making the most of your apg membership
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6/25/2019
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MAKING THE MOST
OF YOUR APG MEMBERSHIP
STAFF MEMBER NAME:
AGENDA
Welcome and Introductions
Three Pillars
Resources
Meetings
Your APG Network
Q & A
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APG’S 3 PILLARS
1. Education
2 national conferences
Committee and regional meetings
Webinars
Tools and Resources, Publications
2. Advocacy
Federal & California
Updates on Government Policies
Comment letters & position papers
Educate staffers, CMS, associations, etc.
3. Leadership
CMS, CMMI, members of Congress
Community leaders
Associations
APG RESOURCES
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APG Risk Readiness Tool
• Hands-on tool to assess your readiness for APMs
• Essential specific checklists:
• patient safety
• effective clinical care
• patient-centered care and provider communication
• care coordination
• population health
5Log into our Resource Library for more info: www.apg.org/resources
STANDARD OF EXCELLENCE (SOE)
An annual, comprehensive survey of capitated, coordinated care infrastructure for America’s Physician Groups’ accountable physician organizations
Five publicly reported domains
1. Care Management Processes
2. Information Technology
3. Accountability and Transparency
4. Patient-Centered Care
5. Group Support of Advanced Primary Care
6. Administrative and Financial Capability (Not Reported)
Physician groups are publicly reported by star system
Released in early March w/ 6-week completion--due late April
Processing, scoring and auditing in early May by NCQA
Final thresholds determined by clinical committee
For more information: www.apg.org/soe6
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SOE® by the numbers in 2018
• 12th year
• 122 groups participated
• 11 first-time SOE participants
• 12.9 million Commercial lives
• 3.2 million Medicare Advantage lives
• 3.7 million Medicaid lives
• 87 Elite members in 2018
• 71% of SOE® participants made Elite designation
• Increase of almost 10 % pts compared to 2017
• 6 new organizations achieved Elite status
SOE ELITESMET THE BENCHMARKS ON ALL 5 DOMAINS
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Case Studies in Excellence
• Highly effective tool to demonstrate what our
coordinated care systems can accomplish
through innovation
• Publication features select examples of
creative and effective programs implemented
by APG members
• Education through sharing of best practices
Log into our Resource Library for more info: www.apg.org/resources
Prescribing Opioids for Chronic Pain
Tools to help end the opioid crisis
Reminder to:
• talk to the patient about chronic pain
• assess pain and function
• consider potential non-opioid therapies
• evaluate risk of misuse
10Log into our Resource Library for more info: www.apg.org/resources
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• Alternative Payment Models (APM
Guide)
• America’s Physician Groups Managed
Care Digest (Health Care Data
Summary)
• Case Studies in Excellence- Medical
• Case Studies in Excellence- Pharmacy
• Healthcare Employee Compensation
and Benefits Survey
• Journal of America’s Physician Groups
• Specialty PMPM Benchmark
• The Ideal PPO ACO Program
APG WEBSITE login button
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APG MEMBER-ONLY ACCESS
APG MEETINGS
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Committees Description
Clinical Quality Leadership (CQL)
APG Staff: Amy Nguyen-Howell, MD
• Topics
• Risk-bearing Contracts
• Population-based Payments
• Clinical Integration
• Population Health Management
Contracts
APG Staff: Jennifer Jackman
• Topics
• Managed Care Contracting
• Contract Analysis And Evaluation
• Best Practices
• Review Of Products, Services, And
Guidelines
• Sharing Of Legally Permitted Information.
Pharmaceutical Care
APG Staff: David Gonzalez
• Topics
• Pharmacy/Pharmacy Benefit Management
• Clinical Quality Measurement Programs
Such As CMS Stars And HEDIS
• Members Work With Health Plans To
Produce An Annual Commercial And
Medicare Formulary Grid.
Committees
Committee Description
State Government Programs
APG Staff: Bill Barcellona
• This committee serves member organizations
that contract and care for Medicaid, Dual
Eligible, and special needs patients.
