Reducing Medical Billing Waste and Abuse with Technology and Expertise
Date: December 13, 2017
Time: 3:00-4:00 pm Eastern
Associate Member Host: MultiPlan
Presenter: Christopher Dorn, Vice President, Payment Integrity at MultiPlan

With the increasing complexity of medical bills, a high volume of waste and abuse is undetected by solutions that rely only on automated claim review. Simple coding errors that can be found by technology account for only a fraction of claim issues.  Incorporating an expert prepayment review doubles your opportunity to avoid paying for inappropriately billed charges while still observing prompt-pay requirements. This webinar will discuss successful solutions that combine technology with human expertise to root out waste and abuse in medical bills.

MultiPlan is committed to helping healthcare payers manage the cost of care, improve their competitiveness and inspire positive change. Leveraging sophisticated technology, data analytics, and a team rich with industry experience, the company interprets clients’ needs and customizes innovative solutions that combine its payment integrity, network-based and analytics based services. MultiPlan is a trusted partner to over 700 healthcare payers in the commercial health, government and property and casualty markets, and saves these companies more than $14 billion annually. MultiPlan is owned by Hellman & Friedman and other investors. For more information, visit multiplan.com.

Total Population Management
Date: November 15, 2017
Time: 3:00-4:00 pm Eastern
Associate Member Host: HMS®
Presenter: Dr. Gary Call, MD, Chief Medical Officer; Ellen Harrison, RN, MBA, SVP, Market Strategy and Consulting; Jill Field, Senior Director, Population Health Technology; Jennifer Butler, Sr. Director Marketing, Total Population Management

To effectively bend the health cost curve, identification of risk is required across your entire population. While management of the high risk population accounts for 50% of your medical costs, that population is fluid. Early identification of pre-conditions such as prediabetes or obesity, can help you manage those from escalating into more serious conditions. Total Population Management provides tools to assess and manage risk in a coordinated platform, engaging your entire population.

Keys to achieving Total Population Management are knowing your members, engaging your members and coordinating care to manage health outcomes. Previously a challenge, HMS can now provide transparency into your total population and management through coordinated tools such as population risk intelligence, member engagement engine, and population health technology platform.

By participating in this webinar, attendees will learn how to:

  • Effectively manage all of your members on a personal level with increased flexibility using fewer resources to drive immediate results
  • Identify risk in your general population and monitor existing conditions to support adherence in an automated approach
  • Activate members through a personalized conversation across multi-channels to build member profiles and assess health status, identify barriers, close gaps in care and increase member retention

Who should attend:

  • Clinical professionals working within health care organizations to manage population health
  • Health care professionals aiming to increase member retention, loyalty, satisfaction, adherence, etc.
  • Clinical and operational experts seeking to drive better health and financial outcomes through a more engaged member population

HMS® (NASDAQ: HMSY) provides the broadest range of solutions in the industry to help risk-bearing organizations improve financial and health outcomes. We deliver coordination of benefits, payment integrity, and total population management solutions to health plans, state agencies, federal programs, employers, and at-risk providers. Using innovative technology and powerful data analytics, we help our clients reduce costs, enhance quality, and safeguard compliance. As a result of our services, our clients save billions of dollars every year and achieve their performance goals.

HEDIS 2018: Driving the Quality Agenda
Date: November 8, 2017
Time: 3:00-4:00 pm Eastern
Associate Member Host: Centauri Health Solutions
Presenter: Melanie Richey, Vice President, Clinical Solutions

The webinar will be hosted by Centauri Health Solutions’ Vice President of Clinical Solutions, Melanie Richey, who will focus on addressing Medicaid-specific changes to 2018 HEDIS technical specifications. Ms. Richey will explain to participants, the impact that key changes will have on health plans and quality improvement strategies. Both Centauri and Ms. Richey are committed to educating stakeholders on HEDIS strategies that will assist in improving quality outcomes.

