CONFERENCE AGENDA
Tuesday, October 6
7:30 am – 1:30 pm Pre-Conference: Workshop Registration
8:30 am – 5:00 pm Pre-Conference: Accreditation Standards Workshops
Designed to provide detailed information about URAC’s accreditation process and standards, these focused training sessions are ideal for those considering accreditation and first-time applicants as well as for companies undergoing re-accreditation, particularly in a new version.
- Health Plan v.6.0 (for re-accreditation only)
- Health Network v. 6.0 (for re-accreditation only)
- Health Utilization Management v. 6.0
- Workers’ Compensation Utilization Management v.5.0
- Case Management v.4.0
- Comprehensive Wellness v.1.0
- Pharmacy Benefit Management v.2.0
- Drug Therapy Management v.2.0
- Core v.3.0
5:00 pm – 6:30 pm Conference Registration and Cyber Café
Wednesday, October 7
7:30 am – 5:00 pm Conference Registration and Cyber Café
7:30 am – 9:00 am Breakfast in Exhibit Hall and Meet URAC Account Management Team
9:00 am – 9:15 am Welcome and Opening Remarks
Alan P. Spielman, President and CEO, URAC
9:15 am – 10:15 am Opening Keynote Address
No Mountain High Enough: A Tribute to Unsung Heroes
Linda Armstrong Kelly, Author/Advocate/Mother of Cycling Champion Lance Armstrong
We all know her as the mother of Lance Armstrong, seven-time Tour de France Champion who credits his mother as the unsung hero who assisted him in reaching his spectacular cycling victories – and in his triumph over cancer. What we don't know is the inspiring story of her life as written in her book, No Mountain High Enough: Raising Lance, Raising Me, that made her the person she is today. In this motivating keynote address, Linda shares her personal story of growing up as a teenage mother, living in poverty, trying her best do the right thing while raising an unstoppable baby boy, and enduring her son's battle with cancer. She’ll speak about the philosophy that helped her overcome life's obstacles, and how her early life experiences helped form the values and positive attitude that both she and Lance carried forward into adulthood.
10:15 am - 10:45 am Presentation of URAC Health Care Stars! Awards
Linda Armstrong Kelly, Author/Advocate/Mother of Cycling Champion Lance Armstrong
Alan P. Spielman, President and CEO, URACJoin us in honoring the awards recipients and paying tribute to the health care professionals who directly impact the lives of consumers they serve.
10:45 am - 11:15 am Coffee Break and Keynote Speaker Book-Signing in Exhibit Hall
11:15 am – 12:30 pm Concurrent Session: URAC Initiatives - Update on Market Development
Market Research: Patient Centered Medical Home and Hospital Websites
Eamon Bobowski, Senior Director of Marketing, URAC
Conceptually, the Medical Home in its ideal state would coordinate care for patients across the care continuum through the assignment of one healthcare practitioner who would manage this care. URAC has conducted an in-depth analysis of the views and opinions of consumers and stakeholders across many areas of health care provision and management to explore the potential future of the Patient Centered Medical Home model. URAC has also conducted an in-depth analysis of the views and opinions of health care consumers on information provided by hospital websites. From demand among consumers for online health resources, to the growing trend of seeking transparent, public reporting of provider performance data, URAC’s study provides a window into what consumers value as they seek to make informed decisions about their health care options.
11:15 am – 12:30 pm Concurrent Session: URAC Initiatives - Update on Surveys and Measures
Dancing with Data
Lynn Martin, PhD, RPh, Director, Research Services, URAC
Emily Schifrin, Director, Measurement Innovation, URAC
Di Shen, PhD, Chief Research Officer, CARF
During the past year, URAC and CARF have collaborated to offer the case management field a psychometrically valid survey instrument for case management participants to provide feedback on their experience. The speakers in the session will describe the history and testing of the survey, and will discuss URAC’s plans to produce aggregate-level comparative industry reports from the survey data. Research and Measurement staff will also provide an update on the measure sets developed to date, the processes for reporting on the measures and the work to date for auditing and verification of submitted data. Additionally, staff will provide an update on additional survey activities under development.
