= Approved for Continuing Nursing Education* (Totaling 26.25 credit hours)
= Approved for Live AAFP Prescribed credits (CME)** (Totaling 27.25 credit hours)
System
Transformation
10:15am – 11:00am
Panel Discussion: Extending Excellence to Post-Discharge Care 
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With nearly 45% of Medicare beneficiary episode spending attributed to post-discharge care, providers in value-based programs are increasingly considering what happens when their patients are discharged. In this session, learn how some professionals from progressive hospitals and health systems have taken a more comprehensive approach to lowering costs in post-discharge care using operational, technological, and analytics capabilities to better connect the dots for patients after discharge. (0.75 credit hours)
Speakers: Rodney Reider, Dr. Leslie Sebba, and Dr. Ashok Roy
11:00am – 11:10am
Break
11:10am – 12:00pm
Panel Discussion: The Home as the Key to Success in Value-Based Arrangements 
As Medicare’s value-based programs evolve, provider organizations are increasingly taking on additional risk and responsibility for what happens to patients “beyond the four walls.” While analytics and new technology can help to cultivate a deeper understanding of the patient care journey, a more adequate approach to managing risk begins by interacting with patients in their communities and in their homes. In this session, innovators in value-based care delivery outline how to capture and address clinical and social needs long before the patient enters the "four walls”. (0.75 credit hours)
Speakers: Laurel Douty, Dr. Maria Han, Lisa Fry
Practice
Transformation
10:15am – 11:00am
New Tools in COPD and Heart Failure
COPD and heart failure are two leading causes of the high cost of care in our country and are also the leading causes of morbidity and mortality. To improve the outcomes for these patients, we must implement new methods of care. Engage with us as we discover new ways to care for patients with chronic disease by identifying those at highest risk and developing new techniques to care for them. (0.75 credit hours)
Speakers: Kim Morgan, Amy Dossey, Ashley Kilpatrick, and Beth Tracy
11:00am – 11:10am
Break
11:10am – 12:00pm
Panel Discussion: Lessons Learned in COPD and Heart Failure
Learn from those who can explain what it is like to launch Caravan Health’s new COPD or Heart Failure programs. Learn what worked well and what they would do differently. (0.75 credit hours)
Speakers: Ashley Kilpatrick, Beth Tracy and Heather Hanson
Primary Care
Leadership
10:15am – 11:00am
Provider Spotlight: Compensation & Career Satisfaction
When health system objectives and provider objectives don't align, it is hard to accomplish... well... anything. When you shift focus to operational processes and quality you can better align what the system wants to accomplish and what providers want to accomplish. Learn from three different Caravan-supported ACO partners about how they did just that and saw success in their provider satisfaction, patient outcomes, and overall team alignment and communication. (0.75 credit hours)
Speakers: Keith Hiatt and Brian Muckerheide
11:00am – 11:10am
Break
11:10am – 12:00pm
Provider Spotlight: Aligning Staff Incentives
When health system objectives and provider objectives don't align, it is hard to be successful. When you shift your focus to operational processes and quality you can better align your goals. Learn from three Caravan Health ACO partners about how they successfully aligned to improve their provider satisfaction, patient outcomes, and overall team communication. (0.75 credit hours)
Speakers: Michael Ryan, Billi Jo Hennika, and Dr. Verlin Janzen
12:00pm – 1:00pm
Networking Lunch
1:00pm – 2:00pm
General Session
1:00pm – 2:00pm
Promoting Health Literacy: A Focus on Older Adults
Only 12 percent of the U.S. adult population has the highest proficiency level of health literacy. This increases to 39% when we include adults aged 75 and older. Join in a conversation about the role of health literacy, how to make appropriate care decisions regarding cancer screenings, and how providers can adopt strategies for communicating effectively with elderly patients to reduce health disparities. (1.0 credit hours)
Speaker: Dr. Tamara Cadet
1:30pm – 4:00pm
Coach's Corner
Coach’s Corner is an opportunity for clients attending the 2022 Accountable Care Symposium to receive 1:1 Coach support. Register for a 15-minute time slot to review a topic of your choosing with a Caravan Subject Matter expert in order to deepen your understanding and share best practices for using Coach. Register Here>>
2:00pm – 2:15pm
Break
2:15pm – 5:00pm
Afternoon Breakout Sessions
Select an educational track to follow for breakout sessions, or mix and match. See track and session details below.
