enables and look forward to working with the thought leaders and diverse membership to continue to improve the lives of patients and reduce the cost of healthcare.

In recent weeks, TapCloud launched a series of COVID-19 focused solutions to support not only the immediate needs of patient and employee screening and telehealth visits, but the full continuum of virtual treatment and ongoing monitoring of coronavirus cases.

– – –

About the Population Health Alliance:

PHA represents stakeholders from across the health care ecosystem that seek to improve health outcomes, optimize medical and administrative spend, and drive affordability. Learn more at PopulationHealthAlliance.org.

About TapCloud:

In 2013, TapCloud was created as the result of the intensely personal experience of caring for a loved one with a serious medical condition. The experience of trying, and often failing to bridge the all-too-frequent communication gap between patient and doctor. TapCloud’s easy-to-use remote monitoring and engagement platform helps patients and their care team communicate crucial information in real time to drive better health outcomes. Today, TapCloud serves over 30 healthcare organizations across the US and Canada, most commonly in targeted programs managing surgery, chronic care, oncology, palliative care, home health, and hospice. To learn more, visit tapcloud.com.

Population Health Alliance
Brent Ling
202.737.5476
bling@populationhealthalliance.org
www.populationhealthalliance.org

PHA Leaders’ Circle: Interconnectedness and Tradeoff Considerations Abound in COVID-19 Response

By: Mary Jane Osmick MD and Jaan Sidorov MD
March 26, 2020

As the unprecedented coronavirus pandemic continues to evolve, the Population Health Alliance has been closely following the growing reports of and debate about the reopening the US economy. Choosing the right timing to take this action requires a medical, public health and scientific understanding of how to equitably and ethically care for, prevent, or slow the spread of the virus for all our citizens while protecting our front-line workers on whom we depend. Yet, at the same time, we also need to find a way to navigate the choppy waters of US economic stability. This navigation requires a well-defined and clearly stated data-driven strategy that provides all Americans the required knowledge and hope to overcome the pandemic and return to economic prosperity.

There is ample research evidence to suggest strong links between overall health, chronic illness, mortality and economic instability. Based on PHA’s national leadership role on health equity and social determinants of health, we find the latter a critical consideration. Nearly half of the US population can ill-afford job and wage loss, having little or no ability to absorb even a small catastrophe. Now, families are being pushed into precarious economic situations, asked to social distance, school children at home, work remotely or not at all – at no fault of their own. The anticipated financial blows from the pandemic can and will lead to significant housing instability, food insecurity, loss of personal safety and access to necessary health care and other social determinants, all of which are amplified by the anxiety and stress of an unpredictable collective future.

For your consideration, we offer a timely and nuanced discussion of this topic in a paper by McKinsey & Company entitled “Safeguarding our lives and our livelihoods: The imperative of our time”. Find the article and exhibits at this link.

McKinsey&Co

Above Chart is Exhibit 2 from “Safeguarding our Lives and our Livelihoods: The Imperative of our Time” ©1996-2020McKinsey&Company

In the paper, authors Sven Smit, Martin Hirt, Kevin Buehler, Susan Lund, Ezra Greenberg, and Arvind Govindarajan note the significant trade-offs that must be made if we choose an “either-or” approach – that is, addressing the viral pandemic OR opening the economy. Instead, the authors suggest a data-driven and historically-supported middle-of-the-road way forward that allows for mitigation of the lingering health effects of the pandemic, while at the same time, avoiding lasting damage to the US economy. In other words, a strategy that works in parallel to successfully achieve both goals – caring equitably for the population while protecting our economic futures.

We recognize and applaud the U.S. House of Representatives, Senate and White House and Senate for their bipartisanship in issuing $2 trillion to support those in need. We also applaud the courageous State Governors and their teams for their cool-headedness, tenacity and unrelenting courage in doing what is necessary at a local level to increase healthcare resources and do what it takes to limit spread of the virus. Countless small and large employers across the U.S. deserve credit for also finding creative ways to keep working, retooling to produce what is needed and continuing to keep their employees working. Finally, the American people should be recognized for our willingness to hear and respond to the efforts of our leaders to respond collectively and protect one another.

We do not know precisely when and how well this will work in the weeks and months ahead, however, we trust that we will overcome this deadly public menace.

Our colleagues at McKinsey & Company suggest the we need to save lives without destroying livelihoods. As members of the Population Health Alliance community, we look forward to working with our political leaders to advance a solution that truly uses an informed and practical approach to the challenges ahead – one that addresses a win-win for the country and our people. We know that the member companies of the PHA stand ready to support continued public health and economic efforts that will lead to a successful outcome to the pandemic.

For Further Reading on The Interconnectedness of Health and the Economy:

– – –

Mary Jane Osmick MD, Principal at Mary Jane Osmick MD Consulting, LLC is a member of PHA’s Board of Directors, a lead author on PHA’s digital textbook: Social Determinants of Health and Health Disparities: Taking Action and presenter of several webinars on the subject of SDOH in Population Health Management Strategies

Jaan Sidorov MD, CEO & President at PA Clinical Network is PHA’s President and Chair of PHA’s Provider Engagement Initiative.

Rose Maljanian, Chairman Emeritus at PHA and Chairman & CEO at HealthCAWS invites thought leadership on pressing topics to our PHA community to join in on our Leadership Circle.

YMCA Joins the Population Health Alliance

Washington, DC, February 2, 2020 — Population Health Alliance (PHA), the industry’s only multi-stakeholder professional and trade association solely focused on population health, recently announced that YMCA of the USA (ymca.net) has joined the organization as a member. “The Y” is the leading nonprofit committed to strengthening community by connecting all people to their potential, purpose and each other through their presence and partnerships in 10,000 neighborhoods across the nation.

Driven by its founding mission, the Y has served as a leading nonprofit committed to strengthening community for more than 175 years. By bringing together people from different backgrounds, perspectives and generations, the Y’s goal is to improve overall health and well-being, ignite youth empowerment and demonstrate the importance of connections across communities nationwide.

The YMCA has been a pillar for individual advancement and community health since the mid 1800’s. We are honored to have such a long standing and currently relevant driving force in population health join the Population Health Alliance”, said Rose Maljanian Chairman & CEO HealthCAWS and Chairman Emeritus at PHA.

Katie Adamson Vice President, Health Partnerships and Policy at YMCA added the following statement: “The Y empowers everyone, no matter who they are or where they’re from, by ensuring access to resources, relationships and opportunities for all to learn, grow and thrive. We are pleased to join the Population Health Alliance because we see value in building relationships with other organizations committed to helping everyone reach their full health and human potential by advancing evidence-based health interventions tackling chronic diseases, preventing injuries or building healthy community environments that address the multiple social determinants of health.

The YMCA recently announced a new partnership to expand bikeshare access and equity by providing free, one-year bikeshare memberships for Lyft-operated bikeshare systems.

PHA represents stakeholders from across the health care ecosystem that seek to improve health outcomes, optimize medical and administrative spend, and drive affordability.

Population Health Alliance
Brent Ling
202.737.5476
bling@populationhealthalliance.org
www.populationhealthalliance.org

Transition to Success® Joins the Population Health Alliance

Washington, DC, January 31, 2020 — Population Health Alliance (PHA), the industry’s only multi-stakeholder professional and trade association solely focused on population health, recently announced that Transition to Success ® (transitiontosuccess.org) has joined the organization as a member. Transition to Success (TTS) is a system of care that changes our collective understanding and treatment response to the condition of poverty.

With more than thirty years of experience in healthcare administration, not-for-profit management, behavioral health, criminal justice, and public sector programing Dr Marcella Wilson created TTS and has established pilot programs in Michigan, Tennessee, Kansas, Louisiana, Wisconsin and Hawaii. In 2016 Dr. Wilson introduced the novel framework in her book Diagnosis: Poverty – A New Approach to Understanding and Treating an Epidemic and introduced her company and concept to the Population Health Alliance as a keynote speaker at their 2019 Innovation Summit in Washington, DC.

We are pleased to welcome Transition to Success® to the PHA family of organizations.” Said Mary Jane Osmick MD, a longtime member who serves on PHA’s Board of Directors. “Led by CEO and Founder Marcella Wilson, PhD TTS has demonstrated how a consistent, evidence-based, and highly scalable program approach can successfully lead individuals and their families from poverty and its associated health outcomes, toward self-sufficiency and wellbeing. Based on a decade’s-long work in Detroit during and after the recent financial crisis, Dr Wilson developed, tested and implemented a set of tools, processes and training in multiple organizations and communities around the US. In her book, Dr Wilson shares the story of how TTS came into being and how it is now changing the way we think of and react to poverty in the U.S.” added Osmick.

