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Program Agenda

Wednesday, April 1, 2009
8:00 am – 5:00 pm	Conference Registration and Cyber Café
8:00 am – 8:45 am	Breakfast Buffet and Cyber Café in Networking Center
8:45 am – 9:00 am	Welcome and Opening Remarks Alan P. Spielman, President and CEO, URAC
9:00 am – 10:15 am	Opening Keynote Address The Future of the Healthcare Marketplace: The Quest for Value for All Americans Ian Morrison PhD, Author, Consultant and Futurist Healthcare is in a constant state of change. Two major forces are shaping the future of healthcare. First, is the relentless pressure on healthcare to deliver value in terms of quality, reliability, and access at an affordable cost. Public and private payers will continue to demand higher performance from the delivery system and will use the tools of transparency, measurement, and reimbursement redesign to galvanize a major transformation in the delivery system. The second major force is the once in a decade movement to expand coverage to all Americans. How will the new administration respond to a challenging economic environment and the pressure to help the uninsured and under-insured? This presentation will focus on the political, economic, and strategic context of change in healthcare and examine how the various actors are preparing for the future. It will identify the leadership challenges and opportunities that lie ahead and will provide strategic insights on how organizations and individuals can flourish in the year’s ahead.
10:15 am – 10:30 am	Coffee Break and Cyber Café in Networking Center
10:30 am – 11:15 am	(3) Concurrent Sessions
	LifeStyle Management Program Suite Kerry Evers, PhD, Senior Vice President, Research and Product Development, Pro-Change Behavior Systems, Inc. According to the CDC, chronic diseases, such as heart disease, cancers, and diabetes, are the leading causes of death and disability in the United States. Using the Transtheoretical Model, Pro-Change Behavior Systems, Inc.’s LifeStyle Management Programs address seven behaviors closely tied to preventing chronic disease, and includes a Health Risk Intervention (HRI) which identifies individuals’ readiness to change unhealthy behaviors and provides brief stage-matched feedback. Users are then offered evidence-based, computer tailored, individualized programs for any of the seven behaviors for which they are at risk, as well as interactive stage-targeted workbooks to help them progress through the stages of change.
	Colorectal Cancer Screening Program Gale Rydel RN, BSN, MS, Director, National Quality Management, CIGNA HealthCare Colorectal Cancer is the third leading cause of cancer-related death in both men and women in the United States. In 2004, CIGNA HealthCare national average for screening was 49.2%. Recognizing that screening reduces cancer incidence and mortality, CIGNA identified this as an opportunity for clinical improvement associated with consumer health. A colorectal cancer screening program was implemented between 2005 - 2007 in an effort to increase the colorectal cancer screening rates among CIGNA's individual customers ages 50 and older. This program addresses health quality improvement that protects the consumer from a short-term or long term health related adverse event (e.g., primary prevention).
	WebMD Health Check Brad Bowman, MD, Vice President, Product Innovation, WebMD A majority of WebMD's 48 million monthly users want to learn how to better manage their health. According to the Institute of Medicine, to better improve the health care system, consumers should have unfettered access to clinical knowledge to make informed decisions. Clinicians and consumers should communicate effectively and share information. WebMD's Health Check empowers users to take a more active role in their care by providing 24/7 access to self-assessment tools. Health Check delivers an unparalleled, personalized experience. Recommendations are based on the most current evidenced- based guidelines to help facilitate communications between physicians and users.
11:30 am – 12:15 pm	(3) Concurrent Sessions
	Children’s Mercy Family Health Partners Disease Management Program Candace Ramos,MHA, Senior Education Coordinator, Children's Mercy Family Health Partners Beth Wilkes, Education Coordinator, Children's Mercy Family Health Partners The Disease Management department of Children’s Mercy Family Health Partners (CMFHP) developed two unique programs that are designed to have an end result of empowering providers and members with chronic diseases, Asthma and Obesity, to manage, treat and prevent complications. Work is done directly with primary care clinicians to educate them on diagnosis and treatment of Asthma and Child Obesity using national guidelines and recommendations. Work is also done directly with members through a health coaching process that is designed to empower them to manage their disease and make lifestyle changes that ultimately lead to decreased complications and improved quality of life.
