Insights for Healthcare Leaders & Change-Makers
In the world of digitally transforming healthcare and addressing mandates like the No Surprises Act (NSA,) you can still expect a lot of surprises along the way.

To help the HCEG Network engage with others and keep current with the challenges, issues, and opportunities presented in this new healthcare ecosystem, we’re offering the following in this newsletter:

  • Upcoming Focus Area Roundtables and recaps of previous roundtables
  • An opportunity to participate and learn results of a payer-focused NSA survey
  • A series of five webinars spanning a four week period
  • Resources on 2021 HCEG Top 10+ priorities

Read on, consider joining other healthcare leaders in our roundtables, and don’t be surprised when you learn something new and make a new acquaintance!
Recapping Interoperability Roundtable #1
Our first Focus Area Roundtable on Interoperability took place Tuesday, July 20th with leaders from health plans, health systems, and care providers discussing the barriers to interoperability their organizations are facing, which use cases have the most potential to increase interoperability among stakeholders, and related topics.

Tim Capstick and Ashley Clark of our Focus Area Partner Surescripts served as industry thought leaders providing perspective gained in working with health plans across the nation. 
The following and more were shared by roundtable attendees. Read more in our Part 1 and Part 2 recaps. And consider joining us for the 2nd Focus Area Roundtable on Interoperability on September 8, 2021 at 11:00 AM PT / 2:00 PM ET
Survey on No Surprises Act - Payer Preparedness
HCEG and Change Healthcare are conducting research surrounding health plan/payer preparedness for the No Surprises Act (NSA) scheduled for January 1st, 2022. 

Leaders at health plan/payer organizations are encouraged to complete this short online survey and will receive results if desired.
Roundtables - Opportunities to Connect, Learn, & Share
Leaders at health plans, health systems, and care provider organizations are invited to participate in roundtable fashion at our upcoming Focus Area Roundtables:
Healthcare Policy & ACA Roundtable #3 - August 12th
Our 3rd Healthcare Policy & ACA Focus Area Roundtable takes place Thursday, August 12th at 2:00 PM PT / 5:00 PM ET. 

Topics facilitated by Softheon will include:

  • How recent legislation has added stability to the ACA Marketplace
  • How health plans can position themselves to capitalize on the growing opportunity the Marketplace offers. 
  • Impacts and opportunities related to the 2022 payment notice from CMS including extending Open Enrollment and Special Enrollment Periods.

Request an invite here.
Interoperability #2 - September 8th
The 2nd roundtable on Interoperability is scheduled for Wednesday, September 8th at 11:00 AM PT / 2:00 PM ET. 

The discussion will focus on interoperability-related topics collected during the first roundtable including stakeholder collaboration, electronic prior authorizations, ePrescribing, and other topics of interest to roundtable attendees. Surescripts is the Focus Area Partner for this roundtable.

See the Part 1 and Part 2 recap of the first roundtable and request an invite here.
Payment Integrity #1 - September 9th
Our 1st roundtable on Payment Integrity facilitated by our new Focus Area Partner MultiPlan takes place Thursday, September 9th at 11:00 AM PT / 2:00 PM ET. 

Discussion will focus on topics concerning what is needed in the new healthcare environment to ensure fair, frictionless, payer-provider transactions. Topics in this first roundtable will help drive content to be shared over the following month leading to the 2nd roundtable. Request an invite here.
HCEG Webinar Series
Starting September 21st, HCEG is facilitating a series of webinars highlighting 2021 HCEG Top 10+ priorities including:
Something Old, Something New: Two Health Plan Executives Share Their Experiences in the ACA Marketplace as a Veteran and a New Entrant
Coming off the coattails of our 3rd Focus Area Roundtable on Interoperability on September 21, 2021, we will continue our discussion around seamlessly entering the expanded ACA Marketplace. Softheon’s GM, SVP of Health Plan Cloud, Kevin Deutsch, will join Terry Burke, former VP, GM of Individual Markets at BCBS of Michigan, and Mark Van Elden, CFO at Community Health Choice. Burke and Elden to share their respective experiences as both a veteran and a new entrant into the ACA Marketplace.

