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Agenda for the November 17-18th ADLS in Baltimore, MD

Portions of the program will be broadcast live via free webcast. To view this webcast, visit www.cms.gov/live during times designated by the "**" below.

Day 1 Morning: Strategy—Goals and Organizational Structure

 

On the morning of Day 1, Participants will learn from the real-world experience of ACO leaders who have developed and implemented organizations that perform the functions of an ACO. The experience of three different types of organizations, including an IPA, PHO, and IDS, will be presented to illustrate different organizational and governance models that pursue broadly similar goals. The private sector perspective will also be presented. The participants will leave Day 1 with a concrete sense of the hard questions their ACO will need to answer concerning leadership and management functions such as priority setting, decision making, and negotiating provider relationships.

 

** The morning of Day 1 will be made available to the public via webcast at http://www.cms.gov/LIVE

 

8:00 – 8:15

Welcome & Introductions**

 

Jonathan Blum, MA

Deputy Administrator, Director, Center for Medicare, Centers for Medicare and Medicaid Services

 

8:15 – 9:00

ACOs and Improving Care for Medicare Beneficiaries**

 

Don Berwick, MD, MPP

Administrator, Centers for Medicare and Medicaid Services

 

9:00 –10:30

Insights From the Field**

 

Moderator: Richard Baron, MD

Director, Seamless Care Models Group, Centers for Medicare and Medicaid Services

 

9:00 - 9:30

Case Study 1: Building an ACO on the Foundation of an IPA**

 

Nancy Boerner, MD, MBA

Chief Medical Officer, Monarch HealthCare

 

9:30 - 10:00

Case Study 2: Building an ACO on the Foundation of a PHO**

 

Paula Phillippe, MA

SVP, Integrated Network and Payer Solutions & Chief HR Officer

 

10:00-10:30

Case Study 3: Building an ACO on the Foundation of an IDS**

 

Craig Samitt, MD, MBA

President and Chief Executive Officer, Dean Health System

 

10:30-11:00

Morning Break

 

11:00-11:30

Panel Discussion: Common Challenges, Common Solutions/Distinctive Challenges, Distinctive Solutions**

 

All Case Study Presenters

 

Moderator: Richard Baron, MD

Director, Seamless Care Models Group, Centers for Medicare and Medicaid Services

 

11:30 – 12:30

A Private Sector Perspective on ACOs & the Changing Payer-Provider Relationship**

 

Scott Sarran, MD, MM

Vice President and Chief Medical Officer, BlueCross BlueShield of Illinois

 

12:30 – 1:30

Lunch Break

 

Day 1 Afternoon: Care Delivery

 

The afternoon of Day 1 will begin a structured series of learning modules related to core competences essential to becoming an ACO. The learning modules will review the core competencies for success as an ACO are intended to provide an interactive opportunity for team-based discussion and peer-to-peer learning. Each module will be offered in an “A” track and a “B” track. This afternoon’s modules will focus on care delivery.

 

The “A” track will generally be of interest to newly forming ACOs comprised of independent providers with limited experience with information sharing and managing shared financial risk.

 

The “B” track will generally be of interest to integrated delivery systems or independent providers with a history of collaboration and experience with shared financial risk.

 

1:30 – 5:45

Learning Modules 1 & 2

 

1:30 – 3:30

Module 1: Care Delivery – Primary Care & Care Redesign

"A" Session faculty:

Jonathan Sugarman, MD, MPH

Qualis Health

"B" Session faculty:

David Eitrheim, MD

Mayo Clinic Health System

3:30 – 3:45

Afternoon Break

 

3:45 – 5:45

Module 2: Care Delivery – Coordinating Care and Managing High Risk, High Cost Beneficiaries

"A" Session faculty:

Barbara Spivak, MD

MACIPA

"B" Session faculty:

Barbara Walters, MD, MBA

Dartmouth-Hitchcock

 

Day 2 Morning: Governance and Health Information Technology

 

Day 2 will begin with a discussion of the organizational and governance challenges that developing ACOs must successfully navigate. It will also provide insights into ACOs from the patient perspective.

 

As a continuation of the previous afternoon, Day 2 will also continue the series of learning modules related to core competences essential to becoming an ACO. Each module again will be offered in an “A” track and a “B” track.

