From Volume to Value: Are ACOs and Bundled Payment Programs The Answer?

NYC Health Business Leaders > From Volume to Value: Are ACOs and Bundled Payment Programs The Answer?

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5:30 to 8:00 PM

Essex Woodlands

Few healthcare topics are generating as much conversation – or consternation – as ACOs and Bundled Payment Programs. By January 1, 2014, over $55 billion of Medicare spending will be running through these programs, with that number likely to double in the subsequent 12 months. There is no precedent in US health care history for such a seismic change in government payment policies. These payment models shift incentives from a system that rewards more volume (fee-for-service) to one that rewards value (outcomes).

Changing how healthcare is delivered and paid for in the U.S. will not be easy and has sparked plenty of debate. All key stakeholders – providers, health systems, payors, technology providers, manufacturers, investors and government – have a stake in the outcome. To address the issues, challenges, and opportunities the models present, we are bringing together leaders in the field with real-world experience. These are the players who are literally on the frontlines as this new model takes shape.



The discussion will be led by Steve Wiggins, a healthcare visionary who founded and ran one of the country’s most innovative insurers, Oxford Health Plans. He then went on to launch HealthMarket, an insurance company that gave birth to Consumer Driven Health Plans. Today Steve is a Managing Director and head of the NYC office of PE firm Essex Woodlands. He recently started a bundled payment company that is the nation’s largest Awardee Convener, with over 50 hospital partnerships.
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Steve will be joined by Richard J. Gilfillan, MD, who was the founding Director of the Center for Medicare & Medicaid Innovation (CMMI), the new organization responsible for creating the ACO and bundled payment programs along with other landmark new initiatives. Dr. Gilfillan headed CMMI from its inception until June, 2013. He previously served as President and CEO of Geisinger Health Plan and Senior Vice President at Coventry Health Care.
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Mark Callahan, MD, the CEO and Chief Medical Officer of Mount Sinai Care, the medical center’s ACO, will provide perspective on the new model from both the physician and health system viewpoints. Mount Sinai Care was selected to participate in the Medicare Shared Savings Program in 2012, which has now attracted nearly 200 ACOs. Dr. Callahan is an internist by training and associate dean for excellence in clinical care at Mt. Sinai’s School of Medicine.
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