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 AHCA/NCAL Population Health Summit Targets Providers

Long term and post-acute care (LT/PAC) providers seeking information and the strategic know-how to launch specialized Medicare Advantage (MA) plans, or Special Needs Plans (SNPs), for their long-stay residents have an opportunity to do so at a December conference organized by the American Health Care Association/National Center for Assisted Living (AHCA/NCAL) with its Population Health Management Summit for Long Term and Post-Acute Care Leaders.

AHCA/NCAL sources tell Provider that as interest continues to grow among LT/PAC providers in the Institutional-SNP, or I-SNP sector, so does the need for information geared specifically to skilled nursing and assisted living owners and operators.

“Every population health management conference that comes up seems to focus on how hospitals, health systems, or physicians can manage the post-acute care stay,” says Jill Sumner, vice president, population health management, AHCA. “These conferences are never about the PAC provider taking the lead.”

Thus, in consultation with Mark Parkinson, president and chief executive officer of AHCA/NCAL, and other association leadership, the idea was born to bring LT/PAC into its rightful place in the discussion through a summit on the world of population health management in general and SNPs in particular, Sumner says.

Since she arrived at AHCA in October of 2018, the association has worked to develop the resources and capacity to aid LT/PAC providers in pursuing population health management opportunities, which also made the summit a natural extension of this effort.

“There is a strong interest and thirst for knowledge in this area,” Sumner says.

AHCA/NCAL staked out new ground when it formed the Population Health Management Council earlier this year as it became clear that there are real opportunities for LT/PAC providers to gain a level of control over their residents’ care than was previously possible, she says.

The goal of the council’s work is to enhance the quality of care and quality of life for Medicare beneficiaries in senior living settings by ensuring the sustainability of long term care provider-owned population health models through advocacy, education, and quality improvement data.

With MA or other emerging population health management models, providers can flex those regulations and waive the three-day stay and use financing to hire and train advanced clinical staff. “It is about keeping people as healthy as possible and providing them with benefits that do that and trying to avoid as much of the preventable emergency care as possible,” Sumner says.

For the providers, legal experts, academics, and others coming to the AHCA/NCAL summit, the agenda items include an opening keynote: Thriving in a World That Doesn’t Exist by health care thought leader Dan Mendelson, founder of Avalere Health.

A sampling of the sessions over the two-day conference cover the expanding role of providers in population health management, building MA plan and network relationships, overviews from officials representing the Centers for Medicare & Medicaid Services, and the nuts and bolts of SNP development.

Council partners AllyAlign Health, American Health Partners, and Provider Partners Health Plan will also play a featured role at the summit, Sumner says. She stresses that providers and other stakeholders who are just thinking about getting involved in the world of SNPs will find what they need at the summit, as well as those entities already deeply along the way in managing their own MA plan.

“We do have something for both ends of the spectrum,” Sumner says. For example, actuaries from Milliman will review how the MA plan bid process works, which is something every plan sponsor must manage on a yearly basis, not just for the first time out.

“That is a fundamental technical session that would appeal to folks just getting in and those already into it. The bid process is very involved and takes hearing a number of times to understand completely,” she says.

In the end, the summit is about how LT/PAC providers can best engage with their business partners and take a leadership role, be it by working with payers or through integrated health networks or entering into value-based contracts. “We are trying to set the overall tone as providers taking a leading role on working within the system and not trying to push against it,” Sumner says.

The event takes place Dec. 9-10 in Washington, D.C. Registration and other information is available at www.ahcancal.org/events/phm/Pages/default.aspx.

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