Fall 2016 Clinical Executives Collaborative Meeting

Overview

The Alliance of Community Health Plans (ACHP) Clinical Executives Collaborative, Medical Directors Council, Pharmacy Directors Collaborative and Marketplace Leaders met concurrently on October 25 – 26 in Chicago, Illinois. The Clinical Executives Collaborative provides ACHP members a forum for rapid learning and communication of plan efforts to improve care management of populations with chronic and complex needs via innovative models of care redesign supported by value-based reimbursement. The meeting agenda addressed an array of topics including the social determinants of health, communicating the value of clinical programs, a policy update, managing chronic pain and opioid use, medical savings strategies and a team-based approach to optimizing primary care. Janet Tomcavage, Geisinger Health System; Mary Cooley, Priority Health; and Jennifer Sulkin, ACHP, serve as leaders of the collaborative.

Summary

ACHP Clinical Executives Collaborative Summary October 2016

Agenda

ACHP Clinical Executives Collaborative Linked Agenda (includes presentations)

Pre-work/Pre-reading Materials

  • ACHP plans to announce a signature initiative at its 30th annual symposium in April 2017. This initiative aims to elevate and solidify the ACHP brand and demonstrate a shared commitment by its member organizations. We have narrowed the list of potential initiatives down to five, with an overview of each provided for your review. Your feedback (e.g., concerns, ideas for how to strengthen individual options, which initiatives spark the greatest interest, etc.) on these options would be greatly appreciated! We will be discussing the initiative in greater detail with the medical directors and board of directors at the meeting, with a goal of narrowing down the list and want to be your voice is captured as well. Please send your comments to Jennifer Sulkin (jsulkin@achp.org) by Wednesday, October 19.
  • David Meltzer, University of Chicago, will join the medical directors and clinical executives to discuss various care coordination interventions, including the Comprehensive Care Physician (CCP) model, which seeks to improve care at low cost for patients at increased risk of hospitalization. Here is an overview of the CCP model.
  • ACHP is looking to streamline its Learning and Innovation programming (i.e. clinical collaboratives) in 2017 to enhance the organization’s influence, accelerate learning and create more focus and alignment with overall organizational objectives. The proposed framework outlines a few modest changes. Greater explanation will be provided at the meeting.
  • We also ask that you come prepared to share your organization’s approach/framework for addressing the social determinants of health.
  • Rebecca Ramsay will discuss how CareOregon is addressing the social determinants of health, focusing on three main areas: housing for the low-income population, food security and social supports/combating social isolation. Attached are a number of background articles (optional reads).
    • A summary of CareOregon’s Housing with Services Program and some of the evaluation framework
    • A case study of a member enrolled in CareOregon’s Housing with Services Program
    • A Health Affairs article written about the impact of housing programs in Portland on health care expenditures and health outcomes
    • The Business Plan document (CCC Housing) that describes CareOregon’s newest housing investment
    • And several Food Rx documents that will give attendees a sense of what CareOregon is doing around nutrition and food security