Achieve Rewards from Your Performance Data


[3049] Achieve Rewards from Your Performance Data

Education-Training Credits:

  • 1.5 Hr(s) HCSSA Administrator/Alternate

Summary: TX MCOs present potential VBP/VPC approaches.

HCSSA Topic(s) Addressed:

  • §558.259[d][4]agency responsibilities
  • §558.260[a][8]skills for working with clients, families, and other professional service providers

Faculty: Angie Parks, United Healthcare; Robert Wells and Ceseley Rollins, Superior Health Plan; Kelley Longhofer, Community First

Program Description: Texas Medicaid payors are beginning to look at new payment models called “Value-Based Payments (VBP) and/or Value Based Contracting (VBC).” The idea behind the new models is for payors to work with providers to ensure delivery of high quality and cost-effective care to their members. TAHC&H brings you three (3) Medicaid Managed Care Organizations (MCOs) to present a panel discussion about steps a provider might want to take for structuring a VBP/VBC with a payor. Providers will also learn how these (3) Texas MCOs are currently rolling-out VBP/VBC. They will spend time discussing the process they implement with providers and elements needed to create VBP/VBC. Implementing a program in collaboration with your MCO could earn your organization rewards for quality services and care. Understanding how your data is involved as well as other reporting requirements is critical to your success, so don’t miss this opportunity to be ahead of the curve rather than behind it!

Presentation Date: 08.09.2017

Learning Outcomes(s): Participants will actively engage in the learning activity and implement agency data evaluation projects that will enhance their ability to participate in Value-Based Purchasing programs.

About the Presenter:
Angie Parks
serves as the Senior Director for Quality Management & Performance for UnitedHealthcare Community Plan of Texas. She has been with the plan since 2013. She oversees the local quality programs for UHC’s Medicaid, MMP and DSNP plans. Ms. Parks is a registered nurse who holds a Bachelor of Science in Nursing from the University of Texas Health Science Center, and a Bachelor of Science in Adult & Corporate Fitness/Wellness from Abilene Christian University.

About the Presenter:
Ceseley Rollins
has been working with the STAR+PLUS program since 1998. She began working in Houston, Texas shortly after the initial implementation for the STAR+PLUS program and has been working for the program ever since. Ceseley has played a significant role with each STAR+PLUS expansion/implementation due to her role as Provider Relations Manager, Director of Operations, through her current role as Vice President, Medicaid Operations for Complex Care Programs which includes STAR+PLUS, STAR Kids and STAR Health.

About the Presenter:
Robert Wells
is the manager of Superior Healthplan’s Transformation Projects group. He designs and manages value based incentive projects and works closely with HHSC to implement state directed alternative payment models. For several years, Robert has been on the forefront of finding new ways for managed care organizations and Superior to interact with their provider networks. Robert has a background in provider relations and business operations and lives in Austin with his wife, three children and six chickens.

About the Presenter:
Kelley Longhofer
has 25 Years in Health Care Operations for Commercial, Medicare and Medicaid, 20 Years in Managed Medicaid Program Management and Operations as well as Provider Network Management, and 18 Years with STAR+PLUS and now STAR Kids in Program Management and Operations. Kelley has worked in national health plan organization as well as local Texas provider sponsored health plans. Kelley is currently working with Community First Health Plans in San Antonio after a long tenure with Amerigroup.

[3049] Achieve Rewards from Your Performance Data

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