CCA - The Forum 10 and Integrated Care Summit

How would you like your name to appear on your certificate?

Profession

What activities did you attend at the event?

Wednesday, October 13 - 1:00 pm - 2:00 pm - Continuum of Care Series

Wednesday, October 13 - 2:15 pm - 3:15 pm - Educational Sessions

Wednesday, October 13 - 3:45 pm - 5:15 pm - Plenary Session

Thursday, October 14 - 9:30 am - 11:00 am - Plenary Session

Thursday, October 14 - 12:30 pm - 1:30 pm - Educational Sessions

Thursday, October 14 - 3:00 pm - 4:00 pm - Continuum of Care Series

Thursday, October 14 - 4:30 pm - 5:45 pm - Plenary Session

Friday, October 15 - 8:45 am - 9:45 am - Educational Sessions

Friday, October 15 - 10:00 am - 11:00 am - Educational Sessions

Friday, October 15 - 1:00 pm - 2:00 pm - Educational Sessions

Friday, October 15 - 2:15 pm - 3:15 pm - Educational Sessions

Agreement

By completing this form, you attest that you have participated in all selected activities in thier entirety.

I agree

Please rate the following:

The program was relevant to my work.

Content matched stated objectives.

Usefulness of handouts/AV.

Quality of facilities.

How well did the educational sessions give a balanced view of therapeutic options, including the use of generic names?

If you rated any of the above questions with 'fair,' 'poor,' 'disagree,' or 'strongly disagree' please explain:

Please rate the speaker(s) as a group. You will have the opportunity to elaborate on an individual speaker in the following question.

Objective 1: Compare solutions to improve employees health and lower the benefits cost trend.

By meeting the above objective my professional competence will increase because I have acquired new strategies. By implementating these newly learned strategies my patient outcomes should also improve.

If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:

Objective 2: Define the latest science and tools to evaluate program outcomes.

Having completed the activity, please rate your ability to meet each of the following objectives:

Discuss the employee perspective on their use of value-based benefits, incentives and their role in improving and managing their own health.

Review the provider’s viewpoint of employer-sponsored health benefits and health promotion programs.

Describe ways to better engage the health care consumer, and the importance of stakeholder collaborations to achieve maximized outcomes.

List five key pillars of a population health management program and core metrics corresponding to each.

Describe a framework for incorporating health as a part of an employer culture and evaluating systems-level processes.

Analyze key factors driving program participation and outcomes; Who participates? Who benefits? How are the two related?

Identify the key competencies, knowledge, skills and background that must be possessed by professionals engaged in care coordination regardless of title.

Discuss the key findings of the largest (nearly 7000 multidisciplinary professionals) and latest (2009) Role & Function Study conducted by the Commission for Case Manager Certification and the implications for the prevention, care coordination and wellness community.

Describe how these competencies contribute to organizational goals and objectives such as accreditation, regulatory compliance, and risk management as well as their potential in pay-for-performance and value-based purchasing initiatives.

Demonstrate how proactive member outreach around preventive women's health topics (including timely screening reminders) can help identify potential cases of depression in a target population and connect them with supportive resources.

Explain how automated, interactive, phone-based outreach can share member-specific and age-specific education and support around preventive health and drive behavior accordingly.

Describe how analytic and design learnings can be applied to dramatically increase member engagement in health topics.

Evaluate a physician-designed and implemented pay-for-performance program that improves clinical outcomes, costs and utilization measures.

Describe methods used to improve provider-driven chronic care management in a private practice setting.

Assess the impact of improved chronic care management on patient risk profiles and measured risk scores over time.

Analyze a pervasive population, along with its utilization patterns and overall health, to improve outcomes.

Define and identify the high-utilizing, substance-dependent population and the size of the problem.

Explore the use of predictive modeling within the substance-dependent population.

Demonstrate the need for and value of diabetes management programs in the workplace setting for both employees and employers.

Compare and contrast two workplace diabetes management delivery models—an integrated value-based design and the NDEP education materials-based program.

Describe the impact of each delivery model on physical, behavioral, and productivity outcomes.

State a basic definition of this online diet lifestyle plan.

Describe the engagement rate brought about by various tools.

Review the weight loss outcomes of this pilot.

Review key barriers to statin adherence, including several barriers that are more significant than cost.

Identify best practices for using IVR technology to improve statin adherence by addressing specific barriers.

