How Payers are Supporting
Providers in Value-Based Care
A phased approach to accelerate success
Karen Amezcua, Senior Director, BlueCross BlueShield of Minnesota
Lori Logan, Chief Product and Client Officer
Oraida Roman, Vice President, Humana
Brian Wheeler, Vice President, CareFirst BlueCross BlueShield
Date: May 3, 2021
Time: 12:30pm ET | Duration: 1 hour
In partnership with World Congress Healthcare, we are excited to present this timely and impactful live webinar.
Despite renewed interest triggered by the success of value-based care over fee-for-service during COVID-19, many providers admit they are still unprepared to take on risk.
During this discussion, hear how three health plans are helping providers transition gradually into value-based care models. You’ll learn about their philosophies, programs, results and lessons learned.
Join our panelists to discuss how health plans are supporting providers across:
- Focused solutions to address immediate needs and realize early wins
- New value-based programs – including primary care – that arose during COVID-19
- Common challenges of payer-provider collaboration (and solutions!)
- Deferred care – how payers can help providers find and prioritize patients most in need
Karen Amezcua is senior director, provider partnerships for Blue Cross Blue Shield Minnesota. She has worked in the healthcare industry for nearly two decades. Her responsibilities at BCBS Minnesota include implementing strategic payment arrangements with all major care systems in the statewide provider network, while also assisting with value-based payment methodologies for commercial and government markets.
In a prior role as senior director of accountable care at Lakeview Health, Karen led implementations to support a seamless integrated, coordinated system of care. She managed clinical outcome and system performance measurement to identify areas for quality and cost improvement and risk mitigation. In earlier positions with Lakeview Health, she held senior roles in quality improvement.
Karen holds a Bachelor of Arts in philosophy from Metropolitan State University.
Lori Logan, Geneia’s chief product and client officer, brings a driving passion to improve healthcare by increasing transparency and innovating consumer-oriented solutions with more than 20 years of experience turning visions into pragmatic solutions.
Most recently, Logan was senior vice president, product and innovation, at venture-backed, direct primary care organization, Paladina Health. Prior to joining Paladina Health, Logan led the provider business at TriZetto, a Cognizant company focused on revenue cycle management. She also held leadership positions at UnitedHealthcare, Cigna, McKesson and Choicelinx Corporation. Lori also serves the wider community with her participation in Impact 100. Sitting on their grant committee, she helps oversees the funding of transformational grants to nonprofits in the Metro Denver area.
Lori holds a Master of Science in computer information systems, innovation and technology from Boston University and a Bachelor of Science in business administration from Regis University. In her free time, Lori enjoys spending time in nature, skiing or biking with her family.
Oraida Roman, MHA, is vice president of value-based strategies for Humana, leading the organizational advancement of innovative payment models that enable Humana to support providers as population health managers in value-based care relationships.
The value-based strategy group develops, supports and deploys the best programs, practices and capabilities that assist Humana’s provider partners and internal customers to successfully achieve enterprise value based goals.
Roman’s career with Humana spans more than 18 years, holding various management roles, including Regional President, Director of Operations, and Director of Provider Contracting. Prior to being Vice President for Humana, Roman worked for several years with DaVita Medical Group as the Chief Operating Officer of Florida and Market President of Colorado.
Roman holds a Master’s in Health Administration from University of South Florida and an undergraduate degree in Biology from Florida State University.
Brian Wheeler is responsible for leading the overall provider and network-related business functions, which includes the Practice and Payment Transformation Group, as well as Provider Contracting and Network Strategy, Network Operations, and Provider Relations and Engagement for CareFirst BlueCross BlueShield.
In this role, he is responsible for leading CareFirst’s five-year transition from “Volume to Value.” He is supported in this effort by a team of experts in value- based payment models, practice transformation, data analytics, contracting strategists, and provider-relationship collaborators, dedicated to making healthcare more affordable and accessible for the communities CareFirst serves.
He gained experience in various areas of the healthcare sector for over 20 years, working in in various management roles, ranging from small provider organizations to start-ups to a multi-national Fortune 500 company.
We’d love to hear from you! Contact us and we’ll be right with you.