Registration and Continental Breakfast

Analytical Review of BCBS’ Quality Programs — How to Replicate the Success of Proven Quality and Pay-for-Performance Programs in New Markets

Blue Cross of California’s Incentive Programs for Independent Physicians in PPOs

• Development of a web-based report card
  Scalable strategies for independent
  physician incentives
• Defining accepted provider quality metrics
• Bonus payments to date and integration into future
  quality benchmarks

Excellus/Rochester IPA’s Application of 5 Years of Acute Care Quality Incentives to Chronic Care Measures

• Identifying which acute care measures are positively
  impacted over a 5 year period
• Using acute care measures to predict impact
  with chronic care measures
• Evolving knowledge of the interplay of measure
  selection and incentive size to create successful
  pay-for-performance programs

John A. Fallon, M.D., MBA, Chief Physician Executive, SVP,
Blue Cross Blue Shield of Massachusetts

As Chief Physician Executive, Dr.Fallon is charged with further expanding the quality, effectiveness and efficiency of health care delivery to BCBSMA's members. He oversees the company's medical policies, acts as the main liaison with the plan's provider network, reviews appealed medical cases, reviews upcoming state legislation for medical impact, manages the regional medical directors and acts as primary company spokesman for medical inquiries.
 

Michael Belman, M.D.,MPH, Staff VP, Medical Quality Management,
Blue Cross of CA (Wellpoint Health Networks)

Dr. Belman's current role entails oversight of external accreditation requirements, quality improvement activities, disease management programs, relationships with the medical leadership of contracted medical groups and production of the annual Blue Cross Provider Group Quality Scorecard.

Kathleen Curtin, Vice President, Quality & Improvement,
Excellus Health Plan

Ms. Curtin is responsible for plan-wide performance improvement for 2.1 million enrollees. The program objective is to enhance clinical and service quality by utilizing population-based measurement and intervention tools in partnerships with practitioners and hospitals. The program also addresses internal operational efficiency for the organization, regulatory compliance and response to purchaser requirements.

Howard Beckman, M.D., Medical Director,
Rochester Individual Practice Association

Dr. Beckman is currently a co-director on one of the RWJ Rewarding Results grants, studying how pay-for-performance for generalists and specialists influences the cost and quality of care. Dr. Beckman is also Clinical Professor of Medicine and Family Medicine at the University of Rochester School of Medicine and Dentistry.