Webinar Series

Member-Centric Behavioral Health Utilization Management

A number of societal, economic and regulatory factors are driving health plans to increase access, improve outcomes and control costs for mental health and substance abuse care. This complimentary webinar- hosted by MEDecision's Vice President of Product Marketing Brian Nagle, Director of Clinical Programs Suzanne Kunze and Clinical Product Manager Dawn Kramer - will analyze the issues insurers need to begin considering today to prepare for the changes coming tomorrow, including a look at the requirements for member-centric behavioral health utilization management workflows.

Other topics will include:

• A Summary review of the 2008 Federal Mental Health Parity and Addiction Equity Act (MHPAEA) and its implications for payers.
• The relationships between medical and behavioral health and the importance of maintaining a holistic member view for utilization and disease management.
• What health plans need to consider to increase access, improve the quality of care and control costs in the new behavioral health environment.
• Member-centric utilization management - the first step in a new way of comprehensive wellness management.

Healthcare Reform: The Legal Implication for Payers

The new healthcare reform law places a heavy emphasis on the increased use of information technology (IT) to improve the American healthcare system. The law identifies health information technology as a substantial part of mandates for coordination of care for the chronically ill, development of the patient-centered medical home care delivery model and the advancement of telehealth, particularly patient monitoring. Since the health reform bill will bring millions of new consumers into the system, the reform law will foster changes in market-wide guidelines and individual state regulations governing health information exchanges. Join MEDecision outside counsel Howard Burde for a complementary webinar examining the technology-related details of the healthcare reform law and what they mean for payer organizations.

Predictive Modeling's Role in Maximizing Care Management Effectiveness

The Patient Centered Medical Home and Evolving Care Management Processes

Join Health Care Service Corporation's Vice President and Chief Medical Officer for Blue Cross and Blue Shield of Oklahoma (BCBSOK) Dr. Joe Nicholson, MEDecision Executive Vice President and Chief Medical Officer Dr. Andrew Schuyler and Matt Adamson, Vice President of MEDecision's medical home initiatives, as they examine the medical home concept and how it correlates with care management processes that have evolved within the payer space. The session will feature a look at BCBSOK's medical home philosophy. It will also discuss MEDecision's two-fold philosophy toward providing products and services to support medical home pilot projects, which is to enable access to complete and comprehensive patient clinical data in order to positively impact care quality; and to provide tools that assist payers, providers and patients in bending the healthcare cost curve.

Introduction to InFrame™: Scalable and Sustainable HIEs, EHRs, and PHRs

Join MEDecision's Senior Vice President of Provider Markets Elliot Menschik, M.D., PhD, for an in-depth look at MEDecision's newest offering, InFrame: the collaborative health information exchange service that enables care delivery organizations (CDOs) to share clinical data among themselves and with patients. InFrame enables CDOs to leverage health information exchange to enhance revenues, extend brand and better manage operational costs by exchanging clinical data in real-time with referring providers and the patients themselves.

Technology’s Influence on the Patient-Aware Philosophy

in MEDecision's Vice President of patient centered medical home initiatives Matt Adamson and Senior Director of Product Marketing Robyn Fritz, as they examine the next generation of health care. Specifically, they will discuss the patient-aware philosophy behind MEDecision's products; that is, the belief that having access to complete and comprehensive patient clinical data can positively impact the quality of care. Being patient-aware allows health care stakeholders to harness the power of knowledge from multiple sources to enable the best clinical decisions about a patient, ensuring that the most appropriate interventions are defined and executed for each individual. This knowledge is information such as a patient's medical history and status, preferred communication methods, personal environment, care community and so on. Making this data readily and universally available creates a framework for many new initiatives, including health information exchanges and the emergence of the patient centered medical home.

This session will provide participants with information regarding:

• MEDecision's patient-aware philosophy.
• How interoperability and health information exchange are key to next generation health care.
• The benefits of a patient-aware approach to health care, specifically, the development of a patient centered medical home.

Deploying Web-Based Communication to Better Engage Health Plan Members in their Care

Join MEDecision's Director of Strategic Alliances Lori Walsh and Vice President of Clinical Programs and Clinical Content Development Marie DiPrinzio along with Emmi Solutions' Vice President of Care Management Bob Tavares for a free webinar examining how health plans can use interactive, Web-based technology to cost-effectively scale care management programs, enhance communication with members and actively engage them in the care process.

