ACHP Financial Leaders & Clinical Meeting

Portland, OR US
October 23, 2019 to October 24, 2019

ACHP is hosting its Clinical Collaborative Meeting in Portland, OR on October 23-24. On the first day of the meeting, all attendees will gather to learn, share and network through joint discussions about core elements of a sustainable health care system, a variety of perspectives on peer-led interventions, and organizational best practices on collaborations addressing cost of care. In breakout sessions, participants will join in an in-depth discussion of mental health parity, interact with Civica Rx’s CCO about ways ACHP members can engage with disruptive drug pricing innovations, and share best practices around using segmentation data and methods to understand populations.

The second day will begin with feature Dr. Molly’ Coye’s keynote presentation on how digital health is transforming consumer and provider interactions, followed by a panel discussion around creating shared value by addressing social needs. Then breakout participants will share their experiences with value-based payment models and ways to incentivize behavioral health integration.

Target Audience

Participants include ACHP Financial Leaders, Behavioral Health Directors, Pharmacy Directors, Quality Leaders, Medical Directors and Clinical Executives from ACHP member plans.

Learning Objectives

At the conclusion of the meeting:

  • Medical Directors will be able to identify new opportunities and challenges that new technologies pose for non-profit, regionally-based health plans; more deeply understand innovative approaches to Coordinated Care Organizations and other multi-stakeholder collaboratives working to address health care costs; and analyze what impedes or accelerates value-based payment models to improve care and lower costs.
  • Financial Leaders will be able to identify the specific barriers to challenging the status quo in health care and collaborative strategies for creating a sustainable health care system; utilize organizational best practices for clinical and financial leader collaboration at their respective companies; and effectively work with clinical leaders at their respective organizations on innovative approaches to address high-cost therapeutics such as esketamine and brexanolone.
  • Pharmacy Directors will be able to effectively work with financial leaders at their respective organizations on innovative approaches to address high-cost therapeutics such as esketamine and brexanolone; apply effective strategies to optimize clinical outcomes, patient experience and affordability for health plan members; and more thoroughly understand new initiatives and approaches to biosimilar adoption and the lingering barriers to utilization
  • Behavioral Health Leaders will be able to identify strategies for implementing peer-led interventions to improve the lives of individuals with serious mental illness; confidently respond to mental health parity regulations; and bring back to their respective organizations clinical and financial approaches to improve behavioral health integration.
  • Clinical Executives and Quality Leaders will be able to apply best practices for success in value-based care arrangements; implement best practices for using a variety of data sources and segmentation methods to understand the needs of their populations ; and bring back to their respective organizations clinical and financial approaches to improve behavioral health integration.
Course summary
Available credit: 
  • 9.50 ACPE Pharmacy
    The UPMC Center for Continuing Education in the Health Sciences is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a Provider of continuing pharmacy education.
  • 9.50 AMA PRA Category 1 Credit™
    The University of Pittsburgh School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
  • 9.50 ANCC
    UPMC Provider Unit is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation
  • 9.50 Attendance
Course opens: 
10/23/2019
Course expires: 
12/31/2020
Event starts: 
10/23/2019 - 7:00am
Event ends: 
10/24/2019 - 1:00pm

Fall 2019 Clinical & Financial Leaders Meeting: Draft Agenda

Partnering on High-Value Coverage & Care

October 23-24 | Portland, OR

* Denotes a plenary session, meaning all attendees are invited: Behavioral Health Leaders, Clinical Executives, Financial Leaders, Medical Directors, Pharmacy Directors, and Quality Leaders. Attendees typically have one of the following degrees: MD, RPh, RN, or MSW. The degrees of the staff comprising ACHP’s Clinical Innovation team mirror those of the attendees: two MSWs, one PharmD, and one MD. The team has devoted considerable thought to the design of the plenary sessions, ensuring that the majority of the sessions are valuable and relevant to all attendees.

 

 

u DAY 1 • TUESDAY, OCTOBER 22

 

 

6:00 p.m.

Optional Networking Dinner

xport bar & lounge

          The Porter Portland

          1355 SW 2nd Avenue – Portland, OR 97201

          (503) 306-4835

Join us on the rooftop for an informal pre-meeting networking event with drinks and a light dinner buffet.

