Clinical Leadership Summit 2020
Event Date: 11/4/2020 - 11/6/2020
Event Overview
Let's work together to bend the cost curve
Will COVID-19 be the catalyst that changes how healthcare is accessed and delivered? Can we pivot fast enough to take advantage of new opportunities to provide more efficient, higher quality, lower-cost care? The shake-up caused by COVID-19 has presented many challenges, but also new ways to bend the cost curve. This Fall, Alliance member clinical leaders are invited to collaborate alongside a lineup of hand-selected innovative thinkers on the toughest challenges facing the health, wellness and cost of care in our communities.
Fireside Chats
Scott Gottlieb, M.D.
Renown physician and the 23rd Commissioner of the U.S. Food and Drug Administration
Dr. Gottlieb is a physician, medical policy expert, and an aggressive advocate for advancing the health of patients, promoting healthcare access, and driving innovation. He previously served as the FDA's Deputy Commissioner for Medical and Scientific Affairs and before that, as a senior advisor to the FDA Commissioner. He also worked on implementation of the Medicare drug benefit as a senior advisor to the Administrator of the Centers for Medicare and Medicaid Services, where he supported policy work on quality improvement and the agency’s coverage process, particularly as it related to new medical technologies.
During this fireside chat, we'll sit down with Dr. Gottlieb to pick his brain about advancing public health, innovative approaches to improving medical outcomes, reshaping healthcare delivery, and expanding consumer choice and safety.
Jessica Cordova Kramer and Stephanie Wittels Wachs
Co-founders, Lemonada, and Creators of the Podcast Last Day
Jessica Cordova Kramer and Stephanie Wittels Wachs know firsthand that a substance use disorder is lonely, dark, complex, and entrenched in shame and stigma. They maintain that what we need now is a deeper understanding of the human toll the crisis has taken on so many people. Enter Last Day, their award-winning podcast that confronts this massive epidemic with humanity, wit and a quest for progress. Season one zooms in on the last day of Jessica and Stephanie's brothers’ lives, exploring how they got there and how we as a society have gotten here. They’ve interviewed experts all across the country, from doctors specializing in addiction medicine to harm reductionist with boots on the ground; from mayors fighting the crisis on the local level to policy makers trying to find solutions on the federal level. They’ve learned that there are a lot of practices that might actually help, that a combination of human-centered solutions can pave the way to a future where far fewer lives are lost to opioid misuse, addiction, and overdose. In this conversation, we leave the numbers behind, and instead use storytelling to understand the depths of this crisis on a human level that invites us to consider the problem differently and imagine what our organizations could do to reframe what addiction and recovery look and sound like in America.
Event highlights
Designed exclusively for Alliance member clinical leaders, you'll have the opportunity to collaborate with your peers and explore challenges and breakthroughs in medical, pharmacy and behavioral health program management. Enjoy a front row seat at facilitated round table discussions, insightful case studies and thought provoking discussions with subject matter experts.
Topics include:
- Industry trends and the implications for medical management
- Best practices for UM and handling escalating costs for chronic disease management
- Shifting the site of care
- Specialty pharma, innovations in genomics, and getting the most from your PBMs
- Managing behavioral health for improved outcomes
BONUS! Coffee + Connections the morning of Day Two
Get to know your Alliance network a little better. There are many new faces in this group—leverage this opportunity to compare notes with your peers and make a new friend or two.
Who should attend
Join other clinical leaders from across the country to hear best practices and innovative approaches to reducing the cost of care.
- CMOs and Medical Directors/leaders
- Pharmacy leaders
- Behavioral Health leaders
- Care management leaders
Join the Clinical Learning Collaborative
The Clinical Collaborative brings together leaders and medical professionals from multiple departments within the health plan. The group delves deeply into clinical-related topics to improve quality of care and outcomes in the most cost-efficient manner and within regulatory guidelines.
Sponsors
Agenda
AGENDA AT A GLANCE
All times listed are central time.