Dr Wilson added the following statement: “Changing the nation’s understanding of and treatment response to the condition of poverty – from a character flaw to a treatable, environmentally-based condition – is our mission at TTS. With the integration of evidence-base best practices and uniform analytics, our system of care screens and responds to the social determinants of health, behavioral health, and addiction issues. PHA is at the forefront of the changing fabric of our country’s healthcare system and provides excellent opportunities to meet and work with industry leaders. We are excited to join this dynamic and influential group.

Dr Wilson and Dr Osmick also recently co-authored a paper Social Determinants of Health—Relevant History, A Call to Action, An Organization’s Transformational Story, and What Can Employers Do? in the Journal of Health Promotion.

PHA represents stakeholders from across the health care ecosystem that seek to improve health outcomes, optimize medical and administrative spend, and drive affordability.

Population Health Alliance
Brent Ling
202.737.5476
bling@populationhealthalliance.org
www.populationhealthalliance.org

THE BRAVO BRIEFING: Addressing and Responding to Social Determinants of Health

The following article was published by Bravo Wellness and was authored by Jim Pshock, Founder & CEO at Bravo and Member of the Board pf Directors at the Population Health Alliance. The original posting can be found here.

Highlights from the Population Health Alliance Innovation Summit

December 19, 2019
Jim Pshock, Founder & CEO of Bravo

I recently attended the Population Health Alliance (PHA) Innovation Summit and Capital Caucus, subtitled “Improving Health Through Financial Security: The Common Denominator Across Social Determinants of Populations.” I’ve been honored to be a member of the PHA board for three years now and have found the organization to be a small but mighty force in the quest for population health. If you’re not familiar with PHA, I strongly encourage you to check out www.populationhealthalliance.org.

Achieving Value Targets by Addressing Social Determinants of Health

As the 2019 theme suggests, one of the primary areas of focus that comprehensive programs must address is financial security and other social issues. While these concerns are not new, PHA Chair, Rose Maljanian, shared that the recent surge in interest among providers and payers is fueled mainly by fundamental changes in reimbursement models linked to value-based designs, HEDIS scores and similar initiatives.

Although many have preached about caring for the total person, it’s clear that our old payment system promoted over-utilization of covered services and paid very little attention to non-reimbursable factors.

As we shift the incentive away from fee-for-service to “bonus for quality,” we finally see more attention to essential elements of care such as transportation needs, lack of food, loneliness and financial security. If you ever doubted the power of financial incentives, look at how the use of these incentives is completely transforming the level of care provided now that things like hospital readmissions and infections result in pay cuts instead of extra revenue!

Responding to the Social Determinants of Health

One presenter, Marcella Wilson, Ph.D., shared exciting results from the Transition to Success program in Memphis, TN. This duplicatable model shows how health care and community services can be combined and organized in a way that addresses the social limitations of those living in poverty. And if you think the poor are the unemployed, think again. The working poor often have greater needs because they don’t qualify for many of the free services available to others. Health plans that leverage a similar approach as the Transition to Success program can have an astounding impact.

“As with any other condition, such as medical or mental, the treatment for the condition of poverty too requires intervention based on science and access to viable, reliable support systems.” – TransitionToSuccess.org

Wellness Success Stories

We also heard from Senator Mike Braun from Indiana. How exciting to have Senator Braun share about the importance of employee wellness programs and the use of substantial incentives. He experienced it first hand at his company in Indiana, where he not only slowed the health cost trend, he eliminated it. It’s so encouraging to have more people in DC who understand the value of engaging individuals in their health rather than fueling the myth that there’s nothing to be done except focusing on discounted services.

Many other terrific speakers, including presenters from Pitney Bowes, Walmart and Comcast, shared incredible success stories highlighting innovation, creativity and impacts that prove that together, we can change lives and control costs.

If you’re looking for a quick, easy and inexpensive way to reverse decades of individuals’ bad habits and inefficiencies, you’ll probably be disappointed. If, however, you commit to analyzing your data and continually fine-tuning your programs to find the right blend of communications, interventions and incentives, you too can have a profound impact.

The Population Health Alliance Announces David Shulkin, Ninth Secretary US Department of Veterans Affairs as a Keynote Speaker at their Annual Forum and Membership Meeting

The PHA Forum and Membership Meeting will take place March 30th, 2020 in Philadelphia

Washington, DC, December 6, 2019 (PR.com) — Population Health Alliance (PHA), the health care industry’s only multi-stakeholder professional and trade association solely focused on population health, today announced that David Shulkin, Ninth Secretary, U.S. Department of Veterans Affairs will be delivering a keynote address at their annual bipartisan PHA Forum and Annual Member Meeting & Luncheon on March 30th, 2020 in Philadelphia, PA.

Described by the New York Times as a “Hands On, Risk Taking Standout”, David Shulkin served as the Ninth Secretary of the Department of Veterans Affairs under President Donald Trump, where he was confirmed by a 100-0 vote by the United States Senate, and beforehand served as Under Secretary under President Barack Obama. Before public service, Doctor Shulkin held positions as the President of Morristown Medical Center, President and Chief Executive Officer of Beth Israel Medical Center in New York City, Chief Medical Officer at Temple University Hospital, Vice President of Atlantic Health System ACO, and Chief Medical Officer at the University of Pennsylvania Health System.

“I look forward to sharing insights with the Population Health Alliance members and constituents from my new book ‘It Shouldn’t Be This Hard to Serve Your Country’ where I will discuss perspectives from both the private and public sectors for improving health at their Annual Forum and Membership Meeting”, said Shulkin.

The author of three books and numerous peer-reviewed journal articles, his latest work describes the Secretary’s fight to improve veteran health care across party lines. His book will be distributed in the welcome package to registrants of the PHA Forum and Secretary Shulkin will be available to sign copies for attendees at the Annual Member Meeting and Luncheon.

“We at the Population Health Alliance are pleased to have David Shulkin, former Secretary of Veterans Affairs to share his expertise in navigating a health system as large and complex as the VA to deliver value to all patients. We salute and join in David’s passion for supporting our Veterans with the level of high-quality care, choice and ease of access fitting their former service to our country”, said Rose Maljanian Chairman and CEO HealthCAWS and Chairman of the Board, Population Health Alliance.

– – –

About the PHA Forum20 and Annual Membership Meeting & Luncheon:

The Population Health Alliance is proud to host the PHA Forum20 in Philadelphia, PA on March 30th. Co-located with the Population Health Colloquium and co-hosted by Jefferson College of Population Health. At this year’s Forum, look forward to learning from industry experts and executive leaders among our membership as they describe how leading innovations in the population health industry can help your organization thrive in value-based care. All registered meeting attendees are invited to join PHA members immediately afterwards for the Annual Member Meeting and Luncheon, featuring a book signing by Secretary David Shulkin.

ShulkinBook

PHA represents stakeholders from across the health care ecosystem that seek to improve health outcomes, optimize medical and administrative spend, and drive affordability.

Population Health Alliance
Brent Ling
202.737.5476
bling@populationhealthalliance.org
www.populationhealthalliance.org

2019 Innovation Summit Video Recording Now Available

Miss the Innovation Summit?

We know you would have liked to be there, and have arranged arranged to have a video recording access be made available for purchase to our community. Both single session ($59) and the entire day’s program ($195) are available, and as always, PHA members are eligible for a discount

CLICK HERE TO VIEW THE INNOVATION SUMMIT PRESENTATIONS

Ceresti Health Joins Population Health Alliance

Leader in technology-enabled family caregiver empowerment adds a new perspective to the Digital Health companies in PHA’s membership

Washington, DC, November 01, 2019 — Population Health Alliance (PHA), the health care industry’s only multi-stakeholder professional and trade association solely focused on population health, today announced that Ceresti Health (Ceresti.com) has joined the organization as a member.

A digital health company that specializes in family caregiver empowerment, Ceresti offers validated solutions that improve outcomes for persons living with dementia or cognitive impairment. Payers and providers delivering value-based care to challenging and vulnerable patient populations utilize their customized tools to supplement and optimize payer/provider care management teams.

We are pleased to welcome Ceresti Health to the PHA family. While there remains no cure for Alzheimer’s disease, Ceresti brings comfort to individuals and families that suffer and are an important component to an overall population health management strategy for clients,” said Rose Maljanian, Chairman and CEO of HealthCAWS and Chairman of the Board for the Population Health Alliance.

Ceresti has developed and a validated comprehensive population health solution for dementia, a condition that drives 25% of all Medicare facility Utilizations,” said Dirk Soenksen, CEO of Ceresti Health. “We are pleased to join the Population Health Alliance because of its leadership position in the industry. We look forward to working together with industry leaders to establish dementia as a condition that is routinely managed in a model that includes supported family caregivers, to improve cost and quality outcomes.