 

u DAY 2 • WEDNESDAY, OCTOBER 23

 

7:00 – 8:00 a.m.

 

Networking Breakfast and Registration

JOINT LEARNING SESSIONS

8:00 – 8:15 a.m.

 

 

 

8:15 – 9:00 a.m.

Welcome & Introductions

Russ Kuzel, M.D., SelectHealth

Beth Monsrud, UCare

*Keynote

Governor John Kitzhaber, M.D.

Former Governor John Kitzhaber will share his views on the core elements of a sustainable health care system, drawing on his experience as an emergency room physician and the longest-serving governor in Oregon history. He will discuss the specific barriers that hold us back and strategies for challenging the status quo through innovation and collaboration.

9:00 – 10:00 a.m.

Peer-Led Interventions for Mental Health

Access to high-quality mental health services is severely limited in many areas of the U.S. Peer-to-peer interventions offer an affordable and promising opportunity to link professional mental and physical health care services to individuals with serious mental illness. In this session, attendees will hear a variety of perspectives on peer-led interventions, helping them identify opportunities to implement these cost-effective, high-touch approaches to improving access to care.

Panelists:     John Sinclair Brekke, PhD, University of Southern California

                       Matt Hurford, M.D., Community Care Behavioral Health               

                       Organization

                       Heather Holladay, PG&E

Moderator:  Jennifer Garber, UCare

This session would be applicable to all attendees except for the pharmacists.

10:00 – 10:30 a.m.

 

10:30 a.m. – 12:00 p.m.

Networking Break

* Cost of Care Discussions (Small Groups)

Attendees will share organizational best practices on clinical and financial leader collaboration at their respective companies to address cost of care.

Table Facilitators: George Isham, M.D., ACHP Senior Advisor

                                    Russ Kuzel, M.D., SelectHealth

                                    Beth Monsrud, UCare

                                    Randy Ruplinger, Dean Health Plan

                                    Bethany Smith, CDPHP

Moderator:  Bethany Smith, UCare

12:00 – 1:00 p.m.

Networking Lunch

 

1:00 – 1:45 p.m.

* Financial Leaders’ Perspectives on High-Cost Therapeutics

Hear from ACHP financial leaders on innovative approaches to address high-cost therapeutics such as esketamine and brexanolone.

Panelists:      Sheila Albeke, PharmD, PacificSource

           Kenneth Bischel, PacificSource

          Alison Little, M.D., PacificSource

Moderator:  Jay Godla, Strategy&, Part of the PwC Network

1:45 – 2:00 p.m.

 

 

 

 

 

2:00 – 2:30 p.m.

 

2:30-3:30 p.m.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3:30 p.m.

 

3:30 – 4:30 p.m.

 

 *Ignite Talk – Microsegmentation Analysis

Learn how Presbyterian Health Plan uses a specific type of cluster analysis to identify and stratify members based on behavior and utilization patterns rather than disease. This innovative approach uses claims and electronic health records that provide both retrospective factors such as hospitalization rates and predictive factors such as future persistence of care seeking.

Gray Clarke, M.D., Presbyterian Health Plan

 

Networking Break

 

Collaborative Breakout One

The Behavioral Health Leaders, Clinical Executives & Quality Leaders, Financial Leaders, Medical Directors and Pharmacy Directors will each meet separately for one hour to dive deeper on topics of interest.

Medical Directors

  • Round Robin: ACHP has welcomed a number of new health plan Chief Medical Officers and Medical Directors over the past year. Hear from your newest colleagues and reconnect with your peers on the latest strategic opportunities and developments at respective ACHP plans. Moderator: Connie Hwang, MD, ACHP

Clinical Executives & Quality Leaders

  • Round Robin: Clinical Executives & Quality Leaders will share current issues in managing quality and population health outcomes alongside total cost of care. Moderator: Eva Powell, ACHP

Pharmacy Directors

  • Round Robin: Pharmacy Directors will engage in discussions focused on pharmacy related challenges in an evolving healthcare landscape. Moderator: Courtney Johnson, PharmD, ACHP

Financial Leaders

  • Round Robin: Financial Leaders will have the opportunity to continue to network and dive deeper on topics of interest. Moderator: Kiana Moore, ACHP

Behavioral Health Leaders

  • Round Robin: Behavioral Health Leaders will have the opportunity to connect with their peers on top-of-mind issues at their respective plans. Moderator: Megan Knauss, LGSW, ACHP

CME Adjournment
 

Collaborative Breakout Two (No CME credit awarded)

There will be no CME Credit awarded for participation in this one-hour session for any participants.

