Payer-provider collaboration will be hot topic at RISE Summit

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The RISE Summit in Nashville has dedicated a whole track to the topic of payer-provider collaboration.

The shift to value-based care has put a premium on coordination and collaboration among payers and providers. Consequently, the upcoming RISE Summit in Nashville has dedicated a whole track to the issue, examining groundbreaking care models, strategies and trends, as well as best practices.

Here are some of the more noteworthy offerings:

Monday, March 6

3:00 p.m.: Robert London, M.D., senior state medical director for Wellcare of South Carolina, and Kevin Kearns, M.D., chief medical officer of Advance Health, will discuss strategies for delivering efficient care for high-risk beneficiaries.

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The session, titled “Optimizing Care and Outcomes Across Episodes of Care,” will focus on how health plans can coordinate with providers to manage chronic care across a variety of settings, as well as lessen the inappropriate use of emergency departments and institutional care.

3:45 p.m.: Medicare’s Independence at Home Demonstration forms the cornerstone of a session titled “The Radical Primary Care Model That Led to What CMS Called ‘The Most Successful Demonstration in Medicare History.’”

Damien Doyle, M.D., medical director of Johns Hopkins Healthcare Medicare Advantage, and Kevin P. Murphy, CEO of Principium Health, will guide attendees through best practices and potential pitfalls that come with the shift to providing comprehensive primary care services at the patient’s home.

Tuesday, March 7

10:30 a.m.: Gary Piefer, M.D., chief medical officer of WhiteGlove Health, will lead a process-focused session on “Improving the Performance of a Delivery Network: Tools, Resources and Strategies to Improve Quality, Cost and Satisfaction.”

Topics on the agenda include identifying drivers of critical outcomes, reducing care gaps for nontraditional patients, and providing in-home care for complex patients and postdischarge follow-ups.

11:20 a.m.: A session titled “Better Together: Fostering Payer-Provider Collaboration to Improve Risk Adjustment & Quality Programs” will discuss the persistent disconnect between payers and providers despite increasing alignment of incentives brought about by the shift to value-based care.

Speakers will include Kristen Connulty, risk-adjustment program manager at Tufts Health Plan Medicare Preferred, and Tom Peterson, executive vice president of risk adjustment for SCIO Health Analytics.

2:15 p.m.: A discussion led by David Mauzey, director of value-based care for Optum, will tackle the practical question of how quickly health plans should undertake the transformation to risk-based care models.

Entitled “The Speed of Transformation: Preparing for the Value-Based Contracting Models of Tomorrow,” the session will cover the challenges and benefits of value-based contracting, as well as the drivers of change and the factors that play into the speed at which organizations can successfully undertake the process.

3:15 p.m.: For a look at the critical challenges coming for payers and providers, “The Three Futures: Preparing Your Organization for the Changes in Healthcare Over the Next 5 Years” traces the evolution of insurance benefits, the incentives embedded in value-based care models and the ways in which consumers will increasingly drive changes in the healthcare industry.

Speakers for the session include Bonnie Washington, vice president and head of public policy at Aetna, along with Caroline Pearson and Elizabeth Carpenter from Inovalon.