PHA represents stakeholders from across the health care ecosystem that seek to improve health outcomes, optimize medical and administrative spend, and drive affordability.

Population Health Alliance
Brent Ling
202.737.5476
bling@populationhealthalliance.org
www.populationhealthalliance.org

HealthEC CIO Sita Kapoor Elected to Population Health Alliance Board of Directors

(original post can be found at HealthEC.com)

Kapoor cited for her healthcare industry leadership and informatics expertise

EDISON, N.J.—September 6, 2019 — HealthEC, LLC, a 2019 Best in KLAS provider of population health management solutions, today announced that Chief Information Officer Sita Kapoor has been elected to the Population Health Alliance (PHA) Board of Directors.

PHA, the healthcare industry’s only multi-stakeholder professional and trade association solely focused on population health management, represents organizations across the healthcare ecosystem that seek to improve health outcomes, optimize the consumer and provider experience, and drive affordability.

“On behalf of PHA, I am pleased to welcome Sita to the Board,” said Rose Maljanian, Chairman of Population Health Alliance and Chairman and Chief Executive Officer of HealthCAWS. “Her leadership experience and deep technical expertise align perfectly with PHA as the healthcare industry continues to advance strategic analytics and digital tools that optimize performance, patient outcomes and cost savings across the healthcare landscape.”

Kapoor oversees a team of engineers and analysts at HealthEC who design, build and deploy data analytics and care management technologies to improve the health of diverse patient populations. She and her team apply mathematical and computing models in the custom development of large-scale data integration and analytics solutions that empower physicians and health-care organizations to identify and engage at-risk patients requiring closer medical attention.

“PHA plays an important role in the population health management community and I am honored serve with such a distinguished group of healthcare professionals,” said Kapoor. “I look forward to sharing my healthcare insights, learning from my fellow Board members, and supporting the industry’s transition to population health and value-based care.”

Kapoor holds a bachelor’s degree in computer science from Rutgers University and earned a master’s degree in computer science from Stevens Institute of Technology. In addition to her work at HealthEC, she co-founded HealthCare InfoXchange India Pvt. Ltd. (HCX), a health-care company that aims to simplify processes related to healthcare in India, and established a non-profit entity supporting humanitarian projects in India.

About HealthEC

HealthEC, LLC is a 2019 Best in KLAS population health technology company on a mission to help its customers succeed with value-based care. HealthEC®, a single-platform solution, enables personalized healthcare by leveraging the power of connectivity and interoperability: connecting claims and clinical systems, enabling data-driven collaboration between payers and providers, and streamlining care coordination across the healthcare landscape. Organizations are empowered with comprehensive analytics and integrated, role-based tools that translate insights into strategies, address care gaps, and improve quality metrics. To learn more, visit us at Twitter, LinkedIn and Facebook.

About Population Health Alliance

Population Health Alliance (PHA) is a corporate 501(c)6 nonprofit organization established in 1998. PHA is the industry’s only multi-stakeholder professional and trade association solely focused on population health management, representing stakeholders (e.g. health systems, health plans, employer solutions, academia, biopharma and technology companies) from across the health care ecosystem that seek to improve health outcomes, optimize the consumer and provider experience and drive affordability.

HealthEC Contact:
Laura Porto
732.652.1519
laura.porto@healthec.com

American College of Lifestyle Medicine (ACLM) is excited to officially join the Population Health Alliance, as we share similar missions and vision for a transformed and sustainable health care system.

A blog submission by PHA Board Member and American College of Lifestyle Medicine President Dexter Shurney, MD, MBA, MPH, FACLM, DipABLM

The American College of Lifestyle Medicine defines Lifestyle Medicine (LM) as the combined use of a whole food, plant-predominant diet, regular physical activity, restorative sleep, stress management, avoidance of risky substances and positive social connection in a prescribed synergistic manner as a primary therapeutic modality for the treatment and reversal of chronic disease. While these positive lifestyle habits are an established component of wellness and disease prevention and a core component of Population Health, it’s the most rigorous application of these concepts and their use as “the first-line medicine” that highlights LM’s65 contribution within the larger Population Health family. In other words, LM compliments and helps to enhance the core tenets of the Population Health in powerful ways. We find that the health synergies created by prescribing a therapeutic dose, individualized to the patient, in each of the lifestyle domains simultaneously is the key to breakthrough outcomes. The change to a patient’s health is often so rapid and profound that it can necessitate a simultaneous and rapid reduction in the patient’s prescription medications.

For instance, type-2 diabetics receiving an intensive LM prescription will often need to reduce their insulin dose by one-half within the first week of treatment to avoid a potentially harmful medication overdose (hypoglycemic) situation. Because of this often-rapid change for the need of medications, partnership with an appropriately trained LM practitioner is important, working hand-in-hand with other population health teammates, to provide the proper patient support and education is ideal.

LM is a powerful intervention, for the simple fact that lifestyle is at the center of so many common chronic conditions like heart disease, type-2 diabetes, pre-diabetes, obesity, dementia, and cancer. Therefore, a single but comprehensive LM intervention can be used to treat multiple disease states. For example, the type-2 diabetic that is experiencing a reduction in the need for insulin will also see an average reduction of 20% in their cholesterol numbers within 7-8 weeks, assuming their cholesterol was elevated to start with. When explaining LM I sometime use the analogy of vegetable gardening. When a plant has the proper soil, sun exposure, and water (not too much/not too little), the entire plant is healthy. The same is true for the human organism. Given the proper sleep, physical activity, nutrition, stress, etc. we see improvements in all the most common chronic conditions (diabetes, obesity, hypertension, heart disease, etc.), i.e. the “entire” human organism becomes healthy. It makes sense that for the 80+ percent of preventable chronic conditions that are rooted in poor lifestyle, that a lifestyle directed treatment option would prove to be tremendously effective.

Population health is a team sport. The complimentary role of Lifestyle Medicine as part of the Population Health Management framework is of vital importance and cannot be overemphasized.

************************************************

About ACLM: Founded in 2004, the American College of Lifestyle Medicine (ACLM) is the medical professional society for physicians and other professionals dedicated to clinical and worksite practice of Lifestyle Medicine as the foundation of a transformed and sustainable health care system. ACLM educates, equips, empowers and supports its members as they provide evidence-based Lifestyle Medicine as the first treatment option in clinical practice and worksite settings through live and online CME-accredited events and educational offerings, certification, clinical practice tools, patient education resources, economic research, networking opportunities and advocacy efforts.

ACLM Logo

The Population Health Alliance Announces Senator Braun of Indiana as a Keynote Speaker at Their Annual Innovation Summit and Capitol Caucus

The Senator will highlight the unique role of the employer in driving innovation in Population Health.

Washington, DC, September 12, 2019 –(PR.com)– Population Health Alliance (PHA), the health care industry’s only multi-stakeholder professional and trade association solely focused on population health, today announced that Senator Braun of Indiana has agreed to deliver remarks at their annual Innovation Summit and Capitol Caucus on October 29 in Washington, DC.

Before being elected to the Senate, Braun built a truck parts and accessories business in his hometown and grew it from three employees to nearly 1000 employees nationwide. His company built a unique health care plan that engaged employees in their own healthcare, encouraged shopping around to find the lowest prices, prioritized wellness, and covered pre-existing conditions with no caps on coverage. Braun held health insurance premiums on this plan flat for his employees at 70 dollars a month for ten years running.

Since being elected to the U.S. Senate. Braun has been vocal about the critical need for transparency in the healthcare marketplace so that working families have the information needed to make their best health care decisions. He has introduced several pieces of novel legislation on healthcare issues, some of which he has already shepherded through the Committee on Health, Education, Labor & Pensions (HELP) in his first year.

“We are honored to have Senator Braun join us as a keynote speaker at our important industry event. Senator Braun’s experience in the private sector to improve health and manage costs and his passion for fueling policy with innovation is sure to arm our attendees with insightful takeaways to advance their own organizations,” said Rose Maljanian Chairman and CEO HealthCAWS and Chairman of the Board, Population Health Alliance.

About the PHA Innovation Summit and Capitol Caucus:

Join the Population Health Alliance’s 2019 Innovation Summit and Capitol Caucus to engage in in-depth conversations about today’s biggest population health opportunities and solutions. The Summit will bring together both stakeholders and policymakers from across the health care industry committed to advancing results in care management, wellness, and prevention for collaborative learning, lesson sharing, and policy & regulatory briefing. This year’s focus on combating the impacts of financial security as the common denominator across social determinants and populations will highlight innovative solutions being advanced in the field and will present attendees with actionable items for their work as they move toward 2020.