• Topics
• Support APG advocacy,
• Identify Opportunities to Promote high
quality and cost-effective Healthcare
Public Relations/Marketing
APG Staff: David Allen
• Topics
• Marketing Best Practices
• Raise Their Visibility
• Promote Consistent, Positive Messages
On Risk-based Car
• Contribute To The Creation Of The APG
Magazine And Journal
Alternative Payment Models
APG Staff: Margaret Peterson
Topics
• Medicare’s APM Options
• Federal APM Policy
• Accountable Care Organizations (ACOs)
• Medical Homes
• Bundled Payments
Committees
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Committee Description
Human Resources (HR)
APG Staff: Lura Hawkins, MBA
• Topics
• Compensation
• Employee Benefits
• Recruitment
• Employment Law
• Market Trends
• Annual National Physician Organization
Compensation and Workforce Survey
California Policy
APG Staff: Bill Barcellona
Topics
• APG’s advocacy in California
• Providing information and direction on
legislation and regulations
Federal Policy
APG Staff: Margaret Peterson
Topics
• Federal legislation and developments affecting
physician organizations and the value
movement.
Pediatric Workgroup
(New!)
APG Staff: Lura Hawkins, MBA
Topics
• Immunizations
• Chronic Conditions
• Pediatric Perspective on the Standards of
Excellence Survey
Committees
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Regions
1 Colorado
2 Inland Empire, CA
3 San Diego, CA
4 Northern CA
5 Northwest
6 Midwest
7 Northeast
8 Southeast
9 Southwest
10 Hawaii
Regional Meetings
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REGIONAL MEETING TOPICS
Best Practice in Managing COPD Patients; Dr. Marc Hoffing, Desert Oasis Healthcare
Increase Your MA Enrollment by Partnering with a Broker; Alan Jones, Sutter Health
Foundation
Oak Street Health Care Model; Dr. Olaoluwa Fayanju, Oak Street Health
Operationalizing a Capitated Contract; Karen Gee, OptumCare Network of
Connecticut
Breast Cancer Screening Best Practices; Dr. Bruce Wollman, Mid-Atlantic Permanente
Medical Group
Emergency Planning: A Case Study; Dr. Richard Manning, WellMed Medical Group
Strategies in Lowering Your ER Use; Jeff Lawrence, Catalyst Health Network
Transitions of Care Clinic; Mark Mantei, The Vancouver Clinic
WEBINAR WEDNESDAY
Educational Series for APG Members Only
Every 2nd Wednesday of the Month, 2:00 pm ET/11:00 am PT
Topics
Medicare Advantage risk adjustment
Deep dives discussion on CPC+
MA Value Based Insurance Design (VBID) models
ACO rules
Industry Experts acting as Guest Speakers, such as
Sean Creighton from Avalere
Bowen 'Bo" Garrett and Laura Skopec from the Urban Institute
Lead by: Valinda Rutledge, VP of Federal Affairs, APG, [email protected]
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ANNUAL CONFERENCE
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ANNUAL COLLOQUIUM
What is it?
A yearly 3 day meeting of healthcare executives held in October in Washington, DC
Sample Agenda
Preconference: A soup-to-nuts primer on the keys to success in population health management
Shared Learning Fest: an interactive opportunity for intimate discussions with APG Consultants
Breakout Sessions: Conversations led by field experts on topics such as: artificial intelligence, digital health, social determinants of health, and more!
What Will You Take Away?
Proven strategies for implementing and improving coordinated care, population health management, risk contracting, physician and patient engagement, and more
Forecasts from political experts on the Administration’s potential impact on healthcare policy
Firsthand accounts and lessons learned from organizations who have been operating under risk contracts for 30 years on where APMs are succeeding and what progress still needs to be made
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YOUR APG NETWORK
YOUR NETWORK: APG STAFF
Name Title EmailDonald Crane President & CEO [email protected]
Amy Nguyen Howell,
MD
Chief Medical Officer [email protected]
William (Bill)
Barcellona
SVP, Government Affairs [email protected]
Jennifer Jackman VP, Business Development [email protected]
Valinda Rutledge SVP, Federal Affairs [email protected]
Lura Hawkins VP, Member Services [email protected]
Cassandra Perkins Director, Administration [email protected]
Dianne Glover VP, APG Conferences [email protected]
Anu Murthy Director, Federal Affairs [email protected]
David Allen Director, Communications [email protected]
David Gonzalez Senior Legislative
Advocate
Shelley Robinette Federal Affairs Manager [email protected]
Nelson Maldonado Executive Assistant [email protected]
Annette Sánchez Administrative
Coordinator
Myles Oliver Administrative
Coordinator
Norma Springsteen Administrative
Coordinator
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YOUR NETWORK: 300+ MEMBERS
Contact information for all of our members is available on the APG Member website
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EXAMPLES
Thank you!
Questions?
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