Centauri Health Solutions harnesses the power of data, technology and human interaction, to reimagine a healthcare system that makes a real difference in the lives— and work— of those who count on it. Our innovative risk adjustment and quality-based revenue software, integrated with eligibility, outreach and revenue cycle services, increases access to and the delivery of proper care.

Care Transitions in Behavioral Health
Date: October 25, 2017
Time: 3:00-4:00 pm Eastern
Associate Member Host: Janssen Neuroscience, Janssen Pharmaceuticals, Inc., a pharmaceutical company of Johnson & Johnson
Presenter: Rick Hankey, MA

Webinar includes consequences of inadequate care transitions, care transitions policy landscape and well known care transition models. The webinar also provides and update on how the mental health community is responding to changes in the transitions sector.

Janssen Neuroscience

Janssen Pharmaceuticals, Inc., a pharmaceutical company of Johnson & Johnson, has a longstanding legacy developing new therapies, especially in mental health.  Learn more at www.janssen.com  

How Medicaid Plans Are Using AI To Improve Care
Date: October 18, 2017
Time: 3:00-4:00 pm Eastern
Associate Member Host: Cyft
Presenter: Dr. Leonard D'Avolio, Assistant Professor at Harvard Medical School & the founder of Cyft

Artificial Intelligence (AI) is getting a lot of attention these days - but how exactly can it help Medicaid Plans? Dr. Leonard D'Avolio, Assistant Professor at Harvard Medical School & the founder of Cyft has spent 10 years developing these technologies. Over the past four years, he has helped dozens Medicaid plans increase care management effectiveness, optimize reimbursement, and reduce member churn. 

Learn why he believes government-sponsored plans are "the healthcare organizations most likely to benefit" from AI and his lessons learned on how to dramatically improve the health of members and plans alike with AI. 

Dr. D'Avolio will share his real-world experiences helping Medicaid Plans, including:

  • Organizational assessments to align technology to problems and priorities
  • Using data to matching individuals to specific interventions
  • Integrating results into existing workflows
  • Reinforcing continuous learning and feedback loops

He will explain these concepts with examples from care management programs that leverage AI to improve care management, reimbursement, and member retention.

Managing Risk in the Treatment of Chronic Pain      
Date: October 11, 2017
Time: 3:00- Eastern
Associate Member Host: Millennium Health
Presenter: Maria Chianta, PharmD Director of Clinical Affairs, Managed Markets Millennium Health

Utilizing opioid therapy for the management of chronic pain must involve careful patient selection and evaluation of risk versus benefit including the risks of misuse, abuse, diversion, overdose and substance use disorders.  Chronic opioid therapy should also be accompanied by an ongoing, multifaceted monitoring plan.  Through discussion of current literature and case study application, this program outlines the necessary steps to evaluate risk, stratify patients, and create a monitoring plan based on individual risk level.  Relevant tools and resources are provided for practical application and creation of risk management plans in clinical practice.

Impact of State-mandated Formularies
Date: September 20, 2017
Time: 3:00-4:00 pm Eastern
Associate Member Host: Express Scripts
Presenter: Krista Ward, Sr. Director – Medicaid

What is the impact on prescription drug utilization and plan costs on a health plan that implements a state-mandated Preferred Drug List (PDL) policy, compared to those of a Medicaid managed care health plan in another state without a PDL?  Join Krista Ward, Sr. Director, Medicaid at Express Scripts as she shares research findings examining these differences and implications for health plans on both sides of the equation.

Complex NICU and Pediatric Care, Risk Management Challenges and Solutions
Date: September 13, 2017
Time: 3:00-4:00 pm Eastern
Associate Member Host: PartnerRe America Insurance Company
Presenter: Jakki Lynch, RN, CCM, CMAS, Vice President, Clinical and Cost Containment Director, PULSE + Plus™ Program; Patrick Burcher, Healthcare Cost and Payment Integrity Consultant & Dr. Edward H. Karotkin, M.D

The neonatal intensive care unit (NICU) is a high-stress environment for both families and health care providers that can sometimes make appropriate medical decisions challenging. We will identify the type of medically complex diagnosis's that require a selective medical management strategy, discuss the potential barriers to allow for effective decision making in the NICU, and provide case examples demonstrating effective collaboration and compassionate decision making while managing the high dollar costs associated with these events

PartnerRe Health is an acknowledged leader in providing risk management solutions to accident and health markets around the world.

