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THE MANAGED CARE PHARMACY INNOVATION SUMMIT The only strategy event for pharmacy executives that will increase star quality ratings, save on drug costs and improve member outcomes

JUNE 20 - 21, 2019 THE UNION LEAGUE PHILADELPHIA, PA

MS 3.26.19 V6


INTERESTED IN LEARNING HOW INNOVATIVE PHARMACY PROGRAMS CAN IMPROVE STAR RATINGS? This all new strategy event—Managed Care Pharmacy Innovation Summit—is designed for pharmacy executives to provide actionable items to help increase star quality ratings, save on drug costs and improve member outcomes. As a delegate you will participate in fluff-free interactive discussions with innovators and experts in their field plus network with all participants. At this one-of-a-kind event, you will walk away with program enhancements for better outcomes while controlling costs.

FRESH INSIGHTS YOU’LL TAKE AWAY: • How to effectively bring pharmacists to the forefront of the health care team • Learn why some populations are resistant to attempts on engagement • Tips to reevaluate the relationship with PBMs within the scope of new market forces • Understand how HEOR data influences the lab benefit and utilization of specialty drugs

Whether you’re from health plans, hospital networks, community and specialty pharmacy, or a part of PBMs, pharmaceutical companies and health care partners, this event is a must-attend for valuable updates.

TOPICS PREVIEW • Evidence-Based Strategies for Addressing Drug Abuse Syndrome • Exploring the Shifting Role of Pharmacy Benefit and Impact on Star Ratings • Transitional Care CMS Innovation Grant

• CASE STUDY: A Dive into How Oklahoma Achieved the Nation’s First Medicaid Contract With CMS • CASE STUDY: Operations and Cost-Containment Strategies for Medically Administered Drugs • CASE STUDY: Evidence Based Medicine Models for Rx

• What will be the Impact and Costs of the Increasingly

Outcomes: Migrating from In-House Infusion Centers

Large Number of Integrated Benefit Organizations?

• CASE STUDY: Ideology to Reality with a Transitional

• Addressing Increasing Crisis of Drug Shortages • Impact of Industry Consolidation on Health Economic Outcomes Research (HEOR) Data Generation in Value-Based Contracting – From Lab Point of View

Care CMS Innovation Grant • EXTENDED SESSION: Medication Therapy Management – Two Sides of The Same Coin • INTERACTIVE SESSION: Effective Member Engagement – How Do We Get It?

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WHO SHOULD ATTEND? The Managed Care Pharmacy Innovation Summit is designed for all Medicaid professionals. With speakers of the highest caliber including CEO’s, Presidents, Executive Directors and Vice Presidents, the content, knowledge, and experience will be hugely beneficial and practical.

HEALTH PLANS

HOSPITAL NETWORKS

• Pharmacy directors

• Clinical pharmacy

• Clinical pharmacy

• Pharmacy directors

• Pharmacists

• Pharmacists

• HEOR

• HEOR

• Population health

• Population health

management • Pharmacoeconomics

PHARMACIES • Director of pharmacy

PHARMACEUTICAL COMPANIES • HEOR • Payor relations

management • Pharmacoeconomics

TOP REASONS TO ATTEND

01 02 03 04 05

Learn how innovative pharmacy programs can improve star quality ratings Hear firsthand about pilot programs enabling pharmacist payment models Identify challenges and solutions for effective team management in transitional care Review case studies on successful MTM programs – from all sides of the healthcare spectrum Discuss with peers their methodologies for effective member engagement

T h e U n i o n L e a g u e | P h i l a d e l p h i a , PA

06 07 08 09 10

Gain insight into the impact of industry mergers and consolidation on small and midsize plans Understand the impact on HEOR data from integrated benefit organizations Learn how Oklahoma pioneered the nation’s first value-based contract with CMS Get an inside take on evidencebased strategies for addressing the opioid crisis Discuss drug shortages and their effect on plans, hospitals and patients

Click Here to Register

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MEET OUR DIVERSE MIX OF INDUSTRY SPEAKERS Victoria Losinski, PharmD, PhD, Director of Pharmacy Services

BLUE CROSS AND BLUE SHIELD OF MINNESOTA

Diane Reist, Clinical Pharmacy Specialist

UNIVERSITY OF IOWA HOSPITALS & CLINICS

Pamela Sherry, Director of Network Pharmacy Management LAHEY CLINICAL PERFORMANCE NETWORK

Allana Alexander, PharmD, MSMTM, Clinical Pharmacist, Health Home Region B

ALABAMA CARE PLAN ADMINISTERED BY VIVA HEALTH, INC.