Evaluate how continuous quality improvement processes were used to drive higher response rates to IVR prescription refill reminder calls.

Identify the core components of the medical home and how these relate to the need to continue to redesign primary care.

Review the quality metrics and outcomes in the targeted Medicare population.

Describe the skilled nursing facilities model in a medical home and its impact on readmissions.

Identify the demographic and organizational barriers associated with medication adherence.

Describe the influences for and decision-making process taken by the State of Missouri regarding the implementation of a medication adherence program.

Demonstrate outcomes from a formalized medication adherence program, including critical success factors and "lessons learned."

Assess data on medical decision making in the United States from the National Survey of Medical Decisions.

Examine research on the surprising disconnect between patient values and physician perception of patient values.

Define the value of shared decision making, including patient decision aids, in helping realign patient and physician perceptions and information so that optimal care can be delivered.

Examine the relationship between TCM and readmissions.

Define readmission predictors.

Demonstrate the value of a post-hospitalization, telephonic, RN case manager-led TCM program.

List national goals for improving care for persons with advanced illness and those approaching end of life.

Demonstrate the value of using predictive modeling for the large-scale identification of individuals needing end-of-life support.

Analyze the potential of telephonic end-of-life counseling as a promising approach for improving quality while simultaneously reducing costs.

Utilize the power of a full replacement, high-deductible medical plan to encourage healthful behaviors.

Describe a cascading approach to education, financial incentives and execution.

Discuss innovative tools and partners to create and sustain a culture of health.

Apply incentives and health quality for all stakeholders.

Identify the qualities of community health innovation.

Evaluate the effectiveness of an alliance in providing pharmacy consultative services.

Define the role of the The Office of the National Coordinator for Health Information Technology under health care reform to promote public- and private-sector wellness and prevention initiatives.

Analyze the implications of the 2009 HITECH Act and and how population health management fits within the Act's meaningful use framework.

Explain how HIT contributes to wellness and prevention efforts.

Review decades of scientific research on human motivation and the mismatch between what science knows and what business does—and how that affects every aspect of life.

Examine three elements of true motivation, autonomy, mastery and purpose, to motivate people for today's challenges.

Apply intrinsic rewards to health care; specifically, how to motivate people to be healthier.

Examine the functions of the quality enterprise and NQF's role in working together with you to fulfill those functions.

Review the NQF's integrated framework for performance measurement, including their role with the Department of Health and Human Services to establish a portfolio of quality and efficiency measures for use in public reporting, payment and quality improvement.

Explore the measurement implications of payment reform models that hold promise for driving positive change in health care financing and delivery.

Discuss the concept and definition of clinical groupware and mission and goals of the Clinical Groupware Collaborative (CGW).

Describe clinical groupware platforms and applications that are interoperable, modular and plug-and-play.

Apply the shifts in health information technology landscape into opportunities for the population health management community to partner with CGW platforms and applications.

Examine advanced models of primary care, such as the patient-centered medical home.

Analyze the challenges and obstacles that small physician practices encounter in the process of transforming into medical home practices.

Describe a new framework in which providers and practices could collaborate with population health improvement organizations to achieve optimal patient outcomes.

Analyze the recently mandated creation of an Innovation Center within CMS is to foster patient-centered care, improve quality and slow the rate of Medicare cost growth.

Illustrate what the Center means to the industry – opportunities it creates and challenges it will help overcome.

Discuss what the future in healthcare may look like.

Review the impact of ethnic-specific messaging on colorectal cancer screening rates and how this differs by ethnicity.

Examine how engagement is influenced by the gender of the voice in communications outreach.

Identify how to use predictive algorithms to project race and ethnicity to support tailored communications.

Identify the unique characteristics and challenges of managing chronic conditions in individually insured populations.

Review outcomes of a randomized controlled study of a disease management program on the individually insured population.

Cite insights that support the necessity of managing chronic conditions in an individually insured population and promising early results of its effectiveness.

Utilize patient-specific data to target and stratify patients for intervention.

Illustrate how early detection of infection of the lower extremities and intervention impacts the risks of more serious complications in diabetics.

Review data analytics that support care management initiatives through the identification and stratification of and interventions for patients with complex conditions.

Create a corporate culture and environment that encourages employees to reach their maximum wellness potential.

Examine Johnson & Johnson and SJE-Rhombus' comprehensive programs and results.

Debate the importance of providing programs to create a "Culture of Health" for effective and sustained behavior change.