Medical Directors, Pharmacy Directors, & Financial Leaders

  • Civica Rx: One Year’s Progress: Join us for an interactive session with Heather Wall, Civica Rx’s Chief Commercial Officer. Discussion focuses on Civica Rx’s recent milestones and ways ACHP members can engage with Civica Rx’s disruptive drug pricing and supply chain innovations.

Moderator: Connie Hwang, MD, ACHP 

Clinical Executives & Quality Leaders

  • Data, Analytics and Segmentation for a Healthier Population: Collaborative participants will share best practices for using a variety of data sources and methods of segmentation to know and understand the needs of their populations. Additional conversation will focus on how these data can be used to engage and partner with financial leaders and other executive decision-makers. Moderator: Eva Powell, ACHP

Behavioral Health Leaders

  • Mental Health Parity: Join us for an in-depth discussion of mental health parity, including a “state of the state,” with Tim Clement, Director of Legislative Development at the American Psychiatric Association. This session will cover topics such as Medicaid parity reviews, definitions and criteria used to make coverage decisions and guidance on financial testing for employer groups. Moderator: Megan Knauss, LGSW, ACHP

5:30 p.m.

Networking Reception and Dinner

          Oregon Museum of Science and Industry (OMSI)

          1945 SE Water Avenue – Portland, OR 97214

          (503) 797-4000

 

Join us for a reception and dinner at the OMSI, only a short walk or three-minute drive from the hotel. We’ll gather in the lobby at 5:30, and attendees should feel free to dress in business casual attire. The featured exhibit will be Exquisite Creatures: A Dialogue with Art, Nature and Science, an extensive art and multimedia sensory experience that unravels man’s intimate relationship with the natural world. Business casual attire welcome.

 

 

 

 

u DAY 3 • THURSDAY, OCTOBER 24

 

 

 

7:00 – 8:00 a.m.

Networking Breakfast

 

 


JOINT LEARNING SESSIONS

 

8:00 – 8:30 a.m.

*Welcome / Regional Perspective

Ken Provencher, PacificSource (invited)

 

8:30 – 9:15 a.m.

*Keynote

 

 

Dr. Molly Coye will discuss digital health and how it is transforming both consumer and provider interactions and care delivery. What opportunities and challenges do these new technologies present to nonprofit, regionally-based community health plans? Coye is executive in residence at AVIA, the leading network for health systems advancing digital solutions, and she previously served as chief innovation officer for UCLA Health.

Molly Coye, M.D., AVIA

 

9:15 – 9:45 a.m.

*CEO Update

Ceci Connolly, ACHP

 

9:45 – 10:15 a.m.

Networking Break

 

10:15 – 11:30 a.m.

 

 

 

 

 

 

 

 

 

 

 

 

11:30 a.m. – 12:00 p.m.

 

12:00 – 1:00 p.m.

 

 

Creating Shared Value by Addressing Social Needs

The current enthusiasm for addressing social determinants of health (SDOH) has fostered important discussions and has led many to ask what the role of health plans and providers should be in addressing pervasive, societal problems. The evolution of value-based care creates an opportunity to develop innovative business models that better serve the needs of patients and communities while delivering more competitive financial returns. Panelists will provide real-life examples of how they have seized this opportunity, the outcomes they’ve achieved and the work that lies ahead.

 

Panelists:       Nicole Friedman, Kaiser Permanente Northwest

                         Krista Hoglund, Security Health Plan

                         Edward McEachern, M.D., PacificSource

                         Sarita Mohanty, M.D., Kaiser Permanente

Moderator:   George Isham, M.D., ACHP Senior Advisor

This session would be applicable to all attendees except for the pharmacists.