Wednesday, November 4
10:30 - 11:30 CT |
FIRESIDE CHAT: Scott Gottlieb, MD, 23rd FDA Commissioner, on the State of the Industry |
11:45 – 12:45 CT |
Taking a Team Approach to the Top 5 percent |
01:00 - 02:00 CT |
Setting the Health Plan’s Virtual Health Strategic Agenda |
02:15 - 03:15 CT |
FIRESIDE CHAT: Virtual First Primary Care Models |
Thursday, November 5
10:30 - 11:30 CT |
Coffee + Connections |
11:45 – 12:45 CT |
Hot Trends in SRx and Genomics: Facts and Straight Talk for Navigating the Changing Landscape |
01:00 - 02:00 CT |
Your relationship with your PBM – The Good, The Bad and The Opportunity! |
02:15 - 03:15 CT |
What’s so special about specialty? Sometimes it’s simpler than you think |
Friday, November 6
10:30 - 11:30 CT |
FIRESIDE CHAT: The Opioid Epidemic with the Hosts of the Podcast Last Day |
11:45 – 12:45 CT |
Population Health and the Challenges in the Behavioral Health Arena |
01:00 - 02:00 CT |
Pharmacy, MTM and Care Management: Reducing the cost of care while improving quality |
02:15 - 03:15 CT |
LIGHTBULB MOMENTS: Innovations in Care Management |
Special Events
Lightbulb Moments: An Alliance Member Show and Tell Session
WHAT
In this fast-paced, facilitated group ideation session, each attending health plan’s team will share a “lightbulb moment” – a focused “show and tell” of their best tactics for care management. Attendees will walk away with a collection of new ideas to take back to your teams!
These Lightbulb Moments should inspire dialogue around one or more of these key questions:
- What care management hurdles have you had to overcome due to impacts of the pandemic and what have you learned? E.g., Work from home staff, shift to virtual for members
- What “tried and true” care management strategies are you particularly proud of that have resulted in improved outcomes?
- Have you implemented peer-based programs or other innovative tactics for management of chronically ill or behavioral health/substance abuse members?
- In what ways has data mining and analytics driven new care management approaches?
- Where has outsourcing benefitted your care management program? How has partnering set you up for success?
- Have you seen improvements as a result of novel member engagement approaches?
HOW
Each health plan attending the virtual summit should submit one (1) “lightbulb moment” before October 21.
- Choose your topic and your team spokesperson.
- Develop a maximum of 2-3 slides that provide a quick overview of the best practice you’d like to share with your Alliance peers.
- Email your submission to jennifer.bosley@healthplanalliance.org before October 28, 2020. Please keep your submission in a PowerPoint file format, NOT a pdf. Use your own PPT template and title your document: <Company name>_2020ClinicalLightbulb.PPT.
- Be prepared to quickly walk through their slides during a special session during the summit.
Thank you in advance for taking the time to share your Lightbulb Moment. Powerful sharing like this, even when we can’t be together in person, is what the Alliance is all about!
Sponsors
Documents
Recording: Virtual First Primary Care Models - November 4, Session 4
Joe Lastinger gets cozy in the front of the virtual fireplace and leads an insightful, candid conversation about the future of telemedicine. Shared during the Clinical Leadership Summit 2020.
Recording: Hot Trends in SRx and Genomics - November 5, Session 2
Summit Re discusses SRx trends, how we got here, where we’re going, and what resources exist to help navigate the ever-changing landscape, with a specific focus on medication therapy management and cost containment. Shared during the Clinical Leadership Summit 2020.
Presentation: Hot Trends in SRx and Genomics - November 5, Session 2
Summit Re discusses SRx trends, how we got here, where we're going, and what resources exist to help navigate the ever-changing landscape, with a specific focus on medication therapy management and cost containment. Shared during the Clinical Leadership Summit 2020.
Presentation: LIGHTBULB MOMENTS - Community Health Options: Innovations in Care Management, November 6, Session 4
In this presentation enjoy Community Health Options sharing lightbulb moments with your Alliance peers - hear others' best tactics care management.
Presentation: LIGHTBULB MOMENTS -Health Alliance Medical Plans: Innovations in Care Management, November 6, Session 4
Enjoy sharing lightbulb moments with Health Alliance Medical Plans. Hear others' best tactics care management.