Ben Johnson, Director of Pharmacy UNION PACIFIC RAILROAD EMPLOYEES HEALTH SYSTEMS

Scott Fries, Vice President Pharmacy Solutions PULSE8

Rachel Anhorn, PharmD, Director, Health Economic Outcomes Research and Payer Policy FOUNDATION MEDICINE

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Managed Care Pharmacy Innovation Summit

Terry Cothran, D.Ph.,Director, Pharmacy Management Consultants UNIVERSITY OF OKLAHOMA HEALTH SCIENCES CENTER

Michelle B. Anderson PharmD, Director of Pharmacy, Managed Care

DENVER HEALTH MEDICAL PLAN ,INC.

James McGinnis, Director of Pharmacy

ATLANTIC GENERAL HOSPITAL

Wayne Russell, Vice-President, Pharmacy PREMIER, INC

Matt Osterhaus, BSPharm, FAPhA, FASCP, Owner OSTERHAUS PHARMACY

Kelli Littlejohn Newman, R.Ph., Pharm.D., Director, Clinical Services and Support ALABAMA MEDICAID AGENCY

Gary Melis R.Ph., Clinical Pharmacist NETWORK HEALTH

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DAY 1: THURSDAY, JUNE 20 7:30

Registration and Networking Breakfast

8:30

Welcome Remarks

STAR QUALITY 8:45

Exploring the Shifting Role of Pharmacy Benefit and Impact on Star Ratings • Gain knowledge on how to effectively bring pharmacists to the forefront of the healthcare team • Review BSBS Results of pharmacist driven MTM programs and the effects it had on star ratings • Consider how your organization can tap into the ability of community pharmacists to improve member outcomes Victoria Losinski, PharmD, PhD, Director of Pharmacy Services BLUE CROSS AND BLUE SHIELD OF MINNESOTA

POPULATION HEALTH MANAGEMENT 9:30

Impact of A Hybrid MTM Program on Stars and HEDIS Performance • Learn how having your health plan pharmacist participate make MTM calls influences Star and HEDIS measures • Understand how promotion of the MTM program to members and agents impacts satisfaction of the health plan • Learn about the financial justification of a hybrid MTM programs Gary Melis, R.Ph., Clinical Pharmacist NETWORK HEALTH

T h e U n i o n L e a g u e | P h i l a d e l p h i a , PA

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10:15

CASE STUDY: Lessons learned: Integrating MTM services within a multidisciplinary team • Get an overview of the program, what the Care Team composition was, its work-flow, and target populations • Understand the pharmacist focus on a patient subset and review the criteria for referral • Review the impact on outcomes and understand the challenges and opportunities Pamela Sherry, Director of Network Pharmacy Management LAHEY CLINICAL PERFORMANCE NETWORK

11:30

CASE STUDY: Pilot Programs for Improving Medication Adherence • Learn how to handle challenges of managing both In-house and outsourced resources • Review lessons learned on how to navigate formula limits • Analyze methods for alleviating social barriers Allana Alexander, PharmD, MSMTM, Clinical Pharmacist, Health Home Region B ALABAMA CARE PLAN ADMINISTERED BY VIVA HEALTH, INC.