11:15 am - 12:30 pm Concurrent Session: URAC Initiatives– Update on Product Development
URAC New and Revised Standards Revisions to Accreditation Products
John DuMoulin, Vice President of Product Development, Government Relations and Education, URAC
Donna Merrick, RN, Senior Director of Standards Development, URAC
Douglas Metz, DC, Chief Health Services Officer, Executive Vice President, American Specialty Health, and Chair, URAC Health Standards CommitteeIn this information-packed presentation, attendees will be brought up-to-the-minute on all recent and ongoing new and revised accreditation standard revisions. Session includes why changes were made, URAC Board approval date and when the programs will be published and available to applicants. This includes a review of the Health and Pharmacy programs with a special emphasis on the recently created URAC Wellness accreditation program. In addition, URAC future trends in accreditation programs will be presented.
12:30 pm - 1:45 pm Special Interest Networking Lunch
Dialogue with colleagues about specific topics of mutual interests or have open discussions during this informal networking lunch. Table topics and floor plan will be posted at the registration area during the conference.
1:45 pm – 3:00 pm Concurrent Session: Quality Improvement
How to Turn Your Quality Improvement Project into a Publication
Griselda Chapa, MS, MPH, Director of Clinical Research and Innovations, Health Management Corporation
Carol Long, RN, CPHQ, FAHM, Clinical Research Manager, Health Management CorporationThis session compares traditional research to quality improvement projects and describes their synergy as a basis for shaping the latter into publishable manuscripts. The speakers will review quality improvement tools that are useful in identifying problems and link this to an analysis plan. They will detail the steps taken from conducting a literature review, examining eligibility files and claims data, running statistics eventually building a multivariate model, to selecting a journal and receiving journal editorial comments.
1:45 pm – 3:00 pm Concurrent Session: Leveraging the Value of URAC Accreditation
Promoting Accreditation with Health Policy Makers and Government Purchasers
Melissa Garrett, Manager, Legislative Affairs, American Specialty Health
Scott Kipper, Commissioner of Insurance, Nevada Department of Business and Industry
Joyce Muller, President and CEO, Imedecs and Past-President, National Association of Independent Review Organizations
Mara Osman, JD, Director, Government Relations, URAC
Government recognition of URAC accreditation often facilitates organizational compliance with federal and state requirements. URAC educates health policy makers and government purchasers about the value of accreditation. This session will focus on how URAC and its clients can partner to promote accreditation with legislators, regulators and government purchasers.
3:00 pm - 3:30 pm Refreshment Break in Exhibit Hall
3:30 pm - 5:00 pm General Session Panel Presentation
Federal and State Health Policy Initiatives: Impact on the Nation’s Health Care Landscape
Morris Chavez, Superintendent of Insurance, Division of Insurance, New Mexico Public Regulation Commission
Joy Johnson Wilson, Federal Affairs Counsel and Director, Health Policy, National Conference of State Legislatures
Scott Kipper, Commissioner of Insurance, Nevada Department of Business and Industry
Moderator: John DuMoulin, Vice President of Product Development, Government Relations and Education, URACIt’s been almost a year since the sweeping election which gave the Democrats the control of the U.S. House, Senate and the White House. In these tough economic times, health care has become a key focus of the domestic political discussion. Health care reform is a top priority for Americans. This panel of health care policy leaders will address pivotal issues with lively discussions and analyses on key public policy decisions and proposals that will shape the U.S. health care system for years to come.
5:00 pm - 6:30 pm URAC Heath Care Stars! Awards Celebration Reception in Exhibit Hall
Join URAC Board and Committee members, staff, speakers, exhibitors, sponsors, attendees and invited guests at this spirited, social event as we celebrate the achievements of all URAC Health Care Stars! Awards nominees.
Thursday, October 8
8:00 am - 2:00 pm Conference /Workshop Registration and Cyber Café
8:00 am - 9:00 am Breakfast in Exhibit Hall
9:00 am - 10:15 am Closing Keynote Address
Understanding the Employer’s Mindset in U.S. Health Care Reform
Robert Galvin, MD, Executive Director of Health Services and Chief Medical Officer, General Electric Company
Employers, historically key players in the U.S. health care system, are as interested in debates over health care reform as they have ever been. As policy analysts evaluate the effects of employer-sponsored insurance on universal coverage, the question of portability, and the lack of central control, employers will be trying to determine whether reform alternatives would leave their company and their employees better off than the current system. In this keynote address, Dr. Galvin will discuss the employer’s perspectives on health care reform.