Presentation: LIGHTBULB MOMENTS - Health First Health Plans: Innovations in Care Management, November 6, Session 4
During this presentation enjoy Health First Health Plans share lightbulb moments. Hear others' best tactics care management as well.
Presentation: Population Health, Challenges and Solutions, HealthScape, Nov 6, Session 2
A panel discussion around how to successfully implement an integration strategy that benefited them system-wide and improved spending, quality and outcomes. Presented at the Clinical Leadership Summit, 2020.
Presentation: Population Health, Challenges and Solutions, Presbyterian, Nov 6, Session 2
Presbyterian Health Plan discusses how integrating physical health (PH) and behavior health (BH) could improve clinical outcomes and reduce costs. Shared at the Clinical Leadership Summit 2020.
Presentation: Population Health, Challenges and Solutions, Geisinger Health Plan, Nov 6, Session 2
Geisinger Health Plan shares insights on how their insourcing approach for Behavioral Health has reduced costs and opened many doors.
Presentation: Pharmacy, MTM, and Care Management: Reducing the cost of care while improving quality - November 6, Session 3
Health Alliance Plan shares how an Alliance member health plan has successfully implemented collaborative programs between medication therapy management (MTM) and ambulatory clinical pharmacists. Shared at the Clinical Summit 2020.
Attendees
Below is a list of all delegates registered to date for this event
- Michael Edgerton
- ALLIANCE GUEST
- Director of Retail & Specialty Pharmacy at New Hanover Health
- Priti Mody-Bailey
- ALLIANCE GUEST
- Chief Medical Officer/VP at Community First Health Plans
- Leelee Thames
- ALLIANCE GUEST
- President, NHH | Chief Value Officer, NHRMC at New Hanover Health
- Mike Abdo
- ALLIANCE MEMBER
- Director of Pharmacy at CommunityCare
- Jordan Anderson
- ALLIANCE MEMBER
- Vice President of Sales at Avera Health Plans
- Khuram Arif
- ALLIANCE MEMBER
- President at Western Health Advantage
- Laura Campbell
- ALLIANCE MEMBER
- Director of Medical Management at Piedmont Community Health Plan
- Eric Cannon
- ALLIANCE MEMBER
- Chief Pharmacy Officer/General Manager at SelectHealth
- Ahmad Chaudhary
- ALLIANCE MEMBER
- Director Health Plan Operations at Mary Washington Health Plan
- Jennifer Chow
- ALLIANCE MEMBER
- Quality Manager at MetroPlusHealth
- Andrea Coffee
- ALLIANCE MEMBER
- Clinical Pharmacist Specialist at Baylor Scott & White Health Plan
- Louanne Cunico
- ALLIANCE MEMBER
- VP of Pharmacy and Clinical Operations at Presbyterian Health Plan
- Pat Curtis
- ALLIANCE MEMBER
- Director, Clinical Care Services at Sentara Health Plans
- Esther D'Arezzo
- ALLIANCE MEMBER
- RN, Clinical Supervisor Risk Adjustment at Neighborhood Health Plan of Rhode Island
- Mary Dicostanzo
- ALLIANCE MEMBER
- Manager Transitional Care Services at New Hanover Health
- Stephanie Dreyfuss
- ALLIANCE MEMBER
- Vice President, Network Development at Providence Health Plan
- Art Edgerton
- ALLIANCE MEMBER
- Medical Director at FirstCarolinaCare Insurance Company
- Hugh Fatodu
- ALLIANCE MEMBER
- AVP, Pharmacy at Johns Hopkins Health Plans
- Jeremy Fejfar
- ALLIANCE MEMBER
- Pharmacy Director Government Programs at Quartz Health Solutions
- Kristin Garrett
- ALLIANCE MEMBER
- Medical Director at Providence Health Plan
- Kena Hahn
- ALLIANCE MEMBER
- Director- Medicare Stars and Outpatient Care Coordination at Health Alliance Medical Plans
- Sara Hansen
- ALLIANCE MEMBER
- Senior Director, Population Health & Clinical Operations at Avera Health Plans
- Jodi Hansgen
