Value Visit: Clinical Excellence 2024

Event Date: 9/16/2024 - 9/19/2024

Event Overview

This event promises to provide you with the essential knowledge and tools to drive cost-effective, high-quality care within your organization. Our final agenda is designed to offer deep insights into ten critical levers, including Utilization Management, Provider Network Management, and Pharmacy Benefit Management. You will gain practical strategies for managing chronic diseases and integrating technology to streamline healthcare delivery. Additionally, we will explore how regional payors are placing health equity at the forefront of their efforts, ensuring every touchpoint is optimized to make all members feel seen, heard, and cared for.

Who should attend

This meeting is only for Health Plan Alliance members and invited guests.

Chief medical officers
Executive sponsors, directors, managers with responsibility for clinical operations, pharmacy, quality, care management, health equity or clinical outcomes
Health services executives or managers

Top reasons to attend

1. Network with Industry Leaders

Engage with top executives and thought leaders in the healthcare industry during keynotes, panels, and networking dinners.

2. Gain Cutting-Edge Insights

Learn about the latest advancements in medical cost management, health equity, patient-centered care models, and AI integration.

3. Explore Practical Strategies

Discover actionable strategies for improving efficiency, enhancing patient care, and managing healthcare costs through interactive exercises and case studies.

4. Participate in Dynamic Discussions

Join in-depth discussions on utilization management, pharmacy benefits, and chronic disease management solutions.

5. Strengthen Community Ties

Connect with peers and build professional relationships that can drive collaborative efforts and shared success in the health plan industry.

Join the Presbyterian Health Plan team in beautiful Albuquerque, NM

Albuquerque is home to Presbyterian Health Plan. At the heart of New Mexico beats the pulse of a vibrant city. In Albuquerque, diverse cultures, authentic art and dynamic traditions have helped shape our centuries-old story. No matter your interests, the city has countless opportunities for you to explore. Sample traditional New Mexican cuisine that takes minutes to make and hundreds of years to prepare, experience world-class museums, and stroll along Central Avenue under the vintage neon glow of Route 66.

Thank you to our event sponsors

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Plan Your Trip

Hotel Albuquerque at Old Town
800 Rio Grande Blvd NW
Albuquerque, NM 87104
505.843.6300
Reservations 866.505.7829

The hotel room block expires on August 26, 2024
Our room rate is $199 plus taxes/fees. This rate may be available three days prior and three days after our meeting dates, depending on the hotel's availability. You can contact the reservations team to book via phone at 505.843.6300 (opt# 1) and can provide the group code(202409VIZIENT) or through our booking link. Should you book after the deadline, you will not be guaranteed to receive our group room rate or the hotel may be sold out. Please note that the group block could sell out before this date.

DRESS
Business casual attire is appropriate for the meeting. Remember that the hotel meeting room temperatures vary, so we recommend that you layer clothing to be comfortable in case the room becomes either hot or cold.

GROUND TRANSPORTATION
Uber/Lyft from the Albuquerque International Sunport (ABQ) is approximately $20. Click here for more details.

ALBUQUERQUE WEATHER
View the latest weather forecast.