Networking Break & Get Lunch

 

Collaborative Breakouts & Lunch

The Behavioral Health Leaders, Clinical Executives & Quality Leaders, Financial Leaders, Medical Directors and Pharmacy Directors will each meet for one hour to dive deeper on topics of interest.

Medical Directors

  • Moving Further and Faster on Value-Based Care: Experience has shown that value-based payment models can improve care and lower costs. Yet, the transition to value has been slower than what many health care leaders have hoped. Join your ACHP Medical Director colleagues in a facilitated discussion on what has accelerated and potentially impeded successful value-based care payment models in your region. Moderator: George Isham, MD, ACHP

Pharmacy Directors

  • Round Robin Part 2: Pharmacy Directors will have the opportunity to continue discussions focused on pharmacy related challenges in an evolving healthcare landscape. Moderator: Courtney Johnson, PharmD, ACHP

Clinical Executives & Quality Leaders, Behavioral Health Leaders, Financial Leaders

  • Incentivizing Behavioral Health Integration: Behavioral Health Leaders, Clinical Executives & Quality Leaders and Financial Leaders will discuss promising practices for engaging primary care and behavioral health providers to promote more integrated care, using innovative clinical and financial models, shared performance goals and educational support. Moderator: Kiana Moore, ACHP

 

1:00 p.m.

Early afternoon

 

 

Meeting Concludes

Winery Tour

             Stoller Family Estate

             16161 NE McDougall Road

             (503) 864-3404

Take some time to relax with your colleagues on this low-key excursion to the

Stoller Family Estate, which will include a tour of the winery, a wine tasting 

and light snacks at the vineyard. Please board the bus outside the lobby by  

1:30 p.m. The activity is expected to take approximately three hours, including

travel time.       

 

The Porter Portland
1355 SW 2nd Avenue
Portland, OR 97201
United States

Faculty Listing

 

Sheila Albeke, Pharm.D

Clinical Pharmacy Manager

PacificSource

Bend, OR

 

Kenneth Bischel, BS

Lead Associate Actuary

PacificSource

Eugene, OR

 

 

 

John Brekke, Ph.D

Professor of Social Work

University of Southern California (USC)

Los Angeles, CA

 

Gray Clarke, MD

Senior Medical Director for Centennial Care

Presbyterian Health Plan

Albuquerque, NM

 

 

 

Tim Clement, MPH

Director of Legislative Development American Psychiatric Association (APA)

Washington, DC

 

Ceci Connolly, BA

President and Chief Executive Officer

Alliance of Community Health Plans

Washington, DC

 

 

 

Molly Coye, MD, MPH

Executive in Residence

AVIA

Chicago, IL

 

Kelly Crowe, BBA, MA

Vice President, Operations

Alliance of Community Health Plans

Washington, DC

 

 

 

Nicole Friedman, MS

Operational Lead, Thrive Local

Kaiser Permanente NW

Portland, OR

 

Jennifer Garber, LICSW

Associate Vice President of Behavioral Health UCare

Minneapolis, MN

 

 

 

Krista Hoglund, BS

Chief Actuary

Select Health Plan of Wisconsin, Inc.

Marshfield, WI

 

Heather Holladay, BA, MS

Integrate Health Manager

Pacific Gas & Electric (PG&E)

San Francisco, CA

Matt Hurford, MD

Chief Medical Officer

Community Care Behavioral Health Organization, UPMC

Pittsburgh, PA

 

Connie Hwang, MD

Chief Medical Officer and Director, Clinical Innovation

Alliance of Community Health Plans

Washington, DC

 

 

 

George  Isham, MD, MS

Senior Fellow

HealthPartners Institute

Minneapolis, MN

 

Courtney Johnson, Pharm.D, RPh

Clinical Innovations Program Manager

Alliance of Community Health Plans

Washington, DC

 

 

 

John Kitzhaber, MD

Former Governor of Oregon

Portland Oregon

 

Megan  Knauss, MSW

Innovations Program Manager

Alliance of Community Health Plans, DC

Russ Kuzel, MD

Vice President and Chief Medical Officer

SelectHealth

Salt Lake City, UT

 

Lauren Leeman, BS

Marketplace Analytics Manager

Alliance of Community Health Plans

Washington, DC

Alison Little, M.D., M.P.H.