Join us on Tuesday, September 21, 2021 at 10:00 AM PT / 1:00 PM ET.
Intelligent Care Management Technology
On Tuesday, September 28, 2021 at 10:00 AM PT / 1:00 PM ET, our new sponsor VirtualHealth will share information on harnessing the power of intelligent care management technology and predictive and real-time analytics to connect payers and health systems to post-acute and community networks, and achieve quality, cost-effective care - particularly in a value-based care payment environment.
Interoperability: Impact of Electronic Prior Authorization & ePrescribing
On Tuesday, October 5, 2021 at 11:00 AM PT / 2:00 PM ET, Surescripts will present a summary of highlights from a series on roundtables on Interoperability including information on leveraging high-value interoperability-related use cases like electronic prior authorizations and ePrescribing.
Increase Member Engagement & Decrease Costs with Virtual 2nd Opinions
On Thursday, October 14, 2021 at 11:00 AM PT / 2:00 PM ET, our new sponsor Medical Review Institute of America (MRIoA) will present how virtual 2nd Opinions help payers and self-insured employers increase member engagement by using evidence-based medicine to educate plan members while decreasing healthcare costs.
“Digital Transformation: Impact & Implications for a Health Plan” - Upcoming Webcast
HCEG is currently working with our sponsor partner Change Healthcare on creating a webcast to share information and insight on the digital transformation of a health plan including:

1. The process for transformation, impacts, and results

2. Ways to differentiate in today's competitive environment such as:
  • Changing organizational dynamics
  • Addressing disparities and inequities in care
  • Responding to shifting federal and state politics/policies
  • Considerations for very different state by state programs

3. COVID impacts that changed thinking on what needs to be done and impacts to the future

Watch for this webcast coming soon
Recent Sponsor Information & News
MultiPlan presents what’s in store for the future of payment integrity and how they are helping health plans make the transition from retrospective to prospective programs.

Read more here
Matthew Albright, Chief Legislative Affairs Officer at Zelis, presents key implications for providers adjusting their systems, processes and technological capabilities to comply with the No Surprises Act (NSA).

Read more here.
Matt Parker, VP of Product at HealthSparq, shares that it’s going to take collaboration between health plans and hospitals – to go above and beyond what’s mandated by the government – in order to transform a muddy mess into something clear.

Read more here
An overview of what research says about second opinions including when patients should get a second opinion.

Read more here
Surescripts shares information on the value of notifying providers - via their EHR’s - of clinical and medication events so that they can address lapses in care, missed care interventions, medication non-adherence, and gaps in care.

Read more here
Eugene Sayan of Softheon, a private exchange technology provider, sat down with Oliver Wyman Partner, Martin Graf, to discuss the possibilities of where the industry may be headed in the next five to ten years

Read more here
A three-part, on-demand webinar series where clinicians and industry experts – including HCEG’s Ferris Taylor and Change Healthcare SVP of Consulting David Gallegos - discuss the evolution of value-based healthcare in the wake of COVID-19. 
Access all three recordings here.
An article from VirtualHealth on integrating coordinated care management to achieve better outcomes for whole-person care.

Read more here
Resources for Healthcare Leaders & Change-Makers
3-Part, On-Demand Webinar Series

A three-part, on-demand webinar series where clinicians and industry experts – including HCEG’s Ferris Taylor and Change Healthcare SVP of Consulting David Gallegos - discuss the evolution of value-based healthcare in the wake of COVID-19.

Access all three recordings here.
Thanks to Our Sponsors
Learn more about our sponsors here. And learn about sponsoring and partnering with HCEG here.
Connect with HCEG
If your or your organization is interested in learning more about becoming a member or expanding your thought leadership and brand awareness, email us at or call 617.302.6224 • 617.302.6224
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