Thank you to our event sponsors

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Gold

Silver

Bronze

Sponsor

Agenda

09/17/2024 7:00 AM - 8:00 AM
Networking Breakfast
09/17/2024 8:00 AM - 8:15 AM
Getting started & Welcome to Albuquerque
09/17/2024 8:15 AM - 9:45 AM
Keynote Address: Driving Accountability and Quality Through Tighter Provider-Plan Alignment The evidence suggests that close collaboration between physician groups and health plans – including through arrangements that fully delegate risk to providers – produces superior results for older adult patients. This session will explore how can more of these partnerships can be fostered across the health care continuum. Speaker: Susan Dentzer , President & CEO America's Physician Groups
09/17/2024 9:45 AM - 10:00 AM
Time to refill your cup and stretch
09/17/2024 10:00 AM - 11:00 AM
Patient-Centered Care Models: Transformative Care Approaches This session will delve into the transformative power of patient-centered care models in managing medical costs while improving patient outcomes. We will explore successful implementations from leading healthcare organizations, highlighting their unique strategies and impactful results. Presbyterian MA Specialty Practice: Discover how Presbyterian’s Medicare Advantage Specialty Practice is redefining patient care through focused, specialty-driven approaches that cater to the specific needs of Medicare Advantage members. Speaker: Sam Hinton, Director Presbyterian Medicare Advantage Clinic Presbyterian The Health Plan Place: Learn about The Health Plan Place, an initiative designed to provide personalized, accessible healthcare services. This presentation will emphasize how creating community-based healthcare hubs can enhance patient engagement, streamline care coordination, and reduce overall healthcare costs. Speaker: Jess Sanchez, Director Health Plan Place
09/17/2024 11:00 AM - 12:15 PM
Navigating the Evolving Pharmacy Landscape: From PBM and Retail Challenges to Manufacturer Strategies and Clinical Insights In this session, we'll kick off by exploring the current state of the pharmacy world, touching on the evolving landscape of PBMs, the retail sector, and the ripple effects of rising costs, regulatory shifts, and new legislation. From there, we’ll dive into the complexities of drug manufacturers, focusing on how their operations influence health plan formulary decisions, rebates, and overall strategy. We'll highlight which high-impact drugs are dominating today's conversations. Finally, we'll pivot to a clinical overview, examining emerging trends and the future of pharmacy care. Join us for a comprehensive exploration of the key forces shaping the industry. . Speaker(s): Eric Cannon, Chief Pharmacy Officer/General Manager Matt Mitchell, AVP Pharmacy Services Select Health and Scripius Jennie Barlow, Director Pharmacy Industry Relations Select Health
09/17/2024 12:15 PM - 1:15 PM
Networking Lunch
09/17/2024 1:15 PM - 2:45 PM
Keynote Address: Beyond the Buzz – Paving the Way for Equal Access and Quality Care for All In this session, you'll gain a comprehensive understanding of health equity and its critical importance in healthcare and learn about the impact of health disparities and social determinants of health on patient outcomes and overall healthcare costs. Explore methods for building organizational competencies in equity concepts and fostering an inclusive company culture and discuss key strategies for embedding health equity into clinical operations, improving cultural competency, and engaging diverse stakeholders. We will also highlight the importance of data in identifying and addressing health disparities to drive continuous quality improvement and promote sustainable change in healthcare. Keynote: Faith Washington, Principal Health Management Associates Case Study: Western Health Advantage: Innovative Approaches to Flu Vaccination Outreach Western Health Advantage will share insights from its innovative flu vaccination campaign aimed at improving health outcomes in its service area. This case study delves into the creative approaches employed to reach is Spanish-speaking populations, including the use of mobile clinics, targeted messaging, and partnerships with community organizations. Speaker(s): Dr. Tasnim Khan, Chief Medical Officer Western Health Advantage Fernanda Durand, Communications Director National Hispanic Medical Association Case Study: Community Health Plan of Washington CHPW aims to become an anti-racist organization by identifying and changing systems, processes and policies that hinder equity. Its team will share practical insights and lessons learned in fostering a culture to advance equity. CHPW aspires to create a culture where equity is not just a goal but one day a lived reality for everyone. Speaker(s): Fathiya Abdi, Program Manager, DEI Community Health Plan of Washington Ugbad Hassan, Program Manager II, Health Equity Community Health Plan of Washington
