ICYMI: Highlights From the NAMCP Spring Forum 2023

During the National Association of Managed Care Physicians (NAMCP) Spring Managed Care Forum 2023, held April 27-28 in Orlando, Florida, value-based care took center stage, alongside treatment best practices, with speakers presenting topics from a business standpoint.

The meeting brings together health care executives from 3 organizations: the American Association of Integrated Healthcare Delivery Systems, the American Association of Managed Care Nurses, and the NAMCP Medical Directors Institute.

Here are the meeting highlights, and you can still read all of our coverage from the 2023 spring meeting.

5. Dr Mark Socinski: In NSCLC, Biomarker Testing Is Key to Treating Patients Properly

In non–small cell lung cancer (NSCLC), there are FDA-approved therapies for multiple biomarkers that are better than standard chemotherapy for patients who have certain genomic alternations. However, to find the best treatment option, comprehensive testing is necessary, explained Mark A. Socinski, MD, executive director of the AdventHealth Cancer Institute. Conducting genomic testing at the time of initial diagnosis and waiting for the results of the genomic test will help ensure that a patient’s first treatment is the best treatment, he added.

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4. Highlighting Opportunities for Progress in a Changing Health Care Landscape

In 2021, Baylor Scott & White Quality Alliance (BSWQA) was a top performer in the country in terms of generating shared savings with a total of $124.5 million in savings in the Medicare Shared Savings Program. During his presentation, Robert L. Waterhouse Jr, MD, MBA, HSM, chief medical officer at BSWQA, shared his experience implementing value-based care in an extensive health system, including 6 areas from BSWQA’s journey that could pose challenges to performing well in value-based contracts.

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3. How Chronic Care Management Can Benefit Providers and Patients

Irina Koyfman, DNP, NP-C, RN, CEO of Affinity Care Expert, led a session at the spring meeting on the potential of chronic care management (CCM) billing for physicians who are not currently doing it and recommendations for optimizing the process. In 2015, CCM was added to the CMS Physician Fee Schedule. CCM billing covers all care coordination activities that go along with treating complex patients who have multiple chronic conditions, but the complexity of the billing has led many physicians to stop using it.

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2. Interventions for Successful Implementation of Value-Based Care

In the first keynote session of the meeting, Jacque Sokolov, MD, president and chairman at SSB Solutions, highlighted the evolution and expansion of digital health and other health care transformations that were forced due to the COVID-19 pandemic. He also covered the state of the health care market, with a focus on tech company investments into the space.

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1. Value-Based Care: Is It Possible for All Providers to Succeed?

In a second keynote session, Craig D. Pederson, principal at Insight Health Care Partners, LLC, discussed the evolving landscape of value-based care, as well as implementation challenges from the provider perspective. One of the challenges to value-based care is attribution, which is determined after the fact. Another is that fee-for-service (FFS) schedules are not going away entirely, and some providers may stay purely on FFS. Overall, he told providers to approach value-based care with caution because of the significant challenges from a financial perspective.

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