10:15 am - 10:45 am Coffee Break in Exhibit Hall
10:45 am – 11:15 am Concurrent Session: Emerging Practices in Consumer Empowerment and Protection
Help From Home: Behavioral Health Intervention
R. Blake Chaffee, PhD, Vice President, Integrated Health Care Services, TriWest Healthcare Alliance
Marjorie Crowl, RN, MA, Director, Behavioral Health, TriWest Healthcare, AllianceOne in six military service members returning from deployments in Afghanistan and Iraq suffer post-traumatic stress disorder (PTSD), according to the National Center for PTSD. Perceived barriers to receiving mental health care can negatively impact affected combat veterans getting the care they need. Addressing the behavioral health needs of those served by TriWest, the company developed and produced Help From Home, an aggressive multichannel network of information resources and pilot programs to help service members and their families make the decision to seek care easier.
10:45 am – 11:15 am Concurrent Session: Emerging Practices in Consumer Empowerment and Protection
Office Based Cardiovascular Stress Testing
Paula Root, MD, Medical Director, Wellness and Policy, Blue Cross and Blue Shield of Oklahoma
Janice Yancey, BSN, RN, Senior Manager, Quality Improvement, Blue Cross and Blue Shield of Oklahoma
From a Peer Review Committee case, a recommendation to further investigate the office based setting for cardiovascular stress testing through office site visits ensued. An Ad Hoc Committee of network physicians and Plan staff developed the criteria for the study. Criteria included patient preparation and consent; personnel training and supervision; physical setting and safety; protocols for emergency situations and emergency equipment availability. Study design and process were approved through the Clinical Services and Quality Improvement Committees.
10:45 am – 11:15 am Concurrent Session: Emerging Practices in Consumer Empowerment and Protection
Health & Wellness Outreach and Engagement
Nikki Barr, Performance Data Analyst, Ceridian LifeWorks
Mary Miller, RN, Director of Health and Productivity Management, Ceridian LifeWorks
The development and implementation of the Outreach and Engagement (O&E) program provides a conduit between identification of health risks and appropriateness for behavior change programs such as heath coaching, disease management programs, EAPs, and other benefits resources for high risk individuals. In addition, the O&E program can also help bridge a gap between identified risks and community and state resources available to participants.
11:30 am – 12:00 pm Concurrent Session: Emerging Practices in Consumer Empowerment and Protection
Catalyzing Informed and Active Patient Decision-Making During Advanced Illness
Elaine Cannizzaro, Director of Counseling Operations, Vital Decisions, LLC
Mitchell Daitz, CEO, Vital Decisions, LLC
Vital Decision’s “Living Well” Program improves the ability and inclination of the end of life patient to participate and exert control over the decisions occurring at the end of life to better reflect their preferences and priorities. An end of life patient who is more participatory in the care planning decisions receives care that is more aligned with their preferences, typically utilizes lower levels but more appropriate services, and achieves higher levels of satisfaction.
11:30 am – 12:00 pm Concurrent Session: Emerging Practices in Consumer Empowerment and Protection
SNAPforSeniors Senior Housing Locator
Eve Stern, President, SNAPforSeniors, Inc.The primary problem with the way consumers have traditionally searched for seniors housing is the lack of a comprehensive national database of senior housing providers. Secondary problems include, a lack of objectivity, difficulty accessing personalized information, and rapidly occurring obsolescence of print directories. SNAPforSeniors provides the most current and comprehensive senior housing data available by regularly collecting and updating information from hundreds of sources nationwide.
12:00 pm - 1:30 pm Lunch and Closing Presentation
Exploring URAC: Promoting Quality Health Care
Bernard J. Mansheim, MD, Chair, URAC Board of Directors
Alan P. Spielman, President and CEO, URACThis closing session provides participants with an opportunity to hear from URAC’s current Board of Directors Chair and CEO about URAC’s future business plans for 2010 and beyond, and includes Q & A dialogue with participants on URAC related issues.
2:00 pm - 5:00 pm Post-Conference Workshop
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Quality Improvement Projects — Concepts and Tools for Success
This advanced and highly interactive training program brings hands-on exercises, group discussion and best practices to the QIP process. Participants will be able to interact with and learn from industry peers as well as with URAC Accreditation Reviewers.
2:00 pm - 5:00 pm Post-Conference Workshop
Lost a Laptop, Data Hijackers & Employee Snooping: The Essentials of HIPAA Security Breaches
This 3 hour post conference workshop will provide attendees with the essential tools for conducting a risk assessment and impact analysis, classification of security incidents and an effective breach response management plan. Attendees will participate in group exercises to successfully navigate a data breach, identify reporting requirements, and risk reduction strategies. The session will also provide an overview of the changes to HIPAA under the American Recovery and Reinvestment Act of 2009 and recent regulatory sanctions.