 

** Presentation will be made available to the public via webcast at http://www.cms.gov/LIVE

 

7:00 – 8:00

Breakfast with CMS Staff

8:00 – 8:10

Welcome & Introductions**

 

Rick Gilfillan, MD

Acting Director, Centers for Medicare and Medicaid Innovation, Centers for Medicare and Medicaid Services

 

8:10 – 8:45

The Patient Experience**

 

Amy Berman, BS, RN

Senior Program Officer, The John A. Hartford Foundation

 

Debra Ness, MS

President, National Partnership for Women & Families

 

8:45 – 9:45

The Organizational and Governance Challenge of Meeting Needs While Lowering Costs**

 

Jay Want, MD

Principal, Want Health Care, LLC

(Former President and CEO, Physician Health Partners, LLC)

 

9:45 - 10:00

Morning Break

 

10:00 – 12:00

Learning Module 3: Connecting Providers and Health Information Technology

"A" Session faculty:

John Blair, MD, MedAllies &

Susan Stuard, MBA, THINC

"B" Session faculty:

Karen Van Wagner, PhD

North Texas Specialty Physicians

 

12:00 - 1:00

Lunch Break

 

Day 2 Afternoon: Putting the Pieces Together and Defining a Path Forward

This afternoon session 2 will conclude the learning modules related to core competences essential success as an ACO.

 

After the last learning module, the conference will end with an opportunity for discussion and Q&A with senior CMS staff.

 

1:00 – 3:00

Module 4: Risk Sharing, Incentives, and Startup/Capital Needs

"A" Session faculty:

Greger Vigen, MBA

Actuarial Consultant

 

"B" Session faculty:

Robert Parke, MBA

Milliman

 

3:00 – 3:15

Afternoon Break

 

3:15 – 4:15

Discussion with Senior CMS Staff

 


Agenda for the September 15th-16th ADLS in San Francisco

Day 1 Morning: Strategy—Goals, Organizational Structure, and Governance

 

On the morning of Day 1, Participants will learn from the real-world experience of ACO leaders who have developed and implemented organizations that perform the functions of an ACO. The experience of three different types of organizations, including an IPA, PHO, and IDS, will be presented to illustrate different organizational and governance models that pursue broadly similar goals. The private sector perspective will also be presented. The participants will leave Day 1 with a concrete sense of the hard questions their ACO will need to answer concerning leadership and management functions such as priority setting, decision making, and negotiating provider relationships.

 

8:00 – 8:15

Welcome & Introductions


Herb K. Shultz
Regional Director, U.S. Department of Health & Human Services, Region IX

 

8:15 – 9:00

ACOs and Improving Care for Medicare Beneficiaries


Peter Lee, JD
Deputy Director, CMS Innovation Center

 

9:00 – 11:00

Case Study 1: Building an ACO on the Foundation of an IPA


Nancy Boerner, MD, MBA
Chief Medical Officer, Monarch HealthCare


Case Study 2: Building an ACO on the Foundation of a PHO


Mark Shields, MD, MBA
Vice President, Advocate Health Care


Case Study 3: Building an ACO on the Foundation of an IDS


Jay Crosson, MD
Director of Public Policy, The Permanente Medical Group


Panel Discussion: Common Challenges, Common Solutions/Distinctive Challenges, Distinctive Solutions


All Case Study Presenters


11:00 – 12:00

A Private Sector Perspective on ACOs & the Changing Payer-Provider Relationship


Scott Sarran, MD, MM
Vice President and Chief Medical Officer, BlueCross BlueShield of Illinois

 

12:00 – 1:00

Lunch Break

 

Day 1 Afternoon: Learning Modules 1 & 2

 

The afternoon of Day 1 will be structured as a series of learning modules related to core competences essential to becoming an ACO. Each module will be broken up into an “A” track and a “B” track. The “A” track will be for staff in newly forming ACOs, while the “B” track will be for staff in more established ACOs.

 

1:00 – 5:30

Learning Modules 1 & 2


1:00 – 3:00

Module 1: Describing Your Population's Clinical and Risk Profile

"A" Session faculty:

Dave Knutson, MS
Department of Health and Human Services

"B" Session faculty:

Matthew Mazdyasni, MS
HealthCare Partners

 

3:00 – 3:30

Afternoon Break

 

3:30 – 5:30

Module 2: Reshaping Care Delivery

"A" Session faculty:

Thomas Bodenheimer, MD
University of California, San Francisco

"B" Session faculty:

Steve Bernstein, MD, MPH
University of Michigan


6:30 - 7:30

Reception for Participants

 

Day 2 Morning: Learning Modules 3 & 4

 

As a continuation of the previous afternoon, the morning of Day 2 will also be structured as a series of learning modules related to core competences essential to becoming an ACO. Each module will be broken up into an “A” track and a “B” track. The “A” track will be for staff in newly forming ACOs, while the “B” track will be for staff in more established ACOs.