Our team of experienced professionals develops innovative, client-specific solutions by thoroughly understanding our clients' goals, risk tolerance and exposures. A suite of proven proprietary financial and analytical tools effectively manage your risk with extensive support services.

Prevalent Pathways to Incontinence: How to Provide the Highest Quality of Care for Members in Challenging Times
Date: August 30, 2017
Time: 3:00-4:00 pm Eastern
Associate Member Host: Medline Industries, Inc.
Presenter: Michelle Christiansen MS PA CN-E, Vice President of Clinical Sales and Marketing, Medline Industries, Inc.

The increasing longevity of older adults in the U.S. poses new challenges for healthcare systems and case management. The CDC notes that critical knowledge gaps exist for responding to the health needs of older adults. For renal, urological and other medical issues leading to incontinence, much remains to be learned about the associated risk factors and effective measures to prevent or delay the onset of these conditions. Excellent healthcare decision-making is a result of being armed with the necessary information and training to gain a clear understanding and successfully manage outcomes. Unfortunately, research continues to demonstrate that today’s health information is presented in ways that are not available or usable by most adults.

If medical issues lead to incontinence, a financially challenging condition develops that creates a costly and labor intensive issue for healthcare providers. What’s more, despite years of research and clinical efforts to improve it, the prevalence of incontinence remains high.  To exacerbate this problem, according to the CDC, an estimated 2 out of 3 individuals 65+ are living with multiple chronic conditions and cost 3 to 5 times more in health care than younger generations.

During this webinar we will discuss solutions to many of the challenges that health plans and case managers/caregivers are facing with incontinent-related issues such as, high staff turnover, financial challenges and proactive member care to maintain skin health and avoid incontinence, falls and other related issues.

Medline’s mission is to help our customers across the continuum of care achieve clinical and financial success. We do that through a personalized approach to understand our customers’ needs in an environment that demands lower costs and better outcomes.As both a manufacturer and distributor, we deliver a robust product portfolio and member-care solutions to help healthcare providers and Health Plans perform at their very best. We are committed to advancing the health of healthcare. 

Nutrition’s Evolving Role in MCO’s Clinical, Quality, Engagement and Cost Strategies
Date: August 16, 2017
Time: 3:00-4:00 pm Eastern
Associate Member Host: Mom's Meals NourishCare
Presenter: Amanda Daines, RD Director Research & Development Mom’s Meals NourishCare & Nathan Jensen Vice President Business Development Mom’s Meals NourishCare

Webinar description is: Managed Medicaid Organizations are innovating at a rapid pace, leading the change to value-based care. As more states implement pay-for-performance models, capitation withholdings, and performance bonuses or penalties, MCOs must focus more than ever on the important quality measures tied to these value-based financial models.  In seeking to drive quality, home-delivered meals are emerging as an indispensable benefit, serving as both effective clinical intervention and a powerful engagement tool. This webinar will describe how condition-specific home-delivered meals are being used by MCOs to drive clinical outcomes, quality measures, member engagement and cost savings.

Active Management: The Keys to Reducing Risk for Medicaid Payers
Date: June 28, 2017
Time: 3:00- Eastern
Associate Member Host: HHAX
Presenter: Tom Meyer, Chief Program Integrity Officer

The home care ecosystem is complex, and visibility into member care, accurate billing and more is difficult for Medicaid payers. Yet, the risk and vulnerability falls squarely on the shoulders of the payers. They are directly responsible for quality of care issues, claw back from plans, states or the federal government, loss of contracts, loss of members and more. This presentation will detail strategies for reducing risk for Medicaid payers by focusing on active management for better channels of visibility into their providers and members. This is much more than implementing an EVV solution, this is how to consistently and effectively communicate with key stakeholders in the home care ecosystem, to improve member care and drive efficiency improvements.

