The Real Value of ACOs
Product Description:
HealthLeaders Media Rounds: Live Webcast from Norton Healthcare
The Real Value of ACOs
Presented on August 16, 2011
12:00–3:00 pm (ET)
11:00–2:00 pm (CT)
10:00 am–1:00 pm (MT)
9:00 am–12:00 pm (PT)
The release of the Medicare Shared Savings proposed regulations in late March may have left you and your healthcare organization wondering what to do next about accountable care organizations. After so much buildup and hype, some healthcare organizations may retreat from the clinical redesign, value-based purchasing, and incentive-based reimbursement principles that are a part of accountable care. Don’t be one of those organizations. Accountable care principles are the right thing to do for your patients and your healthcare system. Learn from Norton Healthcare, Humana, and Palmetto Health—first movers who already have experienced the challenges of building a new framework for healthcare delivery.
Join HealthLeaders Media and national thought leaders on August 16 live from Norton Healthcare. The event includes a roundtable discussion—and interactive Q&A—with lessons learned from top executives, including how to:
- Apply practical strategies for value-based purchasing
- Use accountable care principles for long-term clinical re-engineering
- Refocus on performance- and incentive-based reimbursement
AGENDA
12:00 p.m.–1:45 p.m. Create a Win-Win Provider/Payer ACO Partnership
Steve Hester, MD, MBA, Senior Vice President and Chief Medical Officer, Norton Healthcare
Kenneth C. Wilson, MD, MS, CPE, System Vice President, Clinical Effectiveness & Quality, Norton Healthcare
Thomas James III, MD, Corporate Medical Director, National Network Operations, Humana, Inc.
- Defining the ACO journey
- Tackling the operational ACO challenges
- New partnerships for population management
- Finance implications and physician reimbursement
- Legal and contract issues; balancing insurance risk versus provider risk
- Clinical reengineering and new needs for clinical data
- Understanding and planning for the healthcare strategy impact of ACOs
- A provider and payer view of today’s ACO structures
- Value-based purchasing
- Medicare Shared Savings
- Pioneer ACO model
1:45 p.m.–2:15 p.m. Accountable Care: A Physician’s Perspective
Ellis M. Knight, MD, Senior Vice President of Ambulatory Services, Palmetto Health
- Integration on several levels
- Cultural integration
- Clinical integration
- Making physicians an integral part of the business model
- Economic integration
- Necessary component
- Risk sharing as opposed to cost shifting
- Accountable versus managed care
- Denying payment for unnecessary care versus paying for appropriate care
- Gatekeepers versus care coordinators
- Payer controlled versus provider controlled
- Risk shifting versus risk sharing
- Preparing for a reformed health care system
- Bundled payments
- Patient-centered medical homes
- Partial or global capitation
- Medicare shared savings program
- Value-based reimbursement
- Investing in the future of health care delivery
- Creating a new value proposition for patients and employers
- Partnering with payers and moving away from traditional payer provider transactions
- Funding investments through the elimination of non-value-added waste
- Share data to prove value: providers = process and outcome measures, payers = cost data
- What not to do
2:15 p.m.–3:00 p.m. Interactive Q&A
Agenda subject to change.
SPEAKERS
Steve Hester, MD, MBA, Senior Vice President and Chief Medical Officer, Norton Healthcare, Louisville, KY
Hester joined Norton Healthcare in January 2005 as chief medical information officer. Prior to that, he practiced emergency medicine full time, serving as regional medical director for Kentuckiana Emergency Physicians, a physician group with 40 emergency medicine physicians serving the Louisville community. Hester holds bachelor’s and medical degrees from the University of Louisville and is board certified by both the American Board of Internal Medicine and the American Board of Pediatrics. He also holds a master of business administration degree from Bellarmine University.
Kenneth C. Wilson, MD, MS, CPE, System Vice President, Clinical Effectiveness & Quality, Norton Healthcare
In his role, Wilson has overall management responsibility for the quality and safety programs of Norton Healthcare. He is also a member of the system leadership team guiding the organization’s participation in the Brookings-Dartmouth Accountable Care Organization pilot. And Wilson leads the Technology Assessment Committee, a physician-centric group including senior administrators, finance personnel, and materiel management leadership and staff. In collaboration with the chief medical officer, he envisions, creates, and supports programs which identify and develop physician leaders within the organization.
Thomas James III, MD, Corporate Medical Director, National Network Operations, Humana, Inc.
James is responsible for providing the clinical input into the quality and efficiency measurements and display of healthcare providers within the Humana network. He works closely with national and local professional organizations and societies to explain Humana’s goals on transparency and other clinical issues, and to receive feedback that allows for greater alignment between Humana and the groups. He is also involved with Humana’s group Medicare clinical program development. He has nearly 30 years of experience in health benefits, having served as medical director for such health companies as HealthAmerica, Maxicare, Sentara, Traveler’s Health Network, and Anthem.
Ellis M. Knight, MD, Senior Vice President of Ambulatory Services, Palmetto Health, SC
Prior to his current position, Knight was Palmetto Health Richland's vice president for medical affairs. He served as a medical detachment commander for the U.S. Army, as founding partner and medical director for Inpatient Medical Associates of Columbia, as managing partner for Midlands Internal Medicine Associates, and as clinical associate professor of medicine for USC's School of Medicine. Knight received his degree cum laude in medicine from the University of Oregon Health Science Center's School of Medicine and earned an MBA from the University of Massachusetts at Amherst.
About Our Host
For more than a century, Norton Healthcare’s faith heritage has guided its mission to provide quality health care to all those it serves. Today, Norton Healthcare is the Louisville, KY area’s leading hospital and health care system (44 percent market share) and third-largest private employer, providing care at more than 125 locations throughout Greater Louisville and Southern Indiana. The Louisville-based not-for-profit system includes five Louisville hospitals with more than 1,800 licensed beds, five outpatient centers, 12 Norton Immediate Care Centers, 11,200 employees, more than 470 employed medical providers, and about 2,300 total physicians on its medical staff. Norton Healthcare is the 2011 recipient of the prestigious National Quality Forum National Quality Healthcare Award, and has consistently been recognized as one of the best places to work in Metro Louisville, the state of Kentucky, and nationally. Norton Healthcare and Humana are one of only four national pilot sites, and the only one in Kentucky, to study the Accountable Care Organization (ACO) model through the prestigious Brookings – Dartmouth ACO Pilot Project.
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