Top 3 strategies for HMOs to succeed in post Affordable Care Act market environment - GlobalHealth success story partnering with providers and employers

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To succeed in the post Affordable Care Act market environment, with increased high-risk membership coming from healthcare exchanges, GlobalHealth HMO is making quality healthcare affordable and accessible to all Oklahomans by being more engaged with the health of the members.

The Webinar titled “Top 3 strategies for HMOs to succeed in post Affordable Care Act market environment - GlobalHealth success story partnering with providers and employers” will describe how GlobalHealth expects to achieve a potential savings of $10 MM+ annually, a 4+ STAR rating and continued increase in membership through:

  • Collaborative partnerships with local healthcare provider organizations
  • Innovative care management and population health management using predictive risk analytics
  • High touch member engagement enabled through risk stratification

The speaker, David Thompson will share their story on Global Health’s success in reducing PMPM cost while improving the patient outcomes and patient satisfaction.

Key Learning Points:

  • Risk and Cost Stratification of members and designing individualized outreach programs with a narrow focus on these stratified groups
  • How to develop a 360 degree view of the patient risk profile with a combination of clinical and non-clinical risk factors.
  • Understand how predictive analytics can be used to identify “Hidden” opportunities
  • Design high touch focused care management programs
  • Share the Outcome results from GlobalHealth’s programs

Speaker Profile:

David is the Vice President of health plan operations for GlobalHealth, Inc.; an Oklahoma based health maintenance organization (HMO). He is responsible for all operational aspects of the business including benefits administration, membership eligibility & enrollment, clinical case management, pharmacy and behavioral benefit management, quality improvement, provider contracting, claims processing and health plan customer service.

David brings 15 years of healthcare experience to GlobalHealth, Inc. as a former financial controller with a national specialty hospital system and as a former management consultant with a top 10 national CPA and consulting firm. During his tenure with the hospital system, he served as the lead on initiatives that enhanced healthcare data management and reporting by way of streamlining information system exchanges and improving process and procedural integrity. During his tenure with the firm, he served in a client service capacity by identifying and helping implement financial and operational solutions to a national provider client base.


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