- ALLIANCE MEMBER
- Clinical Pharmacist at Baylor Scott & White Health Plan
- Denise Hart
- ALLIANCE MEMBER
- Clinical Specialist, Behavioral Health at Community Health Options
- Laurie Hawks
- ALLIANCE MEMBER
- Clinical Appeals Nurse at Health First Health Plans
- Bob Heitman
- ALLIANCE MEMBER
- Chief Actuary at SelectHealth
- Tammi Hollenback
- ALLIANCE MEMBER
- Rigistered Nurse - Manager of HCS at Medical Associates Health Plans
- Deanna Homer
- ALLIANCE MEMBER
- Chief Operations Officer at HealthTeam Advantage
- Obie Hooper
- ALLIANCE MEMBER
- QA Clinical Administrator at Alliant Health Plans
- Henry Johnson
- ALLIANCE MEMBER
- Executive Director - Pharmacy at IU Health Plans
- Kristina Johnson
- ALLIANCE MEMBER
- Manager of Resource Utilization at Piedmont Community Health Plan
- Joyce Juan
- ALLIANCE MEMBER
- Pharmacist Managed Care at Baylor Scott & White Health Plan
- Barb Koerperich
- ALLIANCE MEMBER
- Director of Health Care Services at Medical Associates Health Plans
- Kate Kurt
- ALLIANCE MEMBER
- Clinical Pharmacist at Medical Associates Health Plans
- Shawnna Lajoie
- ALLIANCE MEMBER
- Senior Clinical Specialist at Community Health Options
- Tamika Lane
- ALLIANCE MEMBER
- Director, Clinical Innovation and Client Relationships at Sentara Health Plans
- Laurie Lincoln
- ALLIANCE MEMBER
- SVP, Pharmaceutical Care Programs at Capital District Physicians' Health Plan (CDPHP)
- Liz Lorenzi
- ALLIANCE MEMBER
- VP/COO, Population Health at Aspire Health Plan
- Mark Lorson
- ALLIANCE MEMBER
- Pharmacist at Neighborhood Health Plan of Rhode Island
- Christopher Lovato
- ALLIANCE MEMBER
- PHS Director of Pharmacy at Presbyterian Health Plan
- Charlotte Luebbert
- ALLIANCE MEMBER
- Director of Medicare Part D Pharmacy Services at Baylor Scott & White Health Plan
- Lindsay Manning
- ALLIANCE MEMBER
- Director, Commercial/ASO Pharmacy Services at Baylor Scott & White Health Plan
- Claudia McClure
- ALLIANCE MEMBER
- Director Quality Management at Presbyterian Health Plan
- Katie Meiers
- ALLIANCE MEMBER
- Manager, Care Management at Network Health
- Jamie Miller
- ALLIANCE MEMBER
- Associate Vice President, Managed Care Pharmacy Services at Geisinger Health Plan
- Abigail Miller
- ALLIANCE MEMBER
- Chief Medical Officer at PreferredOne
- Helen Noonan-Harnsberger
- ALLIANCE MEMBER
- Vice President, Pharmacy at Providence Health Plan
- Daniel O'Connell
- ALLIANCE MEMBER
- Vice President of Health Services at Cox HealthPlans
- Wendy Partenheimer
- ALLIANCE MEMBER
- Vendor Coordinator at Health Alliance Medical Plans
- Anita Patel
- ALLIANCE MEMBER
- Director, Regional Care Management - Paramount Healthcare at Medical Mutual
- Antonio Petitta
- ALLIANCE MEMBER
- VP, Pharmacy Care Management at Health Alliance Plan (HAP)
- Kelly Pineda
- ALLIANCE MEMBER
- Medicare Stars Program Manager at Sentara Health Plans
- Jacquie Potelicki
- ALLIANCE MEMBER
- Director, Clinical Management at SummaCare
- Yusuf Rashid
- ALLIANCE MEMBER
- Principal Pharmacy Benefits Innovation, Amazon at USI Insurance
- Ted Regalia
- ALLIANCE MEMBER
- VP Pharmacy Benefits at Network Health
- Preston Renshaw
- ALLIANCE MEMBER
- Chief Medical Officer at Avera Health Plans
- Dawn Robinson
- ALLIANCE MEMBER
- Director of Health Plan Care Management at Denver Health Medical Plan
- Athena Santos
- ALLIANCE MEMBER
- Executive Director at AdventHealth (FHHS)
- Sanjiv Shah
- ALLIANCE MEMBER
- Chief Medical Officer at MetroPlusHealth
- Cary Shames
- ALLIANCE MEMBER
- VP and Chief Medical Officer at Sharp Health Plan
- Brian Smolich
- ALLIANCE MEMBER
