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Tuesday August 8, 2006
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8:00 am -
9:00 am
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9:00 am -
9:15 am
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9:15 am -
10:00 am
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| Moderator |
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Margaret E. O'Kane
President
National Committee for Quality Assurance (NCQA)
 View Biography
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Lisa M. Latts, MD, MBA, MSPH
Vice President, Programs in Clinical Excellence
WellPoint, Inc
View Biography
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Nancy Nielsen, PhD, MD
Speaker, AMA House of Delegates
American Medical Association
Co-Chair, AQA Reporting Workgroup
View Biography
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Mark C. Rattray, MD
Consultant, CareVariance;
former National Medical Director, UnitedHealthcare
View Biography
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10:00 am -
10:30 am
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 Show Details |
10:45 am -
11:30 am |
An Outline of Basic Legal Issues in Pay-for-Performance and Understanding the New AMA Principles and Guidelines for Pay-for-Performance Programs |
At its 2005 Annual Meeting, the AMA House of Delegates amended and approved the AMA Principles and Guidelines for the formation and implementation of pay-for-performance programs. As the pay-for-performance concept becomes more commonplace, the healthcare community must work to ensure pay-for-performance programs are properly structured and appropriately applied. This seminar will discuss the legal issues surrounding such programs as well as the principles, guidelines and the legislative attempts to regulate this important issue.
At the conclusion of the seminar the learner will be able to:
- Describe the basic legal issues surrounding pay for performance programs
- Identify the risks and obstacles inherent in implementing pay for performance programs
- Evaluate current state and federal pay for performance programs
- Outline the AMA's pay for performance programs Principles and Guidelines
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Michael Costa
Associate, Health Business
Greenberg Traurig
View Biography
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11:30 am -
12:15 pm |
New Approaches to Pay-for-Performance: Creating Programs for Cardiology, Behavioral Health and Neurology |
- Learn from the metamorphosis of HealthPartners’ pay-for-performance program, implemented in 1996
- Hear early results from new initiatives in creating incentive programs for specialty practices like cardiology, behavioral health, and neurology
- Learn about HealthPartners’ strategy to integrate pay-for-performance into retail pharmacy and physical therapy
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Gail Amundson, MD, FACP
Medical Director
Quality, Measurement and Provider Incentives
HealthPartners Health Plan
View Biography
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12:15 pm -
1:15 pm |
Ask an Expert Working Lunches |
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1:30 pm -
2:15 pm |
Structuring Incentives for the Medicaid Population –An Outline of Nationwide Programs and Outlook for Standardization and Private Sector Collaboration |
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Stephen A. Somers, PhD
President
Center for Health Care Strategies
View Biography
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2:15 pm -
3:00 pm |
Pay-for-Performance and Medicaid to Engage Physicians and Control Costs |
- Hear a profile of Pennsylvania Department of Public Welfare’s implementation of a physician pay-for-performance program
- Develop strategies for physician engagement through effective case management/disease management
- Hear results from early stages of the program
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James L. Hardy
Deputy Secretary, Medical Assistance Programs
Pennsylvania Department of Public Welfare
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| Show Details |
| Track Chair |
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Ricardo Guggenheim, MD, MBA
Vice President - Clinical Content
Design and Development, Products and Services
McKesson Health Solutions
View Biography
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10:45 am -
11:30 am |
Using Evidence Based Medicine to Link Physician Groups Together |
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Donald W. Fisher, PhD, CAE
President and CEO
American Medical Group Association
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11:30 am -
12:15 pm |
Common Ground - Can We Find it between Employers, Health Plans, and Physicians? |
The success of physician clinical value improvement based on clinical performance measurement continues to be imperiled by the narrow lenses of the stakeholders and an underinvestment in collaboration. Physicians, having moved to a production model to maximize revenues, see any change as disruptive to their revenue stream. Moving to value competition requires they acknowledge variation in physician practice value. Conveying physician value relative to physician peers requires sensitive and tactful dialogue. When backed by measurement that is fair, valid, credible, understandable, and actionable, care variation analysis can drive value improvement.
Unfortunately, health care stakeholders have not yet created common ground upon which value competition can take root. Each persists in using their current lens to view the new model. There is yet another chasm to be overcome in healthcare -- the chasm between the current model and the value competition model. This chasm requires intermediaries that understand the lenses of all the stakeholders and the challenges for each to embrace and create this new health care vision. Cross-stakeholder education and understanding is key to success. The author will call upon his personal observations and clinical measurement expertise to begin to frame up how we can reach common ground. |
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Mark C. Rattray, MD
Consultant, CareVariance;
former National Medical Director, UnitedHealthcare
View Biography
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12:15 pm -
1:15 pm |
Ask an Expert Working Lunches |
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1:30 pm -
2:15 pm |
Pay-for-Performance in Specialty Services: Challenges and Opportunities |
- Learn methods that have been used to address the challenges of working with specialists
- Identifying and measuring target conditions to address care and efficiency
- Designing valid scoring mechanisms for payment and delivering incentives for impact
- Engaging specialists and creating feedback methods for improvement
- Developing a business case and reporting ROI
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Kathleen Curtin
Senior Vice President for Client Services
MedVantage, Inc;
former Vice President for Practitioner Performance
Excellus Health Plan
View Biography
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2:15 pm -
3:00 pm |
Board Certification: An Essential Element of Pay-for-Performance |
The medical certifying boards have collectively adopted a program for the ongoing maintenance of board certification that explicitly incorporates the assessment of practice performance. Health plans and purchasers increasingly recognize that active participation in the Maintenance of Certification process sends an important signal about a physician's commitment to maintaining his or her knowledge and skills, and that incentives to participate in Maintenance of Certification can be a powerful stimulant to engage physicians in measuring their own performance. This presentation, will describe the American Board of Internal Medicine's Maintenance of Certification Program, and how it is being used by health plans and payers.