System
Transformation
2:15pm – 3:00pm
Post-Acute Care Navigator: Strategies & Results
There are various strategies and tactics to tackle the complex world of post-acute care (PAC). Team-based care in the primary care setting can lead to improved patient outcomes and better-quality success and a team-based strategy is also essential to successfully navigating post-acute strategies. Learn how incorporating a team-based care approach can help lead to better care for patients who are transitioning from a SNF to their home. (0.75 credit hours)
Speakers: Marie Harris and Paula Price
3:00pm – 3:10pm
Break
3:10pm – 3:55pm
Panel Discussion: Lessons Learned from Partner Networks in Post-Acute Care
Support ACO success with the development of a post-acute care collaborative within your local or regional hospital service area. In this session, learn how to establish metrics and clinical integration with participating SNFs to help facilitate care transitions for patients discharged from the hospital. In partnership, learn how to manage the transition to community resources and help reduce hospital readmissions and improve quality. (0.75 credit hours)
Speakers: Kristine Miller and Dr. Christi Taylor
3:55pm – 4:05pm
Break
4:05pm – 4:55pm
Panel Discussion: Maximizing Your 340B Strategy
Hear the lessons learned from healthcare professionals who implemented 340B drug discount strategies. (0.75 credit hours)
Speakers: Jill Ender and Chris Todd
Practice
Transformation
2:15pm – 3:00pm
Strategies for Assessing Patient Education Materials
A comprehensive approach to increasing health equity and decreasing health disparities includes assessing and adapting patient education materials. When patient education materials are written at high literacy levels, we are not helping to ensure positive patient outcomes. Join in an interactive session to learn how to use one technique, the simple measure of gobbledygook and SMOG, to assess the reading grade level of your materials. (0.75 credit hours)
Speaker: Dr. Tamara Cadet
3:00pm – 3:10pm
Break
3:10pm – 3:55pm
Panel Discussion: Assessing Health Literacy
Patient non-adherence can have a seriously negative impact on patient outcomes. Non-adherence can be mistaken for a patient who does not want to participate in their care; however, non-adherence can be a complex issue that takes a team-based approach to fully unravel. Hear directly from caretakers in the field who strive to dismantle these “silos” and open the lines of communication between care coordinators, providers, and patients to remove barriers to care, identify healthcare biases influencing the patient’s care, identify community resources to help the patient be successful, and build a relationship of trust between all parties. (0.75 credit hours)
Speakers: Kelly Fluharty and Amanda Reynier
3:00pm – 3:10pm
Break
4:05pm – 4:55pm
Strategies for Closing the Health Equity Gap .png?width=20&height=20 "CNE-Credit-Available50px-(1).png")
Eliminating health disparities has moved from a public health goal to a necessity for health plans, hospitals, and health systems reeling from a relentless pandemic and social injustices. Achieving health equity will require that it is not just recognized, but also prioritized. This necessitates a focused investment and collaboration to rethink how we deliver and define the value of care. Hear from the operations director at Patient Quality Alliance to learn how they used HCC capture targeting high-risk chronic condition patient groups to improve health equities in their community. (0.75 credit hours)
Speakers: Brad Rogers, Randee Hokanson, Katelyn Chandler, and Jennifer Bell
Primary Care
Leadership
2:15pm – 3:00pm
100% Virtual Collaborative Care to Beat Clinician Burnout
Physician experts share how implementing virtual collaborative care between behavioral health and primary care has helped to increase levels of joy and satisfaction in their practices. The session will highlight the benefits of collaborative care practices and explain the steps that have helped to reduce administrative burden and increase physician satisfaction prior to, and throughout, the pandemic. (0.75 credit hours)
Speakers: Dr. Eunice Yu, Dr. Doree Ann Espiritu, and Dr. Emmanuel Dizon
3:00pm – 3:10pm
Break
3:10pm – 4:55pm
Mentally Healthy Staff = Great Clinical Outcomes: Building a Culture of Replenishment
(In-person exclusive)
Listen to this interactive discussion about the ways the pandemic has disrupted the working environment for healthcare professionals and how to begin replenishing the workforce for clinicians and non-clinicians to continue to improve patient care outcomes. The ultimate outcome is the ability to continue to improve clinical outcomes for our patients. (1.5 credit hours)
Moderator: Dan Collard
Thursday, May 26
6:30am – 7:00am
Walk & Talk - Wellness Program
Caravan Health’s Journeywell team is hosting a morning Walk-and-Talk featuring scenic views of the bayfront and downtown San Diego.