PHA represents stakeholders from across the health care ecosystem that seek to improve health outcomes, optimize medical and administrative spend, and drive affordability.

Population Health Alliance
Brent Ling
202.737.5476
bling@populationhealthalliance.org
www.populationhealthalliance.org

BMA ALLY BLOG: Deploying Value Based Care Contracts Under the Umbrella of Population Health Management: A Must for Success

The following article was published by the Better Medicare Alliance and was authored by Rose Maljanian, Chairman & CEO HealthCAWS Chairman of the Board at the Population Health Alliance. PHA is an active member of BMA’s Ally Network, and the original posting can be found here.

Join us in Washington, DC on October 29th for PHA’s Innovation Summit and Capitol Caucus to hear directly from both Rose and BMA’s President and CEO Congresswoman Allyson Y. Schwartz as they take a deeper dive into the innovations in population health management for senior populations. Register today and use promotional code BMA20 for a special 20% discount off registration.

– – –

August 14, 2019
Rose Maljanian, Chairman & CEO HealthCAWS
Population Health Alliance

The evolution of our nation’s healthcare system and ecosystem from fee for service to value based care has only just begun, and while the goal is to rapidly accelerate the membership under value based care payments, it will be a long journey to refine the model. Legislation, market driven mergers and disruptive innovation from industry veterans inside and outside of healthcare focused on the consumer are contributing to what at times feels like a roller coaster ride. At the center of all of this is the growing population of seniors who largely receive their health benefits from the government, either directly or indirectly, through managed Medicare, Medicaid or Dual-eligible programs. Seniors as customers want and demand choice, convenience and value as consumers do in other markets and industries. The focus on these three elements is fundamental to any business strategy. However, necessary but distracting details, including type of legal entity, payment rates, payment flow, shared savings methodology and disbursements can completely envelop the airtime in leadership meetings. Alternatively, framing value-based care under the umbrella of population health management supports a focus on seniors’ needs and wants and the strategies that result in affordably achieving optimal health for these populations.

Understanding payment models as financial lever of alignment

Value-based care payment models have been aggressively advanced by CMS and commercial payers over the last several years. CMS’s stated purpose is to transform the health care system through innovation by paying providers for quality versus quantity of services delivered. Whether the program is a CMS program such as Advanced Payment Models (APMs), Merit-based-Incentive Payment System (MIPS) or a value-based contract as part of a commercial payer network, the payment method is simply put, the financial lever to align the care provided with outcomes-quality, experience and cost of care savings.

Virtually all value-based care models promoted or reporting positive results deployed the key elements of the population health management model to achieve success. Under current CMS value-based payment models1 and those proposed for 2020 and beyond2, quality improvement strategies and population health metrics such a readmission rates are prescribed with advancing flexibility to reduce burden and achieve desired value.

In terms of results, Humana reported significant improvements in numerous quality metrics and 23.4% fewer inpatient hospitalizations and 15.6% fewer emergency room visits under value-based care arrangements in Medicare Advantage members. In their report3, they attribute the improvements to population health management infrastructure and strategies such as proactive outreach and whole person management. Aetna similarly cited tools, infrastructure and approaches common to population health management as important to the success of their accountable care organizations. With Banner Health for example their Aetna Whole HealthSM program achieved 24 percent decrease in avoidable surgery admissions, a 4 percent increase in generic prescribing, and a 11.5 percent overall reduction in medical costs.4

In order for the end result to be a value-based contract that produces a positive net income versus one that adversely effects the organization financially, a solid population health management strategy must be deployed, tightly managed and iterated as populations and market conditions evolve. Furthermore, without a positive consumer experience and health outcomes, retention of patients/members in a practice or plan is likely to suffer, further eroding the chance of success.

Staying true to the principles of population health management (PHM)

There are three enduring components of the population health management model:1) defining and understanding the population for which the organization holds accountability; 2) a portfolio of evidence based solutions that can be tailored to individual need at any given point in time and 3) measureable outcome results. The Population Health Alliance outlined a value focused framework for Population Health Management more than ten years ago that included these elements with consumers at the center.5

Defining the population up front (assigned vs attributed) allows organizations to understand their populations, stratify risk and preference for engaging so that when crafting and triaging individuals to programs and tools, the programs and tools are those that consumers want and need.

Programs and tools must be available to address the full continuum of care whether to maintain health, address an acute event, support chronic care management or support comfort at end of life. Furthermore, solutions must include a multifaceted approach depending on where an individual is on the care continuum, their life goals and their preferred means of engaging. Studies by the PEW Research Center have demonstrated consistent increasing uptake in technology for seniors6,7 including 53% owning a smart phone and 59% having broadband access.7 Addressing barriers such as trust, cost and tech support will likely fuel further adoption among all income and educational levels. In recognition of this trend, many organizations are deploying blended high touch and high tech strategies in their senior health programs.

Finally, a focus on the endgame of outcomes across populations will ensure success with multiple value based contracts. The population health management model has always had a focus on outcomes that include clinical, utilization, satisfaction and experience of care and cost metrics. When staff deploy consistently high quality evidence based care that achieves consumer goals, the likelihood of missing mutually agreed-to standard metrics in a value based arrangement as a result of inconsistent care, lack of consumer engagement or gaps from confusion when doing different things for different populations is bound to decrease.

Executing well on solutions that solve needs and preferences

The need to execute well in a world of high visibility of alternatives for care, experience ratings and mounting pressure on cost transparency cannot be overemphasized. Executing well no longer means getting ID cards and EOBs out on time and finding an opening for the consumer in the same week to be seen by a PCP or specialist. It will command listening to what consumers desire to achieve, such as return to playing tennis, being able enough for air travel, controlling their diabetes versus diabetes consuming their life with too many appointments and tests, reducing days not feeling well enough to enjoy getting out and living life or just living long enough to see a marriage or birth. Furthermore, living life involves conserving seniors’ financial resources as well through optimized care, lower total cost of medications and value-added supplemental benefits such as concierge services and care management, home modifications, light housekeeping, transportation and nutrition support. Scan Health Plan recently announced expanded benefits for seniors to age in place at home. This followed a market survey confirming the trend in which 88% of their addressable market in Southern California expressed a desire to stay in their homes.8

As leaders, promoting common understanding of what it means to deliver value and how to get there

As leaders we need to guide the discussion on value amongst our colleagues, all payers and the public at large. Value based care is not about the contract itself. The contract is a financial lever under the umbrella of population health management. it is about delivering value (quality and affordability) to each healthcare consumer, the payer customer, and keeping those that bear risk whole and flourishing as they serve at the front line of healthcare transformation.

References

  1. CMS Value based care programs https://www.cms.gov/medicare/quality-initiatives-patient-assessment-instruments/value-based-programs/value-based-programs.html updated 5.17.2019.
  2. CMS QPP Resource Center https://qpp.cms.gov/about/resource-library updated 7.29.19.
  3. The Intersection of Heath + Care: Value Based Care Report 2018. http://valuebasedcare.humana.com/wp-content/uploads/2019/04/2018-VBC-Report.pdf
  4. Accountable care organizations: Transforming care delivery to support members, increase cost savings https://news.aetna.com/2018/02/accountable-care-organizations-transforming-care-delivery-support-members-increase-cost-savings/ February 12 2018
  5. Population Health Alliance Population Health Management model https://populationhealthalliance.org/research/understanding-population-health/
  6. Anderson M and Perrin A. Tech use climbs among seniors. Pew Research Center May 17, 2017 https://www.pewinternet.org/2017/05/17/technology-use-among-seniors/
  7. Anderson M. Mobile Technology and Home Broadband 2019 Pew Research Center June 13, 2019 https://www.pewinternet.org/2019/06/13/mobile-technology-and-home-broadband-2019/
  8. SCAN Health Plan Addresses Seniors’ Desire to Remain at Home With Expanded Benefits, Reduced Costs Nov 14, 2018, https://www.prnewswire.com/news-releases/scan-health-plan-addresses-seniors-desire-to-remain-at-home-with-expanded-benefits-reduced-costs-300750108.html

HealthEC Joins Population Health Alliance

Washington, DC, August 01, 2019 — Population Health Alliance (PHA), the health care industry’s only multi-stakeholder professional and trade association solely focused on population health, today announced that HealthEC (HealthEC.com) has joined the organization as a member.

A 2019 Best in KLAS provider of population health management technologies, HealthEC helps customers succeed with value-based care by offering a flexible, single-platform solution that aggregates clinical, claims and quality data, and provides actionable insights that can improve health care outcomes. KLAS recognition is important to population health technology providers because it is a third-party validation of service quality and acknowledges provider efforts to help health care professionals deliver better patient care.