09/17/2024 2:45 PM - 3:00 PM
Time to refill your cup and stretch
09/17/2024 3:00 PM - 4:30 PM
Utilization Management: Unlocking the Power of Clinical Leadership in Cost Management Utilizing their unique insights and expertise, clinical leaders can significantly impact health plan costs. Be prepared to delve into actionable strategies and real-world examples from a panel of experts who will demonstrate how clinical leaders can leverage their positions to implement cost-saving measures while ensuring quality of care. Moderator: Tom Lundquist, MD, President Vital Insights, LLC Speaker(s): Marsha Barlocker, Sr. Director of Quality and Case Management Health Team Advantage Ted Regalia, VP Pharmacy Benefits Network Health Dr. Traci Biondi, Chief Medical Officer Prominence Health Plan Michael Lunzer, CEO Itiliti Health
09/17/2024 6:00 PM - 8:00 PM
Dinner: Sawmill Market an artisanal food hall Choose your own experience! Meet in the Sawmill Mill room (upstairs) for cocktail hour and receive a card to go grab dinner from one of the venues onsite then meet back in the room to eat together.
09/18/2024 7:30 AM - 8:30 AM
Networking Breakfast
09/18/2024 8:30 AM - 10:00 AM
Keynote: Technology Integration: Harnessing the Power of AI in Care Management Explore how AI can revolutionize care management through technology integration. This keynote will provide actionable strategies and real-world examples, showcasing how AI can be harnessed to enhance patient care, improve operational efficiency, and drive cost savings. Mendel is the host of the #1 value-based care podcast, Healthcare Trailblazers and author of Unleashing Value: The Case for AI in Value-Based Care. Speaker(s): Mendel Erlenwein, Founder Previva Health Group
09/18/2024 10:00 AM - 10:30 AM
Break & Book Signing - Unleashing Value: The Case for AI in Value-Based Care
09/18/2024 10:30 AM - 11:15 AM
Industry Power Rounds: Chronic Disease Management Solutions Join us for an exciting series of back-to-back presentations from leading vendors in the field of chronic disease management. Each vendor will have a brief, focused session to showcase their innovative solutions and approaches to tackling chronic conditions. This fast-paced format ensures you get a comprehensive overview of the latest technologies and strategies in a short amount of time. Speaker(s): Crystal Onwu, PharmD, Director, Clinical Strategy Omada Reza Alam, Medical Director MPulse Gary Rothenberg, Director, Medical Affairs Podimetrics
09/18/2024 11:15 AM - 12:00 PM
Provider Network Management: Lab Service Legends; Strategies for Network Optimization Navigate the complexities of genetic network optimization with expert insights into how leading healthcare organizations are overcoming genetic testing challenges. Discover best practices and innovative strategies that demonstrate how to enhance lab service delivery, drive genetic lab quality, improve patient outcomes, and reduce costs. Ensuring members receive the right test for the right treatment at the right cost. Speaker: Mike Snyder, EVP of Network Avalon
09/18/2024 12:00 PM - 1:00 PM
Networking Lunch
09/18/2024 1:00 PM - 2:00 PM
Interactive Exercise: Where Is The Payoff: Ranking Cost Management Levers Moderator: Mike Miniati, Chief Growth Officer Toney Healthcare
09/18/2024 2:00 PM - 2:15 PM
Time to refill your cup and stretch
09/18/2024 2:15 PM - 3:15 PM
Alternative Payment Models: Payment Paradigm Shifts: Exploring Innovative Models Explore the transformative impact of one organization's effort to design payment models through the lens of contract modeling. This session will explore how detailed modeling of contracts can provide valuable insights and enhance decision-making for health plan executives. Speaker(s): Brady Gear, VP of Network Strategy Presbyterian Health Plan
09/18/2024 3:15 PM - 3:30 PM
Time to refill your cup and stretch
09/18/2024 3:30 PM - 4:30 PM
Digital Health Maturity: Considerations for Medical Cost Management In today’s rapidly changing business environment, payers face challenges from every angle—evolving market dynamics, regulatory changes, and advancing technology. This session dives deep into these forces and emphasizes the critical role of quality as a foundational element across the entire payer value chain. We’ll explore the importance of operational excellence in areas like data management and predictive analytics and the use of cutting-edge tools like FHIR-based APIs and digital quality measurement solutions. This is your opportunity to learn how to elevate your organization's performance in an increasingly data-driven landscape. Speaker(s): Chenny Solaiyappan., Sr. Director Product Management & Strategy Cognizant
09/18/2024 6:00 PM - 8:00 PM
Dinner: Church Street Cafe
09/19/2024 8:00 AM - 9:30 AM
Networking Breakfast at Garduno's for those that have later flights, drop by for breakfast with the Alliance staff.