	Paradigm for the Telephonic Assessment of Suicide James R. Eyman, PhD, Psychologist, Heritage Mental Health Clinic Brent Halderman, PhD, Clinical Manager, New Directions Behavioral Health New Directions Behavioral Health (NDBH) developed a paradigm for the telephonic assessment of suicidal ideation that enhances assessment, caller cooperation, and care coordination with referral recommendations. A three-stage process to work with callers was developed and implemented over two different three-year periods in two different call centers. The process facilitates collaboration among caller, call center clinician and treatment provider. Goals included reduction in number of police interventions and increased compliance with treatment recommendations.
	Thrive Healthy Living Alexandra Drane, President, Eliza Corporation Amy Compton-Phillips, MD, Physician Director, Population Care Management, Kaiser Permanente, Mid-Atlantic States Building on its successful “Thrive” campaign, Kaiser Permanente of the Mid-Atlantic States (KPMAS) partnered with Eliza Corporation to develop an automated outbound calling program to support healthy lifestyles – specifically around weight management, smoking cessation, and stress management. Eliza placed automated calls on behalf of KPMAS. The member engaged in conversation with the Eliza call, and based on a member’s spoken responses, they were pointed to supportive resources such as classes, discounts, and online self-management tools. This approach also allowed KPMAS to measure the impact of the intervention at the member level.
12:15 pm –1:45 pm	Networking Lunch and Poster Sessions
	Great Moves! Pediatric Weight Management Center Stanley Goldstein,MBA, Chief Executive Officer and Co-Founder, Great Moves! Pediatric Weight Management Center Erinn Rhodes, MD, MPH, Chief Medical Officer, Great Moves! Pediatric Weight Management Center Pediatric overweight/obesity affect approximately one-third of U.S. children. Many obese children become obese adults creating a multigenerational cycle fueled by unhealthy environmental influences. Our family-based, multidisciplinary and medically-supervised program includes support from dietitians, behavioral specialists, and physical activity specialists to provide families with the skills needed to build healthy lifestyles. Great Moves! is a collaboration with the physicians of Children’s Hospital Boston. Our 22-week program includes weekly participation with individual consultations and groups in nutrition, behavior, and physical activity. Our goal is building healthy lifestyles for kids and families.
	Help From Home: Behavioral Health Intervention R. Blake Chaffee, PhD, Vice President, Integrated Health Care Services, TriWest Healthcare Alliance Kathleen Fliehler, Vice President, Corporate Clinical Operations, TriWest Healthcare Alliance One 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 multi-channel network of information resources and pilot programs to help service members and their families make the decision to seek care easier.
	Informed Patient Decision-making During End of Life 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.
	Delaware Physicians Care, Incorporated Diabetes Text Messaging Pilot Project Staci Groland, MBA, Quality Management Analyst, Delaware Physicians Care, Inc. Stanley S. Lynch, Jr. MD, MS, Chief Medical Officer, Delaware Physicians Care, Inc. Medicaid members have a greater incidence of diabetes and are at risk for not obtaining HbA1c tests. The Institute of Medicine’s Guidance for the National Healthcare Disparities Report substantiates the gradient effect and direct relationship between income and obtaining preventive care and screenings. The diabetes text messaging pilot study was an initiative to test the hypothesis that text messaging through cellular telephones could have a positive impact on patient compliance with medical regimens. The goal of the Text Messaging pilot study was to increase the number of diabetes patients that received HbA1c studies.
	Cultural Excellence Training Ann Doyle,RN, Manager, Accreditation and Medical Programs, CareFirst BlueCross BlueShield Poor communication between health providers and minorities lead to lower quality of care. Minority populations have cultures/beliefs about illness and treatment often different from western medicine. Cultural competency training of health providers/organizations increases awareness/sensitivity to minority issues. CareFirst instituted internal cultural training to improve communications with its’ diverse consumers. Nurses, physicians, customer service/provider relations representatives participated in an online cultural training program established in a flexible format that allowed easy access 24/7. Participants learned skills and concepts through case scenarios to help them communicate with diverse populations. Multiple departments collaborated to customize a clinical/non-clinical program to meet associate needs.
	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 mortality involving an office based adenosine treadmill test was identified. 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. The site visit evaluation tool was based on AHA/ACC guidelines. 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.