By the end of this session, participants should have an understanding of:
- The Maintenance of Certification process, and how it is engaging physicians in the assessment of their practice performance
- The certifying boards' overall objectives for certification and Maintenance of Certification
- How health plans and payers can use, and are using, the Maintenance of Certification program and the measurement component of it, to engage physicians in quality measurement and improvement.
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Cary Sennett, MD, PhD, FACP
Senior Vice President, Research and Development
American Board of Internal Medicine
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| Show Details |
10:45 am -
11:30 am |
The Next Generation of Efficiency Scoring: Identifying Overuse and Misuse in your Community |
- Describe the limitations of current efficiency roll up scoring models
- Stress the importance of explicitly defining the goals of one's P4P program
- Proposing the abandonment of quality vs. cost profiling in favor of a focus on overuse, misuse and underuse
- Offering a methodology by which overuse use and misuse can be identified for populations of patients
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Howard Beckman, MD, FACP
Medical Director, RIPA
Clinical Professor of Medicine, University of Rochester
View Biography
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Robert A. Greene, MD, FACP
Associate Medical Director
Rochester Individual Practice Association, Inc.
View Biography
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11:30 am -
12:15 pm |
Learning as We Go: Improving Measurement Reporting in Pay-for-Performance |
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Irene Fraser, Ph.D
Director, Center for Delivery, Organization and Market
AHRQ
View Biography
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12:15 pm -
1:15 pm |
Ask an Expert Working Lunches |
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1:30 pm -
2:15 pm |
Quality over Quantity - Creating Accurate Performance Measures |
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Mary Reich Cooper, MD, JD
Vice President and Chief Quality Officer
Lifespan Corporation
View Biography
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2:15 pm -
3:00 pm |
Strategies to Engage Physicians in Medicare and Medicaid Disease Management |
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Maureen Mangotich, MD, MPH
Chief Medical Officer, Senior Director, Clinical Outcomes
McKesson Health Solutions
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James L. Rosenzweig, MD
Director, Disease Management
Joslin Diabetes Center;
Assistant Professor of Medicine, Harvard Medical School
View Biography
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| Show Details |
| Chairman: |
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Hector Rodriquez
Health Plan Industry Technical Stragtegist
Microsoft
View Biography
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10:45 am -
11:30 am |
Information Technology Support of Personalized Medicine |
| Advances in the understanding of the genomic basis of disease will have a significant impact on the practice of medicine. Genomic information will be used to guide diagnostic and treatment decisions and should lead to more efficient and effective use of procedures, medications and treatments. This potential for improved quality and efficiency is likely to represent a core component of the next generation of pay for performance strategies.
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John Glaser, PhD
Vice President and CIO
Partners HealthCare
View Biography
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11:30 am -
12:15 pm |
Defining Next Generation Electronic Health Records |
- Hear strategies to improve outcomes through EHR implementation including clinical process improvement, knowledge management, and delivery of the right information to the provider through structured documentation tools, order sets, alerts and reminders and tools to manage populations, including prevention populations
- Learn practical tools for effective patient engagement
- Develop a vision for future of EHRs and discuss strategies for implementation
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James Hereford
Executive Vice President, Strategic Services & Quality
Group Health Cooperative
View Biography
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12:15 pm -
1:15 pm |
Ask an Expert Working Lunches |
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1:30 pm -
2:15 pm |
Data Integration to Improve Quality and Efficiency |
- Understand the challenges involved in bringing together hospital information over a wide geographic area and efforts to encourage and assist outpatient providers in their acquisition and use of EHR systems
- Learn about community engagement efforts create a standardized data set and a system to index the master patient identifier
- Hear about the financial sustainability and governance challenges
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Thomas Fritz
Chief Executive Officer
Inland Northwest Health Services
View Biography
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2:15 pm -
3:15 pm |
How Health Information Exchange Initiatives and RHIOs Support Quality Improvement and Pay for Performance: Trends and Three Case Examples |
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Janet Marchibroda
Chief Executive Officer
eHealth Initiative and Foundation
View Biography
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12:15 pm -
1:15 pm
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These luncheon sessions provide the opportunity to have candid conversations with World Congress’ expert speaking faculty and get answers to your most pressing questions and day-to-day concerns. Sessions are limited to 10 participants and contributing faculty members will be announced periodically. Register for these sessions when you arrive at the conference. Lunch will be served.
Click here to view details » |
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3:15 pm -
4:15 pm
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4:15 pm -
4:30 pm
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