APPENDIX B

WORKSHOP AGENDAS

MODELS OF CARE FOR HIGH-NEED PATIENTS

A National Academy of Medicine Workshop

. . . funded by the Peterson Center on Healthcare

July 7, 2015
Keck Center
Room 100
500 Fifth St, NW
Washington DC 20001

NAM LEADERSHIP CONSORTIUM FOR VALUE & SCIENCE-DRIVEN HEALTH CARE

Meeting objectives

1. What are the key characteristics of high-need patient populations, and which subgroups offer the greatest opportunity for impact?
2. What factors are most important in determining the match between a model of care and a patient population?
3. How can lessons learned from past experience with high-need patients be amplified and spread effectively?

AGENDA

• Michael McGinnis, MD, MPP, National Academy of Medicine
• Peter Long, PhD, Blue Shield of California Foundation (Chair)

• Emily Zyborowicz, MPH, Peterson Center on Healthcare
• G. William Hoagland, Bipartisan Policy Center
• Katherine Hayes, JD, Bipartisan Policy Center
• Jose Figueroa, MD, MPH, Harvard T.H. Chan School of Public Health

Brief opening presentation and discussion on the personal perspectives of a patient.

• Jeromie Ballreich, Johns Hopkins University

Presentations and discussion on the existing high-need patient literature, including definitions, categories, challenges, and other considerations. [Meeting Goal: What are the key characteristics of high-need patient populations?]

• Melinda Abrams, MS, The Commonwealth Fund
• Alan Glaseroff, MD, Stanford University

Presentations and discussion exploring special considerations for key subgroups and mechanisms for identifying opportunities for improving quality and controlling costs. [Meeting Goal: Which subgroups offer the greatest opportunity for impact?]

• David Meyers, MD, Agency for Healthcare Research and Quality (moderator)
• Bruce A. Chernof, MD, FACP, The SCAN Foundation
• Frank V. deGruy III, MD, MSFM, University of Colorado, Denver
• Lisa Iezzoni, MD, MSc, Harvard Medical School
• David Meltzer, MD, PhD, University of Chicago

Case studies of successful interventions and care models that engage the priorities of high-need groups. [Meeting Goal: What factors are most important in determining the match between a model of care and a patient population?]

• Arnold Milstein, MD, MPH, Stanford University (moderator)
• John O’Brien, PharmD, MPH, CareFirst BlueCross BlueShield
• Robert Master, MD, Commonwealth Care Alliance
• Bonnie LaPlante, RN, MHA, Health Care Homes, Minnesota
• Rebecca Ramsay, MPH, CareOregon

• Victor J. Dzau, MD, National Academy of Medicine

Presentations and discussion on the challenges that arise in the application and spread of models of care in diverse settings and for diverse patient groups. [Meeting Goal: How can lessons learned from past experience with high-need patients be amplified and spread effectively?]

• Gerard Anderson, PhD, Johns Hopkins Bloomberg School of Public Health (moderator)
• Rajesh Davda, MD, Cigna Healthcare
• Don Furman, MD, Alignment Healthcare

MODELS OF CARE FOR HIGH-NEED PATIENTS

A National Academy of Medicine Workshop

. . . funded by the Peterson Center on Healthcare

January 19, 2016
National Academy of Sciences Building
Lecture Room
2101 Constitution Avenue, NW
Washington, DC 20418

NAM LEADERSHIP CONSORTIUM FOR VALUE & SCIENCE-DRIVEN HEALTH CARE

Meeting objectives

1. Data and segmentation. Review existing data sources on care delivery to high-need patients, and consider how the populations may be best characterized to design and target care more effectively.
2. Design elements. Explore successes and lessons learned from designing various models of care.
3. Policy implications. Consider policies particularly important to spreading the most successful models.

• Michael McGinnis, MD, MPP, National Academy of Medicine
• Jeff Selberg, MHA, Peterson Center on Health Care
• Peter Long, PhD, Blue Shield of California Foundation (Chair)

• Darcel Jackson, Children’s National Health System

Perspectives on the issues and uses of different approaches to segmenting high-need patient populations, and the implications for care delivery and policy.

• David Dorr, MD, MS, Oregon Health & Science University
• Craig Samitt, MD, Anthem, Inc.
• Simon Hambidge, MD, PhD, Denver Health

Primary data sources and insights gleaned about the nature and care for high-need patients, including identification of the limits and opportunities of working with these data.

