The 2021 Health Plan Partnership Summit


The OPEN MINDS Health Plan Partnership Summit: An Assessment Of Payer Partnership Priorities In The ‘Next Normal’

August 26, 2021 | 8:00am – 4:00pm PT


As we move into the post pandemic “next normal” of 2022, health plan priorities are being reshaped to meet new challenges of the changing health and human services landscape. Health plans are facing growing price pressure from private and public clients – and repositioning to meet that challenge through mergers and acquisitions, adopting new tech solutions, and better aligning network provider incentives. This shifting market landscape is creating new opportunities for win-win payer-provider partnerships.

For provider organization executives, understanding the dynamics of the health plans in their market is the key to creating preferred health plan relationships. The question executives are asking themselves is “how?” We will explore the answer to that question in this engaging summit designed to help executives understand the new needs of payers, reposition existing service lines through payer-oriented solution marketing, and build mutually beneficial health plan partnerships.

This summit’s agenda will include a market briefing on the state of payer system realignment, informative case studies with key opinion leader executives, thought leader discussions, and interactive dialogue with attendees.

Agenda

8:00am – 9:00am: Registration/Breakfast

9:00am – 9:30am: Welcoming/Introduction/Health Plan Partnership State-of-the-State

Opening the Health Plan Partnership Summit, OPEN MINDS vice president Richard Louis, III and senior associate Cathy Gilbert, will provide a national overview of the post-pandemic health plan market. They will discuss the impact of payer mergers, acquisitions and strategic partnerships among the major plans, payer movement towards adopting whole person care and integrated service delivery approaches to improve member outcomes and reduce cost, as well as the growth of digital/virtual behavioral health services market, including the quick adoption of this approach by payers. Finally, we will explore the impact of these trends both regionally and nationally and what that may mean for the future success for specialty provider organizations.

Cathy Gilbert, Senior Associate, OPEN MINDS
Richard Louis, III, Senior Associate, OPEN MINDS

9:30am – 10:30am: Transformation To A Collaborative Care Model – A Reimagined Partnership Approach

With seismic shifts in the behavioral health space, Magellan Health is taking the opportunity to partner with its provider network to reimagine how behavioral health is delivered. Caroline, Carney, M.D., Chief Medical Officer at Magellan, will share insights on how the company is working with its provider network to refocus on accessibility to services and measurement-based care. In this session, Dr. Carney will also provide greater detail on how her company has recommitted to the collaborative care model, and, as a c-suite payer executive and practicing clinician, uniquely and anecdotally share what both provider organizations and payers are looking for in partnerships in the next normal.

This keynote will cover:

  • A unique perspective on how to partner with health plans in the next normal.
  • New technologies and innovations advancing integrated, collaborative care.
  • How the overall behavioral health market has shifted and what it means for the future.
Dr. Caroline Carney, MD, Chief Medical Officer, Magellan Health

10:30am – 10:45am: Break

10:45am – 11:45am: CareOregon: A Case Study In Provider Network Stabilization & Patient Experience Improvement

In addition to its recent multi-million-dollar investment in the state’s behavioral health service providers, CareOregon is partnering on several upstream solutions to strengthen the behavioral health ecosystem over the long run. In this case study presentation, CareOregon will share how it’s elevating provider and member voices in the conversation to improve the state’s behavioral health system, relieving the administrative onus of “partner providers” for keener focus on patient care, and supporting provider efforts to increase capacity and explore models that could increase payment parity.

This case study presentation will cover:

  • Payer/provider partnership initiatives in Oregon that address provider burnout, payment disparities, and care accessibility gaps.
  • How strong partnerships between payers and providers require support from government and public-sector communities.
  • How one managed care organization advocated on behalf of its providers in conversations with state and elected officials.
Eric Hunter, President & Chief Executive Officer, CareOregon

11:45pm – 1:00pm: Lunch & Learn: “P” Is For Payers, Priorities, Partnership … & Platforms – Sponsored by Netsmart

Rapid access. Innovation. Demonstrated outcomes. Peer support. Expanding service lines. The list of payer priorities is longer than ever before, but one thing hasn’t changed: the need for technical solutions and partners to help managethem. Join Netsmart and one of their leading human services clients as they share common payer needs, ways to measure and communicate metrics that matter, and how data can build trust in relationships. Hear an example of a right-fit care management platform – one that is interoperable, includes social determinants of health and offers robust solutions – empowers providers to deliver quality care, stay nimble in decision-making and manage costs.

1:00pm – 2:00pm: Uplift Family Services: A Case Study In Building A Strong Community Payer/Provider Partnership Through Innovative, Research-Based Care

With the rapidly changing public health landscape in the state of California, forging strong, innovative relationships between payers and provider organizations is increasingly important. Uplift Family Services is a long-standing behavioral health services specialty provider organization offering a state-of-the-art whole person care approach for children, adolescents, and adults with complex behavioral health challenges. In this case study presentation, attendees will learn how Uplift built a strong infrastructure developing its organization through utilization of implementation science, project and change management, staff development, and relationship development and communication with payers.

The case study will cover the following:

  • Uplift Family Services Health Homes’ program serving complex California managed care Medi-Cal beneficiaries
  • Keys to successful relationship development and communication when establishing health plan partnerships
  • Coordinating behavioral health and primary care to meet growing payer expectations for improved consumer outcomes
Eleanor Castillo Sumi, Ph.D., BCBA-D, Vice President of Research and Program Development, Uplift Family Services

2:00pm – 3:00pm: Windstone Health: A Southern California Success Story Of Sustainability

In this session, privately-owned managed behavioral health organization Windstone Health Services, will share its unique dynamic as a combination payer/provider organization that contracts with large medical groups and IPAs providing coordinated care and integrated services. During the case study presentation, Windstone will also share health plan partnership achievements such as the successful behavioral health risk assessments it provides plan members across the country.

This case study presentation will cover:
  • Health plan partnership success stories of a longtime behavioral health provider organization with a nationwide presence
  • Lessons learned from a state/market hit hardest by the pandemic
  • Key features all provider organizations should strive for to optimize payer partnership success
Peter J. Davidson, Chief Executive Officer, Windstone Health Services
Krystal Melgoza, Provider Relations Manager,  Windstone Health Services
Lesley Nolen, Director of Business Development, Windstone Health Services

3:00pm – 4:00pm: Executive Roundtable

At the end of the day, join Summit co-chairs Cathy Gilbert and Richard Louis, III as they wrap up with a roundtable discussion with all Summit speakers where attendees can dialog with presenters, ask questions about health plan partnership challenges and opportunities, and discuss perspectives on the future of payer and provider organization relationships.

Featuring Summit co-chairs and speakers