Agenda: San Jose Healthcare Informatics Executive Roundtable

Presentation and Discussion

Quality and Payment: The Intersection of MACRA, Quality and Financials

Healthcare can be dysfunctional when it comes to quality vs. cost-- and in value-based care, the quality/cost ratio is the difference between financial strength, and struggling. But, the transition to value-based care isn't stopping, and physicians in addition to provider organizations must position themselves to provide the highest quality care possible--their reimbursement depends on it.

In this session, we visit with the National Committee for Quality Assurance's national head of research and quality measurement, Dr. Michael Barr, as he details benchmarks for quality care delivery from the primary and specialty care perspectives. Hear Dr. Barr describe how launching new care models, like the Patient-Centered Medical Home (PCMH/PCSP), are bending the cost curve, improving MACRA readiness, performance, and reimbursement at the system level, all while improving cost of care and financial health of provider organizations.

Key Takeaways:

Review benchmarking and effects of quality/cost dysfunction in health care delivery from primary care/specialty care perspective
Introduce PCMH/PCSP models of care (Patient-Centered Medical Home; Patient-Centered Specialty Practice) and related programs
Review evidence of successful implementations and effects on quality, cost, experience metrics
Link PCMH/PCSP (+ other programs) to better MACRA readiness, performance, and reimbursement at system level AND quality, cost, access, and clinician/team burnout
Illustrate approach to network/ACO/health system application of standardized assessment/redesign program such as PCMH/PCSP

Session Facilitator:

Michael Barr, MD, Executive Vice President, Quality Measurement and Research Group, National Committee for Quality Assurance (NCQA)

Presentation and Discussion

Data Quality Matters: EHR Data Quality and Where Data Intersects with APMs, MIPS, and Finance

With the January 1 deadline passed, and the March 31, 2018 reporting submission deadline forthcoming, the question of data quality and accuracy can now make the difference between the top quartile of providers, and a 5 percent negative adjustments in Medicare reimbursement. Providers must ensure their data is as accurate as possible, as this premise ultimately overlaps with health system financial teams.

In this session, join Dr. Michael Hogarth, as he illustrates the nuances and differences between both unique incentive programs, and why quality EHR data and analytics matter. Discover how financial penalties are administered baed upon reporting data, what the Centers for Medicare and Medicaid Services (CMS) is looking for when focusing on positive payment adjustments, and suggestions for mitigating these issues throughout this year.

Key Takeaways:

Identify critical differentiators between APMs and MIPS tracks of the quality payment program
Discuss potential financial pitfalls and penalties for both systems, based upon data quality
Outline long-term strategies for success in both tracks, as it related to providing accurate and quality data during reporting periods
Illustrate how these changes impact existing physician group relationships, negotiations, and employment forecasting

Session Facilitator:

Michael Hogarth, MD, Department of Pathology and Laboratory Medicine, UC Davis Medical Center

Presentation and Discussion

Strategies for Value-Based and Quality Payment Program Success

St. Luke’s Health System, the largest nonprofit health system in the state of Idaho, needed a practical strategy to categorize populations, aggregate patient and operational data across enterprise-level systems, and create actionable improvement plans to survive in a marketplace now built around risk management.

Join Dr. Geoff Swanson, former president of St. Luke’s Clinic Coordinated Care and current Chief Medical Officer for Propel Health, as he outlines strategies to mitigate risk, manage defined populations, and improving overall clinical outcomes leveraging value-based performance management.

Key Takeaways:

Learn how St. Luke’s managed common challenges in managing value-based payment programs
See practical strategies behind risk management and quality improvement, highlighting operational trends analysis, evaluation of patient sub-population data, and financial systems assessment
Understand system-wide approach to physician group engagement and collaborative efforts for risk-based contracting
Discuss top challenges, lessons learned, and best practices that can be implemented immediately

Session Facilitator:

Geoffrey N. Swanson, MD, Chief Medical Officer, Propel Health

Keith Brown, Director of Client Engagements, WhiteCloud Analytics

Presentation and Discussion

The MACRA Influence on Strategic Relationships, Physicians, and the Financial Bottom Line

Consolidation and partnerships are only the beginning of MACRA's fast-approaching wave of change. With the 2017 reporting year having began January 1, the financial implications year over year for top performers represents millions of dollars in potential revenue-- but negative adjustments present a sizeable risk as well. Relationships with physician organizations have already evolved, with notable trends of small practice consolidation, new physician affilliations, association affiliations, and unique business agreements between physician groups and hospitals. What must senior leaders be aware of to succeed?

In this engaging session, hear from ACO leader and a key member of one of the top national performers in the Medicare Shared Savings Program (MSSP), Dr. Jim Whitfill, as he discusses the financial risk and capital requirements for value-based care that will continue to drive consolidation and partnership among physician groups. Listen in as Dr. Whitfill identifies key employment issues, shining a spotlight on the shared revenue balancing equation.

Key Takeaways:

Financial risk and capital requirements for VBC will continue to drive consolidation and partnership among physician groups
Describe how hospital systems will have to negotiate relationships with internal and external stakeholders
Outline the critical driving factors and financial importance of productivity and engagement, highlighting real-world examples

Session Facilitator:

Jim Whitfill, MD, Chief Medical Officer, Innovation Care Partners

MACRA Executive Roundtable: Implications of MACRA

Take your seat at the boardroom table-- join Healthcare Informatics Editor-in-Chief Mark Hagland, and senior executives from across the country as they share their top best practices, tactical visions, financial strategies, organizational structures, and lessons learned in this interactive roundtable discussion.

Be part of this engaging session, and walk away with tools to survive and thrive throughout the 2017 MACRA reporting year.

Join Mark Hagland, Editor-in-Chief, Healthcare Informatics as we host a strategic discussion around blueprints for success in the MACRA era.

Moderator: Mark Hagland, Editor-in-Chief, Healthcare Informatics

Roundtable Participants:

Michael Barr, MD, Executive Vice President, Quality Measurement and Research Group, National Committee for Quality Assurance (NCQA)

Michael Hogarth, MD, Department of Pathology and Laboratory Medicine, UC Davis Medical Center

Dr. Geoffrey N. Swanson, Chief Medical Officer, Propel Health

Keith Brown, President, WhiteCloud Analytics

Jim Whitfill, MD, Chief Medical Officer, Innovation Care Partners

Thursday, April 13, 2017