	SNAPforSeniors Senior Housing Locator
	Eve Stern, President, SNAP for Seniors. 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, SNAPforSeniors has been able to create listings for every licensed senior housing provider in the country. Data is kept current and provided objectively. Health & Wellness Outreach and Engagement Nikki Barr, Performance Data Analyst, Ceridian Life Works Mary Miller, Director of Health and Productivity Management, Ceridian LifeWorks A missing link has been identified between the administration of a health risk assessment (HRA), or life health assessment (LHA), and behavior change programs. 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.
1:45 pm – 2:30 pm	(3) Concurrent Sessions
	CONNECTIONS PLUS Mary Mason, MD, Senior Vice President/Chief Medical Officer, Centene Corporation Centene Corporation developed the CONNECTIONS PLUS program in response to the identified need for real-time communication with at-risk members. This program seeks to eliminate lack of safe reliable access to a telephone as a barrier to coordinating care and thus reduce avoidable adverse events such as inappropriate emergency room utilization, hospital admissions, and/or premature birth. The CONNECTIONS PLUS program is overseen by a central cell phone distribution program that allows Centene to manage the program, distribute best practices to the field, and consistently monitor outcomes.
	Essential Solutions for Depression Management John Emerick, MD, Medical Director, Companion Benefit Alternatives, Inc. Lynn Watts,RN-BC, Director of Clinical Services, Companion Benefit Alternatives, Inc. Untreated or under-treated depression leads to significant personal morbidity, increased utilization of medical services, increased mortality and employer burden due to absenteeism and decreased productivity. The Essential Solutions for Depression Management program is a flexible and replicable telephonic disease management model designed to support best practice management for the behavioral health disorders of members seen in primary care.
	Drug Interaction Alert Program Brian K. Solow, MD, Vice President, Medical Director, Prescription Solutions Drug-drug interactions (DDIs) cause significant morbidity, mortality and economic burdens each year. The risk of DDIs increases with the number of drugs prescribed, which can be a major concern in the elderly. After recognizing a unique opportunity to improve patient safety, Prescription Solutions implemented the Drug Interaction Alert Program (DIAP). The goals of DIAP were to reduce the incidence of clinically significant DDIs and the risk of associated adverse events by directly engaging prescribers through faxed, patient-specific notifications on a real-time basis. This program served as a valuable collaborative opportunity between prescribers and Prescription Solutions to optimize members’ health care.
2:30 pm – 2:45 pm	Refreshment Break and Cyber Café in Networking Center
2:45 pm – 3:30 pm	(3) Concurrent Sessions
	OptumHealth Treatment Decision Support Michael Rosnick, MD, MPA, Director, Clinical Affairs, OptumHealth Care Solutions Healthcare consumers frequently make treatment decisions that are not supported by evidence based medical data which contributes extensively to suboptimal care and healthcare inefficiency. This program is intended to provide consumers with the numerous documented benefits of an empowered and informed health care consumer including innovative treatment strategies and interventions. The TDS program is designed for members who are actively considering treatment for conditions which have high treatment variability, and high related costs.
	The Positive Impact of Written Asthma Action Plans Carol Wilhoit, MD, MS, Medical Director, Quality Improvement, Blue Cross Blue Shield of Illinois While national guidelines recommend use of a written asthma action plan, few asthmatics were receiving them. Motivating physicians to use an asthma plan to better manage asthma care and better educate members was seen as an opportunity to improve asthma care and potentially to improve asthma outcomes. BCBSIL collaborates with network physicians through payment and public recognition based upon the percentage of asthmatics receiving a written asthma plan from their physician. Goals include increasing the asthma action plan rate and reducing asthma ER and inpatient utilization.
	Drug Therapy Management Carolyn L. Stang, PharmD, Senior Advisor Clinical Program Management, CVS Caremark Improved monitoring of drug therapy to ensure positive outcomes and prevent adverse effects is needed. A single adverse drug event increases the costs of direct health care services. A communication breakdown exists between patients and practitioners resulting in preventable adverse drug events. Strategies to improve patient understanding of their drug therapy and improve patient-practitioner communication are essential. The primary focus of the initial pharmacist contact is to review the participant’s medical condition(s) and medications; address primary drug therapy concerns and major drug therapy issues.