HHAX is improving the overall healthcare system by making home care more effective in the face of an aging national population. By connecting payers, providers and members in the home care industry, HHAX is reducing costs, improving efficiencies and allowing our most vulnerable populations to stay in their homes longer.

Managing Opioid Utilization in Your Medicaid Benefit
Date: June 21, 2017
Time: 3:00- Eastern
Associate Member Host: Express Scripts
Presenter: Krista Ward, Senior Director, Medicaid, Express Scripts

Opioid utilization is a topic that is center stage in the national spotlight, but has long been a focus of Medicaid plans.  During this webinar, attendees will hear some of the latest observations about opioid utilization in the Medicaid population and learn best practices to help manage this increasingly concerning class of drugs.  We will also share tools health plans can use to analyze their trend and make changes before problems start.

Outreach for Tough Measures - Maternal Health, Behavioral Health
Date: June 14, 2017
Time: 3:00- Eastern
Associate Member Host: HealthCrowd
Presenter: Neng Bing Doh, CEO

Join Bing, CEO of HealthCrowd, for a presentation consistent with her signature style -- outcomes-focused and low on fluff. The first half of the webinar will cover a case study on mobile outreach and Maternal Health, showcasing:

  • A pioneering maternity prenatal & postpartum engagement program (Medicaid)
  • Tips on how to set up new and innovative programs for success
  • Results and insights from the continuing effort 

In the second half, we will explore the still nascent but high potential area of Behavioral Health. Bing will share the efforts of a few trailblazing Medicaid plans and the early data they are observing. 

Whether your objective is to offer a great experience for your members, strengthen your HEDIS outreach efforts, or bring your case management programs to new heights, this webinar should be one every health plan and state representative can derive value from. 

HealthCrowd is an end-to-end digital communications platform for healthcare. The technology unifies, automates and optimizes multimodal communications to deliver personalized member engagement at scale. The impact is profound: A positive difference in members’ perceptions of health plan communications, and significant, quantifiable savings to the health plan. Our approach is prescriptive and based on data. We believe in rapid testing and optimization with the utmost sensitivity to the member experience. Our technology, service excellence and pride of ownership are the driving force behind HealthCrowd’s success, from member navigation and activation, to gap closure (HEDIS, STAR), disease management, retention and redetermination. For more information, please visit www.healthcrowd.com.

DRGs, Payment Misperceptions and Care Management Impact in the NICU:  A Nationwide Study Focused on Inlier Trends and Costs
Date: May 24, 2017
Time: 3:00- Eastern
Associate Member Host: ProgenyHealth
Presenter: Dr. Ellen Stang, President & CEO, ProgenyHealth Scott Harris, Managing Director, Milliman

The ongoing quest to contain health care costs is often hampered by the common misconception that DRG payment methodologies limit the options for Medical Management. ProgenyHealth has a proven model that care management done the right way, in collaboration with providers, hospitals and families, leads to significant improvements in health outcomes and lower costs. Over the last decade, ProgenyHealth has delivered consistent results to its clients reducing the costs of both inlier and outlier payments across the NICU population.  The complexities of DRGs and the premise that all cases with the same diagnosis, and in the same facility always result in the same payment can obscure the realities of DRG payments. These findings have now been independently validated through a study by Milliman focused on APR-DRGs and MS-DRGs inlier cases.

Please join ProgenyHealth and Milliman for a presentation of their newly released White Paper.


  • How LOS correlates to payment in the NICU
  • Impact of billed charges on payment
  • Discussion of the root causes of payment variation
  • Medicaid and Commercial specific results
  • Impact of Care Management on inpatient costs

ProgenyHealth is the only national company dedicated to NICU Population Health.  The study took findings from ProgenyHealth’s extensive NICU database and independently validated them, with the actuaries/analysts at Milliman, against a national database of over $17 billion in NICU paid claims data.

Milliman is among the world’s largest independent actuarial and consulting firm. The company has extensive experience in the payer and hospital market, with a broad understanding of costs trends in healthcare. Milliman is deeply committed to research and data driven solutions to support health care organizations to make informed decisions.

