Conference Season: A Four-Part Fall 2020 Recap

(Originally published on November 16-23, 2020 at www.salienthealthcare.com.)

Since the Fall 2020 conference season was quite a busy one, I have combined all four blogs into one LinkedIn article that includes NAACOS, HLTH, FLAACOS, and APG Colloquium.

NAACOS FALL 2020

Time flies, right? It was just this past summer that we were attending NAACOS Live Spring 2020, and only a few months later we were into NAACOS Fall 2020. A lot of that is because the Spring edition occurred later than originally planned, so it created a bit of short “offseason” so to speak. This fall is the beginning of what we know to be conference season in which there’s a slew of conferences to attend; this year they’re all virtual though. Some of the same speakers were featured during the fall edition. NAACOS CEO Clif Gaus always gives us a great state of where value-based care stands, and Dr. Don Berwick gave a more political speech than in past events when discussing “Transforming the Healthcare System.”

If you asked me what my favorite presentations were this year, I’d be lying if I didn’t toot my own horn. My colleague Maria Nikol and I were fortunate to be able to present “Managing Performance Across Payers: Getting Different Populations on the Same Page” during Week 1, Day 2. We really appreciate Lacey Wattles from Rocky Mountain Accountable Health Network and Dan Bailey from ProHealth Solutions ACO for providing us their use cases. If you click the link attached to the title, and have access to NAACOS, you’ll be able to watch the recording. The presentation is a proud moment for us at Salient because we were able to showcase how complicated it is to bring in data from Medicare, Medicare Advantage, Medicaid, commercial insurance, etc. and get it all into one solution. Both ACO’s use cases showed how the Salient solution was able to help them get a more apples-to-apples comparison of their populations, and fortunately many of the Salient ACOs achieved shared savings this year partly because of this.

Maria also joined Travis Broome, Aledade’s Senior Vice President for Policy & Economics, and Kent Locklear, LightBeam Health’s Chief Medical Officer, to discuss “ONC Rules on Data Sharing.” The focus was how the Office of the National Coordinator for Health Information Technology’s final rule establishes a secure, standards-based application programming interface (API) requirement to support patient access and control of their electronic health information. For those who have been closely following all of the interoperability talk, APIs are the foundation of everything interoperability-related. Due to this new rule, patients will be able to securely and easily obtain, and use, their electronic health information from their provider’s medical record for free using smartphone apps much like you currently can monitor your own secure bank account.

Healthcare data, the usual where are we headed, what happens after COVID-19, and policy updates were all consistent topics through much of NAACOS Fall 2020. More than anything, I would say the fall iteration of this conference picked up right where spring left off. ACOs are trying to adjust following the pandemic, rule changes and adjustments require more flexibility on behalf of ACOs and their teams, and everyone wants more data. There can never be enough data. The downside to virtual conferences, of course, is that you lose some of the opportunity to network. Big thanks to Prime West ACO’s Sakina Pasha for setting up a few virtual happy hours. They were casual, but certainly effective in bringing back the “conference feel” that we all enjoy.

Hopefully by next spring we’ll be back to in-person events. NAACOS Spring 2021 is scheduled for April 26th through 28th in Baltimore, MD and Fall 2020 is scheduled for October 6th through 8th in Washington, DC. If you’re interested in seeing what one of the best national conferences in value-based care is all about, you can visit their website at www.naacos.com.

HLTH VRTL 2020

Fresh off the first leg of conference season with NAACOS Fall 2020, the Salient Healthcare team became first timers at a relatively new healthcare conference: HLTH. Every year we evaluate what conferences we want to be a part of, and lately it’s getting tougher and tougher to decide because there are so many (which are also all virtual this year). In 2018 and 2019 we attended HiMSS in Orlando, FL, but this year we opted for HLTH when HiMSS was cancelled due to the COVID-19 pandemic.

The great thing about HLTH is it’s geared more towards what Salient Healthcare is about. New healthcare ventures, interoperability, larger healthcare networks, and really the future of what healthcare is becoming. While only three years old, the HLTH conference has quickly become a known name in the healthcare conference circuit right alongside mainstays like Rise and MGMA.

Our team had the opportunity to speak with executives and other bright minds from major companies including Wal-Mart, Ohio State Wexner Medical Center, Fresenius Medical Care, and UC Health. As far as the seminars, over the course of the five days, I would have to say the various presentations on emerging technologies were enjoyable. I also think they put on a great effort to include value-based care with “A Push Into Value-Based Care” featuring Dr. Farzad Mostashari and Timothy Ferris in which they debated which was better: hospital-led ACOs or independent physician-led ACOs.