6:30am – 8:00am
Onsite Registration and Breakfast
If you haven't yet, sign in and collect your badge and some Symposium gear. Then, join other symposium attendees for breakfast.
8:00am – 10:30am
General Session
8:00am – 8:55am
Impacting Patient Care with a Replenished, Engaged Workforce
When maximizing the most important “capital” in your organization, your human assets, think beyond piecemeal “fixes.” A comprehensive approach is required that encompasses an array of interconnecting components that form an effective ecosystem to engage and retain talent. Quint Studer will introduce the six components of the ecosystem and provide sample tools and techniques to fully engage and motivate your workforce to provide the highest quality of patient care. (0.75 credit hours)
Speaker: Quint Studer
8:55am – 9:00am
Accountable Care Organizations Population Health Award Winners
Moderator: Greg Paris
9:00am – 9:45am
Meeting of the Minds: Partnering with CMS to Shape the Future of Patient Care
Listen as Tim Gronniger and Liz Fowler discuss how to succeed in value-based care programs and the importance of partnering with CMS. They will talk about the future of CMS and cover health equity, social determinants of health, the new ACO REACH model, and how to continue delivering high-quality care in the evolving field of healthcare. (0.75 credit hours)
Speakers: Liz Fowler (virtual) and Tim Gronniger
9:45am – 10:00am
2023 ACO Options: Basic, Enhanced, or REACH. Which one is right for you?
The REACH ACO Model provides new and enhanced opportunities for safety net providers to help improve quality of care. As you consider your next steps in accountable care, there are several important factors that should be considered. Join Lynn Barr, Founder, Caravan Health, and Chief Innovation Officer, Signify Health to hear about new ACO options that are expected to significantly improve care for the underserved and reward providers for delivering whole patient care.
Speakers: Lynn Barr
10:00am – 10:30am
Legislative and regulatory briefing: The latest from Capitol Hill
Get the inside track on healthcare policy priorities that stand to impact how healthcare is paid for and delivered. Experts will provide views from inside the beltway on the issues that will likely shape our industry, including the latest on CMS’s strategies to enhance value for beneficiaries in Medicare, Medicaid, and marketplaces, and how healthcare politics in an election year will or will not affect change. You will walk away from this briefing with fresh insights that will inform risk adjustment, population health, and cost-management strategies. (0.5 credit hours)
Speakers: Jennifer Young and Kimberly Brandt
10:30am – 10:45am
Break
10:45am – 12:30pm
Morning Breakout Sessions
Select an educational track to follow for breakout sessions, or mix and match. See track and session details below.
