Name: Beyond Survival: Realizing Sustainability in Medicare Advantage
Start: 2023-11-08T16:00:00Z
End: 2023-11-08T16:00:44.000Z
Location: BrightTALK
Rating: 4

Xtelligent Healthcare Media is the leading healthcare B2B media company using data to deliver relevant content to our readers and ROI to over 300 advertisers.

Primary care only works if patients can adequately access it. However, patient care access is far from a reality, with fewer than half of U.S. adults reporting a usual source of care. To that end, primary care offices increasingly realize the need to meet patients where they are out in the community. Explore how payers and providers work with community-based organizations (CBOs) to address social determinants of health (SDOH) that bar patient care access. Learn key strategies to implement community-based care and foster strong bonds with community health partners.

Panel: Closing the Gap: Bringing Primary Care into the Community

The era of AI in healthcare is upon us. With numerous use cases across the healthcare continuum, from risk stratification to clinical decision support to patient care access, the technology is ripe to enhance the primary care system. Learn how emerging AI technologies, such as machine learning, natural language processing and agentic AI, are deployed to reshape the primary care landscape

Keynote: AI Meets Primary Care: Transforming Access, Outcomes, and Insight

Primary care is often called the quarterback of care teams, especially in a value-based care system. However, primary care has historically been undervalued compared to specialty and hospital-based care. Misaligned incentives and low reimbursement rates have also strained primary care practices. What are the payment structures needed to bolster primary care? Learn what types of incentives and other payment arrangements payers and providers are using to lift primary care for improve population health management.

Panel: Aligning Primary Care Incentives Across Payers and Providers

Connected health technology is a must-have in today's healthcare ecosystem. But how can healthcare leaders cut through the hype and make the right technology purchasing decisions for their organization? 

In this session, healthcare leaders will: 

• Gain insight into defining the ROI of connected health technology 
• Discover approaches for evidence-based technology selection
• Understand best practices for technology implementation

Understanding Connected Health Technology's ROI to Make Informed Tech Decisions

Device selection and implementation are critical in the effort to improve chronic disease management, but these are only the initial steps. Following this, healthcare providers must create sustainable care models that leverage connected health technology to deliver meaningful improvements in patient outcomes. In this panel, you will:

• Gain insights into the operational, technical and workforce barriers to scaling connected health initiatives for chronic care
• Understand how to effectively incorporate connected health technologies into clinical workflows without creating bottlenecks
• Learn how to measure the success of chronic care models and expand them across care settings

Beyond the Device: Creating sustainable connected health models for chronic conditions

Digital health pilots are essential in helping healthcare organizations discern between different connected health tools and models to decide which is best for their needs. However, deciding when and how to move from a pilot to broader scale implementation presents numerous challenges and can contribute to 'pilot fatigue'. In this session, you will:

• Learn about best practices for turning small-scale pilots into sustainable, high-value programs
•Discover strategies for addressing common obstacles that prevent successful pilots from scaling
• Understand evaluation methodologies to assess digital health pilots' ROI and potential for scaling


Participants:
Michelle Stansbury, Associate Chief Innovation Officer & VP of IT, Houston Methodist
Meg Barron, MBA, Managing Director, Engagement & Outreach, Peterson Health Technology Institute
Khang Nguyen, Chief Medical Officer of Care Navigation, The Permanente Federation
Chris Waugh, Chief Design and Innovation Officer, Sutter Health

Scaling digital health pilots with ROI in mind

Rapid advancements in connected health technology development have resulted in an abundance of options to enhance chronic disease management. However, these solutions often exist in silos, addressing one condition, one population or aspect of the care continuum. In this session, healthcare leaders will learn how to: 

• Evaluate connected health technologies that advances health equity
• Select and integrate connected care solutions into clinical workflows
• Create a seamless chronic care journey that boosts health equity

Driving health equity through connected chronic care programs

Originally approved for metabolic disorders such as diabetes and obesity, GLP-1 receptor agonists are now being studied for a range of expanded therapeutic applications, including musculoskeletal, reproductive, neurological and behavioral health disorders.

This panel brings together several industry experts to discuss the growing potential of GLP-1s in new areas of care, focusing on clinical development, regulatory strategies and market impact.

What you’ll learn:

• Emerging therapeutic areas where GLP-1s are showing promise
• Clinical, regulatory and reimbursement barriers to expanded use
• Strategies for advancing development and commercial uptake in new indication

Panelists (full titles): 
Jayne Hornung, Chief Clinical Officer, MMIT
Joseph P. Schacht, Ph.D., Associate Professor, Department of Psychiatry, University of Colorado School of Medicine
Patrick F. Smith, PharmD, Senior Vice President, Translational Science, Certara
Nicole Snow, PharmD, BCSCP, CSP, Senior Clinical Pharmacy Liason, Olympia Pharmaceuticals

Beyond Obesity and Diabetes: Exploring the Expanded Therapeutic Potential of GLP-1s

Despite the end of the FDA-declared shortage, compounded versions of semaglutide and tirzepatide remain widely available. Compounded GLP-1s, often manufactured without FDA oversight using foreign-sourced ingredients, pose growing safety risks and are being marketed alongside FDA-approved brands like Wegovy, Ozempic, Zepbound and Mounjaro.

