We have secured some of the industry’s most sought-after speakers who will address both the broader healthcare challenges facing executives today as well as the specific components of a holistic on-demand model. While this market has always been competitive, in recent years we have seen disruption coming from multiple directions, and the competitive ante has been raised. Recognizing that you need to develop immediate solutions to either compete or partner in this space or yield to new entrants, our speakers will address timely and relevant topics, sharing action steps you can implement in your strategic plan immediately.
Allan is one of the foremost analysts on healthcare policy and more specifically on health insurance plan trends and forecasting throughout the United States. His work not only looks at national trends, but has covered individual market dynamics in Minnesota, Arizona, Kentucky, Colorado, Florida, New Jersey, California, Illinois, Michigan, Ohio and Texas. Apart from the Kaiser Family Foundation, Allan is perhaps the single greatest source of analytics on the U.S. health insurance industry. His talk will guide us in projecting how commercial and government payer trends will impact the structure of the on-demand healthcare industry
Tom will provide Merchant Medicine’s most recent data from the on-demand healthcare market and draw a number of conclusions covering the future of private and chain urgent care operators, what it will take for health systems to compete in the on-demand space and how players like Optum and CVS Health are changing the landscape.
There are now hundreds of companies working with payers at identifying high-cost patient populations and coming up with solutions to bring those costs in line with the general population. Mobē is one such company whose story is compelling, not just with the economic value it is creating, but with its patient success stories and track record of increasing payer engagement. These case studies are instructive to the on-demand medicine space as it seeks to quantify its value to payers in what is rapidly becoming an industry with too much capacity and increasing saturation.
Moving to value-based care will involve a number of changes by all parties in the healthcare value chain. Among them will be behavior change, not just among patients, but among providers and health insurers. VAL Health are the leaders in applying behavioral economics to develop programs around behavior change. They bring together scientific evidence generated by Scientific Advisory Board Members, Drs. Kevin Volpp and David Asch, together with commercial experience. What happens with patient engagement when their care is delivered at the time and place of their choosing, i.e. on-demand medicine? Karen will walk us through the irrational logic behind behavioral economics and provide a number of case studies.
Tammy Mallow is a former Merchant Medicine consultant and national expert on urgent care payer reimbursement trends who works on behalf of health systems and private operators. Every health system in the country needs to be concerned - and laser focused - right now on their payer contracts and reimbursement issues. The urgent care sector is becoming saturated and still more growth is planned, particularly by health systems. Demonstrating your organization's "value add" to the payer requires a new level of sophistication. Tammy will start by reviewing the latest national trends and outlook on urgent care rates, an outlook that is becoming alarming for anyone playing in this space. Tammy will then talk about what leading health systems and larger operators need to be doing about payer contracts. This advanced course will provide the know-how ambulatory executives need to be successful in urgent care going forward (not "Start-up Payer Intro 101"), based on the largest single source of real-time urgent care reimbursement data. For health plan attendees, this talk will also be instructive on the key factors and differentiators for network design decisions.
As health care delivery, networks and payment models evolve away from fee-for-service medicine, the relationships between them are also evolving. Dr. Pham will offer a broad perspective on the shifts in what payers and large employers want from urgent care providers and hospitals. She can speak to the ways Anthem is considering and already integrating these new modes of care delivery into its strategy. Dr. Pham was chief innovation officer at CMS’s Center for Medicare and Medicaid Innovation before joining Anthem in 2017. A general internist, Mai has published extensively on payment policy issues including care fragmentation and coordination, and also practiced for several years at safety net clinics in the Washington D.C. area. Mai received her undergraduate degree from Harvard University, her MD from Temple University, and her MPH degree from Johns Hopkins, where she was also a Robert Wood Johnson Clinical Scholar.
Michael is an investment banker who has been involved in some of the largest urgent care and ambulatory care transactions in the last few years. He will help us interpret the meaning of some of the most recent transactions and in terms of how they are shaping the walk-in landscape. Michael has presented at one of our previous conferences. He speaks with such clear logic and honesty, presenting both good news and bad to attendees in a useful and effective way.
Dr. Sanders and his partner started Zoomcare as a next-generation urgent care chain back in 2006, but with a vision to combine on-demand aspects of convenience with value-based approaches to pricing and the avoidance of unnecessary procedures. That vision will advance to a much broader reality this fall with the offering of a regional ACO in partnership with Aetna in the Pacific Northwest. That offering is a Zoomcare-only network of urgent care, virtual care, primary care, specialty care and emergency services, packaged and offered to employers as a lower cost alternative option to employees and dependents during open enrollment.
Mr. Stavisky is tasked with developing Walmart’s vision for the future of employee benefits for their 1.5 million U.S. associates. As many of you know, Walmart has become a leader in direct contracting with health systems. Mr. Stavisky will discuss how they are looking at those and other contracting models designed to surface better ways to drive more appropriate and higher quality care.
Tianna’s career as a clinician, researcher and technologist includes over 15 years as a Physician Assistant working in Cardiothoracic Surgery and Director of Clinical informatics Department of Surgery at Columbia University Medical Center. From the beginning of her career, with her roots in clinical research at Stanford University, she has had a deep interest in data driven, systems-based medicine and is now one of Microsoft’s leading authorities on the application of blockchain technology in healthcare. Blockchain is most recognized for its use as the fundamental platform underneath cryptocurrencies. But when it comes to healthcare, blockchain may surprise you, not only in the applications that are already being deployed but in how (invisible) they are to the consumer. She will help us understand what blockchain is, the most recent applications in healthcare and where she see blockchain showing up in the on-demand space five years from now.
This case study shows how an urgent care center can achieve breakthrough patient volumes, i.e. greater than 120 visits a day, and higher acuity levels through team-based culture change and attention to detail.
This case study provides an example of how to effectively grow an employer services business alongside an urgent care service line to achieve very high patient volumes and reduced leakage to competitors.