Paying for value continues to gain momentum in the industry and presents significant challenges, as well as interesting opportunities for health plans. With the growing acceptance of value-based payments, health plans and providers must transition from the traditional fee-for-service model in order to drive down soaring costs and positively impact patient outcomes.
With this transition, there are many obstacles to successfully implement value-based payment models. Developing the capabilities to effectively respond to change doesn’t happen overnight. Health plans must have flexibility to develop, implement and administer the contracts that reward providers for positive performance and encourage poor performers to improve. Join Independent Health and HealthEdge as they discuss how successful value-based arrangements are based on the real-time exchange of information and shared goals between health plans and providers.
In this webinar, you will learn:
- Why health plans leaders should pay attention to the movement from fee-for-service to value-based payments
- Real-life example from health plans that have developed technology-driven payment strategies
- How the model created by MACRA is impacting commercial contracts
Enterprise Core System Operations
Independent Health
Dave Mika plays an integral role in leading the operations unit at Independent Health, located in Buffalo, NY. He is responsible for the coordination of activities across the organization to more effectively manage workloads and partner closely with individual business unit owners to achieve operational excellence. Prior to his current role, Mika served as director, core systems, and had also served as a business lead for the replacement of the Core Administrative Platform (CAP) – a four-year, multimillion dollar project. He also previously worked as director, claims operations for twelve years, overseeing a staff of 115 employees and the processing of over five million medical and dental claims annually. A former Army Reserve combat medic and Licensed Practical Nurse with more than 30 years of experience in the health insurance industry, Mika has also held management positions in member appeals, provider relations, project management and product development and implementation.
Marketing
HealthEdge
Harry has worked with both payers and providers through many dynamic changes in healthcare for a number of years. He is currently responsible for Marketing at HealthEdge, including product marketing, demand generation and thought leadership. He previously had similar responsibilities at Evariant and NaviNet and has collaborated with many transformative entities across the healthcare landscape. Harry has helped introduce and promote innovative enterprise software solutions that enable payers to improve their competitive effectiveness, as well as perform valuable communications between payers and providers, and allow providers to effectively collaborate with patients and consumers as well as with each other. He is a frequent speaker at industry conferences and forums and contributor to the ‘Edge Report, the HealthEdge blog.
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