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September 7, 2016 — Free Executive Web Briefing Sponsored By PLEXIS Healthcare Systems

Population health management is becoming more complicated. First, there are the payers — Medicaid, Medicare, commercial plans, and employers. Mix a wide range of new populations — those covered by Medicaid expansion, dual eligible consumers, and consumers with intellectual disabilities. Add a range of new services — long-term services and supports, medication management, and nursing home, home-based, and social services. Finally, muddle it all with an entirely new vocabulary for contract arrangements — from capitation to case rates to bundled payments and more. This complicated recipe can leave provider organizations wanting more management capabilities from their information systems.

The Strategic Question: How do to you leverage your current infrastructure, including information systems, to manage the multiple, complex lines of risk-based contracts?
The Solution: Adopt or build on your current infrastructures through focused strategy to add capacity!

In this webinar, hear OPEN MINDS chief executive officer, Monica Oss, discuss the new world of risk-based contracting (and the associated models) as it relates to payers, consumers, and services. Along with exploring the current landscape, Avante Health, PLEXIS Healthcare Systems, and OPEN MINDS faculty will discuss challenges to managing multiple lines of business and how to assess (and even extend) your current information systems to successfully manage multiple risk-based contracts.


Agenda

During this 90-minute executive web briefing, attendees will:

  • Explore the new world of risk-based contracting – payers, consumers, services, and models
  • Understand the challenges for managing multiple lines of business
  • Learn how to assess and extend your current information systems to manage multiple risk-based contracts
  • Hear an exciting case study on managing multiple risk-based contracts from Avante Health, an insurance payer specializing in behavioral health

Featured Speakers

Monica E. Oss, Chief Executive Officer, OPEN MINDS — Monica E. Oss, M.S. is the founder of OPEN MINDS. For the past two decades, Ms. Oss has led the OPEN MINDS team and its research on health and human service market trends and its national consulting practice. Ms. Oss is well known for her numerous books and articles focused on the strategic and marketing implications of the evolving health and human service field. She has unique expertise in payer financing models, provider rate setting, and service pricing. She has led numerous engagements with state Medicaid plans, county governments, private insurers, managed care programs, service provider organizations, technology vendors, neurotechnology and pharmaceutical organizations, and investment banking firms – with a focus on the implications of financing changes on delivery system design.

Prior to founding OPEN MINDS, Ms. Oss served as an executive with a national managed behavioral health organization, with responsibility for market development and for actuarial analysis and capitation-based rate setting. She also held a position as a vice president of the U.S. risk management and underwriting division of an international insurance company.

Todd Galbraith, Chief Information Officer, Avante Health — Todd Galbraith is the Chief Information Officer at Avante Health an Insurance Payer specializing in Behavioral Health. A Computer Science graduate from Southern Oregon University Todd has been working within the Information Technology space for the past 18 years. He lives in Salem Oregon with his wife and three children.

Juan Mas, Sales Director, PLEXIS Healthcare Systems —Mr. Mas has over 10 years of experience in the health insurance industry, with a focus on the international travel medical and individual/group major medical markets. His areas of expertise include business development, relationship building, and business growth strategy + implementation.

Before joining PLEXIS, Mr. Mas held a number of positions at HCC Medical Insurance Services, starting as an Account Executive in the Sales Department. He was promoted through the years, eventually becoming Director of the International Business Unit of HCC. HCC experienced consistent growth year over year during Mr. Mas’ tenure with the company; up to 25% growth in his final year with the organization. His international medical insurance experience transitioned into Latin American markets as Head of Corporate Sales for Bupa Global Latin America (BGLA) in Miami, FL. At Bupa, Mr. Mas led business development for the international employee benefits division and oversaw Corporate Sales for BGLA in the Caribbean and Latin America, including 6 regional offices and teams throughout the territory.

Mr. Mas joined the PLEXIS team in January, 2016 with plans to help PLEXIS further expand its reach in the Eastern United States and internationally throughout the Latin American region. Mr. Mas holds a Bachelor of Arts in Communications from Indiana University Purdue University at Indianapolis (IUPUI).

Sarah Lesowski, Senior Product Specialist, PLEXIS Healthcare Systems —As a principal leader of PLEXIS product demonstrations, Sarah Lesowski is known for her astute product expertise and her proficiency in communicating complex topics to technical and non-technical people. Ms. Lesowski brings her vast knowledge of healthcare technology systems to illuminate the dynamic ecosystem of the PLEXIS payer platform and catalyze mission-critical business values for payer organizations.

Ms. Lesowski spent three years serving clients in PLEXIS technical support where her uncompromising attention to detail supported advanced SQL-scripting, product design, and product configurations that drove higher auto-adjudication rates. After joining the PLEXIS sales team in 2014, Ms. Lesowski quickly leveraged her product expertise to excel at identifying business needs and delivering the innovative solutions to a wide range of payer organizations.

Registration for this executive web briefing has been provided at no charge courtesy of PLEXIS Healthcare Systems.

Unable To Attend? Still register! At the conclusion of the event, all registrants will receive a recorded copy of the executive web briefing and presentation slides — regardless of attendance.

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