How to Thrive in the Current Health Care Ecosystem: Recommendations for Providers to Address Payer Challenges

Chapter 1: Optimizing Patient Management Through Payer/Provider Communications
Chapter 2: Advancing Overall Value through Multiple Stakeholder Collaborations

• Release Date: March 26, 2018
• Expiration Date: September 30, 2019
• Estimated Time to Complete Activity: 0.75 hour per chapter
• Compatible with all modern browsers and mobile devices

Distinguished Faculty

Vanita Pindolia, PharmD, BCPS, MBA Vice President, Ambulatory Clinical Pharmacy Programs_PCM Henry Ford Health System/Health Alliance Plan of Michigan Click here for biography Mark T. Reding, MD Associate Professor of Medicine Division of Hematology, Oncology, and Transplantation Director, Center for Bleeding and Clotting Disorders University of Minnesota Medical Center Click here for biography Edmund Pezalla, MD, MPH CEO Enlightenment Bioconsult, LLC Click here for biography Jay Bryant-Wimp, RPH Owner/CEO Accurate Rx Pharmacy Click here for biography

Target Audience

• Hematologists, physician assistants, registered nurses, nurse practitioners, social workers, and other health care professionals engaged in the care of patients with hemophilia.

Statement of Need/Program Overview
As the nation’s health care system continues to seek quality improvement and cost reduction, hemophilia providers require enhanced skills to succeed in a changing health care ecosystem.  Furthermore, rapidly evolving payer strategies, including medical necessity guidelines and benefit designs, are affecting patient access and out-of-pocket expenses, which can impact long-term health outcomes for patients with hemophilia.

This activity is designed for both hemophilia treatment center (HTC) and non-HTC physicians, nurses, social workers, and other health care professionals to improve collaboration with various managed care, specialty pharmacy providers, and payer professionals to provide appropriate access and receive adequate reimbursement, and comprehensive care for their patients with hemophilia.

Educational Objectives

Chapter 1
After completing this activity, the participant should be better able to:

• Employ managed care organizations (MCOs) benefit strategies to facilitate coverage for optimal treatment in members with hemophilia
• Utilize communication strategies for hemophilia providers to optimize treatment regimen approvals and coordination of care with various payers
• Apply multidisciplinary strategies for better care coordination with hemophilia treatment center (HTC) pharmacy services and payer driven specialty pharmacy services

Chapter 2
After completing this activity, the participant should be better able to:

• Examine best practice examples in hemophilia management including data collection and analysis, cost management strategies, and the provision of collaborative care
• Provide examples of hemophilia coverage and reimbursement scenarios that will enhance patients’ comprehension of insurance vicissitudes
• Assess economic analyses with current and new hemophilia agents amidst significant scientific and technical advances

Joint Accreditation Statement

In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine, the National Hemophilia Foundation, and Impact Education, LLC.  Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Physician Continuing Medical Education
The Postgraduate Institute for Medicine designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

• Chapter 1: 0.75 CME credit
• Chapter 2: 0.75 CME credit

• Chapter 1: 0.7 contact hour; Designated for 0.2 contact hours of pharmacotherapy credit for Advance Practice Registered Nurses.
• Chapter 2: 0.7 contact hour

Social Worker Continuing Education
This program is Approved by the National Association of Social Workers for 2.0 continuing education contact hours.

• Chapter 1: 1.0 contact hour (Approval #886733890-2232)
• Chapter 2: 1.0 contact hour (Approval #886733890-2233)

DISCLOSURE OF CONFLICTS OF INTEREST
Postgraduate Institute for Medicine (PIM) requires instructors, planners, managers and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest (COI) they may have as related to the content of this activity. All identified COI are thoroughly vetted and resolved according to PIM policy.  PIM is committed to providing its learners with high quality CME activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.

The faculty reported the following financial relationships with commercial interests whose products or services may be mentioned in this activity:

PLANNERS AND MANAGERS
The PIM planners and managers, Trace Hutchinson, PharmD, Samantha Mattiucci, PharmD, CHCP, Judi Smelker-Mitchek, MBA, MSN, RN, and Jan Schultz, MSN, RN, CHCP have nothing to disclose. Impact Education, LLC and the National Hemophilia Foundation planners and managers have nothing to disclose.

DISCLOSURE OF UNLABELED USE
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners.  Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

DISCLAIMER
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

METHOD OF PARTICIPATION AND REQUEST FOR CREDIT
There are no fees for participating and receiving CME/CE credit for this activity. During the period March 26, 2018 through September 30, 2019, participants must 1) read the learning objectives and faculty disclosures; 2) study the educational activity; 3) successfully complete the post-tests with a score of 75% or better; 4) and complete the evaluation forms. Upon completion of each CME/CE activity, your certificate will be made available immediately to download and print.

MEDIA
Internet

FEE INFORMATION
There is no fee for this educational activity.