Breakout sessions
WednesdayMARCH 4
Morning SESSIONS
Morning and afternoon sessions run 60 minutes, then repeat. There is a 15-minute break between sessions.
Lessons from the National Health Plan Collaborative – 10 Years of Health Plan Innovations to Reduce Health Care Disparities, Improve Quality and Health Care Outcomes
Rita Carreon
Director of Clinical Strategies & Health Care Equity
America’s Health Insurance Plan
Rhonda Moore Johnson
Senior Medical Director,
Health Equity & Quality Services
Highmark, Inc.
- Recognize the historical context, accomplishments and impact of the National Health Plan Collaborative (NHPC)
- Describe the innovative strategies underway by NHPC health plans to improve culturally competent care, patient – centered strategies, language access services and pay for performance initiatives.
- Hear “lessons learned” from Highmark Inc. corporate efforts to reduce disparities and improve health literacy.
Understanding the 340B Drug Pricing Program
James Kenney, Jr.
Pharmacy Operations Manager
Harvard Pilgrim
- Review Participation Requirements for the 340B Program
- Understand 340B Finances
- Discuss exclusions for Medicaid and Orphan Drugs
- Evaluate Potential 340B Opportunities for Health Plans
Primary Medication Non-Adherence in Specialty pharmacy
Melissa Laurie
Manager, Specialty Pharmacy
OptumRx
- Definition and Prevalence
- Identification
- Reasons
- Financial Impact
- Interventions
Preparing for Potential Disruption
Lindy Hinman
Senior Vice President
Avalere Health
- Identify next significant milestones and potential impact to the market
- Anticipate impact of upcoming Supreme Court decision
- Learn what benefit designs are succeeding in driving enrollment
A Model for Putting Accountability in Oncology Care: The Patient Comes First
Laura Long
Chief Medical Officer, VP of Clinical Innovation
BlueCross Blue Shield South Carolina
- Identify at least three key drivers of change in the oncology practice model today.
- Discuss key attributes of at least 3 current oncology models to align payment and quality.
- Identify key components to include in future oncology practice redesign to achieve accountability.
Assessing Quality and Competency in Cancer Care: The Managed-Care Perspective
John Fox, MD, MHA
Associate Vice President of Medical Affairs
PriorityHealth
- Understand the current cost/quality disparities that exist in our American Healthcare system as well as widespread variation in practice patterns and outcomes
- Understand the concept of an accountable care organization (ACO) as potential a solution to the problem of cost/quality disparity in American healthcare
- Understand the features of ACOs that could enable their success vs. failure
When to Call the Cavalry: Medical Science Liaisons in Support of Formulary Discussions
Edmund Pezalla
VP, National Medical Director for Pharmacy Policy and Strategy
Aetna
- What are the key points that help make that case?
- What resources will you need?
- What are some key clinical uses that payors need to address in making selections for closed formularies?
Using the ACO/Provider collaboration model for enhanced pharmacy management including Quality and Cost
Chronis Manolis, RPh
Vice President of Pharmacy Services
UPMC Health System (Pennsylvania)
- Using pharmacists in the medical home – is it effective?
- P&T optimization for enhanced decision support
- Using physician risk models to enhance drug management
AFTERNOON SESSIONS
Sessions are 60 minutes beginning at 2:30 pm – 3:30 pm and repeated again at 3:45 pm – 4:45 pm.
The Community Pharmacist and The Value Equation
Greg Drew
President
Value Drug Company
Community pharmacy, regardless of channel, provides most medications to US health care.
Let’s see how they may be major influencers of pharmaceutical outcomes:
- The community pharmacist and the impact on Star Ratings
- Can a local specialty pharmacy model be beneficial?
- How might Medication Therapy Management and Med-synch programs enhance adherence?
- Are the market forces too much to let them participate?
Understanding the Role of ACO's in our Healthcare Delivery System
Kenny Cole, MD
Associate Chief Medical Officer and VP of Care Delivery
BlueCross BlueShield Louisiana
- Understand the current cost/quality disparities that exist in our American Healthcare system as well as widespread variation in practice patterns and outcomes
- Understand the concept of an accountable care organization (ACO) as potential a solution to the problem of cost/quality disparity in American healthcare
- Understand the features of ACOs that could enable their success vs. failure
Orphan Diseases – What Makes Them So Unique?
Charlie Bell
Director, New Business Development
UBC – An Express Scripts Company
- Explore coverage challenges
- Highlight distribution channel options
- Discuss necessary patient support services
Specialty Pharmacy at Retail
Mark Montgomery
President and CEO
Axium Healthcare Pharmacy, Inc.
- Specialty Pharmacy Market Drivers
- SPRx at Retail Highlights
- Patient Engagement
Changing the Conversation from Unit-Cost to Quality and Outcomes
Jay Weaver
VP, Pharmacy Operations
Centene
- Review current pharmaceutical care quality-related metrics including STARS and HEDIS measures
- Survey the evolving landscape of procurement and reimbursement methodologies incorporating quality metrics
- Understand the value-proposition of promoting adherence to and utilization of necessary medications
- Outline current PBM and payer solutions to improve key quality metrics
- Explore health plans efforts to select drug products which provide the most value; considering quality, cost and outcomes
- Discuss opportunities for pharmaceutical manufacturers to partner with payers to drive pharmaceutical care quality
Building a Healthcare System That Works
Jeffrey Weisz
Medical Director/Officer
Kaiser Permanente (Northwest)
- Understanding the direct relationship between high quality and affordability in the Healthcare delivery system.
- Understanding the paradigm shift from illness, to wellness and prevention.
- Patient centered Healthcare / The new patient physician bond.