12:15

Networking Lunch

1:30

Addressing Increasing Crisis of Drug Shortages Soumi Saha, Senior Director of Advocacy PREMIER, INC

2:15

INTERATIVE SESSION: Effective Member Engagement – How do we get it? • Review how managed care is attempting to engage members and help them create a healthier lifestyle. • Analyze why some populations are resistant to attempts on engagement • Share with peers’ illustrations of managed care systems working with pharmacists to help move the process along? Ben Johnson, Director of Pharmacy UNION PACIFIC RAILROAD EMPLOYES HEALTH SYSTEMS

3:00– 3:30

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Networking Break

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SPECIALTY DRUGS AND VALUE BASED PRICING 3:30

Impact of Industry Consolidation on Health Economic Outcomes Research (HEOR) Data Generation in Value-Based Contracting – From Lab Point of View • Examine the current challenges to utilization of HEOR data in establishing value-based pricing of specialty drugs • Understand how HEOR data influences the lab benefit and utilization of specialty drugs • Explain the expectations of industry consolidation that will allow data sources to be fully integrated and connected Rachel Anhorn, PharmD, Director, Health Economic Outcomes Research and Payer Policy FOUNDATION MEDICINE

4:15

Payers and Providers Response to Pharmacy Industry Consolidation and Government Regulation • Discuss strategic imperatives that result from recent consolidation of health plans, pharmacy benefit managers (PBMs), pharmacies, and drug manufactures • Learn how to build and utilize the necessary reporting, benchmarks and analytics to evolve your relationship with your PBM and pharmacy networks • Review trends in pharmacy value-based contracting and explore the opportunities to employ in specialty pharmacies in your network Scott Fries, Vice President Pharmacy Solutions PULSE8

5:00

Networking Cocktail Reception

T h e U n i o n L e a g u e | P h i l a d e l p h i a , PA

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DAY 2: FRIDAY, JUNE 21 8:00

Networking Breakfast

9:00

Opening Remarks

COST CONTAINMENT STRATEGIES 9:00

CASE STUDY: A Dive into How Oklahoma Achieved the Nation’s First Medicaid Contract With CMS • Learn about Oklahoma’s approach to establishing a value-based contract with CMS • Understand the methodology used for achieving consensus about measures and outcomes for the contracts • Learn what was easy to implement and the challenges faced about agreeing on datapoints and measurements • Create your own blueprint for initiating talks on value-based contracts Terry Cothran, D.Ph.,Director, Pharmacy Management Consultants UNIVERSITY OF OKLAHOMA HEALTH SCIENCES CENTER

9:45

CASE STUDY: Operations and Cost-Containment Strategies for Medically Administered Drugs • Understand how Denver Health determines what medications to review • Review established systems for coordination between Utilization Management and Pharmacy Departments • Analyze the data reporting that provides oversight and works to monitor outcomes Michelle B. Anderson PharmD, Director of Pharmacy, Managed Care DENVER HEALTH MEDICAL PLAN, INC.

10:30

Networking Break

11:00

CASE STUDY: Evidence Based Medicine Models for Rx Outcomes: Migrating from In-House Infusion Centers • Review why Atlantic General instigated a change in its infusion system • Obtain understanding of different infusion models considered • Gain insight into data driven reasons behind establishing “right patient” centers • Examine the use of datamining evidence to prove efficacy • Discover lessons learned from methodology that can be applied to other area’s of patient care James McGinnis, Director of Pharmacy ATLANTIC GENERAL HOSPITAL

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OPIOIDS 11:45

Evidence-Based Strategies for Addressing Drug Abuse Syndrome - Medicaid Opioid Prescribing and Pharmacy Trends • Learn about the Alabama Medicaid prescribing and pharmacy statistics • Understand the Opioid Naïve edit and preliminary outcomes • Analyze the MME description and cumulative MME edits Kelli Littlejohn Newman, R.Ph., Pharm.D., Director, Clinical Services and Support ALABAMA MEDICAID AGENCY

12:30

Networking Lunch

1:30

Addressing Increasing Crisis of Drug Shortages • Understand the reasons for the shortages and how it impacts costs, formulary management, patient access and outcomes • Learn how to anticipate drug shortages and what resources are available for managing drug shortages • Discuss the unintentional consequences of opioid shortages • Explore innovative partnerships of hospitals that are working together to create their own pharmaceutical manufacturing plans to address shortages Soumi Saha, Senior Director of Advocacy PREMIER, INC.