In this session, Peter J. Pitts, President of the Center for Medicine in the Public Interest and former FDA Associate Commissioner, presents findings from his July 2025 report, "FDA Regulatory Failures in Enforcing Limits on GLP-1 Compounding."

What you’ll learn:

• Regulatory and enforcement gaps behind mass-produced GLP-1 knockoffs.
• Rising safety concerns associated with unapproved compounded drugs.
• Steps regulators must take to restore market integrity and protect patients.

Buyer Beware: How Weak Oversight of Compounded GLP-1s Threatens Patient Safety

Despite the trillions that the United States spends on healthcare, the American people fall short on numerous health measures compared to other high-income countries, including rates of chronic disease, mortality and life expectancy. Healthcare organizations are investing in population health approaches and advanced technology to enhance health outcomes and achieve value-based care. 

In this panel, leaders from healthcare provider organizations will discuss innovative technologies that support population health programs and how these technologies can be integrated into care delivery to move the needle on value-based care goals. 

Panelists:
- Brandi Clark, Vice President, Digital Care, OSF OnCall
- Dan Shields, CEO, Digital Medicine, Ochsner Connected Health
- Kristina M. Kury, MD, Medical Director of Eden ICU at Sutter Health Hospital and Regional Medical Director, Sound Critical Care East Bay

Population Health Tech Strategies to Advance Value-Based Care

This presentation will offer a comprehensive overview of AdventHealth, including the newly re-organized statewide Clinically Integrated Network and diverse value-based contract portfolio. Attendees will learn about AdventHealth PHSO’s Value Based Strategic Framework and learn how they partner with each of their markets to drive strategic growth in Value-Based Care. 

Gain a deeper understanding of the capabilities and competencies, and hear about their primary areas of focus, including Medicare, government programs, and direct-to-employer contracting.

Driving Value-Based Care Growth at a Clinically Integrated Network

In this session, Don Antonucci, President and CEO of Providence Health Plan (PHP), will discuss the critical intersection of value-based care and population health. Leaning on insights from his 25+ years in the industry and PHP’s Health For All vision, Antonucci will shed light on innovation he’s seen throughout his career and how payers and providers can prioritize proactive, personalized healthcare by defining shared objectives and goals to enhance health equity, reduce costs, and ultimately foster a healthier, more resilient population.

Blending Value-Based Care and Population Health Strategies

As the healthcare industry continues its pursuit of better outcomes and lower costs by way of value-based care models, population health has come to the forefront. But a good population health strategy relies on data that's interoperable, high-quality, and consistent, and those ideals can often feel out-of-reach. In this panel, industry leaders will discuss how data standards can support data governance, as well as how to realistically implement data standards as part of a population health strategy.

Panelists:
- Rachel Harrington, PhD, Assistant Vice President, Health Equity Sciences, NCQA
- Sheila Sudhakar, MD, VP of Enterprise Population Health/Value Based Care, Cigna
- Kristina Rollings, Chief Growth Officer, CAQH

Exploring the Challenges and Benefits of Using Data Standards for Population Health

Though the healthcare landscape is becoming increasingly connected via digital health and virtual care technologies, social determinants of health (SDOH) can impede access and adoption of these technologies. SDOH like food and housing insecurity, language barriers, and the digital divide, can keep people from experiencing the benefits of connected care technologies. In this panel, industry leaders will discuss the trenchant nature of SDOH challenges, strategies to tackle SDOH issues, and the multi-institutional support needed to make these efforts a success.

Panelists:
Arianne D. Dowdell, Vice President, Chief Diversity, Equity & Inclusion Officer, Houston Methodist  
Eric Kim, Senior Director, Digital Strategy & Experience, Mount Sinai Health System  
Caitlin A. Moore, DNP, Associate Director, Clinical Operations, Clemson University: Clemson Rural Health

Boosting Equitable Connected Healthcare Access & Adoption

Connected and integrated healthcare models play a vital role in accelerating the move toward value-based care, which emphasizes high-quality and affordable healthcare. At Kaiser Permanente, various connected healthcare efforts, ranging from telehealth to AI-powered ambient listening, aim to bring value to patients, reduce administrative burden for physicians, and lead to greater efficiency within the health care delivery system. In this fireside chat, Ainsley MacLean, MD, Chief Medical Information Officer and Chief AI Officer, Mid-Atlantic Permanente Medical Group, will discuss system-wide efforts, including strategies to implement, scale, and standardize them.