“We are pleased to welcome HealthEC as a member of the Population Health Alliance. We were impressed with their KLAS ranking as well as the tremendous leadership that President and CEO Arthur Kapoor provides to the industry at this important juncture for digital transformation,” said Rose Maljanian Chairman and CEO of HealthCAWS and Chairman of the Board for the Population Health Alliance. “We look forward to Arthur and his executive team participating in important PHA initiatives including policy and advocacy, quality and research, and uniting the population health community through membership, learning and networking events,” added Maljanian.

“Advancing population health and value-based care is a top priority for HealthEC and we are pleased to align with an organization dedicated to these objectives,” said Kapoor. “The Population Health Alliance plays an important role in our evolving industry and we invite our fellow population health solution providers to join us at PHA.”

PHA represents stakeholders from across the health care ecosystem that seek to improve health outcomes, optimize medical and administrative spend, and drive affordability.

Population Health Alliance
Brent Ling
202.737.5476
staff@populationhealthalliance.org
http://www.populationhealthalliance.org

PHA Announces 2019 Innovation Summit and Capitol Caucus in Washington, DC

Improving Health Through Financial Security: The Common Denominator Across Social Determinants and Populations

2019CaucusLogo
Washington, DC — The Population Health Alliance (PHA) announced today that their annual Innovation Summit and Capitol Caucus will be held on October 29, 2019 in Washington, D.C. This year’s theme, “Improving Health Through Financial Security: The Common Denominator Across Social Determinants and Populations” will give the much needed focus to the latest risk-analyses, innovative intervention efforts, and targeted health and cost outcomes achieved, presented by our group of national experts; including:

Congresswoman Allyson Y. Schwartz, MSW – President and CEO, Better Medicare Alliance
Peter Skillern – Executive Director, Reinvestment Partners
Patricia Hasson – President and Executive Director, CLARIFI
David Hoke – Sr. Director, Associate Health and Well-being, Walmart
Ralph Gildehaus, JD – Senior Program Director, MDC Inc.
Laura Samuel, PhD CRNP – Assistant Professor, Johns Hopkins School of Nursing
Mike Criteli, JD – Retired CEO from Pitney Bowes, Entrepreneur, Health Care Consultant, Feature Film Producer, Speaker

The Population Health Alliance Innovation Summit & Capitol Caucus 2019 will gather key stakeholders from across the health care industry and D.C. area policymakers committed to driving innovation in care management, wellness, and prevention for focused briefings on high-impact legislative and regulatory issues. PHA members will focus the critical discussion on social determinants of health on the heels of the release of the Quality and Research Committee’s eBook, “Social Determinants of Health and Health Disparities,” and will have substantial opportunity to network with the event speakers, PHA Board of Directors, and a diverse group of industry leaders and policy decision makers.

“The theme of our Innovation Summit this year could not be more timely as the industry has been awoken by the evidence linking financial security and other nonclinical factors to health and cost outcomes. The issue is cross cutting amongst employees, seniors and others participating in government sponsored programs. PHA members and constituents are leading action with innovative solutions to solve this important problem.” Rose Maljanian Population Health Alliance, Chairman of the Board.

Join us at the Population Health Alliance 2019 Innovation Summit and Capitol Caucus to engage in in-depth conversations about pressing population health challenges and solutions. To register for the Innovation Summit and Capitol Caucus 2019, visit https://www.eventbrite.com/e/pha-innovation-summit-and-capitol-caucus-2019-tickets-62271226916.

Not a PHA member? Join PHA Today!

About Population Health Alliance:
Population Health Alliance (PHA), a corporate 501(c)6 nonprofit organization, is the industry’s only multi-stakeholder professional and trade association solely focused on population health management, representing stakeholders from across the health care ecosystem that seek to improve health outcomes, optimize the consumer and provider experience and drive affordability.

Jay Desai | Founder & CEO | PatientPing

Mr. Desai started PatientPing in 2013 with one goal in mind: To connect providers everywhere to seamlessly coordinate patient care. Prior to founding PatientPing, Jay worked at the CMS Innovation Center (CMMI) where he helped develop ACOs, bundled payments, and other payment initiatives. Jay’s passion lies at the intersection of technology, policy, and community building. He has an MBA in healthcare management from Wharton and a BA from the University of Michigan. Jay feels lucky to love his work, but also loves running, all things music, and spending time with his family and friends.

Gaurav Lal | Executive Director | Innovative Solutions at Merck

Mr. Lal received a BS degree in biological sciences from Oklahoma State University and a MBA degree from Kellogg Graduate School of Management at Northwestern University. After beginning his career in the pharmaceutical industry with E.R. Squibb & Sons, he joined Merck in 1988 as a Professional Sales Representative in Texas. In his career, Gaurav has held positions of increasing responsibility in a broad range of business functions. His experience includes sales, sales training, field communications, sales management, managed markets, strategy & commercial model innovation In 2016, he moved into his current Executive Director, Innovative Solutions role responsible for expanding Merck’s capability to develop and incubate innovative programs and tools that address unmet needs of top customers, including integrated delivery systems, payers, retail chains and other influencers of health care decision-making that support Merck’s core franchises.

Anne Marie Polak | Senior Director | Leavitt Partners

Ms. Polak is a senior director based in Washington, D.C. In her role, she provides policy counsel and analysis to clients with matters involving regu-lations, legislation, and business implications. Anne Marie’s experience includes developing strategic messages and policy positions for Capitol Hill, administration, trade associations, and corporate audiences. Prior to joining Leavitt Partners, Anne Marie was a vice president for Faegre BD Consulting in the firm’s health and biosciences group. She also spent five years with the Podesta Group in Washington, D.C., while completing her law degree in the evenings at the George Mason University School of Law, graduating cum laude in 2010. Anne Marie also worked in the government and legal affairs office of Novo Nordisk in Washington, D.C., and as a congressional aide to Rep. Michael Ferguson of New Jersey.

Raymond J. Fabius, MD, CPE, FACPE
Co-Founder & President, HealthNEXT
Co-Chair, PHA Program and Membership Committee

Dr. Fabius has recently returned to his start up. HealthNEXT, a company dedicated to the development of organizational cultures of health — after serving as Chief Medical Officer of Truven Health Analytics (formerly the healthcare business of Thomson Reuters), the world’s leading source of intelligent information for business and professionals. In this capacity he is charged with developing and deepening relationships with customers, advising on product development, and providing counsel to the leadership on business strategy and medical issues. Formerly, Dr. Fabius served as strategic advisor to the President of Walgreens Health & Wellness Division. This organization will coordinate over 1,000 workplace health centers and 10,000 pharmacies, many with retail clinics, into a seamless primary care network across the country within the next five years. In the not too distant future, it will be possible to offer large employers medical and fitness services on-site as well as episodic illness care, health coaching and disease management monitoring at the employee’s nearest Walgreens pharmacy.

Dan Buettner | Founder | Blue Zones

Mr. Buettner is an explorer, National Geographic Fellow, award-winning journalist and producer, and a New York Timesbestselling author. He discovered the five places in the world—dubbed Blue Zones—where people live the longest, healthiest lives. His articles about these places in The New York Times Magazine and National Geographic are two of the most popular for both publications.

Buettner now works in partnership with municipal governments, large employers, and health insurance companies to implement Blue Zones Projects in communities, workplaces, and universities. Blue Zones Projects are well-being initiatives that apply lessons from the Blue Zones to entire communities by focusing on changes to the local environment, public policy, and social networks. The program has dramatically improved the health of more than 5 million Americans to date.

Mary Ann Cooney, RN, MSN, MPH | Chief | Association of State and Territorial Health Officials (ASTHO) Center for Population Health Strategies

Ms. Cooney provides strategic direction for the Centers three Pillars of Population Health – Clinical to Community Connections, Health Equity and the Social Determinants of Health, and Public Health Data Analytics and Informatics. Mary Ann previously worked for 14 years at the New Hampshire Department of Health and Human Services where she was Deputy Commissioner for the Department and Director of Public Health.

Mary Ann has served as adjunct faculty member for the Master of Public Health Program at the University of New Hampshire and recently re-ceived UNH’s 2016 Distinguished Alumni Award. She was School Health Director for the City of Manchester Public Health Department and President of the New Hampshire Public Health Association.

Tom Scully | General Partner | WelshCarson, Anderson & Stowe, Former CMS Administrator

Mr. Scully is a General Partner in the Healthcare Group, having joined WCAS in 2004. Before joining WCAS, he was the Administrator of the Centers for Medicare and Medicaid Services (CMS) for three years and the President and CEO of the Federation of American Hospitals for six years. He also served as the Deputy Assistant to the President and as the Associate Director of OMB under President GHW Bush from 1989 to 1993, and has practiced law at Alston and Bird; Patton Boggs; and Akin, Gump, Strauss Hauer and Feld. He is a Principal at the Lincoln Policy Group.