Documents

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9/18/2024

Presentation: Industry Power Rounds - Chronic Disease Management Solutions
Gary Rothenberg, Director, Medical Affairs with Podimetrics delves into the costliness of diabetes. Learn about their innovative solutions for combatting this chronic condition. Shared at the Clinical Excellence Value Visit on September 18, 2024 in Albuquerque, NM.

9/18/2024

Presentation: Provider Network Management_ Lab Service Legends; Strategies for Network Optimization
With the help of Avalon, navigate the complexities of genetic network optimization with expert insights into how leading healthcare organizations are overcoming genetic testing challenges. Shared at the Clinical Excellence Value Visit on September 18, 2024 in Albuquerque, NM.

9/18/2024

Presentation: Where Is The Payoff_Ranking Cost Management Levers
Mike Miniati, Chief Growth Officer; Toney Healthcare, presents how we can strategize cost management levers to achieve our goals. Shared at the Clinical Excellence Value Visit on September 18, 2024 in Albuquerque, NM.

9/18/2024

Presentation: Alternative Payment Models: Payment Paradigm Shifts_Exploring Innovative Models
Clinical Excellence host, Presbyterian presents how we can explore the transformative impact of our organization's effort to design payment models through the lens of contract modeling. This session will explore how detailed modeling of contracts can provide valuable insights and enhance decision-making for health plan executives.

9/18/2024

Presentation: Complete Don't Compete - Virtual Care to Support Chronic Conditions
Crystal Onwu, PharmD, with Omada shares how they utilize virtual care to treat chronic conditions. Learn how virtual care can bridge a gap between visits, and not compete with in-person provider care. Shared at the Clinical Excellence Value Visit on September 18, 2024 in Albuquerque, NM.

9/18/2024

Presentation: Digital Intervention for Rising Risk Populations
In this Chronic Disease Management Solution session presentation, learn how your plan can transform the consumer health journey with mPulse's configurable Health Experience and Insights products. Shared at the Clinical Excellence Value Visit on September 18, 2024 in Albuquerque, NM.

9/18/2024

Presentation: Digital Health Maturity
In today's rapidly changing business environment, payers face challenges from every angle - evolving market dynamics, regulatory changes, and advancing technology. Chenny Solaiyappan, Sr. Director Product Management & Strategy with Cognizant dives deep into these forces and emphasizes the critical role of quality as a foundational element across the entire payer value chain. Shared at the Clinical Excellence Value Visit on September 18, 2024 in Albuquerque, NM.

9/17/2024

Presentation: Getting Started & Welcome to Albuquerque
John Johnson provides a brief overview of Presbyterian Health Plan's healthcare systems and New Mexico's healthcare landscape. Shared at the Clinical Excellence Value Visit on September 17, 2024 in Albuquerque, NM.

9/17/2024

Presentation: Streamlining and Automating Prior Authorization Processes for Payers, Providers, and Members
Itiliti Health shares a brief overview of their prior authorization process. Learn about the problems with this process and the potential solutions Itiliti has found. Shared at the Clinical Excellence Value Visit on September 17, 2024 in Albuquerque, NM.

9/17/2024

Presentation: Delegation and Value-Based Health Care - Driving Accountability for Costs and Quality Through Tighter Provider-Plan Alignment
The evidence suggests that close collaboration between physician groups and health plans - including through arrangements that fully delegate risk to providers - produces superior results for older adult patients. Susan Dentzer, President and CEO of America's Physician Groups, explores how more of these partnerships can be fostered across the health care continuum. Shared at the Clinical Excellence Value Visit on September 17, 2024 in Albuquerque, NM.

Page 1 of 2

Next | Last