 

8:00 - 12:30

Learning Modules 3 & 4


8:00 - 10:00

Module 3: Connecting Providers and Managing High Risk Beneficiaries


"A" Session faculty:

Julie Schilz, BSN, MBA and Patrick Gordon, MPA
Colorado Beacon Consortium

"B" Session faculty:

Steve Jacobson, MD and Jennifer Wilson-Norton
The Everett Clinic



10:00 – 10:30

Morning Break

 

10:30 – 12:30

Module 4: Risk Sharing, Incentives, and Startup/Capital Needs

"A" Session faculty:

Greger Vigen, MBA
Actuarial Consultant

"B" Session faculty:

Matthew Mazdyasni, MS
HealthCare Partners


12:30 - 1:30

Lunch Break

 

Day 2 Afternoon: Putting the Pieces Together and Defining a Path Forward

 

This afternoon session will focus on the organizational and governance challenges that developing ACOs must successfully address. It will include an implementation planning exercise designed to enable participants to identify their key priority actions and tasks.

 

1:30 – 2:30

The Organizational and Governance Challenge of Meeting Needs While Lowering Costs


Jay Want, MD
Principal, Want Health Care, LLC (Former President and CEO, Physician Health Partners, LLC)

 

2:30 – 5:00

Putting the Pieces Together for Implementation Planning—Gaps and Priorities


Jay Want, MD
Principal, Want Health Care, LLC (Former President and CEO, Physician Health Partners, LLC)

 

2:30 – 2:45

Where do we go from here?

2:45 – 4:30

Implementation planning and breakout groups

4:30 - 5:00

Report from breakout groups: critical capacities and action steps


Agenda from the June 20 – 22 ADLS

Click on the plenary agenda items in Day 1 and Day 2 to view archived video and slides from each presentation

Day 1: ACO Formation: Leadership and Priority Setting

 

On Day 1, presentations and discussion will emphasize the importance of understanding patient populations, market environment and the core functions of an ACO as a starting point that will guide ACO formation and provider relationships. The plenary, case studies and team based exercises will show how data and market intelligence can be used to set strategic ACO goals and priorities that bind providers and inform ACO development. Participants will also leave the day 1sessions with an understanding of the other ACO competencies they will need to develop

 

1:00 – 1:15

Welcome & Introductions

 

1:15 – 1:30

Opening Remarks from CMS


Rich Baron, MD, Group Director, Seamless Care, CMS Center for Innovation


Jon Blum, Deputy Administrator & Director, CMS Center for Medicare


 

1:30 – 3:30

Setting Priorities and Leading ACO Formation


How becoming an ACO changes perspective, priorities, and leadership


John Bertko, F.S.A., M.A.A.A., CMS


Essential questions an ACO needs to ask – and what it takes to answer them


Paul M. Katz, MBA, Chief Executive Officer, Intelligent Healthcare


  • This session will introduce the two-day program. It will demonstrate the importance of grounding the ACO’s strategy on a solid understanding of the population for which it will be responsible, existing patterns of care and opportunities for improvement in that population, clearly defining the role and responsibility of all participating providers for meeting the needs of the population and achieving strategic goals for improvement, establishing a workable organizational structure, and leading efforts to change the way care is organized, delivered and managed. This session will introduce the notion of a “recipe for success” that reflects an ACO’s understanding of the local market it operates in, the specific goals that it will need to achieve, and the core competencies it both has and needs to develop, given the different starting points of each organization.

3:30 – 3:45

Break

 

3:45 – 5:30

Insights from the Field

  • Participants will learn from the real-world experience of ACO leaders who have developed and implemented organizations that perform the functions of an ACO.
  • Issues to be addressed include leadership and management functions such as priority setting, decision making, and negotiating provider relationships.

