Breakout sessions
ThursdayMARCH 5
Morning SESSIONS
Sessions are 60 minutes beginning at 9:30 am – 10:30 am and repeated again at 10:45 am –11:45 am.
Provider Contracting - Updates on the Latest Trends on Payer Contracting With: Specialty, Mail and Retail Providers
Bill Barre
Vice President, Business Development
MedImpact Healthcare Systems, Inc.
- Understand new trends and developments and contracting between PBMs and pharmacy providers for retail, mail service and specialty.
- Review developments to drive network traffic through preferred, limited and/or mandated fulfillment solutions.
- Develop new insights into alternative and emerging fulfillment solutions.
- Understand the role and impact for pharmaceutical manufacturers as it relates to drug fulfillment strategies.
Exchanges and Multicultural Populations: Still a Significant Market Opportunity!
Russell Bennett
Vice President/SVP
UnitedHealthcare
- How are health plans reaching out to multicultural populations?
- Has enrollment of diverse populations been successful?
- What remains to be done?
- As more individuals get coverage, what hard-to-reach eligible populations remain?
- Once they get coverage, how do we engage them in the health system
Specialty Pharmacy Contracting
Charles Bell
Director, New Business Development
Express Scripts
- Detailed review of the key components of a contract between a specialty pharmacy and a manufacturer
- Discussion of best practices during the contracting process including timelines, internal coordination, and general preparedness
- Overview of pricing structures and the role of Fair Market Value assessments
Medicare Advantage Stars: A View from Above
David Larsen
Director, Quality Improvement
SelectHeath
- Update: Stars 2015- Wishing on a Star
- How to have a successful Stars management program
- Visions of Stars 2016
- Working with Medicare Advantage plans to help them improve their Star ratings
One Size Does Not Fit All
Barbara Haasis
Sr. Clinical Lead, Alternative Payment Programs
Florida Blue
- Diverse geography and physician practice composition across the state required Florida Blue to design multiple programs appropriate in scope and design to move the quality and cost bar; one size does not fit all!
- Understand how national PCMH recognition standards such as NCQA impact practices in ACO’s and PCMH models. They play a significant role in the transformation to patient centeredness.
- Behavior will not change without meaningful and understandable data. I will provide samples of the data shared 24/7 with providers and physicians through our portal
- Provide the results of implemented programs. Significant cost savings and reductions in ER utilization admissions, preventable avoidable complication already realized in both ACO and PCMH
Advancing the Twin Goals of Improving Quality While Slowing Spending Growth: The Alternative Quality Contract (AQC)
Sean Murphy
Senior Director, Network Contracting
Blue Cross Blue Shield of Massachusetts
- How to approach the holy grail of health care reform, reducing costs while increasing quality
- Important considerations when building a reimbursement model that puts providers at risk for total medical expense
- Ways to partner with and support providers to be successful in risk contracts
The Pharmaceutical Value Equation – Contracting with Integrated Health Services Organization
Peter Mikhail
Associate Vice President Procurement Services
Geisinger Health System
- Understanding the evolution of healthcare systems and the associated value shift
- Understanding the full economic picture and value equation
- Understanding the partnership potential between manufacturer, provider, and payer
Update on Future Direction of Oncology Drug Markets
Burt Zweigenhaft, MBA, CHIE
Vice Chairman
Onco360
- Understand the different market segments mega trends
- Help evaluate business segment risks and opportunities
- Adjust you strategy and position on market segment for success
- Develop a market implementation plan to navigate business channels
- Understand who has market control and influences drug access to coverage
AFTERNOON SESSIONS
Sessions are 60 minutes beginning at 2:30 pm – 3:30 pm and repeated again at 3:45 pm – 4:45 pm.
Understanding the Value of Specialty Pharmacy from the Payer perspective
Megan Bender
Sr. Director Specialty Sales & Account Management
BriovaRX a subsidiary of Catamaran
- High-touch Care Model
- PA facilitation
- Increased Adherence
- Channel strategy
- Biosimilars strategy
- Therapy management and preferred products strategies (including their questions around manufacturer copay card utilization)
The importance of Star Ratings and what it means to payers and how pharma can best partner
Flo Osterbauer
Medicare/Senior Products Director
Cigna
Patient Reported Outcome Data – The Next Wave in Big Data
Neil B. Minkoff, M.D.
Founder and CEO
FountainHead Healthcare
- Understand current barriers to PRO use
- Understand how technology can address these barriers
- See where understanding of disease states benefit most from PROs
Managing the Medicaid Population: Forging a New Blueprint for Success
Jena L. Estes
Vice President, Government Program Integrity and Senior Government Initiatives
BlueCross Blue Shield Association
With the explosion of the newly insured population expected to continue to grow and the large numbers that will move into the Medicaid program, many represent newcomers to the healthcare system. Our traditional systems and approaches to managing this population will be challenging as many health plans are already experiencing. How will our industry align itself to manage and improve the health of one of our most vulnerable populations?
In this session, we will discuss this issue by:
- Exploring existing belief systems and how they support innovative approaches
- Understanding the impact of limiting beliefs
- Review current quality measures specifically addressing medication-related metrics
- Exploring foundational building blocks for a new blueprint for succeeding in the Medicaid market
Contracting in New Age of Formulary Management
Jason Zilocchi
Sr. Director Pharmaceutical Strategies and Solutions
Express Scripts
- Current strategies in formulary management
- Forces driving current behavior
- Different Contracting Strategies (PMPM, Net Price, Outcomes)