Advancing Value-Based Care Through Digital Healthcare Avenues

In the last few years, the number of advanced connected care technologies has proliferated, from telehealth and RPM to digital therapeutics and VR. However, their success depends on numerous factors, including seamless integration into clinical workflows, provider buy-in, and patient education. During this panel discussion, leaders from provider and payer organizations will discuss barriers to successful technology integration, strategies to break down those barriers, and the opportunities that these technologies can unlock.

Panelists:
Lauren Hopkins, MPH, Assistant Vice President of Virtual Care & Community Engagement, WellStar MCG Health
Anjali Bhagra, MD, Medical Director, Enterprise Automation Hub & Office of Equity, Inclusion & Diversity, Mayo Clinic
Frank Osborn, MD, Chief Medical Officer, Tufts Medicine Integrated Network, Tufts Medicine

Integrating Advanced Connected Care Technologies into the Care Continuum

Implementing digital healthcare technologies requires careful consideration of the clinician digital journey. In a keynote address, Michael Oppenheim, MD, Senior Vice President of Clinical Digitial Solutions at Northwell Health, will discuss how the health system deploys advanced technologies, such as remote patient monitoring, chatbots, and AI, through a framework that considers clinician and patient experience and administrative burdens with the goal of supporting coordinated and more continuously connected healthcare.

Optimizing the Clinician & Patient Digital Journey to Foster Connected Care

This panel discussion will cover advancements and challenges in cell and gene therapy (CGT), focusing on the implications for healthcare technology. Sanjay Srivastava, PhD, will share insights on the scientific and operational strategies needed to bring CGTs from concept to market, highlighting best practices in R&D, supply chain, and patient engagement. Stella Vnook, PhD, PharmD, MBA, will discuss the translational aspects of cell and gene therapy, emphasizing the journey from bench to bedside and critical factors for successful commercialization. Dalip Sethi, PhD, MBA, will speak to the technological advancements in cell processing and manufacturing, addressing how these innovations enhance cell-based therapies' scalability and efficacy. Matthieu de Kalbermatten, MSc, MBA, will offer insights into the strategic and operational challenges of bringing innovative therapies to global markets. Drawing on his track record of successfully growing businesses, Matthieu will discuss effective corporate strategies, partnerships, and market expansion tactics essential for advancing cell and gene therapies.

Together, they will provide a holistic view of cell and gene therapy's current and future direction, offering healthcare professionals valuable knowledge.

Advancing Medicine Through Cell and Gene Therapy

Collaboration between providers and payers enables the pooling of resources, expertise, and data, fostering coordinated and efficient care for communities. This unified approach, especially in value-based care models, promotes preventive health measures, streamlines processes, and addresses holistic community health needs. Parkland Center for Clinical Innovation President & CEO Steve Miff will share real-world examples and best practices for combining the right people, efficient processes, and advanced technology to address the needs of underserved individuals and populations.

Collaborative Data-Driven Strategies for Healthy Communities

Rising costs, stagnant outcomes, and workforce strain signal a need for change in healthcare. Value-based care promises better provider satisfaction, improved patient outcomes, and cost reduction. However, providers remain hesitant to adopt risk-based, quality-focused models. Join a discussion on building provider support with Humana's AVP of Physician Strategy & Medical Affairs, Alexander Ding, MD, MBA.

Building Provider Support for Value-Based Care

From payers to providers and everyone in between, every healthcare stakeholder contributes to health and wellness. Yet, connecting the dots across the care continuum is a major challenge. Data siloes, lack of interoperability, health literacy and engagement obstacles, and rules and regulations are just some of the issues preventing effective care coordination across provider types. This panel explores the state of care coordination in a more medically complex and consumer-driven environment.

Lauren Grimshaw, Senior Vice President of Member Health Operations, CDPHP
Hallie Bleau, VP of Care Management, Northwell Health Solutions
Rich Steinle, CEO of Carium

Guiding Patients to Health with Care Coordination

The past few years have brought significant attention to the impact of social determinants of health on individual and community well-being and health outcomes. Understanding these environmental, economic, and sociopolitical factors is integral to effective population health management where care management and interventions are tailored to the needs of specific groups or geographies. UnitedHealthcare Vice President of Social Determinants of Health Alexander Billioux, MD, DPhil, will discuss strategies for addressing individual health-related social needs and broader community health drivers to improve outcomes and costs.

Improving Population Health by Addressing Social Needs

4th Annual Payer+Provider Virtual Summit

Success in Medicare Advantage can be hard to achieve—and  in today’s hypercompetitive and regulatorily complex MA market, it’s only getting harder. Stakeholders looking to survive—let alone succeed or scale—in MA must understand how to operate leanly while balancing growth and sustainability. We’ll discuss:

• How the Medicare Advantage landscape has changed and what that means for you
• How plans are measuring success in MA and related best practices 
• How to fine-tune risk adjustment and STARS practices

Beyond Survival: Realizing Sustainability in Medicare Advantage

Health

Health Plan

Medicare

Scalability

Risk Adjustment

Payer

Provider

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