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First Illinois Healthcare Financial Management Association & Chicago Health Executives Forum’s 2019 Managed Care Symposium

By Laura Grochowski, Manager, Contract Auditing, Boncura Health Solutions and a member of the CHEF Chapter Communications Committee

Below are key takeaways from the FIHFMA & CHEF 2019 Managed Care Symposium held on February 7, 2019 at the University Club in Chicago:

From the keynote: “Achieving Superior Performance Through Value Based Care Transformation” presented by Frank Williams, CEO and Co-Founder, Evolent Health:

  • For the ACO population, it’s critical that risk scores match the severity of the population
  • Need the ability to predict patients with the highest probability of adverse effects
  • System thinking is necessary to drive transformational changes
  • Key to creating a sustainable market advantage is to provide clinical value, capture value and infrastructure/capabilities

From “Disruptive Innovators Who Will Affect Healthcare Delivery” presented by Joel Shalowitz, MD, MBA, Adjunct Professor of Preventive Medicine, Northwestern University, BDO Fellow:

  • One person’s innovation may be another person’s disruption
  • Truly disruptive innovation is one that improves the cost, quality and access triangle
  • Adoption requirements for value-added disruption include maximizing profit by minimizing expense and/or becoming the new state-of-the-art, evidence-based standard while being accepted by key stakeholders

From “Social Determinants of Healthcare” presented by Art Jones, MD, Chief Medical Officer, Medical Home Network & Principal, Health Management Associates and Luke Hansen, MD, AMITA Health Chief Medical Officer, Population Health:

  • 25-60 percent of deaths are attributable to social determinates
  • Screening Health Risk Assessment must be continually evaluated over time as it is constantly changing. Patients should continue to be restratified using Artificial Intelligence scores from machine learning
  • Inpatient care management should be led by population health as well as outpatient care

From “State of Chicago Healthcare” presented by David E. Smith, Founder, Third Horizon Strategies and Co-Founder of HC3:

  • It’s important to understand that elections have consequences
  • We will see more affiliations and partnerships rather than mergers and acquisitions
  • What can we do without government that is impactful to address health disparities?

From “Industry Insights” presented by Donna Levigne, Divisional Vice President, Health Care Delivery, Blue Cross Blue Shield of Illinois:

  • It’s important to leverage analytics to produce actionable insights
  • Narrow networks and benefit plan/incentive changes are coming in the future
  • Current market trends include behavioral health, point of care, digital health and value-based care models

From the “C-Suite Panel Discussion”, that was moderated by Jim Watson, Principal, BDO, and included panelists Jim Kiamos, CEO, CountyCare Health Plan, Brad Buxton, SVP of Strategy, Northwest Community Healthcare, Jason Whetsel, Executive Director, Benefits and Health Management, UChicago Medicine, and Angela Breton, VP of Sales & Client Services, Boncura Health Solutions:

  • It’s important to close gaps in care and condition management by turning on/off triggers for patients when completing care coordination
  • Creative partnerships are key
  • Healthcare has shifted past the point of going back to fee-for-service models
  • High deductible plans are not driving employees to make better choices; many are choosing to delay/postpone care or not receive care at all
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