Name: Characterizing the Reimbursement Landscape for Cell and Gene Therapies
Start: 2024-09-18T15:00:00Z
End: 2024-09-18T15:01:00.000Z
Location: BrightTALK
Rating: 0

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In the last few years, the number of advanced connected care technologies has proliferated, from telehealth and RPM to digital therapeutics and VR. However, their success depends on numerous factors, including seamless integration into clinical workflows, provider buy-in, and patient education. During this panel discussion, leaders from provider and payer organizations will discuss barriers to successful technology integration, strategies to break down those barriers, and the opportunities that these technologies can unlock.

Panelists:
Brennan Spiegel, MD, Gourrich Chair in Digital Health Ethics & Director of Health Services Research, Cedars-Sinai
Lauren Hopkins, MPH, Assistant Vice President of Virtual Care & Community Engagement, WellStar MCG Health

Integrating Advanced Connected Care Technologies into the Care Continuum

Collaboration between providers and payers enables the pooling of resources, expertise, and data, fostering coordinated and efficient care for communities. This unified approach, especially in value-based care models, promotes preventive health measures, streamlines processes, and addresses holistic community health needs. Parkland Center for Clinical Innovation President & CEO Steve Miff will share real-world examples and best practices for combining the right people, efficient processes, and advanced technology to address the needs of underserved individuals and populations.

Collaborative Data-Driven Strategies for Healthy Communities

Success in Medicare Advantage can be hard to achieve—and  in today’s hypercompetitive and regulatorily complex MA market, it’s only getting harder. Stakeholders looking to survive—let alone succeed or scale—in MA must understand how to operate leanly while balancing growth and sustainability. We’ll discuss:

• How the Medicare Advantage landscape has changed and what that means for you
• How plans are measuring success in MA and related best practices 
• How to fine-tune risk adjustment and STARS practices

Beyond Survival: Realizing Sustainability in Medicare Advantage

Rising costs, stagnant outcomes, and workforce strain signal a need for change in healthcare. Value-based care promises better provider satisfaction, improved patient outcomes, and cost reduction. However, providers remain hesitant to adopt risk-based, quality-focused models. Join a discussion on building provider support with Humana's AVP of Physician Strategy & Medical Affairs, Alexander Ding, MD, MBA.

Building Provider Support for Value-Based Care

From payers to providers and everyone in between, every healthcare stakeholder contributes to health and wellness. Yet, connecting the dots across the care continuum is a major challenge. Data siloes, lack of interoperability, health literacy and engagement obstacles, and rules and regulations are just some of the issues preventing effective care coordination across provider types. This panel explores the state of care coordination in a more medically complex and consumer-driven environment.

Lauren Grimshaw, Senior Vice President of Member Health Operations, CDPHP
Hallie Bleau, VP of Care Management, Northwell Health Solutions
Rich Steinle, CEO of Carium

Guiding Patients to Health with Care Coordination

The past few years have brought significant attention to the impact of social determinants of health on individual and community well-being and health outcomes. Understanding these environmental, economic, and sociopolitical factors is integral to effective population health management where care management and interventions are tailored to the needs of specific groups or geographies. UnitedHealthcare Vice President of Social Determinants of Health Alexander Billioux, MD, DPhil, will discuss strategies for addressing individual health-related social needs and broader community health drivers to improve outcomes and costs.

Improving Population Health by Addressing Social Needs

Behavioral health issues continue to plague Americans, resulting in a rising demand for behavioral healthcare services, particularly among underserved populations that face multiple social determinants of health barriers. This panel will focus on how organizations are using connected care devices and strategies to enhance access to behavioral healthcare, the challenges they are facing, and how they are addressing those challenges to extend much-needed healthcare.

Deploying Connected Health Strategies to Close Behavioral Healthcare Gaps

Connected healthcare has become a critical part of the overarching healthcare delivery system in the United States. However, the benefits of connected care efforts can be hindered by digital health inequities, such as lack of access to the internet or technology. In this fireside chat, Natasha Khouri, assistant vice president of Digital Health Strategy & Solutions at UPMC Health Plan, will discuss the importance of tracking digital engagement among health plan members, the barriers to digital health equity, and innovative strategies to achieving equity goals.

Opportunities & Challenges of Ensuring Digital Health Equity in Connected Care

Wearable devices are becoming an increasingly popular way to track health outcomes and help patients achieve health goals, especially in the chronic care arena. But, as organizations explore the utility of wearables in healthcare, the benefits and hurdles have become apparent. This panel will focus on how organizations are using connected care wearables to improve chronic disease management, the barriers to provider and patient adoption, and what they are doing to expand access to wearable-enabled healthcare.

Using Connected Care Wearables to Boost Chronic Disease Management

Rural America faces the predicament of being a population in dire need of convenient access to healthcare while often lacking the means to ensure that access. Connected healthcare has been heralded as a solution to this predicament, but rural populations face digital divide barriers, making access to connected healthcare challenging. In a fireside chat, Jared Antczak, chief digital officer at Sanford Health, will discuss these challenges and strategies to help alleviate access barriers. The discussion will also cover his thoughts on the future of rural healthcare and virtual care's role in this landscape.

