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Pre-Conference Workshops – Wednesday, December 3, 2008

WORKSHOP A 9:00 a.m. – 12:00 p.m.

The Value Measurement Life Cycle: Measuring Healthcare Quality & Efficiency

The U.S. healthcare system’s desire to measure the value of care has never been greater, fueled by the demand from consumers who expect published, transparent information on healthcare delivery. Providers are also concerned with having visibility into the measures that impact them. They want to verify that the measures are correct and also understand how these measures affect patients and services, so that they can improve the quality of the care provided. Recent discussions about how to best meet these requirements have highlighted the importance of three key elements – the need for more meaningful data, transparency regarding measure development and the strategic use of this information.

This workshop examines the role of data quality in the life cycle of healthcare value measurement and its impact on physician/provider engagement. By attending, health plan managers learn key considerations for engaging providers, while obtaining, managing and reporting quality and performance-related information. The workshop also examines data collection issues involved with acquiring, aggregating and managing electronic health information from a wide variety of organizations. Specific workshop objectives include:

  • Understanding the value of standards in improving data quality

  • Organizing stakeholders around data quality goals and help secure physician/ provider engagement.

  • Identifying the key technology, business process, and organizational management issues involved in the acquisition, aggregation and dissemination of key health and performance-related data

  • Understanding the primary considerations related to the development and use of evidence-based outcomes, quality of care and performance measures for provider and payer organizations

  • Understanding how the adoption of key health information technology systems can facilitate performance measurement data collection and reporting

The Workshop Leaders:

Joe Nichols, MD, Medical Director, ViPs, General Dynamics Technology Company has oversight responsibility for value measurement products, including HEDIS reporting, provider profiling and cost/efficiency measurement applications. Nichols has a wide range of experience in healthcare information technology on the provider, payor and vendor sides of the healthcare business. He has numerous publications around healthcare quality and other health-related topics and was contributing author to a university text on electronic health records.

Donald Storey, MD, Former Medical Director, Aetna is an expert A i n p a y f o r p e r f o r m a n c e , v a l u e - b a s e d b e n e fi t d e s i g n , a n d o t h e r i s s u e s i n v o l v e d w i t h h e a l t h p l a n s . D r . S t o r e y w a s a l s o A e t n a s n a t i o n a l m e d i c a l d i r e c t o r f o r t h e A e x c e l h i g h - p e r f o r m a n c e s p e c i a l t y n e t w o r k , w h e r e h e w a s r e s p o n s i b l e f o r p e r f o r m a n c e m e a s u r e i d e n t i fi c a t i o n a n d i m p l e m e n t a t i o n , p r o g r a m c o m m u n i c a t i o n a n d g e n e r a l c l i n i c a l o v e r s i g h t .

WORKSHOP B 1:30 p.m. – 4:30 p.m.

How to Successfully Implement Pay for Performance or a Value-Based Benefit Design Program

P4P is in the next generation phase of development, with a goal to improve quality performance and cut costs. This workshop examines the fundamentals for designing and implementing a successful pay-for-performance or value-based benefit design program.

In the past, people have looked at systems first rather than providers, which has lead them to failure. Many health plans have put programs into action, but have not done the proper research beforehand. Based on the fact that there are 100 different types of pay-for-performance systems now in place, most hospitals and health plans realize that they must design a specific strategy that will fit their market. By researching purchaser and provider needs in the community, the sponsoring organization can better prepare itself for a successful launch of a sufficient value-based strategy.

This workshop incorporates all of the critical parts to launching a successful P4P and value-based benefit program, leveraging experience from health plan and employer case studies. The workshop also lays out the necessary tools to ensure your program’s effectiveness. Following the workshop, attendees

will have the opportunity to identify which programs are most appropriate and feasible for their organizations’ needs. Specific workshop highlights include:

  • Developing appropriate rewards and incentives to drive quality performance and improvement

  • Incorporating next generation strategies to ensure successful program development

  • Evaluating reimbursement options and working with physicians

  • Accessing cover monitoring and reporting options

The Workshop Leader:

B W i l l i a m J . D e M a r c o , M A , C M C , P r e s i d e n t a n d C h i e f E x e c u t i v e O f fi c e r , D e M a r c o a n d A s s o c i a t e s , h a s w o r k e d w i t h a v a r i e t y o f h e a l t h p l a n s a n d e m p l o y e r s t o b e t t e r r e l a t i o n s h i p s a n d t o b u i l d n e w a p p r o a c h e s f o r p r o d u c t s a n d s t r a t e g i e s . F o r t h e p a s t 2 3 y e a r s , D e M a r c o h a s e s t a b l i s h e d a s p e c i a l i z e d a n d i n d e p e n d e n t a n d o b j e c t i v e s o u r c e o f h e a l t h c a r e m a n a g e m e n t , m a r k e t i n g a n d s t r a t e g i c a d v i s o r y s e r v i c e s .

Past Attendees Gave

“The conference was an excellent overall opportunity to hear both industry trends and what other health plans are doing and planning related to their P4P programs. I especially appreciated the details on program design and results that were presented. It both confirmed our plan’s approach and challenged our thinking on some aspects.”

  • BLUE CROSS BLUE SHIELD OF FLORIDA

“The processes of all stakeholders were pointed out.”

  • WELLMARK

These Rave Reviews

“Pay for performance is evolving nationally, and internationally, at an amazing pace. World Research Group provides a clear, comprehensive, and up-to-date forum for those wishing to be at the forefront of change.”

  • INDEPENDENT HEALTH

“The conference provided an excellent overview of the industry.”

  • HORIZON BLUE CROSS BLUE SHIELD OF NEW JERSEY

e-mail: info@worldrg.com www.worldrg.com/p4p

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