• Gerard Anderson, PhD, Johns Hopkins University
• Ashish Jha, MD, MPH, Harvard T.H. Chan School of Public Health
• Paul Bleicher, MD, PhD, Optum Labs

Q&A and Open Discussion

Synthesis of what we know about segmenting high-need patient populations, and the activities underway to build the taxonomy.

• Melinda Abrams, MS, The Commonwealth Fund

Q&A and Open Discussion

Two small-groups discuss: 1) the use of a segmentation strategy for high-need patients; 2) challenges and opportunities in use of different approaches and data sources for segmenting patients; and 3) implications of groupings for design, organization, and financing of care delivery.

Panelists explore attributes of successful models.

• Molly Coye, MD, MPH, Network for Excellence in Health Innovation
• Randall Brown, PhD, Mathematica Policy Research
• Rahul Rajkumar, MD, JD, Center for Medicare & Medicaid Innovation

Q&A and Open Discussion

Panelists introduce policy strategies and opportunities to improve care for high-need patients.

• Arnold Milstein, MD, MPH, Stanford University
• Katherine Hayes, JD, Bipartisan Policy Center
• Sandra Wilkniss, PhD, National Governors Association

Q&A and Open Discussion

Two small-groups: 1) discuss key barriers to scaling new delivery models for high-need patients; and 2) identify essential elements for a policy framework that would mitigate these barriers.

A facilitated large group discussion reviews outcomes and takeaways from the breakout.

• Peter Long, PhD, Blue Shield of California Foundation (Chair)
• Michael McGinnis, MD, MPP, National Academy of Medicine

MODELS OF CARE FOR HIGH-NEED PATIENTS

A National Academy of Medicine Workshop

. . . funded by the Peterson Center on Healthcare

October 21, 2016
Keck Center
Room 100
500 Fifth St, NW
Washington, DC 20001

NAM LEADERSHIP CONSORTIUM FOR VALUE & SCIENCE-DRIVEN HEALTH CARE

Meeting objectives

1. Examine tools to improve care delivery for high-need patients. Discuss a patient “taxonomy” matched to care models with the most potential to improve outcomes and lower costs, and the use of measures to enhance care delivery.
2. Advance policy to support better care for high-need patients. Consider a policy-level approach and other insights to support and accelerate the spread and scale of effective care models.
3. Synthesize and identify future opportunities. Provide a synthesis of the three-part workshop series and identify approaches and priorities for advancing progress.

• Michael McGinnis, National Academy of Medicine
• Jeff Selberg, Peterson Center on Healthcare
• Peter Long, Blue Shield of California Foundation (Chair)

• Eric De Jonge, MedStar Total Elder Care
• Veronica Humes Butler, Long-time Caregiver
• Gretchen Nordstrom, MedStar Total Elder Care

This session will examine a taxonomy of high-need patients matched to care models with the most potential to improve outcomes and lower the total cost of care for high-need patients.

1. Melinda Abrams, The Commonwealth Fund, Planning Committee Member
2. Arnie Milstein, Stanford University, Planning Committee Member

Q&A and Open Discussion

Introductory comments:

• David Blumenthal, The Commonwealth Fund

The planning committee offers insight on opportunities to advance policy.

• Gerard Anderson, Johns Hopkins School of Public Health, Planning Committee Member

Bipartisan Policy Center policy framework for implementation of effective care models for high-need patients, particularly Medicaid and Medicare eligible.

• Katherine Hayes, Bipartisan Policy Center, Planning Committee Member

Reactor panel:

• Julian Harris, Care Allies
• Melanie Bella, Formerly CMS and Independent Consultant
• Carolyn Ingram, Molina

Q&A and Open Discussion

Experts discuss the use of measures in health care payment, and their role in enhancing and incentivizing high-value care for high-need patients.

• Helen Burstin, National Quality Forum
• Shari Ling, Centers for Medicare and Medicaid Services
• Rick Kronick, University of California San Diego

Q&A and Open Discussion

A synthesis of suggestions and insight gleaned to date from the three-part workshop series.

• Ashish Jha, Harvard School of Public Health, Planning Committee Member
• Peter Long, Blue Shield of California Foundation, Planning Committee Chair

A tightly moderated discussion of priorities for stakeholder action to improve care for high-need patients.

Moderator: David Meyers, AHRQ, Planning Committee Member

Reactor insight:

• Payer: Aelaf Worku, CareMore
• System representative: Dave Chokshi, NYC Health + Hospitals