 

Case Study 1: Building an ACO on the foundation of an Integrated Delivery System (IDS)


Craig Samitt, MD, Chief Executive Officer, Dean Health


Case Study 2: Building an ACO on the foundation of an IPA


Karen van Wagner, PhD, Executive Director, North Texas Specialty Physicians


Case Study 3: Building an ACO on the foundation of a Physician-Hospital Organization (PHO)


Lee Sacks, MD, Chief Executive Officer, Advocate Physician Partners

 

5:30 – 6:30

Orientation to ACO planning

 

 

Day 2: Acquiring Core Competencies for ACO Success

 

8:00 – 8:15

Welcome to Day 2 – and Day 1 Summary

 

8:15 – 9:00

Remarks by CMS Leadership


Don Berwick, MD, MPP, Administrator, Centers for Medicare & Medicaid Services


Rick Gilfillan, MD, Acting Director, Center for Medicare and Medicaid Innovation, CMS


 

9:00 – 10:30

Overview of Core Competencies Essential to ACO Success


Overview of Competencies Related to Organizing & Delivering Care


James Rogers, MD, St. John’s Health System, Springfield, Missouri


Overview of Competencies Related to Assuming & Managing Risk


Mark Eustis, MHA, Chief Executive Officer, Fairview Health Services


 

10:30 – 10:45

Break

10:45 - 6:00

Learning Modules:

The remainder of Day 2 will be structured as a series of break-out sessions each presenting a learning module related to one or more core competencies.

 

  • One track of learning modules will address the competencies related to the delivery of care. These modules will be attended by clinician member(s) of each team.
  • A second track of learning modules will address the competencies related to financial and risk management. These modules will be attended by the manager member(s) of each team.

 

Within each track, participants will break into two smaller groups.

 

Track 1: Clinicians

Track 2: Management/Operations

10:45 – 12:00

Module 1: Connecting providers (EHR/HIT)

Glenn Loomis, MD, St. Elizabeth Physicians

Keith Hepp, HealthBridge

John Blair, MD, MedAllies

Susan Stuard, MBA, THINC

Module 6: Describing your population’s risk profile

David Knutson, MS, Department of Health and Human Services

David E. Kelleher, MS, HealthCare Options Inc.

 

12:00 – 12:45

Lunch Break

Lunch Break

12:45 – 2:00

Module 2: Describing your population’s clinical profile

Steve Bernstein, MD, University of Michigan

James Rogers, MD, St. John’s Health System

Module 7: Risk management

Shashank Kalokhe, PhD, Everett Clinic

Greger Vigen, FSA

Independent Actuary

2:00 – 3:15

Module 3: Coordinating care for high-risk patients

Steve Bernstein, MD

University of Michigan

Barbara Walters, MD

Dartmouth-Hitchcock Medical Center

Module 8: Financial modeling

Greger Vigen, FSA

Independent Actuary

Rob Parke, FSA

Milliman

3:15 – 3:30

Break

Break

3:30 – 4:45

Module 4: Primary care and specialist services

Rich Baron, MD, CMS

Jeff Schiff, MD

State of Minnesota Public Programs

Module 9: Capitalization

Barbara Spivak, MD, Mount Auburn Cambridge Independent Practice Association

Matthew Mazdyasni, MS

HealthCare Partners

4:45 – 6:00

Module 5: Leading care process improvement

Christine Sinsky, MD

Medical Associates Clinic and Health Plans

David Moen, MD

Fairview Physician Associates

Module 10: Incentive payments

Craig Sammit, MD

Dean Health

Barbara Spivak, MD, Mount Auburn Cambridge Independent Practice Association

 

Day 3: Competing Successfully on Value

 

8:00 – 8:15

Welcome to Day 3 and Summary of Day 2

8:15 – 9:15

Methods for meeting patient needs while reducing the total cost of care

William Chin, MD, HealthCare Partners

  • This session will summarize the competencies that were covered in the learning modules on Day 2 and demonstrate how these competencies come together in the effort of the ACO to compete successfully on the basis of value.

9:15 – 9:30

Break

9:30 – 11:30

Development of implementation plans

  • Breakout groups for teams to identify next steps and questions
  • Facilitated discussion with panelists

11:30 – 12:00

ACOs and successful competition in a mixed payment environment

Scott Sarran, MD, MM, Chief Medical Officer Blue Cross Blue Shield of Illinois

  • Concluding keynote address by a leading private purchaser on how the development of successful ACOs that compete on value will change the relationship between providers and purchasers.

 

                                                                                                                                                                                                                                                           

If you have any questions, please contact us.