System
Transformation
10:45am – 11:35am
Panel Discussion: Clinical-Community Linkages to Improve Patient Care
Community paramedicine programs expand the roles of EMS professionals to provide health services in places where access to physicians, clinics and/or hospitals may be difficult, such as rural America. In this session, experts from McKenzie Health System will discuss the results of their Community Integrated Paramedicine program pilot, which focused on reducing readmission rates, reducing unnecessary emergency department visits, and better chronic care management for their patients. (0.75 credit hours)
Speakers: Karen Dickinson and Billi Jo Hennika
11:35am – 11:45am
Break
11:45am – 12:30pm
Key Resources to Prevent Post-Acute Bounce Back 
Prevent the post-acute bounce-back! Learn how Reid Health partnered with nursing homes to stop the revolving door and decrease nursing home readmissions by taking an inside-out approach as well as developing a Community Paramedic Program to reduce unnecessary emergency room visits. (0.75 credit hours)
Speakers: Shannon Fanning and Billie Kester
Foundational:
Practice
Transformation
10:45am – 11:35am
Risk Adjustment in Team-Based Care
When patient complexities are communicated properly, your pool of high, medium, and low risk patients becomes more accuate. This is why it is so important to ensure that all of your patients' conditions are reflected in your documentation. But this documentation doesn't have to be the work of just one or two individuals. Come learn about how you can incorporate your entire team into coding and billing to help both relieve responsibilities and also paint a better picture of your patient population. (0.75 credit hours)
Speakers: Caroline Mei
11:35am – 11:45am
Break
11:45am – 12:30pm
Panel Discussion: Becoming Better Coders
Do you have specific questions for coding, billing, and scheduling experts? Bring your questions to this interactive discussion. This panel will be an open forum to learn more about how to utilize your resources to better represent your patient population. (0.75 credit hours)
Speakers: Krystyna Sienkiewicz, Kristin Kohl, and Jayden Miracle
Advanced:
Practice
Transformation
10:45am – 11:35am
Panel Discussion: Advances in Episodes of Care Programs and Bundled Payments
Episodes of care and bundled payment programs have become prominent value-based care arrangements for government and commercial payors. In this session, attendees will hear from episodes and bundled payment experts about recent policy developments, continued episode expansion from Medicare’s BPCI, a program to commercial payors, the interface and implications on other alternative payment models, and considerations for those deciding to participate in episodes and bundled payment arrangements. (0.75 credit hours)
Speakers: François de Brantes and Kim Holland
11:35am – 11:45am
Break
11:45am – 12:30pm
Understanding Quality in Episodes of Care Programs
The delivery and measurement of quality in value-based programs have been an increasingly hot topic of debate as a growing number, and variety, of value-based programs has been introduced. In this session, experts dive deeper into the clinical aspects of episodes of care and bundled payment program participation for Medicare and commercial programs, including how to measure success, and key quality levers. (0.75 credit hours)
Speakers: Sage Nakagawa and Dr. Amita Rastogi
Primary Care
Leadership
10:45am – 11:35am
Communication: The Key to Care Coordination
The active engagement of senior leaders in care coordination is pivotal to a successful program. The use of evidence-based communication techniques, team-building initiatives, and leadership strategies are equally important. Take a journey with one organization and peek into the program then and now. Learn how a department of one RN care coordinator grew into an award-winning, highly successful Medicare annual wellness visit clinic. (0.75 credit hours)
Speaker: Michelle Franklin
11:35am – 11:45am
Break
11:45am – 12:30pm
Improve Your Communication: Huddles and Team-Based Documentation
Whether communication was never delivered or never received, there is always a risk of patient harm when communication breaks down. Effective communication can take place in a variety of ways, and it is important to determine which variation works best for everyone involved. If you have questions about how to get your team to communicate better, learn new strategies to make sure nothing slips through the cracks. (0.75 credit hours)
Speaker: Daniel Nelson
System
Transformation
1:30pm – 2:20pm
Panel Discussion: The Dynamics of Primary and Specialty Care in a Value-based World
