Last Friday, the Managed Care Committee held their annual conference in Norwood, MA. This year’s conference theme, “The Path to Value,” was reflected throughout the day by speakers on a variety of topics. The morning kicked off with a welcome message from our new Chapter President, Garrett Gillespie. Following the welcome, Alex Calcagno, Director of Federal and Community Relations at the Massachusetts Medical Society, presented on legislative updates from DC. Given the current uncertainty around health care issues at the federal level, the presentation had the audience’s full attention.
The morning panel, “Innovative Approaches to Addressing Pharmaceutical Costs and Utilization,” addressed the critical issue of drug pricing and brought together stakeholders from across the issue. Robert Mechanic, Senior Fellow, Brandeis University and Director of the Health Industry Forum, moderated the panel with speakers Mara Bloom (Executive Director, MGH Cancer Center), Patrick Davish (Associate Vice President for Global Market Access, Merck), Michael Sherman, MD (Chief Medical Officer, Harvard Pilgrim Healthcare), and Amy Vachon (Director of Clinical Pharmacy, Atrius Health) discussing their diverse, and sometimes divergent, viewpoints on the issue. One key takeaway was the need to devise payment systems based on the efficacy of drugs to drive value.
In keeping with the timely topics of the conference, the keynote by David Williams (President, Health Business Group), “Alexa: What Can Healthcare Expect from Amazon?” addressed the role of disruptors in a healthcare landscape that is increasingly seeing new, non-traditional market participants.
Following lunch, Christy Matheson (Vice President of Coding, Medical Records Associates, LLC) spoke to “Improving Revenue Integrity through Effective Coding and Denials Management.” Ms. Matheson emphasized that while healthcare providers can gather a lot of data about the revenue cycle and denials, it is essential to understand the measures and metrics that are useful to the revenue cycle team and to separate the signal from the noise. Ms. Matheson’s presentation also emphasized the need to turn data and information into effective training for staff to improve coding and denials management.
The afternoon panel, moderated by Nancy Turnbull (Senior Associate Dean for Professional Education, Harvard T.H. Chan School of Public Health) brought the conversation local, focusing on “Healthcare Reform Efforts in the Commonwealth.” Panelists Roberta Herman, MD (Executive Director, Group Insurance Commission), Amy Rosenthal (Executive Director, Health Care for All), Eric Weil, MD (Chief Medical Officer, Primary Care, Partners Center for Population Health), and Jean Young (President, Tufts Health Public Plans) addressed a variety of efforts to contain costs and improve care in Massachusetts. Those efforts include risk stratification of patients, address behavioral health needs, integrating oral health with other health needs, and creating standardized quality metrics. As the Commonwealth continues to confront the opioid epidemic, the panel spoke to efforts to address the shortage of providers and the need to empower primary care providers to do behavioral health assessment and make referrals, as well as to the need for recovery coaches and community social workers in Massachusetts.
Thank you to the Managed Care Committee and Co-Chairs Karen Granhoff and Kim Carlozzi for another fantastic conference!