Mr. Ferris made a valid point that we look at healthcare as a marketplace, but from a global perspective, “The application of market economics to healthcare doesn’t always work because there are a lot of pieces of healthcare that do look like markets, but there’s also a lot of pieces of healthcare that look like utilities. Particularly the capital-intensive sides of it.” Therefore, even though many have been succeeding in value-based contracts, we’re using that pressure that comes from those contracts to reallocate capital that benefits the system overall. That’s what generates the benefit for the patients. It’s going to require continual reinvestment into the system over time in order to really keep value-based care going. Mr. Ferris continues to pontificate on the motivations of healthcare executives because, “If you are in business to maximize revenue, then you’ll stay away from value-based contracts, and you’re minimize the extent to which you’re integrating yourself with the local community to provide an integrated delivery system.” Consider that a calling out of sorts to those who got into healthcare just for the financial benefits. If we want to fix our healthcare system, that can’t be the only motivation.

Other topics of note included “How to Operationalize Remote Patient Monitoring” which was an invite-only event, Aneesh Chopra’s “The Era of Health Information Fiduciaries,” and a great discussion on the value of women in leadership positions in healthcare by Dr. Nicole Fisher and Terry Stone. My takeaway from Dr. Fisher and Ms. Stone’s conversation was that, “We don’t have a gender problem. We have a leadership problem.” Organizations are trying to find ways to get women into more leadership positions, but the progress has been slow. Per the seminar, it’s possible that part of the reason for the sluggishness may be that each gender has a different idea of “what good looks like.” Dr. Fisher and Ms. Stone mention that “good leadership” is a subjective term, and each gender prioritizes different traits with regards to what leadership consists of. Healthcare, and certainly value-based care, has a lot of women among our ranks, and I really hope to see even more female leadership going forward. Personally, I’m proud to have several female leaders on my team, and I think they each have excellent leadership skills.

The biggest challenge with HLTH is because it’s so massive, you really have to curate your own agenda ahead of time. If you just try to show up and watch everything, you’ll be booked solid from morning until late evening trying to hear everything. That means you’d miss out on some of the network opportunities that HLTH provides. It was definitely a positive experience, and I’d love the opportunity to head to Las Vegas, NV and see what it’s all about in person. I think you’ll start to see more value-based care woven into the agenda, and I would love for the opportunity to be able to speak on behalf of that subject.

If you’re looking for healthcare conferences to attend in the future, I think it’s safe to say that at this point HLTH should absolutely be on your radar. Since I suspect we’ll be back, we hope to see you there!

FLAACOS 2020

Another round of virtual conferences in the books! This week was especially tough in that there were actually three different population health-related conferences going on at exactly the same time. I, along with my team, had to split up a few responsibilities to make sure everything was covered. That being said, the Florida Association of ACOs (FLAACOs) has always been a favorite conference of mine. FLAACOs has gradually gone a little bit more national as of late, but given that I live in West Palm Beach, this conference usually gives me the opportunity to speak with experts in my industry right in my own back yard.

This year my colleague Maria Nikol and I, along with Kelly Conroy of Pinnacle Healthcare Consulting, teamed up to present “Managing Performance Across Payers on One Platform: Dream or Reality?” Given that Kelly has over 30 years of healthcare finance and management experience, including starting the first Medicare ACO in the United States, her perspective is always appreciated. She’s presented with other members of my team at other conferences, and we were glad to have her with us this week. Also, special thanks to Accountable Care Options ACO’s CEO Rich Lucibella for a great introduction.

We know, and have experienced, the challenges that ACOs, especially in Florida, face in trying to manage all of their data. There are so many uses, such as trying to assess the quality of care you’re providing, interpreting your ER readmission rates, and ensuring you’re not losing beneficiaries to plurality. However, there are other important data uses that aren’t often spoken about. How about payer contract negotiation or providing insights to your Joint Operating Committees? Finally, there’s also planning for potential unforeseen circumstances- and we know this more than ever due to COVID. Data gives you the ins and outs, the trends, and the predictive capabilities so that you’re always in a position of strength when making important decisions. We covered that and more, and if you’d like to watch the replay of our presentation, simply click here. Keep in mind, you’ll probably have to register with FLAACOs before you can view the session.