Don Wright, M.D., M.P.H. | Deputy Assistant Secretary for Health, Director | Office of Disease Prevention & Health Promotion

Dr. Don Wright has served as the Deputy Assistant Secretary for Health and Director of the Office of Disease Prevention and Health Promotion (ODPHP) since January 2012. In this capacity, he leads coordination and policy development for public health and prevention activities within the Office of the Assistant Secretary for Health, U.S. Department of Health and Human Services. He is also currently the acting Executive Director of the President’s Council on Fitness, Sports & Nutrition.

Jaan Sidorov, MD | President & CEO | The Care Centered Collaborative

Dr. Sidorov is a board-certified in general internal medicine physician with more than 25 years of experience in primary care, inpatient care, medical education and evidence-based practice. Jaan believes physician leadership throughout the continuum of care is the bedrock of value-based care delivery. He received his medical degree from Pennsylvania State University College of Medicine, and completed his internship and residency at the Dartmouth Hitchcock Medical Center in Hanover, New Hampshire. Jaan also served as a Chief Resident at Reading Hospital in Reading, Pennsylvania.

Andrey Ostrovsky, MD | President & CEO | Concerted Care Group; Former Chief Medical Officer, CMS

Dr. Ostrovsky is a practicing physician, social entrepreneur, and health policy expert who specializes in human-centered design, lean manage-ment, quality improvement, population health, and digital health. Dr. Ostrovsky was most recently the Chief Medical Officer for the Center for Medicaid and CHIP Services (CMCS), the nation’s largest insurer covering over 74 million people, annually.

Denee Choice, MD | Vice President and Medical Director Physical Medicine | American Specialty Health

Dr. Choice is vice president and medical director for physical medicine services at American Specialty Health (ASH). Dr. Choice oversees the Rehabilitation Services Clinical Quality Evaluation program and leads the content development, training and clinical quality processes for ASH’s musculoskeletal health and pain management products.

Previously, she served as a Medical Director of Pain Management in the VA System where she led the development and implementation of multi-specialty clinics and treatment teams, complementary and alternative medicine services, and co-authored opioid safety guidelines, with the focus of reducing reliance on opioids for chronic pain.

Mary Jane Osmick, MD
Vice President & Medical Director Medical Services Department,
American Specialty Health
Chair, PHA Quality and Research SDH Task Force

Dr. Osmick is Vice President and Medical Director for the medical services department at American Specialty Health (ASH), one of the nation’s leading providers of specialty health services. As a physician executive with extensive internal medicine clinical expertise, Dr. Osmick provides medical management, quality oversight, clinical review and product development support across ASH product lines, including specialty health care, population health, and fitness and exercise services.

Helene Forte | Vice President, Public Plans Emerging Markets | Tufts Health Plan

Ms. Forte is responsible for leading Tufts Health Public Plans expansion efforts. Prior to her current position, she was vice president of care management for all Public Plans members.

Prior to joining Tufts Health Plan in 2014, Helene held positions in clinical program support and engagement strategy, care advocacy and medical management for Aetna, a national health plan. She also has served as vice president of medical operations at APS Healthcare Inc., a health management organization servicing commercial, Medicaid and state employee members, while serving consecutively as manager of health programs and manager of case management for Tufts Health Plan. She began her career as a staff nurse — and has taught classes in nursing at Mount Wachusett Community College and Montachusett Vocational School.

Elise Bowman | Director of Strategic Initiatives | Health Leads

As Director of Strategic Initiatives, Ms. Bowman oversees new social needs intervention initiatives among our clinical partners — including program design, resource database build-outs, and integration of Health Leads’ signature technology, Reach. Elise brings 10 years of direct service experience to her role, having previously served as a Health Leads program manager, a case manager for adults struggling with mental illness and homelessness, and in developing parent engagement initiatives in public education settings.

Elise has a passion for helping client-facing staff find sustainable, workable solutions to integrate social needs efforts into their daily work — and loves the opportunity to bring her experience and expertise to bear on the systemic change that comes from spreading social needs programs.

J. David Johnson | Vice President & Senior Consultant | Sage Consulting

Mr. Johnson leads the Sage Consulting’s work for a number of public sector, corporate, non-profit and multi-employer clients. David brings particular expertise in evidence-based workplace wellness programs and leveraging Behavioral Economics principles in Human Resources Management. He is also an Adjunct Professor in the Department of Psychology at Towson University.

David has over 29 years of experience in Health Care and Human Resources. He is a frequent national and regional speaker on workplace wellness and behavior change strategies. David has published multiple articles on employee benefits issues and has been quoted in US News & World Report, the Washington Business Journal, the Baltimore Business Journal, and Employee Benefits News. He holds an MBA in Health Care Management from Johns Hopkins University and a BS in Public Health from the University of North Carolina at Chapel Hill.

Sandeep Wadhwa, MD, MBA | Senior Vice President | Solera Health

Dr. Wadhwa is a leader in building population health programs for vulnerable populations. He serves as the senior vice president of market innovation and is the chief health officer for Solera Health where he is focused on scaling the Diabetes Prevention Program as well as health-related, social support interventions. Previously, Sandeep held population health leadership positions with 3M and McKesson. He also served as the State Medicaid Director for Colorado under its former Governor. While there, he oversaw a $4 billion program and led the effort to implement an accountable care collaborative. Sandeep also serves on the board of Reinvestment Fund, a $1 billion non-profit, financial institute devoted to revitalizing low-income neighborhoods. Sandeep continues to see patients at the Seniors Clinic at the University of Colorado Hospital where he serves as associate clinical professor in the division of Geriatric Medicine.

Anil Jain, MD | VP & Chief Health Informatics Officer | IBM Watson Health

Focused on the intersection of information technology, informatics, clinical medicine and innovation, Dr. Jain is VP and Chief Health Informatics Officer at IBM Watson Health. He was Co-Founder, Senior VP and Chief Medical Officer of Explorys, Inc. formed in 2009 based on innovations that he developed while at the Cleveland Clinic. In April 2015, Explorys was acquired by IBM as an integral component of the newly formed Watson Health business unit. In 2017, he was appointed by Congress to the Federal Health IT Advisory Committee established by the 21st Century Cures Act.

Rose Maljanian
PHA Board Chair
Chairman and CEO, HealthCAWS, Inc.

Ms. Maljanian is an accomplished senior executive with more than 25 years of experience in the health care industry. Rose’s leadership experience
spans corporate managed care, specialty population health management, delivery systems and public health settings and include product strategy,
design and development, M&A; operations and fiscal management; and quality improvement/outcomes research.

Rose, founder of HealthCAWS, Inc. serves as Chairman and CEO of HealthCAWS, Inc., a privately held corporation focused on improving health and making health care more affordable by aligning accountability models and supports for success. As President, Strategic Health Equations, LLC, her initiatives included sourcing and diligence for venture and private equity firms; and for existing companies, product portfolio development and strategic planning. Prior, Rose served as SVP Product Innovation at Magellan and VP Clinical Interventions at Humana and as chief executive for the Institute for Outcomes Research and Evaluation at Hartford Hospital. She holds a Bachelor of Science in nursing, was critical care certified and holds an MBA from Rensselaer Polytechnic Institute.

Colorectal Cancer Screening: How Technology Can Increase Screening Rates

SPEAKER:
Josh Sclar, MD, MPH
Chief Medical Officer, BioIQ

It’s 2018, which means the moment of truth has arrived for the National Colorectal Cancer Roundtable’s “80% by 2018” initiative for colorectal cancer screening. Needless to say, we’re not measuring up. And with the American Cancer Society lowering their recommendation of age that screening should start — from 50 to 45 — even more unscreened people may need this critical test. We discuss how technology, convenience and personalization can transform colorectal cancer screening rates and save more lives.

———————————————

Joshua Sclar, MD, MPH, is BioIQ’s Chief Medical Officer. Sclar is board certified in preventive medicine and public health and has over 15 years experience in healthcare. His career has spanned clinical practice, health services research and public health instruction in addition to building innovative, prevention-oriented healthcare delivery models for academia and business.

Prior to joining BioIQ, Sclar was the Chief Medical Officer at Ingenios Health Co., which developed one of the first purpose-built mobile technology platforms for health risk assessment. Sclar was a member of the steering committee that created the Johns Hopkins Sibley Innovation Hub and served as its first Lead Designer and Innovator in Residence. He has published research on a variety of topics in healthcare delivery while working at the FDA, Columbia University Medical Center, and the Johns Hopkins Center for Public Health and Human Rights. He has also been a full-time practicing physician at St. Luke’s Hospital in St. Louis, MO.

