701 Pennsylvania Ave. N.W.
Suite 700
Washington, DC 20004
(202) 737-5980
dmaa@dmaa.org
www.dmaa.org

Sunday, Sept. 7, 1:30 - 2 p.m.
PACESETTERS SERIES

Disease management organizations support individuals with a wide range of chronic conditions along the care continuum, including those facing end-of-life care decisions. Yet many organizations only have a passing understanding of hospice, palliative care and advance care planning. A 2007 study by researchers at Duke University found that hospice reduced Medicare costs by an average of $2,309 per hospice patient and is more cost effective for non-cancer patients for more than five months of care. Yet the average length of stay for hospice patients is only 59 days with a median length of stay of only 20.6 days. In this session: learn how palliative care and hospice can benefit disease management clients; understand common triggers for referral to palliative care and hospice; and identify ways to partner with end-of-life care providers to increase quality of life and optimize resources.

Christin Regas, MSW, is director of consumer programs and services director at the National Hospice and Palliative Care Organization (NHPCO). She joined the staff at NHPCO in 2003, after working as a hospice social worker. For more than 10 years, she has specialized in end-of-life care, focusing on end-of-life care planning, access to care and consumer advocacy.

Recent initiatives illustrate how Internet-based interventions promote widespread behavior change. Employees received incentives to use an online health risk appraisal, which indicated high prevalence rates of insomnia (30 percent) and depression (31 percent), resulting productivity losses of $9.4 million and $30 million, respectively. Using the data, tailored e-mail messages recruited employees for online interventions for depression and insomnia. Insomnia outcomes showed significant improvements in hours of sleep per night, quality of sleep and confidence to manage insomnia and significant decreases in difficulty falling asleep and staying asleep. Participants showed a 6.1 percent improvement in productivity impairment, saving $3,060 per participant per year. Depression outcomes included a 26 percent decrease in depression level, resulting in a 7.7 percent productivity impairment reduction, saving $3,855 per participant per year. Learn how to identify the impact of behavioral health problems on medical outcomes, health care costs and productivity, and use Internet tools to identify behavioral health problems and provide interventions.

Richard C. Bedrosian, PhD, a clinical psychologist, is director of behavioral health for HealthMedia. A pioneer in developing online behavioral health interventions, he also is a faculty member in the psychiatry department at the University of Massachusetts Medical School.

Neil Oktavec, MS, is manager of benefits strategy and analytics at McKesson. Previously, he was manager of benefit decision support and analytics at Wells Fargo. He has a bachelor's degree in sociology from UC-Berkeley and a master's in statistics at California State-Hayward.

Through the implementation of an integrated system of care management, a home and community-based medical management program can achieve both cost savings and improved clinical outcomes. Hear program specifics and successful outcomes of a blended-care management model of both telephonic intervention and community-based care managers for outreach and support. Using data captured on more than 100,000 senior members, this session will discuss the impact of co-morbid conditions on elderly populations, the correlation between acute and chronic care, cost savings to the acute care payer and out of pocket expenses for custodial home care, and obstacles to successful care management intervention in home and community-based settings.

Maureen Lillis, RN, CCM, is the senior vice president for CHCS Services. With more than 25 years experience as a professional nurse, she has gained extensive knowledge in the coordination of both acute care and custodial care. She holds a registered nursing degree specializing in geriatrics with an emphasis on payer systems.

In 2006, the DMAA Compliance Committee published Compliance Program Guidance to encourage population health organizations to develop and carry out a compliance program. An effective compliance program is a sound business investment with the potential to enhance the overall effectiveness of population health improvement and further the fundamental mission of all population health organizations by improving the quality of health among individuals. In this session, attendees will be introduced to the Compliance Program Guidance and the seven elements that constitute an effective compliance program. Learn how to integrate risk assessments into your compliance program and discuss key legal risks.

Adam J. Falk, JD, MPH, is a partner at Feldesman Tucker Leifer Fidell LLP. He teaches health care corporate compliance at George Washington University. Mr. Falk previously served as counsel to the Alliance of Community Health Plans and trial attorney at the Department of Justice.

Dee J. Warrington is corporate compliance and chief privacy officer at LifeMasters Supported SelfCare Inc. and chairs the DMAA Compliance Committee. She has held various compliance/privacy positions with respected health care organizations. Ms. Warrington is pursuing a graduate certificate in health care corporate compliance from George Washington University.

During the last year, both DMAA and the National Committee for Quality Assurance (NCQA) have been actively engaged in health promotion and wellness. DMAA, as part of its Outcomes Guidelines Initiative, has developed a definition of a wellness program, a program impact model and a series of guiding principals for evaluating a wellness program. NCQA has developed a certification program for health promotion programs and begun field testing the proposed measures. This session will review the work of each organization and discuss project synergies, as well as the broader applications to the industry.

Craig F Nelson, MS, DC, is director of health services research at American Specialty Health. He has published a wide range of scientific journals and is currently on the editorial board of the Journal of Manipulative and Physiologic Therapeutics. In 2001, Dr. Nelson completed an National Institutes of Health fellowship in health services research at the University of Minnesota.

Philip Renner, MBA, the assistant vice president for quality measurement at NCQA, is responsible for the development, testing and implementation of national health care quality reporting initiatives, including the Health Plan Employer Data and Information Set (HEDIS) and provider recognition programs. In addition, he serves as project director for several efforts to develop measures and reporting systems to support national and regional efforts in quality reporting and pay for performance.

Transparency is a major issue for patients, providers and payers. While transparency on cost and quality holds promise for quality improvement, cost containment and higher levels of patient satisfaction, it is not without risk. The challenges arise as one considers the practical implementation issues. This session will show that transparency can, in fact, be achieved as long as the opportunities and potential drawbacks are recognized and strategies for mitigating risk and promoting reward are employed. Understand key issues relating to health care transparency, including the promises and pitfalls. Further, learn about strategies and tactics for getting physicians, patients and payers on the same page, such as incentive programs and pay-for-performance.

Elizabeth McGlynn, PhD, is an associate director for RAND Health and responsible for strategic development and oversight of the research portfolio and for external dissemination and communications of the findings of RAND Health research. She is an internationally known expert on methods for evaluating the appropriateness and technical quality of health care delivery.

David Wennberg, MD, MPH, is president and COO of Health Dialog Analytic Solutions and also serves as chief science and products officer for Health Dialog. In addition to these roles, he is a member of the Primary Project Team of the Dartmouth Atlas Working Group at the Dartmouth Institute for Health Policy and Clinical Practice.