Topics to be discussed include:

• How augmenting MEDecision's Alineo™ collaborative health care management platform with award-winning Emmi^® programs gives health plans advanced tools to help members take an active role in their care.
• How to supply care managers with intelligent member communication resources that are more engaging and effective than paper mailings and passive Web sites.
• Why implementing interactive, Web-based technology is an effective way to increase members' self-management of chronic conditions and to support members contemplating elective surgery.
• How to utilize interactive, Web-based technology to efficiently assess and track member engagement.

Optimizing Care Management for Medicaid Populations

Join MEDecision Vice President of Clinical Programs and Clinical Content Development Marie DiPrinzio, RN; and Rosalyn Stephens, Director of Medical Management, DC Chartered Health Plan, Inc., for a free webinar examining how to optimize care management for Medicaid populations.

Recognizing the need to streamline operational efficiencies, reduce waste and increase care quality through enhanced business agility, controlled costs and better risk and compliance management, DC Chartered has embraced MEDecision technology as a means to optimize care management for its population. In this case study presentation attendees will learn:

Topics to be covered include:

• How DC Chartered configured its care management programs to emphasize care coordination teams that support greater penetration within the population.
• The process for using the care management system to task programs to the nurse/social worker after care coordination specialists complete telephonic and/or field-based outreach.
• How automating transactions can increase the efficiency and effectiveness of the care management process.
• The benefit of expanded reporting capabilities for monitoring staff production and regulatory reporting.

A Case Study Examining How KePRO Uses MEDecision Technology to Maintain Costs and Improve Provider Satisfaction

Join MEDecision's Andrew Schuyler, M.D., Chief Medical Officer and EVP of Product Marketing and Medical Services; and Alice Stollenwerk Petrulis, M.D., Chief Medical Officer, KePRO, for a Webinar examining how KePRO implemented MEDecision's Nexalign™ iEXHANGE^® to reduce the overall cost-per-review and increase provider satisfaction through rapid turnaround. In this case study presentation, the speakers will discuss how the health plan combined the technology with its internal information to offer provider networks an innovative solution that generates significant cost, time and resource savings for both parties.

Topics to be discussed include:

• Deploying existing information and technical automation to improve care management processes.
• Leveraging a detailed analysis of successful auto-approval procedures.
• Enhancing provider relationships and satisfaction through increased communication.
• Achieving a significant cost savings through automation.

Introduction to Nexalign™ iEXCHANGE® 7.0

Join MEDecision Senior Director of Product Marketing Robyn Fritz and product managers Maureen Ewing and Kelly Sanderson, RN, as they demonstrate Nexalign™ iEXCHANGE^® 7.0. The session will provide an in-depth overview of the latest version of iEXCHANGE - MEDecision's Web-based multi-payer solution that allows physicians and other health care providers to quickly and easily submit transactions to health care payers in real-time.

Topics to be covered include:

• A demonstration of the enhancements that improve the provider workflow experience including an interface with Milliman^® CareWebQI^®.
• How iEXCHANGE captures relevant provider information that can be used to identify patients for early-intervention.
• Why automating transactions can increase the efficiency and effectiveness of the care management process.
• How Nexalign iEXCHANGE 7.0 will integrate with Alineo 2.0 - MEDecision's health care management platform for case management, disease management and utilization management

Introduction to Alineo™ 2.0

Alineo 2.0 continues MEDecision's growing momentum in the marketplace and reinforces its commitment to technical innovation that facilitates nationwide health care reform. A newly released version of MEDecision's Alineo collaborative health care management platform, Alineo 2.0 allows health plans to optimize automation and efficiency in the delivery of care management programs while fostering a more member-centric, whole-person approach. This supports business growth by enabling health plans to strengthen business processes and control medical and administrative costs.

Join Mary Boyle, MEDecision Vice President of Alineo Product Marketing and her team of Alineo product Managers for a Webinar featuring a preview demonstration of Alineo 2.0. Learn how your organization can leverage the technology's latest enhancements to improve the overall quality, safety and affordability of health care.

The Webinar will include discussions of how Alineo 2.0 can:

• Simplify integration with other internal and external medical management systems.
• Provide advanced gaps-in-care identification and related intelligence.
• Enable health plans to maximize the effectiveness of case, disease and utilization management initiatives.
• Provide advanced support for National Committee for Quality Assurance (NCQA) reporting and compliance tracking.