Sclar received his medical degree from the State University of New York and completed residency training at Johns Hopkins. He earned a master’s degree in public health as a BJC Healthcare Scholar at Washington University in St. Louis, and holds a bachelor’s degree from the University of Miami.

View This Webinar

Successful Physician Engagement in the Value-Based World Webinar

SPEAKER:
Gary Stelluti
Principal & Chief Strategist, HC Marketing

In this webinar, Gary Stelluti will outline what is becoming the Holy Grail of population health: physician engagement. Drawing on his experience in working with a number of high performing physician-led organizations, Mr. Stelluti will describe the successful elements of physician engagement. Using real world examples, this webinar will offer lessons learned that could be applied to other settings that are looking to engage physicians, drive value and achieve organizational success.

———————————————

Gary Stelluti has 20 years of experience in physician-specific marketing and communications, earning a reputation as a physician-engagement expert. Gary oversees client relations and the creation / implementation of market-specific physician engagement strategies. His experience includes working for large physician networks and IPA’s, single specialty practices and physician-owned companies throughout the United States.

View This Webinar

Making Money on Population Health: The Transformational Imperative for Improving Health and Quality

Wednesday, November 7th, 2018
3 p.m. – 4 p.m. Eastern

SPEAKER:
Gary L. Morel, MHA, FACHE
CEO, FiveFifty Health

Gary Morel, MHA, FACHE, is the CEO of FiveFifty Health.  Five percent of the population accounts for Fifty percent of all health care expenditures.  FiveFifty has helped companies realize organizational managed care dreams for over 20 years.  Morel pioneered the concept of provider-sponsored community health plans and was instrumental in the establishment, management, or rehabilitation of seven different fully insured health plans.  Morel has served national health leadership and board roles in the fields of wellness, quality, policy, and business advocacy.  Prior to forming FiveFifty, Morel was the visionary CEO of two teaching hospitals and a regional healthcare alliance.  Morel has been an innovative transformational force in healthcare delivery and is now an advocate of aligning payer-provider incentives to practice value-based care and population health management.

View this webinar

Activating Physician Leadership in Population Health

SPEAKERS:
William Faber, MD, MHCH
Managing Principal
Lumina Health Partners

Lucy Zielinski
Managing Partner
Lumina Health Partners

MODERATOR:
Jaan Sidorov, MD
CEO & President
The Care Centered Collaborative

Population Health demands strong physician leaders. Many physicians are taking on executive and leadership roles as the industry shifts to value-based care. For example, physicians are leading by creating strategies and executing plans to transform care delivery, managing clinically integrated networks and ACOs, and facilitating various work groups. These new roles require a new skill set.

In this seminar, we will discuss practical techniques to activate physician leadership. A roadmap to leadership effectiveness will be shared, as well as the top 5 leadership competencies physicians must master.

View This Webinar

Social Determinants of Health and Health Disparities

SPEAKER:
Mary Jane Osmick, MD

Vice President and Medical Director
American Specialty Health

Join PHA’s next webinar detailing the recent release of the White Paper, examining the definition, impact, and potential interventions to reduce the effect of negative social determinants of health (SDH) on health status in the U.S. PHA’s Quality and Research Committee spearheaded this initiative to identify best practices and highlight areas where additional research is required to support organizations intervening in SDH.

The Population Health Alliance and its member organizations use best practices and recommendations in the White Paper to enhance and improve effective population health programs for employers, health plans, and other stakeholders. The White Paper is available as a benefit to members of the Population Health Alliance. Non-members may access an Executive Summary.

View This Webinar

Driving Quality through Population Health Management Strategies: An Overview of the PHA Framework & NCQA Accreditation Standards

SPEAKER:
Rose Maljanian

Chairman & CEO
HealthCAWS, Inc.

Board Chair
Population Health Alliance

Rose Maljanian, Chairman & CEO, HealthCAWS, Inc., and PHA Board Chair will lead with a discussion on driving quality through application of PHA’s Population Health Management Framework across the care continuum and across market segments. Patricia Barrett, Vice President, Product Design and Support, NCQA will do a deep dive into the newly released NCQA Population Health Management accreditation standards and their implications for improving the value of PHM across the healthcare ecosystem.

View This Webinar

A Care Management Guide: Moving Volume to Value


SPEAKER:
Diane Littlewood RN MSN CCM 

VP, Care Management and Practice Integration
The Care Centered Collaborative
at The Pennsylvania Medical Society

View This Webinar

Social Determinants of Health: Implications for Provider Value-Based Care Arrangements Webinar

SPEAKER:
Jaan Sidorov, MD

CEO and President
The Care Centered Collaborative
at The Pennsylvania Medical Society

Join PHA’s next webinar detailing the recent release of the White Paper, “Taking Action: Social Determinants of Health and Health Disparities,” examining the implications for provider value-based care arrangements.

The Population Health Alliance and its member organizations use best practices and recommendations in the White Paper to enhance and improve effective population health programs for employers, health plans, and other providers. The White Paper is available as a benefit to members of the Population Health Alliance.

View The Webinar

Healthcare’s Shifting Risk: The Implications for Physicians

SPEAKER:
Daniel Brooks

Senior Vice President
HealthEC

In this webinar, Daniel Brooks, Senior Vice President, HealthEC will review the rise of value-based purchasing and how the market has responded with consolidation and the entry of new players.  He will focus on the transition from “IDN” (integrated delivery systems) to “RBE” (risk-bearing entities) and how that has prompted the arrival of alternative arrangements for providers, such as clinically integrated networks (CINs).  Dan will provide insights on how providers can pursue success in this new market, how they will need to consider the pros and cons of “sponsorship alternatives” and carefully consider payer outreach strategies.

———–

Mr. Brooks currently serves as Senior Vice President at HealthEC, an international physician enablement and Population Health Platform provider. Dan has a long career serving the provider community, including as Vice President, Business Development at a multi-hospital health system, 20+ years healthcare management consulting, as Chief Strategy Officer at a Practice Management supplier, and as Executive Director of Medicare and Commercial ACOs.

View This Webinar

 

Employer Interest in Population Health Improvement: Opportunities (and Challenges) for Providers


SPEAKER:

Neil Goldfarb
President and CEO
Greater Philadelphia Business Coalition on Health

Mr. Neil Goldfarb is President and CEO of the Greater Philadelphia Business Coalition on Health, an employer-led non-profit organization established in 2012 with the mission of developing best practices for maintaining a healthy workforce, and ensuring that when healthcare is needed it is safe, high-quality, accessible and affordable. Mr. Goldfarb brings over 30 years of healthcare research and management experience to his Coalition leadership position.

As Associate Dean for Research in the Jefferson School of Population Health, he was responsible for developing and carrying out the School’s research agenda, focused on healthcare quality and value, and economic evaluation of healthcare technologies. Concurrently, Mr. Goldfarb served as Director of Ambulatory Care Performance Improvement for the Jefferson faculty practice plan. His previous positions include Executive Director of a quality improvement consulting and data collection firm, and Vice President of Health Services for the Philadelphia region’s first Medicaid managed care plan.

Mr. Goldfarb has authored over 60 articles in the peer-reviewed literature, focused on his interests in health and disease management, quality measurement and improvement, care for the underserved, and health economics and outcomes research. He has served as adjunct faculty for the Jefferson College of Pharmacy and University of the Sciences. Mr. Goldfarb is Chair of the Board of Governors of the National Alliance of Healthcare Purchaser Coalitions (National Alliance), and founding co-Director of the National Alliance College for Value-based Purchasing of Health Benefits.

View This Webinar

Orthopedic Medicine and Excellence in Episodes of Care: The Rothman Institute’s Journey

SPEAKER:
Chris Vannello
Director of Quality
Rothman Institute

Chris Vannello is the Director of Quality at Rothman Institute in Philadelphia Pennsylvania. The Rothman Institute is one of the largest orthopedic practices in the country. Chris oversees all quality improvement initiatives internally, locally and nationally for the practice. She is responsible for the episode of care management as it relates to alternative payment models, monitoring of outcomes, the patient navigation process, MIPS and establishing and sustaining orthopedic centers of excellence with hospital partners. Chris sits on the Quality committee for the National Orthopedic Spine Alliance and is the co-leader for a national outcomes benchmarking group.

Before working at Rothman Institute Chris was a Director of Quality at Main Line Health Systems, Riddle Hospital in Media, Philadelphia. She was responsible for the overall hospital quality improvement initiatives including the stroke, chest pain and hip and knee replacement programs and certifications. She began her career as a nurse at Bryn Mawr Hospital in Bryn Mawr, Pennsylvania.