3:45 pm – 4:30 pm	(3) Concurrent Sessions
	Automated Alerts for Cost-effective Drug Therapy Joe Fazio, Vice President of Clinical Health Solutions, WorldDoc, Inc. The number of prescriptions used by the average American has increased, but so has the cost of prescriptions. While insurers put more financial burden on their members, some studies show increased out-of-pocket expenses can decrease medication adherence, which raises concerns of an increased risk of adverse health events. WorldDoc has designed an internet-based prescription drug monitoring and intervention application intended to reduce patient out-of-pocket drug expenses and minimize the number of patients reaching coverage gap, and thereby reduce any potential interruptions in therapy.
	Improving Employee Health Through Behavior Change Nico Pronk, PhD, Vice President, Health Management, HealthPartners The primary goal of the partnership between HealthPartners and the employer group BAE Systems was to promote, in a cost-effective manner, healthy lifestyles and improved chronic condition management for BAE employees and their spouses. The objective was to initiate and sustain positive behavior change while decreasing health care costs. A new benefit design was created to incent employees and spouses to participate in health promotion activities. The practice included annual completion of HealthPartners health assessment and participation in a qualifying health promotion activity. The initiative required collaboration between employer, employee and the health plan to create a successful program.
	Arkansas Diabetes Disease Management Program Phase 3 Becky Adams, MPH, RD, CDE, Associate Branch Chief, Lifestage Health, The State of Arkansas Department of Health Sandra Ballentine, Director, Clinical Field Operations, Comprehensive NeuroScience, Inc. In an effort to combat the growing prevalence of diabetes in Arkansas, the Arkansas Diabetes Disease Management Program began in 2002 when the Arkansas Department of Human Services and Eli Lilly and Company partnered to establish diabetes management centers in underserved areas of the state and then began enrolling Medicaid patients with diabetes in intensive education programs. In addition to improving health care for patients, the program aimed to prove the value of education in diabetes care in a select population of people and reduce costs for total diabetes care by decreasing hospitalizations, emergency room visits and other diabetes-related expenses.
6:30 pm – 10:00 pm	Awards and Dinner Gala Join members of URAC Board of Director and staff awards finalists, speakers, sponsors, exhibitors, attendees and invited guests for this black-tie event as URC announces the Awards Recipients in the designated awards categories .
Thursday, April 2, 2009
8:00 am –12:00 pm	Conference Registration
8:00 am - 9:00 am	Continental Breakfast and Cyber Café in Networking Center
9:00 am - 10:30 am	General Session Presentation Turning Innovative Practices into Best Practices in Consumer Empowerment and Protection Patricia Adams, Vice President, Business Operations & External Affairs, National Pharmaceutical Council Connie Commander, RN, BS, President, Commanders Premier Consulting Corporation Peter R. Kongstvedt, MD, Principal, P. R. Kongstvedt Company, LLC Michael J. Thompson, Principal, PricewaterhouseCoopers Deborah Unger, RN, Clinical Director, State of Alabama Employees’ Insurance Board Susan Willette, National Practice Leader, Health & Productivity Management, Mercer Moderator: Thomas W. Wilson, PhD, DrPH, President, Trajectory HealthCare, LLC and Chair, Best Practices Awards Judge Panel Representing various stakeholder perspectives, this select panel of judges from the Best Practices Awards program will discuss how consumer-focused programs impact and enable consumers to be more effective navigators and managers of their own health care, and how various segments of the health care industry can operationalize the concept of consumer empowerment and protection. The judges will also reflect on the strengths and weaknesses of the programs they reviewed in the awards competition and the factors that were significant in distinguishing the “best” from among the many innovative and promising programs reviewed.
10:30 am – 10:45 am	Coffee Break in Foyer
10:45 am – 11:45 am	Closing Keynote Address In an Instant: A Health Care Consumer's Journey of Healing and Empowerment Lee Woodruff, Author/Contributing Editor, Good Morning America Life changed in a heartbeat for successful freelance writer Lee Woodruff when her husband, Bob Woodruff, co-anchor of ABC's World News Tonight, was wounded while broadcasting from Iraq. Her experience as a caregiver and patient advocate during her husband's recovery will be the focus of her inspiring keynote address. Lee's story will underscore the consumer's role in health care and echo the themes presented in the award-winning programs featured during the conference.
11:45 pm	Adjournment