Hospitals Developing Health Plans: Key Steps to Becoming a Provider-Payer

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Hospitals Developing Health Plans: Key Steps to Becoming a Provider-Payer

Product Code: YK071614

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Presented on: Wednesday, July 16, 2014 | 1:00 p.m.–2:30 p.m. ET

Presented by: Alan J. Murray and Ruth Krystopolski

Rebroadcast from March 28 due to popular demand.

One in five health systems will create their own health plans by 2018, according to a recent study. Spurred by healthcare reform, the creation of health insurance exchanges, and a shift to population health, many health systems are assessing the costs and benefits of becoming a payer.

Health plan leaders from North Shore-LIJ and Sanford Health outline the strategic transition from provider to payer, and new opportunities for controlling costs, managing risk, and maximizing reimbursements.

At the conclusion of this program, participants will be able to:

  • Understand how to structure your organization for short and long term success, including what to buy versus build
  • Determine what you need in your market to attribute patients to your health system
  • Recognize the risks and benefits of assuming an payer role
  • Learn how to effectively integrate clinical care and insurance coverage across delivery system
  • Align incentives to ensure your organization is moving toward population health


Agenda

  • Building an insurance/health plan infrastructure
    • Understanding the market dynamics
    • Assessing business opportunity
    • Identifying the barriers
    • Assuming a start-up mentality
    • Hiring the right skill sets
  • North Shore-LIJ perspective
    • Pinpointing the “right time”
    • Leveraging internal lessons learned
    • Evaluating risk initiatives
  • Identifying benefits to the customers
    • Unique capabilities of integrated healthcare systems
    • Affordability perspective
    • Customer experience
  • Understanding the implications of risk and insurance
    • Establishing long-term goals and success metrics
    • Managing risk and population health
  • The Sanford Health perspective
    • Leveraging internal lessons learned
    • Managing risk
    • Evaluating financial performance
  • Integrating clinical care and insurance coverage
    • Touch points and documentation
    • The Sanford Standard
    • Leveraging health plan data for quality and efficiency measures
  • Initial scope, long-term goals
  • Steps toward population health management
    • Patient acquisition through health plans
    • Predictive analytics
    • Identification of care gaps

Meet the Speakers

Alan J. Murray, President & CEO, North Shore-LIJ CareConnect

Ruth Krystopolski, EVP of Care Innovation and President for Sanford Health Plan in Sioux Falls, South Dakota

Who Should Attend?

CEOs, COOs, CFOs, VPs/SVPs of business development, directors of payer strategy and relations, consultants

Note: Agenda and Speakers are Subject to Change

Webcast system requirements and program materials:

To fully benefit from the webcast experience, please note you will need a computer equipped with the following:

Browser: Microsoft Internet Explorer 6 or later, Firefox, Chrome, Safari, with JavaScript enabled
Internet: 56K or faster Internet connection (high-speed recommended)
Streaming: for audio/video streaming, Adobe Flash plug-in or Safari browser on iOS devices

Four days prior to the webcast, you will receive an e-mail with detailed system requirements, your log-in information, presentation slides, and other materials that you can print and distribute to all attendees at your location.

CAN'T LISTEN LIVE?

No problem. You’ll be able to download the on demand version to at no additional charge when you buy the live version. Use it as a training tool at your convenience—whenever your new or existing staff need a refresher or need to understand a new concept. Play it once or dozens of times! $279 value!

PLEASE NOTE

Participation in the webcast is just $279 per site. All materials must be retrieved from the Internet. Live orders are assessed a $5 processing fee. CD orders are charged $18 for shipping and handling.