In a value-based care environment, the dynamics between primary and specialty care are becoming more important as new government and commercial risk models emphasize co-management to drive optimal patient outcomes. Join industry experts as they discuss the importance of primary care in co-managing patients within specialty networks, obtaining the best possible specialist referrals, and engaging community specialists to drive horizontal integration with primary care and specialty care, rather than the classic vertical integration through health systems and hospitals. (0.75 credit hours)
Speakers: Francois de Brantes and Dr. Rachel Reid
2:20pm – 2:30pm
Break
2:30pm – 3:15pm
Panel Discussion: The Benefits of Partnering with Specialty Networks
Even though specialty care makes up a significant portion of total medical spending, specialty care providers are often left behind in value-based payment and care delivery transformation. In this session, leaders in specialty-based networks share their perspectives on how specialists can best engage with other providers and facilities to participate and collaborate in a value-based ecosystem. (0.75 credit hours)
Speakers: Francois de Brantes, Dave Spalding, and Kelsey Mellard
Foundational:
Practice
Transformation
1:30pm – 2:20pm
Using Pre-Visit Planning to Improve Scheduling
Patient visits start long before the patient walks in the door because a significant amount of patient information can be gathered prior. What is the best strategy to collect this information? How can you best utilize your team to make sure that the right information is not only gathered but also communicated to the proper people? Learn these answers and discover ways to improve your pre-visit planning and scheduling strategies to make the biggest impact in your clinic. (0.75 credit hours)
Speakers: Francesca High and Kari Loken
2:20pm – 2:30pm
Break
2:30pm – 3:15pm
Reducing Unnecessary ED Visits
Patients visit the Emergency Department (ED) for various reasons, but how can you make sure those visits are warranted? Is there a particular communication strategy that should be used with certain patient populations? By focusing your efforts on patients who are more likely to visit the ED and enhancing communication efforts, there are opportunities to help patients reduce unnecessary ED visits and provide better continuity of care. (0.75 credit hours)
Speakers: Dr. Steven Reeves, Stacy Coco-Curry, and Ifeekam Ozonuwe
Advanced:
Practice
Transformation
1:30pm – 2:20pm
Best Practice Tips in Care Management
The transition from hospital to home, or SNF to home, can be a struggle for patients. It is important to provide best practice support in the transition of care. Knowing an entire primary care team is on hand to provide support during these transitions will help to improve patient satisfaction and compliance which can decrease the risk of readmissions and help to improve the continuity of care. (0.75 credit hours)
Speakers: Paula Price and Ashley Kilpatrick
2:20pm – 2:30pm
Break
2:30pm – 3:15pm
Hybrid Presentation: The Role of Technology in Remote Patient Monitoring & Advanced Care Management
With remote patient monitoring (RPM), we now have the capability to treat the conditions our patients live with, as opposed to merely treating the symptoms as they present during a 15-minute office visit. Learn how to implement various technologies to improve your RPM, discover the keys to successful implementation, learn about the coding and billing requirements for RPM, and hear patient success stories. (0.75 credit hours)
Speaker: Melissa Hayse
Primary Care
Leadership
1:30pm – 2:20pm
Utilizing Continuous Glucose Monitoring and Managing High-Risk Patients with Diabetes 
Continuous glucose monitoring (CGM) technology has changed the face of diabetes management and has been a key factor in improving diabetes outcomes for a small rural health clinic over the past five years. CGM provides 24/7 glucose data that healthcare providers use to make informed and safe therapy adjustments for patients with diabetes which leads to higher patient and clinician satisfaction and better patient outcomes. Learn how you can start the framework for a successful CGM in your clinic. (0.75 credit hours)
Speaker: Sara Gaul
2:20pm – 2:30pm
Break
2:30pm – 3:15pm
Panel Discussion: Better Management of High Risk Patients with Diabetes
Do you have questions surrounding high-risk patients with diabetes? Or how to utilize various technologies that contribute to better diabetes care? Learn how you can apply these diabetic care management strategies to your patients with diabetes and expand the steps to care for other patients with chronic diseases. (0.75 credit hours)
Speaker: Sara Gaul and Amy Dossey