Describe incentives that drive improved health outcomes through behavior change, community leadership and meaningful rewards.

Identify the connection between behavioral health and sustainable health improvement.

Summarize the qualities of community health innovation.

Discuss how mobile technology can be leveraged to deploy highly effective and engaging behavior change and adherence tools.

Cite clinical research on the impact of mobile health solutions on health and cost outcomes for diabetes care.

Examine a pilot implementation of a mobile phone-enhanced disease management program.

Apply the construct of well-being to lost productivity.

Compare a new measure of productive well-being to two established measures of productivity.

Examine how productive well-being can serve as an outcomes measure and a diagnostic tool for tailoring counseling to enhance well-being and productivity.

Review Deloitte’s third annual Survey of Health Care Consumers and the role that consumers play in the health care system.

Evaluate the expanding role of the Internet in consumers’ lives – more than half of consumers (55%) have looked online for information about health care treatment options.

Examine how Americans use social networks to find fellow patients, discuss their conditions and leverage other consumers’ knowledge before making health care decisions.

Define the real levers of behavior change.

Examine innovative approaches to identification and engagement of high-risk individuals.

Analyze how principles of behavior change can be used to implement wellness support for metabolic syndrome, which includes weight and tobacco components.

Evaluate the level of evidence assessing the relationship between medication adherence and improved clinical, utilization and economic health outcomes.

Identify gaps in the adherence evidence across highly prevalent and/or costly disease states and its impact on population health.

Demonstrate the important role physicians play in influencing patient medication adherence behaviors.

Define binge eating and its little-known relationship with obesity.

Summarize the impact of binge eating on health and its surprising effect on workplace productivity, as reflected by data from a large sample of binge eaters.

Discuss innovative population health interventions for screening, prevention and remediation of binge eating problems, along with data on participation and outcomes.

Examine the challenges, costs, and barriers of adherence to diabetes care.

Identify the key areas of communications improvement between patient, provider and health plan.

Review the value based design matrix for chronic care management, wellness and care delivery.

Apply outcomes measures and data requirements to each stage of value based design.

Explain the dividends that can be gained through the use of the design by reviewing successful case studies that are specific to each stage and category of value based design.

Analyze how the Patient Protection and Affordable Care Act—the health care reform law—will affect employer-sponsored wellness programs and financial decisions.

Examine whether health reform will contain health care costs, encourage more healthful lifestyles and achieve key workforce management goals, such as improving productivity.

Describe the best new strategies for engaging workers in health and wellness programs.

Review the major effects of ICD-10 on population health management's value chain.

Identify business and information technology architecture (e.g. downstream dependencies, medical policy, claims transactions, vendor feeds, authorizations and referrals, predictive modeling, data warehouse, etc.) of ICD-10 impact areas as it relates to people, process and technology.

Define key strategic opportunities offered by ICD-10.

Examine a cost-effective mechanism for chronic disease management in primary care offices.

Demonstrate a proactive patient outreach program based on the patient-centered medical home (PCMH) that integrates the personal physician, patient-centric care, services, quality and safety.

Discuss lessons learned during the implementation of an automated chronic disease management program.

Describe the Illinois ABD program, including specific program interventions and objectives for impacting medical and behavioral health conditions.

Explain the importance of rigorous program design and evaluation methodology, as seen in the panel data and multivariate regression analysis of the Illinois program.

Review the results of a dose response analysis to identify the optimal number of condition-specific disease management contacts needed to reduce inpatient admissions and re-admissions and emergency department visits.

Analyze the new population health management evaluation methodology, framework and caveats.

Review the self-reported measures of medication adherence, as well as organizational medication adherence best practices.

Define operational measures, including a new definition of engagement.

Illustrate the employer daily perspective.

Review the Healthiest Maryland Business Initiative, which strives to make the State of Maryland the healthiest state in the nation.

Discuss employer motivations to partner with public health to improve community health.

Examine the components necessary to develop and implement a health management program with strong return on investment.

Discover the financial value of incentives in mitigating the impact of health risks and chronic conditions with a total population.

Evaluate the methodology for assessing return on investment for a health management program.

Review six best practices to achieve maximum engagement in a health management program.

Leverage technology to intelligently recruit populations into appropriate digital coaching programs.

Show how health risk assessment data can inform participation strategy.

Explain how you would recruit, train and launch virtual interdisciplinary teams for different chronic conditions in outpatient clinical settings.