2:15

Roundtable Discussions Bring a topic! This is your chance to contribute to the agenda. Bring a topic you would like to discuss. The chairman will select five and place them on the tables. Attendees can choose what table they want to go to for unfacilitated networking and discussion. After 35 minutes tables will share what they talked about and any findings they have come up with.

3:00

Closing Remarks

T h e U n i o n L e a g u e | P h i l a d e l p h i a , PA

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VENUE DETAILS THE U NION LE AGU E OF PHIL ADELPHIA 140 S Broad St Philadelphia, PA 19102 (215) 563-6500 The Union League of Philadelphia, ranked the #1 City Club in the Country, is a shining jewel of history in a city defined by such treasure. Founded in 1862 as a patriotic society to support the Union and the policies of President Abraham Lincoln, The Union League of Philadelphia laid the philosophical foundation of other Union Leagues across a nation torn by civil war. The League has hosted US presidents, heads of state, industrialists, entertainers and dignitaries from around the globe and has proudly supported the American military in each conflict since the Civil War.

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CONFERENCE RATES EARLY BIRD RATE

STANDARD RATE

ONSITE RATE

Health Plans & Health Care Providers

$ 1,195

$ 1,395

$ 1,595

Pharmacies

$ 1,395

$ 1,595

$ 1,795

Service Providers & Consultants

$ 1,895

$ 2,095

$ 2,295

Ends 5/3/19

Ends 6/18/19

GROUP DISCOUNTS ARE AVAILABLE Please contact Blake Valentine at 704.341.2451 or bvalentine@risehealth.org In order to secure a group discount, all delegates must place their registrations at the same time. Group discounts cannot be issued retroactively. For information regarding refund, complaint and/or program cancellation policies, please visit our website: www.risehealth.org/thefineprint.aspx

HOW TO REGISTER

CALL

REGISTER ONLINE

MAIL

(704) 341-2451

https://risehealth.org/mcp

Wilmington FRA 3420 Toringdon Way, Suite 240 Charlotte, NC 28277

(Click to Register Online)

T h e U n i o n L e a g u e | P h i l a d e l p h i a , PA

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CONFERENCE ORGANIZER RISE is the premier community for health care professionals who aspire to meet the extraordinary challenges posed by the emerging landscape of accountable care and government health care reform. Recognized industry-wide as the number one source for information on risk adjustment and quality improvement within health care, RISE strives to serve the community on four fronts: networking, education, industry intelligence and career development. Through cutting-edge conferences, online courses, in-house training, webinars as well as an association comprised of over 2,500 members, RISE provides professionals with industry insights and critical information they need to stay ahead of the curve. RISE produces more than 30 conferences annually, focused on sophisticated topics and ample networking opportunities for thousands of executives from mid- to senior-level and C-suite. Our team of subject matter experts is often first to market with emerging topics and we pride ourselves on consistently delivering on topquality operations and logistics to produce a seamless event. Established in 2006 as an extension of Health care Education Associates (HEA), RISE now operates as the sole health care arm offering the original capabilities of HEA as well as an expanded product line. Headquartered in Charlotte, North Carolina, RISE operates alongside its counterpart, Foundation Research Associates (FRA), which serves the finance, law enforcement, government, legal and compliance communities in a similar capacity. LEARN MORE AT RISEHEALTH.ORG

SPONSORSHIP AND EXHIBIT OPPORTUNITIES Enhance your marketing efforts through sponsoring a special event or exhibiting your product at this event. We can design custom sponsorship packages tailored to your marketing needs, such as a cocktail reception or a custom-designed networking event. To learn more about sponsorship opportunities, please contact Michelle Elam at 704.341.2393 or MElam@risehealth.org SPONSOR THIS EVENT 12

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Profile for WilmingtonFRA

The Managed Care Pharmacy Innovation Summit [H668]  

This all new strategy event—Managed Care Pharmacy Innovation Summit—is designed for pharmacy executives to provide actionable items to help...

The Managed Care Pharmacy Innovation Summit [H668]  

This all new strategy event—Managed Care Pharmacy Innovation Summit—is designed for pharmacy executives to provide actionable items to help...