Kelly actually participated in another excellent presentation titled “Good Trouble: ONC and CMS Introduced Interoperability Rules. Here’s What it Means for Your Practice.” It featured Care Journey’s President, Aneesh Chopra, and Aledade CEO Farzad Mostashari. It was arguably the most well-attended presentation this week. The focus was primarily about how interoperability is going to play a key role in value-based care going forward. It’s similar to what Maria spoke about with Travis Broome and Kent Locklear during the last NAACOS conference. Aneesh noted that the key word in everything that the ONC has put together is Substitutable Medical ApplicaTions (SMART) on Fast Healthcare Interoperability Resources (FHIR). What SMART on FHIR does is, if you ask for it, give you that interoperability between EHRs and other applications. The problem is you have to actively ask for it i.e. it’s not “default” so to speak. It’s a step in the right direction, but I think everyone is a little frustrated with the fact that interoperability isn’t yet the default option.

I would be remiss not to mention that FLAACOS nearly didn’t happen. With the pandemic wreaking havoc on in-person events, some conferences didn’t have the experience to revamp their event into something virtual. FLAACOS managed to regroup and get everything together with the combined help of ACOExhibitHall and the Accountable Care Learning Collaborative. They did a solid job given the challenges. All the major topics were covered: direct contracting, behavioral health, interoperability, data analytics, policy changes, and COVID-19 challenges. At the end, the theme is that value-based care continues to evolve, and despite what 2020 has thrown at us, we expect to come back even stronger in the coming years. Hopefully we’ll see everyone in person in Orlando in 2021.

APG COLLOQUIUM 2020

Last, but certainly not least, the APG Colloquium. Another conference that’s typically in-person, but was virtual for the first time. I was really excited to go to the in-person APG Annual Conference, which is different from the colloquium, in San Diego. It’s nice to get to travel to places you don’t visit often. Unfortunately, the annual conference was canceled in the spring, and the 2020 Colloquium took place in the same place that every conference took place this year. If you guessed “in my house,” you are correct.

America’s Physician Groups has had this conference running since 2014, and they’re the leading national association of physician groups. When it comes to value-based care, these guys are more “boots on the ground” than even some ACOs. The colloquium is usually more policy based, and as expected Direct Contracting was a big topic of conversation. Also, the question of “Where is healthcare headed” seemed to pop up a lot. In fact, the keynote speaker was Congresswoman Donna Shalala, and her seminar was titled “The State of Healthcare in America.”

This was something I really wanted to see for multiple reasons. First, Donna was actually my colleague, Amy Kotch’s professor in college when she was at the University of Miami. Second, my father actually hosted Donna at our house in Parkland, FL when she was campaigning for then-Governor Bill Clinton. My father’s radiology group, North Broward Radiologists, PA, had donated to Clinton’s campaign, so she came to speak to everyone. I said hello to her, but I was 13 years old, so I highly doubt she remembers me. Finally, and most importantly, she’s been involved in healthcare, specifically health policy, that I was probably most intrigued by her seminar more than anyone else.

Congresswoman Shalala discussed how we really need an integrated health system for the entire country, and that the COVID-19 pandemic has highlighted how fragmented our health system really is. Shalala pontificated that part of it is a mentality in how you bring about patient care. Because of this, she’s proud that the University of Miami, where she was President from 2001-2015, now requires their medical students to also get an MPH, alongside their MD, so that public health is top of mind when they get out into the field.

Congresswoman Shalala also mentioned how, mostly thanks to financial incentives, our healthcare system has been slimmed down to run more efficiently and to focus on outcomes. However, that meant that the health system had no built-in redundancies to handle something like a once-in-a-generation pandemic. She believes that agility matters, and we need to start incentivizing healthcare organizations and providers to provide care in a way that really matters given today’s challenges.

Another panel I enjoyed was Andy Slavitt, Marc McClellan, and Frederick Isasi’s “Mid-Pandemic: Should We Be Doubling Down on Value?” The general consensus was that it seems everyone is trying to, “get back to normal,” which means a lot of healthcare organizations are jumping right back into fee-for-service without really leaning into value-based care. All of the panelists agreed that alternative payment models work, but it’s just too easy for most organizations, which are businesses first, to go back to what doesn’t work for the country. At the same time there’s also a huge divide in how people relate to each other, and we can’t have a healthcare system that reflects that polarization. Value-based care works, but we need to get our focus in the right direction before we start actually changing anything. It may take some time. APG’s President and CEO, Don Crane, moderated most of the presentations, and as expected, had a lot of great questions for all of the speakers.

APG really has a different group of attendees, but some of the speakers are familiar if you’re used to attending a lot of population health conferences. Part of that is the world of population health isn’t very big. That being said, I enjoyed all of the conversations, and it really seems like everyone wants to head in the right direction. Let’s hope in 2021 we can actually start to do that.