Talking to Members about Incontinence:  A Hands- On Guide for Case Managers
Date: May 10, 2017
Time: 3:00- Eastern
Associate Member Host: First Quality
Presenter: Christine Pruneau RN, BSN, RAC-CT, Clinical Director for Homecare, First Quality

Ineffective use of absorbent incontinence products (like adult diapers and underpads) can often have a surprisingly negative impact on member care, as well as drive up unintended costs. As Medicaid health plans increasingly care for MLTSS and other populations with chronic conditions, proper continence management in the home setting is more important than ever.  Tap into First Quality’s 25+ years of LTC experience and clinical expertise managing incontinence to learn more about:

  • Incontinence in our most vulnerable Medicaid managed care populations
  • The high costs of untreated & unmanaged incontinence
  • Preventing skin issues, UTIs and falls
  • Case management strategies to help members get more effective care

One Continuing Education credit for CCM Certification is available upon completion of the course. 

Leveraging Transportation Network Companies in Traditional NEMT Programs
Date: May 3, 2017
Time: 3:00- Eastern
Associate Member Host: MTM, Inc.
Presenter: Eric Reynolds, MTM's VP of Business Development

With the rise in popularity of Transportation Network Companies (TNCs) nationwide, many health plans are considering utilizing on-demand providers like Uber and Lyft to augment or enhance their non-emergency medical transportation (NEMT) programs. There is a great need for NEMT providers who can enhance on-demand service provisions within NEMT networks, and TNCs fulfill that need. However, solely utilizing TNCs for transportation service poses compliance risks to NEMT programs such as drivers and vehicles not meeting stringent credentialing requirements and challenges around advance scheduling.

When TNCs are utilized properly by a NEMT benefits manager as service providers on a controlled quantity basis, the risks drastically decrease, allowing health plans to be confident in the safety and compliance of their NEMT program while taking advantage of the high quality, technologically savvy operations offered by TNCs. This webinar will explore the opportunities and benefits available to health plans through this model, including:

  • Enhanced gap filling, particularly in response to short notice and on-demand trips such as those for hospital discharges, will calls, and stranded passengers
  • Cost savings with standard TNC rates that are typically below Medicaid rates paid to traditional NEMT providers for short notice and on-demand trips
  • Improved network adequacy through large networks that can be deployed almost immediately in urban markets
  • Technological advances, such as text message notifications to passengers with trip details and estimated arrival times

How can aligning with Medicaid initiatives improve healthcare value? 
Date: April 19, 2017
Time: 3:00- Eastern
Associate Member Host: 3M Health Information Systems
Presenter: Jared McKee

Value-based payment (VBP) is top of mind for all who work with a Medicaid population in states across the country. Medicaid has become the nation’s most consequential health program, implementing new health care delivery systems and other VBP initiatives.  In response, managed care plans are tasked with creating new opportunities to improve access to quality, equitable care that incentivizes value over volume.

As states are increasingly looking to move away from volume-driven fee-for-service payments and toward VBP arrangements, this webinar will discuss how 3M can help managed care organizations:

  • Control the variation of costs within patient populations
  • Measure total cost of care
  • Help providers improve healthcare value
  • Analyze patient risk, utilization, and socio-economic determinants of health to improve networks of care

At 3M, we generate population health analytics for 55 million lives in Medicaid, Medicare and commercial populations across the US.  For ten million of those lives, we directly participate in the design and measurement of the VBP arrangements in which the populations are enrolled.

Date: April 12, 2017
Time: 3:00- Eastern
Associate Member Host: Veyo
Presenter: Josh Komenda, President of Veyo

In this webinar, Josh Komenda, President of San Diego based Veyo will share 5 ways the company is using technology to redefine the outdated patient transportation industry for health insurance carriers who manage non-emergency transportation (NEMT) benefits, patient transportation providers and drivers, and Medicaid and Medicare members who utilize the service.