View This Webinar

Activating Physician Leadership in Population Health


SPEAKERS:

William Faber, MD, MHCH
Managing Principal
Lumina Health Partners

Lucy Zielinski
Managing Partner
Lumina Health Partners

Moderator:
Jaan Sidorov, MD
CEO & President
The Care Centered Collaborative

Population Health demands strong physician leaders. Many physicians are taking on executive and leadership roles as the industry shifts to value-based care. For example, physicians are leading by creating strategies and executing plans to transform care delivery, managing clinically integrated networks and ACOs, and facilitating various work groups. These new roles require a new skillset.

In this seminar, we will discuss practical techniques to activate physician leadership. A roadmap to leadership effectiveness will be shared, as well as the top 5 leadership competencies physicians must master.

View This Webinar

Population Health Management (PHM) for the Practicing Provider

SPEAKER:
Rose Maljanian
Chairman & CEO
HealthCAWS, Inc.

Board Chair
Population Health Alliance

Rose Maljanian, Chairman & CEO, HealthCAWS, Inc., and PHA Board Chair will lead a discussion on driving quality through application of PHA’s Population Health Management Framework across the care continuum and across market segments. Patricia Barrett, Vice President, Product Design and Support, NCQA will do a deep dive into the newly released NCQA Population Health Management accreditation standards and their implications for improving the value of PHM across the healthcare ecosystem.

View The Webinar

The Provider Engagement in Population Health: Organized Medicine as a Catalyst

SPEAKER:
Jaan Sidorov, MD

CEO and President
The Care Centered Collaborative
at The Pennsylvania Medical Society

Jaan Sidorov, MD, CEO of the Care Centered Collaborative, will provide an update on the role that state medical societies can play in organizing networks of physicians to adopt population health in the pursuit of value-based health insurance contracts.  As the Triple Aim expands to include the 4th Aim of improving the work life of health care clinicians, stakeholders in population health are interested in leveraging independent community-based based physician as an additional resource.  This webinar will describe several “lessons learned” in this emerging area of health care, and how local medical societies can potentially partner with other organizations in arrangements that further expand the population health market.

View This Webinar

Six Strategies for Successful Physician Alignment

SPEAKERS:
Esther Nash, MD
Deloitte Consulting Specialist Executive
Deloitte Consulting LLP

Dorrie Guest
Consulting Managing Director
Deloitte Consulting LLP

MODERATOR:
Jaan Sidorov, MD
CEO and President
The Care Centered Collaborative at
The Pennsylvania Medical Society
and Population Health Alliance Provider Engagement Chair

As the healthcare system continues to rapidly evolve, physicians and hospitals are seeking approaches that help them better deliver affordable quality while simultaneously achieving their revenue objectives.  In this webinar, speakers will present results from a recent study by the Deloitte Center for Health Solutions and discuss six readily achievable alignment strategies that they’ve uncovered in the course of interviews with health system executives across the United States.  This webinar will focus on those strategies and how they can be deployed to meet providers’ preferences, leverage physician leadership, achieve actionable data insights, deploy financial incentives, maximize transparency and support optimal workflows.

View The Webinar

Pediatric Population Health: Of Offspring and Outcomes

SPEAKER:
Gregory Dean, MD
View This Webinar

Presenter:

John Haughton MD, MSJohn Haughton MD, MS
Chief Clinical Improvement Officer – Independent Health
Chief Innovation Officer – Chautauqua AMP (MSSP ACO)Dr. Haughton brings over 25 years of clinical experience and building and deploying population care workflow systems. He has an expertise in predictive modeling and is a member of the Population Health Alliance Board of Directors.


Description:

The discussion will include the following topic areas and use Independent Health and the Chautauqua AMP experience as examples of use in clinical care today:

  • Which patients and why (ID and stratification)
  • What information and when it’s relevant (plan)
  • What labor and shared care (intervene)
  • What success (measure – population effectiveness)

View this webinar

Nicole Alexander-Scott, MD, MPH
Director, Rhode Island Department of Health
President, Association of State and Territorial Health Officials

Nicole Alexander-Scott has been the director of the Rhode Island Department of Health since May 2015. She brings to this position tremendous experience from her work as a specialist in infectious diseases for children and adults at hospitals in Rhode Island affiliated with Brown University and at the Rhode Island Department of Health. Her clinical and academic responsibilities were balanced with serving as a consultant medical director for the Office of HIV/AIDS, Viral Hepatitis, STDs, and TB in the Division of Infectious Diseases and Epidemiology at the Rhode Island Department of Health. Alexander-Scott is board certified in pediatrics, internal medicine, pediatric infectious diseases, and adult infectious diseases. She obtained a Master of Public Health degree from Brown University in 2011. She is also an assistant professor of pediatrics and medicine at the Warren Alpert Medical School of Brown University.

Originally from Brooklyn, New York, Alexander-Scott attended Cornell University, majoring in human development and family studies, and subsequently graduated from medical school in 2001 from SUNY Upstate Medical University at Syracuse. After completing a combined internal medicine-pediatrics residency at SUNY Stony Brook University Hospital in 2005, Alexander-Scott finished a four-year combined fellowship in adult and pediatric infectious diseases at Brown in 2009.

Presenter:
Suzanne Mitchell, MD, MS
Founder, See Yourself Health LLC
Associate Professor, Family Medicine and Palliative Care
Boston Medical Center/ Boston University School of Medicine

A healthy lifestyle is an essential part of disease prevention, chronic disease management and population health. New technology solutions emerge each day designed to help people with lifestyle management. Yet few use scientific and evidence based strategies to make healthy lifestyle changes more achievable. This webinar will provide an overview of design, implementation and dissemination of the See Yourself Health platform – a novel educational platform targeting adults with chronic disease who are striving to make lifestyle changes. The program’s founder and lead scientific investigator, Dr. Suzanne Mitchell, will present early research findings and share how this novel approach is being used to help create communities of learning and change for patients with chronic disease.

View this webinar

Presenter:
Ken Goldblum, MD
Chief Medical Officer
Tandigm Health

How can a network of high performing primary care practices work with an insurer to increase value for high risk populations? In this webinar, Tandigm’s Chief Medical Officer Ken Goldblum will describe this organization’s coordinated and regional approach to care southeast Pennsylvania that led to measurable increases in value.

View this webinar

Presenter:
Dawn Tice RN, BSN, MBA
Division Vice President, Clinical Operations
Main Line Healthcare

Dawn Tice RN, BSN, MBA is the Division Vice President, Clinical Operations for Main Line Healthcare. Her presentation will examine how a regional health system successfully implemented a robust ambulatory quality strategy that included patient-centered practice transformation the implementation of centralized care management, and systemwide adoption of population management.

View this webinar

Presenter:
Mary Jane Osmick, MD
Vice President & Medical Director
American Specialty Health

View this webinar

Presenter:
Dr. Sanjay Seth
Chief Medical Informatics Officer, HealthEC

This webinar will review examples of how provider-led organizations have implemented population health management and value-based care solutions, lessons learned along the way, and how to leverage data for value-based contracting.

With over 30 years of clinical, administrative and consulting experience, Dr. Seth helps provider organizations transition to population health management, develop value-based care strategies, and engage in contract negotiations.

Dr. Seth has supported two physician groups in the formation of Accountable Care Organizations under the MSSP initiative, creating collaborative care coordination agreements and introducing technology and processes to manage ACO operations. He also established a payer supported Virtual Patient Centered Medical Home program for over 15,000 lives with care coordination and technology to comply with quality measures and utilization metrics.

Prior to joining HealthEC, he was a part of the turnaround team for Interfaith Medical Center, Newark Beth Israel Hospital Center at Orange and East Orange General Hospital, leading the implementation of complex hospital and physician clinical, financial, contractual and compensation relationships. Dr. Seth has also led numerous physician groups in their formation or re-structuring efforts including modification of billing systems, implementation of EMR’s and development of partnership agreements.

View this webinar

Creating true “value” for patients, practices and payers requires a commitment to quality, total cost of care and understanding your entire patient population. Practices serving pediatric patients have unique challenges in the move from fee for service to value based payments. Explore ways in which even small, independent practices can transform the care they deliver to create high value and remain financially viable in the changing healthcare landscape.

View this webinar

Rose Maljanian, PHA Board Chair, will lead with a discussion on driving quality through application of PHA’s Population Health Management Framework across the care continuum and across market segments. Patricia Barrett, Vice President, Product Design and Support, NCQA will do a deep dive into the NCQA Population Health Management accreditation standards and metrics.

View this webinar