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  • Evaluating the impact of P4P with the medical home model

  • Emphasizing the importance of how the medical home work with P4P programs

  • Identifying the current state of medical home management and P4P: what has been done and what needs to be done in the future Frank Opelka, MD Vice Chancellor for Clinical Affairs and Professor of Surgery LOUISIANA STATE UNIVERSITY

4:30 Bridges To Excellence - A Successful Employer Initiative in the P4P Market: Where Are We Today and Where We Expect To Be Tomorrow

Clear Choice Health Plans and Bridges to Excellence worked together on healthcare quality improvement. There are many new occurrences with P4P and the health quality landscape. This session examines where the health quality landscape is today and how Bridges to Excellence fits into that picture. Moreover, there will be a critical discussion regarding the Bridges to Excellence strategy on addressing healthcare quality delivery. Specifically, this session examines:

  • Understanding the Bridges to Excellence program and its affiliation with health plans

  • Why employers find Bridges to Excellence appealing, especially around their ability to provide a comprehensive healthcare management strategy on supply and demand chain management

  • Why providers are getting involved with Bridges to Excellence Joseph Johnson, MD Vice President of Medical Affairs CLEAR CHOICE HEALTH PLANS

  • Integrating Medical Home with Consumerism behaviors, Transparency tools,

and Pay-for-Performance quality programs

Robert Cetti Director of Provider Relations CIGNA HEALTHCARE

4:30 Integrating New Incentives that Drive Quality Improvement into Contracts

Aligning Forces for Quality is a Robert Wood Johnson Foundation endeavor that seeks to lift the quality of health and health care by teaming up with those who get care, are given care and pay for care. This project applies a wealth of resources, expertise, and training to impact real results in health care quality. The experience of Kansas City’s role will be examined with a special focus on how physicians can get ready for public reporting, scorecards, and P4P. Additionally, the KCQIC group brings together health plans, physicians, and community leaders for health and quality improvement activities. This session focuses on:

  • Identifying “how-to” of quality improvement

  • Capitalizing on increasing consumer engagement

  • Increasing public reporting

  • Initiating nurses to lead the way on quality

  • Addressing equity and language matters Marla Tobin, MD Regional Medical Director AETNA

5:15 Conclusion of Day One

Day Two Friday, December 5, 2008

7:15 Morning Coffee

7:50 Chairperson’s Opening Remarks

8:00 Creating a Phase Two P4P Program

Health plans look to reduce costs and improve quality performance. P4P is a main topic in the healthcare industry and many programs have been implemented. It is time to evaluate what strategies were used and the pitfalls learned. This sessions examines the critical approach taken to evaluate each step prior to P4P implementation and during the implementation stages. The session focuses on:

  • Researching your health plan to identify what actions need to be taken before implementing a P4P program

  • Designing a successful P4P program that is appropriate for your health plan

  • Targeting the roles that each individual must take for a successful P4P program

Owen Poole President and Chief Executive Officer

Paula Claytore Director of Managed Care MOUNTAIN STATES HEALTH ALLIANCE

8:45 Maximizing Collaboration Between Hospitals and Health Plans to Pay for Value

Highmark partners with network hospitals to improve patient safety and patient care using its innovative P4P program. Through alignment with national programs and collaboration with providers to solve local issues, this contracting strategy demonstrates quality improvement and managed reimbursement increases. This session focuses on the design and outcomes from the initiative. Other highlights include:

  • Creating a strategy for an innovation design for a hospital P4P program

  • Define how a health plan has used P4P in its contracting strategy with


Michael Madden, MD Medical Director HIGHMARK

9:30 Networking Break, Refreshments & Announcement of Raffle Winners

10:00 Transitioning from a Static P4P to a Value-Based P4P

Amerigroup Mercy Health Plans is one organization that has implemented P4P programs. While implementing these programs, the plan found many benefits and pitfalls. Even though some components of this P4P were advantageous to the organization, the plan moved to a more value-based P4P program. Each part of the process took research, advisory meetings, and strategic planning from the provider side and others involved in contracting. This session focuses on:


TO REGISTER: Call: 800-647-7600 or 781-939-2500 Fax: 781-939-2543

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