What to expect. Webinar participants will learn about how Veyo is:

  • Using innovative methods to collect member data and improve the member experience
  • Leveraging automation to reduce fraud, waste, and abuse
  • Connecting a once fragmented process into an organized, interconnected platform
  • Establishing an innovative supply model in new states
  • Increasing data transparency and reporting

Who should attend? Anyone generally interested in how data and technology can work to improve the patient transportation experience – especially those responsible for contracting and overseeing NEMT service vendors at Medicaid and Medicare Advantage plans and state organizations.

News You Can Use: Insights into 2016 Express Scripts Medicaid Drug Trend Report
Date: April 5, 2017
Time: 3:00- Eastern
Associate Member Host: Express Scripts
Presenter: Krista Ward, Senior Director – Medicaid, Express Scripts

Now more than ever, it’s important for Medicaid plans to optimize your pharmacy benefit in a way that helps keep your plan costs lower while providing the right access to the medications your members need.  This means focusing on effective utilization management and innovative solutions to dealing with common problems like adherence, refilling medications on time and utilizing the most appropriate and cost effective care settings. Join us as we share the Express Scripts 2016 Medicaid Drug Trend Report, our data-driven analysis of current trends in prescription drug spending and utilization for Medicaid managed care plans.

Machine Learning & Medicaid Today: Progress in Care Management and Optimizing Risk Adjustment
Date: March 15, 2017
Time: 3:00- Eastern
Associate Member Host: Cyft
Presenter: Dr. Leonard D’Avolio

How can we use the untapped mountains of data we possess to keep people and the organizations that care for them healthy?

This is the question driving 10 years of research by Harvard Medical School Assistant Professor, Dr. Leonard D’Avolio. His work emphasizes the practical and measurable applications of advanced analytics like machine learning rather than overhyped promises of ‘artificial intelligence.’ His focus on value and clear explanations have made him a nationally recognized researcher, author, and speaker on the topic.   

Learn why he considers complex / chronically ill Medicaid populations to be the most likely to benefit from advanced analytics.

In this webinar, Dr. D’Avolio will share lessons learned and best practices from real world experiences helping >20 Medicaid plans transform the way they approach risk and care management.

Who should attend: those responsible for revenue recognition, risk stratification, care management, and / or analytics. Or anyone generally interested in separating fact from fiction when it comes to AI, cognitive computing, machine learning, big data, etc. and how it’s currently being used today. 

What to expect:

  • A clear explanation of what machine learning is (and isn’t) with Medicaid-specific examples
  • An understanding of why certain methods are particularly well suited to Medicaid plan priorities
  • Progress in the application of advanced analytics with Medicaid plans
  • Specific examples, lessons learned, and ROI from real world implementations
  • A Q&A session to allow members to dive deeper on any topics covered

Fall Prevention
Date: March 1, 2017
Time: 3:00-4:00 pm Eastern
Associate Member Host: Byram Healthcare
Presenter: Cindy Nissen, RN, MSN, CWCN

This course will examine the causes of falls in the geriatric population, with a focus on prevention. Risk factors, patient, home and work environment assessments, and the role of the nurse and therapist in the evaluation, prevention and treatment of falls will be discussed. 
This week's webinar will be presented by MHPA Associate Member, Byram Healthcare, a leading provider of medical supplies, providing the products, services, and support needed to maximize clinical outcomes and manage benefits. Byram Healthcare is recognized for its clinical support programs that include diabetes, wound care, ostomy, urology, incontinence, enteral nutrition and breast pumps. This course is designed and accredited for case managers, nurses, social workers, WOCNs, certified diabetes educators and registered dietitians. It is valid for one (1) continuing education credit hour.

The March 1st webinar will be presented by Cindy Nissen, RN, MSN, CWCN. 

Cindy has over fifteen years as an advanced practice nurse with clinical specialization in adult health and aging, and health promotion. She currently is the Course Author and Director of the Wound and Ostomy Care Section for Hi-R-Ed, 
Online University. 
She develops and reviews CE courses, journal clubs and conference reviews on subjects related to aging, medical/surgical nursing and wound, ostomy and continence care. 
Join MHPA and Byram Healthcare to learn more! 