Leveraging Connected Care Strategies to Expand Rural Access to Healthcare

The accessibility and affordability of biologics and biosimilars are greatly influenced by the dynamics and pricing differences within the prescription drug supply chain. These factors can impede the adoption of biosimilars, leading to reduced competition and fewer cost savings for patients and healthcare systems. Ross Day, RPH, DP, former Director of Pharmacy at Vizient and current pharmaceutical consultant, and Antonio Ciaccia, CEO and co-founder of 46brooklyn, President of 3 Axis Advisors, will explore the dynamics of the prescription drug supply chain and pricing disparities related explicitly to biologics and biosimilars during this panel discussion.

Learning Objectives
• Gain comprehensive insight into the profound impact of prescription drug chain dynamics and pricing disparities on the accessibility and affordability of biologics and biosimilars
• Explore the intricacies surrounding barriers to biosimilar adoption and their far-reaching effects on market competition
• Engage in meaningful discussions to devise effective strategies for mitigating pricing disparities, enhancing access to biologics and biosimilars, and realizing substantial cost savings for patients and healthcare systems

Navigating Supply Chain Dynamics & Pricing Disparities of Biologics, Biosimilars

Join this webinar to learn about the current trends shaping the specialty pharmacy market, and how these pharmacies will change in the coming 5-10 years. This session will focus on the shifting landscape of specialty medications, the evolving demands on specialty pharmacies, and opportunities for collaboration between stakeholders such as specialty pharmacies, pharmaceutical manufacturers, health plans, and PBMs.

Things you’ll learn:
• How stakeholders will need to partner and collaborate to meet new challenges 
• Where the specialty pharmacy market currently stands, and our predictions on where it’s headed 
• Which disruptors are worth watching in the specialty pharmacy market

The Future of Specialty Pharmacy

In the healthcare industry, cannabis holds promising therapeutic benefits for various health conditions; however, regulatory implications and evidence-based regulations must be carefully considered and developed to ensure safe and responsible use. In this keynote presentation, Peter Grinspoon, MD, primary care physician, educator, and cannabis specialist at Massachusetts General Hospital; an instructor at Harvard Medical School; and a certified health and wellness coach, reveals the truth about cannabis and sheds light on its potential benefits and risks. He will also discuss the therapeutic potential of cannabis, responsible usage, and the impact of cannabis legalization on the healthcare system and patient care.

Learning Objectives
• Discover the therapeutic potential of cannabis for chronic health conditions and gain an understanding of the importance of responsible use
• Explore the risks and challenges associated with cannabis use, with a particular focus on addiction and recovery
• Engage in a discussion about the impact of cannabis legalization on healthcare and patient care, emphasizing the need for evidence-based regulations and further research in the field

Unveiling Cannabis: Exploring Therapeutic Benefits and Regulatory Implications

The key to a successful population health management program lies in data. To move the needle on clinical outcomes and cost of care, data and clinical teams must partner to identify the highest risk patients, develop targeted care plans, and allocate resources. With data as the cornerstone, OSF OnCall has formed a multi-disciplinary Advanced Care team, dedicated to providing in-home treatment for patients with complex conditions such as hypertension, CHF, COPD, and asthma. Discover how OSF leverages data to optimize program design and operations, resulting in maximum impact on clinical outcomes and cost control.

Key discussion areas will include:

• Using data analytics to identify consumers with high-risk conditions
• Facilitating smooth data interoperability across systems
• Designing data-driven clinical protocols and interventions using real-time RPM data
• Measuring care program ROI and success.

How OSF OnCall is Leveraging Data to Scale Chronic Disease Management

The care-at-home continuum is vast, ranging from chronic disease management to hospital-at-home programs. While this move to home-based care provides numerous patient and provider benefits, scaling these services can be complex. Dr. Eve Cunningham, group vice president and chief of virtual care and digital health at Providence, will detail the evolving care-at-home continuum and challenges to scale, strategies the health system has employed in its care-at-home journey, and why health systems need to invest in these services today to prepare for healthcare's tomorrow.

Opportunities, Barriers to Scaling the Care-at-Home Continuum

Though remote patient monitoring is increasingly used to boost care access and improve outcomes, several hurdles stand in the way of RPM technology use. This panel will focus on the reimbursement and regulatory challenges preventing widespread RPM adoption and use across the continuum of care. It will also include a discussion on what RPM providers can do to overcome these challenges and what they need from lawmakers to spur RPM use.

Strategies for Driving Patient Education & Engagement in RPM Programs

The COVID-19 pandemic boosted the use of virtual care strategies like remote patient monitoring. But as the public health emergency winds down, RPM use is moving past the pandemic response. In this keynote address, Dr. Zenobia Brown, associate chief medical officer at Northwell Health and executive director of Northwell Heath Solutions, will discuss the role of RPM in achieving value-based care, how it can be leveraged to support population health strategies, and the barriers that need to be torn down to enable RPM to reach its full potential.

Advancing RPM Beyond the Public Health Emergency

PharmaLifeSciences 2024: Advancements in Cell and Gene Therapy

The rapid advancements in cell and gene therapies have transformed the treatment landscape for various conditions, including cancer, genetic disorders, and autoimmune diseases. However, the reimbursement environment for these groundbreaking therapies presents unique challenges and opportunities. In this session, Monet Stanford, PharmD, Director of Access & Reimbursement Policy at the Alliance for Regenerative Medicine, will explore the current realities of the payer environment, focusing on Medicare and Medicaid and the emerging models of value-based pricing and outcomes-based agreements.

Characterizing the Reimbursement Landscape for Cell and Gene Therapies

Pharmaceutical

cell therapy

gene therapy

Demand Generation

Therapy

Reimbursement Landscape

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Characterizing the Reimbursement Landscape for Cell and Gene Therapies

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