- Vice President of Quality and Managed Care Operations at Health Alliance Medical Plans
- Stacy Staudenmeier
- ALLIANCE MEMBER
- AVP, Behavioral Health and Health Choices at Geisinger Health Plan
- Mike Takach
- ALLIANCE MEMBER
- Senior Pharmacy Consultant at Community Health Options
- Robert Tourek
- ALLIANCE MEMBER
- Manager - Medicare Programs at Sentara Health Plans
- James Troyer
- ALLIANCE MEMBER
- Director of Medical Management at Alliant Health Plans
- Elaine Tucker
- ALLIANCE MEMBER
- Compliance Consultant at IU Health Plans
- Rebecca Welling
- ALLIANCE MEMBER
- VP Risk adjustment at SelectHealth
- Kelly Zofchak
- ALLIANCE MEMBER
- Manager, Formulary and Pharmacy Benefits at SummaCare
- Lyle Berkowitz, MD
- SPEAKER
- Physician, Informaticist, Innovator, Entrepreneur, and Telehealth Expert at Back9 Healthcare Consulting
- Keith Gaetano
- SPEAKER
- Director, Health Plan Product at Rx Savings Solutions
- Jeff Green, PharmD
- SPEAKER
- Vice President, Pharmacy at Rx Savings Solutions
- Tej Shah
- SPEAKER
- Managing Director at HealthScape Advisors, LLC
- Jeremy Stenger
- SPEAKER
- Managing Director at HealthScape Advisors, LLC
- Jacqueline Vitta
- SPEAKER
- Director at HealthScape Advisors, LLC
- Emily Comfort
- SPONSOR
- Vice President, Health Plans at Rx Savings Solutions
- Brian Fehlhaber
- SPONSOR
- Senior Vice President at Summit Re
Speakers
- Lyle Berkowitz, MD
Physician, Informaticist, Innovator, Entrepreneur, and Telehealth Expert at Back9 Healthcare Consulting
click here for full people profile
- Jessica Cordova Kramer
Co-Founder and CEO at Lemonanda
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- Keith Gaetano
Director, Health Plan Product at Rx Savings Solutions
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- Scott Gottlieb, MD
Former FDA Commissioner at
click here for full people profile
- Jeff Green, PharmD
Vice President, Pharmacy at Rx Savings Solutions
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- Kena Hahn
Director- Medicare Stars and Outpatient Care Coordination at Health Alliance Medical Plans
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- Laurie Hawks
Clinical Appeals Nurse at Health First Health Plans
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- Joe Lastinger
President at Health Plan Alliance
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- Wendy Partenheimer
Vendor Coordinator at Health Alliance Medical Plans
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- Yusuf Rashid
Principal Pharmacy Benefits Innovation, Amazon at USI Insurance
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- Sanjiv Shah
Chief Medical Officer at MetroPlusHealth
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- Tej Shah
Managing Director at HealthScape Advisors, LLC
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- Brian Smolich
Vice President of Quality and Managed Care Operations at Health Alliance Medical Plans
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- Stacy Staudenmeier
AVP, Behavioral Health and Health Choices at Geisinger Health Plan
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- Jeremy Stenger
Managing Director at HealthScape Advisors, LLC
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- Mike Takach
Senior Pharmacy Consultant at Community Health Options
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- Jacqueline Vitta
Director at HealthScape Advisors, LLC
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- Stephanie Wittels Wachs
Co-founder, Chief Creative Officer & Host of Last Day at Lemonanda
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