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Monday April 4, 2005
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12:30 pm
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12:45 pm
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- Discern the relevance of "person-centered health", identify its components, and understand why is it essential for successful disease prevention and management
- Learn how the Veteran’s Administration is using electronic health records, identifying standards and managing information to implement change
- Recognize how person-centered health leads to better outcomes and status
- Examine ideas for integrating person centered health into regional markets
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Gary Christopherson
Senior Advisor for the
Under Secretary for Health
Veterans Administration
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1:50 pm
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| Chronic Care Management in Medicare: Update on Current Initiatives |
| The Chronic Care Improvement Program is a component of the Medicare Modernization Act and demonstrates a commitment to improving and strengthening the traditional fee-for-service Medicare program. This program is the first large-scale chronic care improvement initiative under the Medicare FFS program, and seeks to help beneficiaries manage their health, adhere to their physicians’ plans of care, and assure that they seek or obtain medical care that they need to reduce their health risks. |
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Sandra Foote
Senior Advisor
Chronic Care Improvement, Center for Medicare Management
Centers for Medicare and Medicaid Services
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Stuart Guterman
Director, Office of Research
Development & Information
Centers for Medicare and Medicaid
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2:35 pm
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In this session you will:
- Master the complexities of the Medicaid environment including serving diverse populations of the poor and the sick, utilizing unusual provider networks, and attempting to modernize legacy programs
- Hear how Florida's disease management experience has affected other states
- Discern how Pay for Performance is evolving in the Medicaid context
- Identify strategies for resolving issues around defining populations and performance, dealing with non-traditional providers, and identifying workable "pay" incentives
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A. Michael Collins PhD
Consulting Practice Leader
Thomson/Medstat
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3:20 pm - 3:50 pm
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Chip Hunzinger
Deputy Administrator, Government Programs
McKesson
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| Changing Face and Focus of Disease Management: Partnership Approach to Pay for Performance in Rural Pennsylvania |
The presentation explores the alternative “managing-of-care” models to capitated managed care. Trends include integrating disease management into traditional primary care management programs, pay for performance contracting and an increased focus on provider partnerships all of which are changing the face of disease management. The Pennsylvania Department of Public Welfare (DPW) is launching a program to provide disease management through its enhanced primary care case management program to 250,000 individuals – half of all the Commonwealth's fee-for-service Medicaid beneficiaries.
In this session you will:
- Discuss the integration of quality improvement into pay for performance
- Discuss how disease management can be integrated into primary care management programs
- Analyze how a disease management program is implanted in a fee-for-service rural environment
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James L. Hardy
President
JLH Enterprises, Inc
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3:50 pm - 4:20 pm
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4:20 pm - 5:05 pm
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Predictive Modeling has long been used to identify populations at risk and provide members with tailored disease management solutions. This session will address new methods of predictive modeling that improve care and mitigate cost.
In this session you will:
- Study the fundamentals of predictive modeling
- Distinguish key drivers of the economic model
- Establish the types of predictive models
- Assess the value of risk stratification compared with intervention strategies
- Recognize strategies to apply the economic model to produce a financial return in disease management
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Ian Duncan FSA FIA FCIA MAAA
Partner
Lotter Actuarial Partners, Inc
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5:05 pm - 5:35 pm
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Alan Muney
Chief Medical Officer
Oxford Health Plans
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5:35 pm - 6:35 pm
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Much debate has centered on the validity of disease management measurement and the best methodologies for proving the effectiveness of employer programs. Join two industry experts in a lively discussion on benchmarking methodologies and their implications on program design and delivery.
In this session you will:
- Benchmark the validity of disease management programs
- Examine disease management program procurement options for employers
- Demonstrate how research methods apply in a real world setting
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6:35 pm
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