Continence Management for Case Managers Preventing Complications, Improving Care & Reducing Cost
Date: February 8, 2017
Time: 3:00- Eastern
Associate Member Host: First Quality
Presenter: Louanne King, MSN, RN, WOCN, RAC-CT

Join First Quality’s e-Nurse Louanne King to learn more about managing incontinence, which can be challenging in the elderly and disabled managed Medicaid populations.  Better understand the complications that can come from lack of proper continence management and learn about best practices to improve care for your members.  Information on hospitalization and other costs associated with poor management will also be reviewed.  One Continuing Education credit for CCM Certification is available upon completion of the course.

Interactive Mobile Messaging: How to Truly Activate Medicaid Populations
Date: February 1, 2017
Time: 3:00- Eastern
Associate Member Host: mPulse Mobile
Presenter: Chris Nicholson, CEO of mPulse Mobile and Heather Winters, National Director of Healthcare Accounts at mPulse Mobile

Activating members is a primary goal for Medicaid plans. Improving the health activation for your members leads to improved HEDIS and CMS star ratings, reduced operational and administrative costs, and healthier members overall. To improve population health, Medicaid plans should interact with individual members through tailored, meaningful dialog.

This discussion will dive into an analysis of how healthcare organizations currently communicate with consumers, recommendations for improving interactions across communication channels, and insights on how to drive true health activation, especially for difficult-to-reach populations. Additionally, a case study with a Medicaid plan will be presented to demonstrate the strategy, execution and results.

Webinar participants will learn about:

– The three levels of healthcare communications
– Five steps your organization can take to better activate members
– Case Study: How Inland Empire Health Plan activates its members

More Than Just An App: How Technology is Transforming Non-Emergency Medical Transportation
Date: January 18, 2017
Time: 3:00- Eastern
Associate Member Host: Veyo
Presenter: Stan Sipes, Executive Vice President of Business Development, Veyo

Did you know that among low-income suburbanites, 25% of missed healthcare appointments were due to transportation problems? And 66% of dialysis patients depend on someone else for transportation to their appointments? With an aging population and increasing rates of chronic illnesses, patient transportation is now more important than ever. 

Join us to learn more about Non-Emergency Medical Transportation (NEMT) and discover how technology has revolutionized patient transportation. It’s about more than just an app – discover how new models of supply, GPS technologies, and Big Data are bringing transparency and insights to NEMT. During the webinar, we’ll discuss the basics of NEMT, how new technologies are improving healthcare outcomes and member satisfaction, and how Veyo has created over $7 million in savings for healthcare payers with their revolutionary model for NEMT. 

Your Captive Audience: Engaging Members in LTPAC
Date: January 11, 2017
Time: 3:00- Eastern
Associate Member Host: PointRight Inc.
Presenter: Pamela Gould, Vice President, Business Development & Payer Strategies, PointRight

It’s no secret that your most expensive, and highest-need members are those receiving care from a long-term, post-acute care (LTPAC) provider. What steps can health plans take to ensure their members are receiving the most efficient, effective, and reliable care in these settings? This session addresses how to utilize real-time, clinically based analytics to not only identify high-risk members in LTPAC settings, but devise successful strategies for engaging them in wellness programs such as fall prevention, smoking cessation, influenza vaccinations and behavioral health. We will also provide examples of how to build high-performing LTPAC networks with standard performance measures that are based on clinical practice by diagnosis group, rather than overall Five-Star ratings. Data transparency and standardization enable payers to foster collaborative partnerships with LTPAC providers and tailor care management programs to fit the needs of a specific member. In turn, the plan is able to keep costs down with fewer readmissions and more satisfied members. Let predictive analytics place your members in the right care setting, at the right time.

Learning Objectives:

  • Utilize real-time, clinically based analytics to drive proactive care interventions for LTPAC members
  • Align the unique needs of members with facility capabilities  
  • Create high-performing partnerships with LTPAC providers using standard key performance metrics