8:00 REGISTRATION & WELCOME COFFEE
8:50 CHAIRPERSON’S OPENING REMARKS
John (JD) Donnelly, Founder & CEO, FRONTRUNNER HC
9:00 OPENING ICE BREAKER: SHARING INSIGHTS INTO EFFICIENT METHODS TO REMAIN UPDATED ON HEALTHCARE MARKET TRENDS IMPACTING REIMBURSEMENT
Through this interactive session, participants in the event are given the unique opportunity to meet with fellow delegates and speakers, all while exchanging tips on preferred methods to collect market intelligence, ultimately kicking off the event knowledge-sharing and networking platform.
9:30 PAYER ROUNDTABLE DISCUSSION: UNVEILING PERSPECTIVES INTO DIAGNOSTIC REIMBURSEMENT REQUIREMENTS
• Comparing coverage & reimbursement decision-making mechanisms
• Focus on the quality & quantity of evidence to demonstrate value
• Perspectives into partnerships with providers & value-based agreements
MODERATOR:
Christopher Ho, MYRIAD GENETICS
PANELISTS:
Dirk Slaker, OPTUM HEALTH SOLUTIONS
Krystal Revai, HEALTH ALLIANCE
Eugean Jiwanmall, INDEPENDENCE BLUE CROSS
10:15 COFFEE & NETWORKING BREAK
10:45 FIRESIDE CHAT: SHEDDING LIGHT ONTO LBM DIAGNOSTIC TEST REVIEW PROCESSES
With the prominent position that Laboratory Benefit Managers have progressively taken in the reimbursement landscape, laboratories and test manufacturers alike are eager to secure a deeper understanding of the review process itself and differing requirements from one organization to another. Through questions coming directly from the audience, LBM representatives in this session will provide replies enabling a clarified approach to diagnostic test value assessment.
Tara Burke, VP, Payment & Healthcare Delivery Policy, ADVAMED
Ben Horton, VP, Medical Director, AVALON HEALTHCARE
11:30 THE CRITICAL PATH: STRATEGIES TO MAXIMIZE REIMBURSEMENT VIA PLA & CPT CODES
• Evidence requirements for PLA vs Cat I CPT codes
• Applicable timelines & processes for code obtention
• Payer acceptance & coverage of PLA vs Cat I CPT codes
• Implications on pricing strategy for both coding pathways
Eric Lam, Sr. Director of Market Access, HULL ASSOCIATES
12:15 LUNCHEON FOR ALL SPEAKERS, SPONSORS & ATTENDEES
1:30 PANEL DISCUSSION: IMPROVING REIMBURSEMENT & PATIENT SATISFACTION BY ENSURING CLEAN ORDERS
• Common desire that payers, providers & labs may share: A clean order
• Critical points hindering clean orders:
» Inaccurate patient data
» Prior authorizations
» Medical Policy
• Proactive approach to problem-solving by leveraging smart technology
• Benefits in approaching reimbursement from the front end
• Reducing claims denials, wasted time & patient/physician dissatisfaction with a clean claim
MODERATOR:
John (JD) Donnelly, FRONTRUNNER HC
PANELISTS:
Ryan Hortin, MYRIAD GENETICS
Matt Collins, MEDLAB2020
2:15 MAXIMIZE INSURANCE REIMBURSEMENT USING ACTIONABLE ANALYTICS
• Reimbursement environment complexities for newer diagnostic tests
• Advanced analytics to pinpoint areas of improvement
• Actionable analytics beyond standard financial metrics & KPIs
• Varied & multidisciplinary approach to common actions to optimize reimbursement
• Examples of analytics triggering a change to the reimbursement strategy
Tom Cronin, VP of Client Services, QUADAX
Chad Miles, Director of Client Services, QUADAX
3:00 COFFEE & NETWORKING BREAK
3:30 WHOLE GENOME SEQUENCING – IS BIGGER BETTER?
• What is a Genome
• When is it important to test
• Pro & Con of testing
• Open dialogue on audiences thoughts
Debbie Windsor, VP Market Access, GENEDX
4:15 CLARIFYING THE NO SURPRISES ACT & IMPLICATIONS FOR LABS & MANUFACTURERS
• Rationale for & implementation of the act
• Areas of impact on laboratories & developers
• Legal considerations for a robust compliance strategy
• Opportunities & positive outcomes to expect
Brian Carey, Partner, FOLEY HOAG
5:00 FIRESIDE CHAT: PROS & CONS TO ADVOCATING FOR LABORATORIES IN THE WAKE OF MEDICARE & PAMA
• Realistic approach to Medicare & PAMA frameworks
• Clarifying lobbying initiatives from independent organizations
• Paths forward & projected outcomes in the short & long term
Tara Burke, ADVAMED
Rob Dumanois, THERMOFISHER SCIENTIFIC
5:30 CLOSING REMARKS AND END OF DAY 1