Informatics and Analytics 2016 Value Visit

Audio: Community First Case Study: Validating EDGE server risk scores
Understanding how HHS computes your enrollees’ risk scores can help ensure accurate data submission to the EDGE Server. In this case study presentation, Community First Health Plans (CFHP) presents a simple, low-cost approach to validating and troubleshooting risk scores. CFHP demonstrates how to bring various pieces together to simulate their enrollees’ risk scores within the risk adjustment model. Various data, systems and configuration issues are discussed in a start-to-finish manner. By manipulating data, programs and files, CFHP shows how to extract information that yields an understanding of how important data completeness is to risk adjustment.

Audio: Presbyterian Case Study - Data and analytics done right: Driving value creation
This case study presentation from Presbyterian focuses on recognizing the changing data and analytics requirements faced by health care providers with health plans and will analyze a new seven-step data and analytics operating model. In addition, Soyal Momin and Amor Brannin of Presbyterian will lead the group through a discussion on appraising the integration challenges a data and analytics transformation represents in a joint payer/provider organization; Evaluating experience-based recommendations for staging a successful data and analytics transformation in a complex digital environment; Assessing the benefits an end-to-end data and analytics transformation can deliver.

Presentation: Curating a culture of data-driven decision making
In this open discussion session facilitated by Michael Cousins of Forecast Health, stakeholders from Alliance member plans explore what it means to be data-driven and discuss organizations? efforts to curate a culture that embraces data analytics into strategic and operational discussions at every level. We?ll discuss the HIMSS maturity model, as well as other tools that can support these efforts for both independent and provider sponsored plans.

Presentation: Case Study: Clinically meaningful actionable relevant interventions
Health plans and health care providers have access to more than data than ever before. Unfortunately, only a fraction of the valuable data is being used to impact patient care. The challenged faced by fractionated care that often silo?s data among providers, specialists, hospitals, and pharmacies can make utilization of big data a real challenge. However, there are a number of ways that data can be retrieved and analyzed to create real-time actionable intervention opportunities that result in improved care, better STAR ratings, and other quality metric improvements.

Presentation: Next-generation analytics: Getting past the hype and finding real value
We are at an interesting crossroads in the journey to better healthcare and the analytics that support it. Market forces like population health management, consumerism, public and private exchanges, value-based care initiatives, and new provider relationships are intersecting with newer technology and data sources to move us to new frontiers. It can be challenging to navigate the crossroads of new technology and data sources when, day to day, you?re facing an immediate need for information and analyses to successfully manage your business while simultaneously hearing about what you could be doing.

Presentation: Sentara Case Study: Identifying and communicating opportunities to deliver more efficient care
As competition for employer group business gets more intense, health systems are hard-pressed to demonstrate value. Sentara is providing ACO leaders with very specific intel on what areas have unwanted variation, empowering them to reduce inefficiencies.

Presentation: Optima Case Study: A journey from transparency to a system-wide rate overhaul
While implementing a cost transparency approach to support the needs of their consumers, Optima uncovered the need to refine pricing for services and ensure a consistent approach to managing the total cost of care across the delivery system. Learn how embracing transparency led to big efforts in managing costs, sharing risk, and more consistent pricing.

Presentation: Using data insights to design and implement effective care management programs for persistent high cost individuals
As you tailor your services for population health management and value based purchasing , how do you detect high-risk members, engage them, design programs for care management to optimally promote high-quality, cost-effective healthcare? Learn how several managed care organizations effectively approached the identification of individuals with persistent and emerging high needs and retooling care management programs away from event based management to person based management.

Presentation: Case Study: Validating EDGE server risk scores
Understanding how HHS computes your enrollees? risk scores can help ensure accurate data submission to the EDGE Server. In this case study presentation, Community First Health Plans (CFHP) presents a simple, low-cost approach to validating and troubleshooting risk scores. CFHP demonstrates how to bring various pieces together to simulate their enrollees? risk scores within the risk adjustment model. Various data, systems and configuration issues are discussed in a start-to-finish manner. By manipulating data, programs and files, CFHP shows how to extract information that yields an understanding of how important data completeness is to risk adjustment.

Presentation: Case Study: Data and Analytics done right: Driving value creation
This case study presentation from Presbyterian focuses on recognizing the changing data and analytics requirements faced by health care providers with health plans and will analyze a new seven-step data and analytics operating model. In addition, Soyal Momin and Amor Brannin of Presbyterian will lead the group through a discussion on appraising the integration challenges a data and analytics transformation represents in a joint payer/provider organization; Evaluating experience-based recommendations for staging a successful data and analytics transformation in a complex digital environment; Assessing the benefits an end-to-end data and analytics transformation can deliver.