Develop best practices in communication, evidence-based treatment guidelines and patient self-management to build effective virtual teams.

Discuss how the National PACE Association, a nationally recognized geriatric care organization is offering a standardized interdisciplinary team training curriculum for its 71 member programs.

Outline PAM design, empirical backing and the application of this activation model to improve patient outcomes.

Discuss program evaluation, including cost, utilization and clinical findings in the context of patient activation; and the relationship of activation levels to health behaviors, utilization and cost.

Report the use of a patient activation measure in predictive modeling efforts to help better predict utilization demands and target coaching resources accordingly.

Examine the impact of chronic pain in the workplace.

Identify the three levels of chronic pain management to stop the ripple effect of chronic pain in the workplace.

Evaluate outcomes of a study focused on integrated pain management through the use of a digital coaching intervention.

Discuss best practices for designing and sustaining an integrated wellness program.

Measure quantifiable improvements in employee health.

Interpret how this data will help manage overall wellness and cost-savings strategies.

Design a population health management program to address a diverse workforce and overcome initial skepticism.

Integrate union support to promote a company-wide health initiative.

Demonstrate program effectiveness by achieving clinical outcomes, reducing health care costs and changing corporate culture.

Describe the various program factors of patient and physician engagement that correlate to clinical success.

Explain the various barriers to adoption and patient/provider engagement and discuss solutions to overcome these.

Anaylze and compare various effective methods of using technology for chronic disease management in an outpatient setting.

Define the correlation between early patient access and quality improvements.

Identify best practices and specific tools that primary care practices can use to promote early patient access.

Review a program of 25,000 Medicare Advantage patients that increased patient access and improved quality and disease management outcomes.

Examine the Community Life Space model of care.

Summarize best practices, including the structure of an in-home asthma visit program.

Demonstrate program outcomes using logistic regression and propensity score matching.

Adjust health coaching call process and objectives to increase member retention.

Identify how to improve enrollment process and assessment tools to increase engagement.

Analyze existing processes and tools (i.e., call flow, scheduling and quality scorecards) to identify areas for improvement.

Review the importance of timing of delivery of care recommendations and determine strategies to effectively align delivery with provider workflows.

Develop best practices for integrating real-time clinical alerts into already-established office processes and policies.

Examine the benefits for provider offices as a result of receiving and using real-time clinical data triggered by administrative transactions.

Describe effective tools to manage and coordinate the care of large numbers of chronically ill patients using a care guidance approach.

Summarize the organizational structure and operational infrastructure needed to manage a population with a large number of participating providers.

Describe how to build relationships between the patient and provider using online technology.

Outline the rationale to center a model on patient-specific goals.

Name the key activities to transition patients successfully from the inpatient and emergency department settings to home.

List the challenges and define strategies to overcome barriers.

Describe how the doctor-patient mutual accountability incentive model triangulates the interests of consumers, providers and payers by integrating with most any wellness and care management solution to improve both health and health care, which leads to cost containment.

Discuss the scientific evidence that explains the power of information therapy, when combined with precision-guided incentives, to improve health and control costs through consumer health literacy.

Apply lessons learned from trial installations to optimize results with the doctor-patient mutual accountability incentive model.

Discuss the studies that have been conducted to date on the effectiveness of total population health management.

Review evidence of improved clinical metrics and net cost savings from Healthways’ chronic care management and fitness programs for seniors.

Describe evidence of outcomes and lessons learned from an evaluation of disease management programs for asthma, congestive heart failure and diabetes for TRICARE patients.

Identify best practices for using communications effectively to improve adherence to care across a diabetic population.

Objective 4: Analyze innovative HIT strategies to improve wellness and care management programs.

Please answer the following:

Do you believe this activity was appropriate for the scope of your professional activities?

Was the educational content scientifically sound?

Was the educational content free of commercial bias?

Was the mode of education effective to learning?

If faculty spoke about off-label or investigational uses of a product, was that information disclosed to you?

If you answered "No" to any of the above questions, please explain.

Were you solicited by sales personnel in an educational room while you attended this educational activity?

If you answered "Yes" to the above question, please explain.

What did you learn during this activity that you intend to integrate into your scope of practice?

What topics do you want to see the focus of future meetings?

What barriers might you have that would interfere with implementation of new information learned from this training?

How can this training be improved to better impact competence, performance and/or patient outcomes?

Additional comments: