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Wichita Association of Health Underwriters
7th Annual Healthcare Symposium
April 6, 2017
~ 2 ~
Wichita Association of Health Underwriters
Presents the 7th Annual
HEALTHCARE SYMPOSIUM
7:30 am – 7:55 am Registration and Breakfast
7:55 am – 8:00 am Welcome – WAHU President, Jennifer Elliott
8:00 am – 9:00 am Pam Mitroff, Senior Director of Health Reform Compliance with NAHU
Legislative and regulatory update, and presentation on compliance changes concerning
penalties, affordability measures, timelines, HRAs, cash in lieu of affordability, and reporting
requirements.
9:00 am – 10:00 am Jared Estes – Keynote Speaker & Ethics Perspective
“Fire Back”
10:00 am – 10:15 am Break & Visit Exhibitor Booths
10:15 am – 11:15 am Jason Lacey, Partner with Foulston Siefkin, LLC - Legal Perspective
Legislative & compliance update regarding Healthcare and the ACA
11:15 am – 12:00 pm Edward J. Hett, MD, Medical Director, New Models of Care, Via Christi Health
“Transforming the Primary Care Practice”
12:00 pm – 12:45 pm Lunch & Visit Exhibitor Booths
12:45 pm – 2:20 pm How ACOs are Changing Healthcare - Carrier Perspective
Health insurance carriers will discuss the impact of Health Care Reform on their businesses,
ACO Implementation and Performance Based Payments. Participants include:
Ramona (Mona) Burt, R.N., M.S.A., Population Health Management
Tracy E. Bassett, VP of Network Strategy & Innovation, UnitedHealthcare
John Stockton, Market Head of Sales, Aetna
2:20 pm – 2:40 pm Break & Visit Exhibitor Booths
2:40 pm – 3:25 pm Francie Ekengren, MD, Medical Director of Wesley Medical Center &
Lindy Garvin, MPA, CPHRM, Division VP Quality Improvement & Patient Safety,
HealthOne/HCA Continental Division
“Quality Outcomes in Today’s Healthcare Market”
3:25 pm – 4:10 pm Mark Fendler, President, MedTrakRx – PBM Perspective
“The Future of Rx and Managing the High Cost of Prescriptions”
4:10 pm – 4:15 pm Closing Remarks – WAHU President, Jennifer Elliott
Conference Agenda
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Wichita Association of Health Underwriters
Presents the 7th Annual
HEALTHCARE SYMPOSIUM
Board of Directors
President/ HUPAC Chair Jennifer Elliott HUB International Mid-America
Director/Communications Chair Kristen Hoffman Delta Dental of Kansas/Surency Life & Health
President Elect Lindsay Smith Hays Companies of Kansas
Treasurer Jack Graham USI Insurance Services
Secretary/ Education Chair Gaylee Dolloff Health Partners of Kansas
Director/ Legislative Chair Doug Dixon Insurance Resources, Inc.
Director/ Media Relations Chair Sarah Sampson Fee Insurance
Director/ Membership Co-Chair Bob Langhofer Ridge Consulting Group, Inc.
Director Sean Bateman Delta Dental of Kansas/Surency Life & Health
Director/Membership C0-Chair Kylie Hurtig Arthur J. Gallagher & Co.
Director Mike Wise Wise & Associates
Director Courtney Hurley Blue Cross Blue Shield of Kansas
Director/Past President Dallas Scrip Benefit Management Inc. (BMI)
~ 4 ~
Wichita Association of Health Underwriters
Presents the 7th Annual
HEALTHCARE SYMPOSIUM
Pam Mitroff, MBA, Senior Director of Health Reform Compliance with NAHU
Pamela Mitroff joined the staff at the National Association of Health Underwriters in March of 2011 as a Director of State Affairs. She was promoted to the new position of Senior Director of Health Reform Compliance in November 2013. In that role, Mitroff has provided NAHU members consultative compliance assistance, answering more than 1000 inquiries in 2015 alone!
She has more than 30 years in the health care and workers’ compensation insurance and cost control field. Mitroff is a licensed Illinois insurance producer and has held positions with a major insurance company and a third-party administrator of benefit plans for self-funded companies. She was a lobbyist for the Illinois State Chamber of Commerce, lobbying on health insurance, employee benefits and workers’ compensation issues.
Prior to joining NAHU’s staff, Mitroff had been an active NAHU member on federal, state and local levels. Mitroff established the professional lobbying role for the state association (ISAHU). She was Associate Chairman for Employee Benefits of NAHU’s Legislative Council from 2007 to 2010.
Mitroff previously had a Wheaton, Illinois based consulting firm, Pamela D. Mitroff Consulting, Inc. The firm provided services to insurance companies, employers, brokers and associations in the public policy, government relations, employee benefits compliance, marketing and training areas.
In 2012, Mitroff was awarded the prestigious Edward H. O’Conner Memorial Distinguished Service Award from the Chicago & Northeastern Illinois Association of Health Underwriters. She received NAHU’s Distinguished Service Award in 2006 and the NAHU Region 3 Distinguished Service Award for Legislative activities in 2007.
Pam will review the political landscape as well as legislative and regulatory updates in her presentation
“Politics, Compliance and Thriving in 2017”. She will cover the following subjects:
President Trump’s Healthcare Policies & the new congress
Repeal and replacement of ACA
Compliance Issues for 2017
Reporting Requirements
~ 5 ~
Wichita Association of Health Underwriters
Presents the 7th Annual
HEALTHCARE SYMPOSIUM
Keynote Speaker – Jared Estes
Presents “Fire Back”
As newlyweds at age 25, Jared, his wife Paige, and two friends were driving home from a hockey game when they were struck by a drunk driver going over 120 mph. This horrific moment changed the course of Jared’s life in ways he could have never imagined. Jared barely escaped death as he suffered 2nd and 3rd degree burns on half of his body. As he began to endure more than 50 surgeries, doctors delivered devastating diagnoses, including a lifetime of pain and loss of functionality. Even worse, his bride of only six months was killed in the crash. Jared began to sink into a deep depression - he had trouble recognizing himself in the mirror and battled feelings of resentment towards the person who caused this situation. He was truly at a crossroad in his life... torn between giving up and surviving. With the love and support of his family and friends, Jared was able to find a new perspective that helped him emerge from the darkness. He realized the value of gratitude and forgiveness, and became determined to recover beyond the doctors’ diagnoses. His character was molded as he maintained an optimistic attitude throughout his physical therapy and numerous complex surgeries. Jared had a realization that he could decide to surpass mere survival… he could FIRE BACK. Jared’s perseverance paid off - he is clearing his bucket list by checking off marathons and sitting in tankers swapping stories with soldiers. His endurance has allowed him to discover his life mission – to help others by sharing his amazing story of tragedy and triumph. Jared realizes that trials and the need for perseverance is not unique to him, rather is it something that we all must deal with in life. His mantra is that there will be times when life will get us down, and kick us while we are down. When that happens, we must not only get back up, but we must FIRE BACK.
Sponsored By:
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Wichita Association of Health Underwriters
Presents the 7th Annual
HEALTHCARE SYMPOSIUM
Jason Lacey, Partner with Foulston Siefkin, LLC
Jason Lacey practices primarily in the areas of income taxation, ERISA, employee benefits, and executive
compensation. He assists both taxable and tax-exempt employers with a wide variety of employee benefit and
executive compensation issues, including design and administration of welfare benefit plans and qualified and
nonqualified pension, retirement savings, and deferred compensation plans. He also represents clients with
respect to the tax and business aspects of entity formation, tax-advantaged exchanges and reorganizations,
and tax controversies, and has significant practice experience in the areas of estate administration, estate and
gift taxation, and the federal tax aspects of municipal finance transactions. He has been selected by his peers
for inclusion in The Best Lawyers in America, the Missouri & Kansas Super Lawyers Rising Star list, and
Chambers USA as a leading business attorney in the United States. He was recognized by Best Lawyers as the
2014 and 207 Wichita Employee Benefits (ERISA) “Lawyer of the Year”.
Jason will present on topics including the IRS memorandum on specified disease taxability, EEOC activities on
non-discrimination and DOL audit examples and outcomes.
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Wichita Association of Health Underwriters
Presents the 7th Annual
HEALTHCARE SYMPOSIUM
Edward J. Hett, MD, Medical Director, New Models of Care, Via Christi Health
Presents, “Transforming the Primary Care Practice”.
Dr. Edward J. Hett started in 1981 as a Family Medicine resident at St. Joseph Medical Center, which became part of Via Christi Health when the system was formed in 1993. While he still maintains a family medicine practice as an employed physician within the Via Christi Clinic, Dr. Hett assumed an administrative role in 2012 as Medical Director for New Models of Care and later became the Chief Executive Officer for Via Christi Health’s accountable care organization. As the physician leader for the health systems’ population health initiatives, Dr. Hett is responsible for new and redesigned models of care, the integration of cost with quality network performance, patient centered medical home transformation, clinical integration across ACO care sites, and leading the subsidiary company in its’ efforts to expand the physician network regionally. Dr. Hett has responsibility for ensuring that the Via Christi Health ACO remains consistent with clinical models implemented by Ascension Health’s National ACO, MissionPoint Health Partners.
