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First Illinois Healthcare Financial Management & Chicago Health Executives Forum’s Managed Care Conference 2018

By Laura Grochowski, MHA, Boncura Health Solutions, CHEF Communications Committee Member

Takeaways from the FIHFMA & CHEF Managed Care Conference 2018 held on February 15, 2018, at the University Club included:

From the Keynote: “Navigating Turbulent Times in a Changing Environment” presented by Dan Shellenbarger, Partner, Oliver Wyman

  • Shift 80/20 focus from Boomers to future funders of healthcare- Gen X and Millennials
  • 47% of Millennials expressed high interest in new service offerings
  • Time to start giving consumers what they want from healthcare
  • Provide off-campus services on “their” terms
  • Wire in capabilities Millennials want
  • Become an information business

From “Payor-Provider Partnerships-Variety and How to Enhance Them” presented by Jeffrey Leibach, Director, Navigant

  • Relationship lines blurred as new models of partnerships sought between payers, providers and employers
  • Insufficient data and analytic capabilities increase probability for poor performance when transitioning from Fee For Service to Value Based Payments
  • Healthcare organizations that explore the value possibilities of strategic alliance partnerships can stay ahead of the curve
  • Contract negotiations pivot on who has the best data

From “Impact of Diagnostic Errors: Patients & Payors” discussed by Paul Epner, Co-Founder and CEO, Society to Improve Diagnosis in Medicine

  • Diagnostic Errors occur more frequently in the outpatient setting but with less severity than inpatient setting
  • Challenge-Symptoms not captured in data, only diagnosis
  • Everyone has a part: patient, providers, payers

From “The Multibillion-Dollar Bet on IT/Data Analytics” presented by Krishna Ramachandran, VP, Health Data Strategy and Enterprise Network Operations, BlueCross BlueShield IL, MT, NM, OK and TX

  • Currently little overlap in ownership and low integration of data pools
  • Claims and cost data can generate insights into performance, utilization and leakage
  • Strive for a more perfect union of data with integration of claims, EHR, pharma, personal, behavioral, weather, air-quality, and socio-economic data sets
  • As data sharing increases, key is determining what data is helpful

From “Legislative Update” provided by Elena Butkus, VP and Head, State Government Affairs, Aetna and Larry Lewis, Government Affairs, Aetna

  • Government experiencing congressional healthcare fatigue
  • Emphasis on regulation versus major health care changes
  • Opioid Crisis/Behavioral Health
  • Election year

Lastly projected trends from the “C-Suite Panel Discussion” that included Brad Buxton, SVP of Strategic Planning at Northwest Community Healthcare, Tom Earth, Account Executive at Aetna, Jim Kiamos, CEO at CountyCare, Lee McGrath, Divisional VP of Network Innovation and Strategy at BlueCross BlueShield of Illinois, and Scott Powder, SVP & Chief Strategy Officer at Advocate Health Care

  • Increased high quality narrow networks versus open networks
  • Increased Employer interest in partnerships with providers and payers
  • Increased Consumer “control” and responsiveness
  • Increased role of retail as seen by Amazon, Berkshire Hathaway, JP Morgan’s entry into healthcare
  • Increased need for payers and providers to continue to work together toward the common goal of Value Based Care






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