2021 Star Ratings Power Hour: Bottom-Line Impact and Strategies

Inside the Beltway Insights from Maverick Health Policy

As election year dynamics unfold, the impact on healthcare policy will be significant. This exclusive webinar, presented by Maverick Health Policy and hosted by Medecision, offers you a front-row seat to understand these changes. Our panel of Washington, D.C.-based experts will dissect the latest developments and forecast what these mean for the future of healthcare.

• Election Year Insights: Gain a deeper understanding of how the 2024 elections will impact healthcare legislation and the regulatory landscape.
• Expert Analysis: Hear from leading health policy advisors who specialize in healthcare innovation.
• Critical Topics Covered:
  • The impact of the presidential election and congressional action on health policy.
  • Latest advancements and issues in AI and utilization management.
  • Federal scrutiny on cybersecurity, data privacy, and the dynamics of M&A in healthcare.
  • Future directions for Medicare Advantage and social determinants of health (SDOH).

Meet Our Panel:

• Julie Barnes, JD – Founder and CEO, Maverick Health Policy
• Eric Schiavone, MPH – Director, Maverick Health Policy

The Top Care Management Barriers — And How To Tackle Them

To manage costs and advance value-based care models, health plans and health systems that take on risk need effective care management and population health programs. However, many legacy tools involved in these efforts are frustrating to use and produce fragmented data, hindering successful cost and quality management.

This conversation will examine the current state of care management, including the top barriers and how organizations can break through them. Learn how to:

• Efficiently and proactively identify at-risk individuals
• Empower patients to achieve better outcomes
• Increase collaboration across the care continuum

Panelists

Kenneth Young, President & CEO, Medecision
Dr. Robert Groves, Executive Vice President & Chief Medical Officer, Banner | Aetna
Jessica Chaudhary MD, Medical Director, Carelon

Learn more at https://www.medecision.com/

The State of Utilization Management 2024

The executives examined independent market research that surveyed health plan leaders about the current state of UM and what organizations need to transform both Utilization Management and Care Management.
Key findings relative to UM include:

- More than half of survey respondents say fragmented data (57%), data that doesn’t flow into UM workflows (55%), and burdensome data integration are the top barriers to current tools

- 68% say inefficient workflows are their organization’s primary frustration with current tools, followed by high costs associated with data silos (49%), and provider abrasion (40%)

- Why? Because respondents say current tools are not easy to use and they need technologies that are “very effective” at accessing real-time data to drive down administrative and medical costs while improving health outcomes

In addition to sharing the research, the speakers also discussed:

- Data types healthcare organizations should be integrating into UM workflows

- The power of personalization in making UM more trusted by members and providers

- How predictive modeling for risk stratification, as well as UM workflow optimization with AI and automation, can propel UM efficiency, results, and outcomes

- What leaders should understand about regulations relative to UM – including the newly-released ePrior Authorization rule

January: The Year Ahead in Care Management, Utilization Management, Personalization & Population Health

Did you know that, despite 95% of health plan executives stressing the importance of personalization, only a third consider their operations highly personalized?

This podcast will examine the results of Medecision's exclusive market research. We will explore the current state of utilization management and care management, the value of a contextually-aware view of members, how personalized experiences are driving impact at the health inflection point and the opportunities to more strategically leverage data.

View the Market Report here.

2021 Star Ratings Power Hour: Bottom-Line Impact and Strategies

The 2021 Star Ratings Power Hour: Bottom-Line Impact and Strategies was recorded on June 30, 2021.

In this episode, Julie Barnes, JD, Founder and Principal of Maverick Health Policy, and Kimberly Swanson, Vice President of Quality and Clinical Integration at Network Health Plan share valuable insights on the new measures and weighting, and ideas for optimizing your technology tools while implementing best practices to improve your member experience.