Medical Director for Medicaid Programs

PacificSource Community Solutions

Bend, OR

 

Edward McEachern, MD

Chief Medical Officer

PacificSource

Springfield, OR

Sarita  Mohanty, MD, MPH, MBA

Vice President, Care Coordination of Medicaid and Vulnerable Populations

Kaiser Permanente

Oakland, CA

 

Beth Monsrud, BA

Senior Vice President and Chief Financial Officer

UCare

Minneapolis, MN

Anthony Montoya, MPS

Public Policy Associate

Alliance of Community Health Plans

Washington, DC

 

Kiana Moore, MS

Director, Market Strategy and Analytics

Alliance of Community Health Plans

Washington, DC

Eva Powell, MSW

Senior Manager, Quality Programs

Alliance of Community Health Plans

Washington, DC

 

Ken Provencher, MBA

President and CEO

PacificSource Health Plans

Springfield, OR

Randy Ruplinger, BS

Vice President and Chief Financial Officer

Dean Health Plan

Madison, WI

 

Bethany Smith, CPA

Executive Vice President of Finance and Chief Financial Officer (CFO)

CDPHP

Albany, NY

Maria Velasco, CMP

Manager, Events and Business Development

Alliance of Community Health Plans

Washington, DC

 

Heather Wall, MBA

Chief Commercial Officer

Civica

Riverton, UT

Jay Godla, MBA, MS

Vice President & Lead Partner

Strategy&, part of the PwC network

Oak Brook, IL

 

Tricia Brooks, BA, MA

Vice President, External Affairs

Alliance of Community Health Plans

Washington, DC

 

Faculty Disclosure

All individuals in a position to control the content of this education activity including members of the planning committee, speakers, presenters, authors, and/or content reviewers have disclosed all relevant financial relationships with any entity producing, marketing, re-selling, or distributing health care goods or services, used on, or consumed by, patients.

The following relevant financial relationships were disclosed:

  • John Brekke, Ph.D, USC and Pacific Clinics, Joint Negotiated Proprietary Interest
  • George Isham, MD, Center for Health Economics and Policy at FTI Consulting, Consultant and Member of the Advisory Board / ACHP, Senior Advisor and Consultant / Martin's Point Health Care, Member of the Board of Directors
  • Russ Kuzel, MD, Rigel Pharmaceuticals, Inc., Member of Advisory Board / Ilumina, Site Visitor
  • Sarita  Mohanty, MD, MPH, MBA, COPE Health Solutions, Member of the Board of Directors
  • Molly Coye, MD, MPH; AVIA, Executive Sponsor of Medicaid Transformation, Executive in Residence / 98point6, Member of the Medical Advisory Board / ConsejoSano, Member of the Board of Directors / Aetna, Member of the Board of Directors 2005-2018 / WiserCare, Member of Advisory Board / Babyscripts, Member of Advisory Board / Ginger, Member of the Board of Directors

 

No other planners, members of the planning committee, speakers, presenters, authors, content reviewers and/or anyone else in a position to control the content of this education activity have relevant financial relationships to disclose.

In support of improving patient care, this activity has been planned and implemented by the Alliance of Community Health Plans and the University of Pittsburgh  is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Physicians

The University of Pittsburgh School of Medicine designates this live activity for a maximum of 9.5 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Pharmacists

This knowledge-based activity provides 9.5 contact hours of continuing pharmacy education credit.

Universal Activity Number List:  JA4008223-9999-19-004-L04-P

Nurses and Nurse Practitioners

The maximum number of hours awarded for this Continuing Nursing Education activity is 9.5 contact hours.

Other health care professionals

Other health care professionals will receive a certificate of attendance confirming the number of contact hours commensurate with the extent of participation in this activity.

Available Credit

  • 9.50 ACPE Pharmacy
    The UPMC Center for Continuing Education in the Health Sciences is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a Provider of continuing pharmacy education.
  • 9.50 AMA PRA Category 1 Credit™
    The University of Pittsburgh School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
  • 9.50 ANCC
    UPMC Provider Unit is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation
  • 9.50 Attendance

Accreditation Period

Course opens: 
10/23/2019
Course expires: 
12/31/2020
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