Please note that this is a preliminary program and schedule, multiple updates, including speakers, are expected closer to the date as the program is finalized. We are not accepting speaker applications for this program.

Tuesday, May 18, 2021
 
2:00 p.m. to 2:15 p.m. Welcome Remarks/Event Preview


Kari Niblack
Chairwoman-Elect
Self-Insurance Institute of America, Inc.  
 
2:15 p.m. to 3:15 p.m.

The Basics & the Value Proposition
The first step in the “life cycle” is to learn exactly what Direct Provider Contracting means, including knowing the difference between a “one-off” contract and building out an entirely new network and the variations in between. Value propositions for all key stakeholders will be discussed – employer, provider, risk taker and plan participant. This session will provide that foundation so you will have a clear idea of the “what” and the “why” in order to determine whether such arrangement would make sense for your organization and/or your clients.

MODERATOR:

Jerry Castelloe
Principal
Castelloe Partners, LLC

SPEAKERS:

Blake Allison
Executive Vice President
Employers Health Network


Brad Byars
Executive Director, Product Develop.
Providence Southern California Region


John Farnsley
Executive Vice President
90 Degree Benefits


Bob Murray
Director, Whole Health, Medical and Wellness
Whole Foods Market


Lauren Pickard
Business Development Manager
RGA Reinsurance Company

3:15 p.m. to 3:45 p.m.
 
Break
 
3:45 p.m. to 4:45 p.m. Getting the Buy In
So you now understand the “what” and “why” and have concluded this is a market segment that would be good for your business, what’s next? You need to share this knowledge in order secure the necessary “buy in” to actually move forward. For providers, this means an internal sell within your organization to convince key decision-makers of the positive business opportunities. In the self-insured payer world, TPAs and/or brokers/advisers would need to take the time to educate their employer clients. This session will share some proven, real world approaches that have resulted in “go” decisions.

MODERATOR:

Mike Ferguson
President & CEO
Self-Insurance Institute of America, Inc.

SPEAKERS:

Darren Reynolds
President & CEO
Consociate


Nick Stefanizzi
CEO
Northwell Direct

Additional speaker to be announced
 
Wednesday, May 19, 2021
 
1:00 p.m. to 2:00 p.m. The Set Up
Once the preliminary due diligence has been completed and a provider and payer are ready to do business together, the real work begins…actually setting everything up. This session will focus on key considerations for both providers and payers as they begin to structure their partnership arrangement, as well as the important “nuts and bolts” details that need to be addressed. Specific topics will include mutual alignment of value props, contract development, financial terms, roles and responsibilities, communication plan and implementation planning.

MODERATOR:

Jerry Castelloe
Principal
Castelloe Partners, LLC

SPEAKERS:

Meghan Cassidy
Sr. Director, Sales & Product Develop.
Cleveland Clinic


Deborah Hodges
President and CEO
Health Plans, Inc.
 
2:00 p.m. to 2:30 p.m.
 
Break
 
2:30 p.m. to 3:30 p.m. Building the Team
Once there is general agreement between payer and provider on the framework for their direct contracting arrangement, it is likely that additional professional resources will need to be brought into the development process, if not already. Areas of expertise will likely include actuarial, stop-loss, data analytics, legal, and employee communications. This session will provide specific guidance for both payers and providers on determining who needs to be added to the team, the role they should play and how to keep everyone effectively engaged.

MODERATOR:

Nick Stefanizzi
CEO
Northwell Direct

SPEAKERS:

Blake Allison
Executive Vice President
Employers Health Network


Paul Forte
Senior Vice President, Strategic Development
Health Plans, Inc.


Deke Lape
Employee Benefits Consultant
Mitchell Insurance, Inc / D2E Health Plans


Lauren Pickard
Business Development Manager
RGA Reinsurance Company
 
3:30 p.m. to 4:00 p.m.
 
Break
 
4:00 p.m. to 5:00 p.m. The Launch
The team has put it all together and now it’s time to go live. This session will provide a detailed checklist of key implementation details to help ensure a successful start, as well as address the importance of clearly defining roles and responsibilities from the beginning. As part of this, we’ll also discuss internal and external communication strategies both providers and payers can utilize to encourage optimum utilization and positive patient experience, as well as to properly establish shareholder expectations. A provider case study will be incorporated as part of the discussion.

MODERATOR:

Peter Robinson
Managing Principal
EPIC Reinsurance

SPEAKERS:

Blake Allison
Executive Vice President
Employers Health Network


Morgan Barreth
EVP, Relationship Management and Risk Strategies
Vault Strategies


Lauren Pickard
Business Development Manager
RGA Reinsurance Company
 
Thursday, May 20, 2021
 
2:00 p.m. to 3:00 p.m. Administration
With everything now operational, the success or failure of your direct contracting arrangement is now dependent on effective administration. This session will highlight both payer and provider considerations, as well as mutual responsibilities related to data flow/analytics, transparency/access to data, documentation, vendor contracts, stop-loss claims reporting, billing practices and member engagement.

MODERATOR:

Jerry Castelloe
Principal
Castelloe Partners, LLC

SPEAKERS:

Brad Byars
Executive Director, Product Develop.
Providence Southern California Region


John Farnsley
Executive Vice President
90 Degree Benefits
 
3:00 p.m. to 3:30 p.m.
 
Break
 
3:30 p.m. to 4:30 p.m. Measure Success
Congratulations, your direct provider contract has been up and running with active utilization for some time now. But is it working as planned and meeting expectations? This session will focus on how payers and providers can leverage data analytics as well as other tools and strategies to quantify results on an ongoing basis. Both clinical and non-clinical outcomes will be addressed.

MODERATOR:

Peter Robinson
Managing Principal
EPIC Reinsurance

SPEAKERS:

Blake Allison
Executive Vice President
Employers Health Network


David Wilson
CEO
Windsor Strategy Partners, Inc.


Laura Zehm
SVP & Chief Administrative Officer
Montage Health
 
4:30 p.m. Forum Concludes

 

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