~ 8 ~
Wichita Association of Health Underwriters
Presents the 7th Annual
HEALTHCARE SYMPOSIUM
Carrier Perspective Attendees
Ramona (Mona) Burt - Blue Cross Blue Shield of Kansas
Tracey E. Bassett – United HealthCare
John Stockton – Aetna
Discussion Outline
These presentations allow the State’s largest health insurance carriers to provide their perspectives “How
ACOs are Changing Healthcare”. Each presenter has been asked to address:
Their ACO Activities: Locally Nationally How are Physicians Being Measured? What are the Reimbursement Methodologies being used to reimburse physicians? What should self-funded employers expect to pay in additional reimbursement on average per member? What specific outcomes are you expecting for the patient, the provider and expected costs? If applicable do you have a timeline for full Kansas market implementation
Each representative will speak for 30 minutes on the topics identified above.
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Wichita Association of Health Underwriters
Presents the 7th Annual
HEALTHCARE SYMPOSIUM
Ramona (Mona) Burt, R.N., M.S.A.
Population Health Management Coordinator
Blue Cross Blue Shield of Kansas
Ramona (Mona)Burt has been a practicing registered nurse since 1979. She started at BCBS in 2001 as part of
the Medical Review team, and since 2013 has served as the Population Health Management Coordinator
where she is responsible for performing extensive clinical analysis to identify areas of risks and opportunities
for programs and processes to improve the total cost of care of the population. In this role, she delivers
information on the high-risk population, identifies gaps in care and understands utilization, costs and
associated trends to identify targeted opportunities to assist and support quality management programs to
improve the quality based activities and outcomes.
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Wichita Association of Health Underwriters
Presents the 7th Annual
HEALTHCARE SYMPOSIUM
Tracy E. Bassett
Vice President of Network Strategy & Innovation
UnitedHealth Network, UnitedHealthcare
Tracy has most recently been the Vice President of Network Strategy and Innovation for 12 states that make
up the Central Region of UnitedHealth Networks. In this role, she is charged with developing and deploying
successful network strategies for the diverse markets in the region. In her current role, she is at the forefront
of transforming provider relationships with UnitedHealthcare by negotiating innovative reimbursement
structures built on the Triple Aim to deliver higher quality healthcare more efficiently with better patient
outcomes. She utilizes the new reimbursement structures to support the development of innovative products
that provide UnitedHealthcare customers with options that offer higher quality and lower cost benefits to
their employees. Prior to this role, Tracy was the Regional Ancillary Lead for the Central Region where she
developed the ancillary contracting strategy and assured that UnitedHealthcare members had access to a wide
variety of high quality and efficient ancillary providers. Tracy’s first role at UnitedHealthcare was a hospital
contract negotiator in Indiana where she built strong relationships with hospital systems that helped produce
best in class rates.
Prior to joining UnitedHealthcare, in January 2005, Tracy was the Finance Manager of a group of Physician
Hospital Organizations (PHO) in Indianapolis where she developed reimbursement strategies and
implemented performance based measures for a risk-based HMO. She started her career in healthcare
managing the chargemaster for St. Vincent Health, the flagship hospital of Ascension Health.
Tracy completed a Bachelor of Science degree in Corporate and Institutional Finance with an emphasis in
International Business and later completed a Masters of Business Administration from Ball State University.
She is currently a member of the Advisory Board for the Economics Department of the Miller College of
Business at Ball State University.
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Wichita Association of Health Underwriters
Presents the 7th Annual
HEALTHCARE SYMPOSIUM
John Stockton
Market Head of Sales – Kansas, Nebraska, Western Missouri
Aetna
John Stockton has over 29 years of employee benefits and health insurance experience. John joined Aetna in
1999 and held market leadership positions over Kansas City, St. Louis, Oklahoma, and Colorado until 2012.
From 2013 through most of 2016, John held the position of Regional Head of Sales for Aetna Accountable Care
Solutions (ACS) and served as the national Director of Distribution for ACS. He had oversight for the sales
strategy of the Mid America Region for membership growth into an Aetna Whole Health product model ACO
(Accountable Care Organization) solution. John worked closely with Aetna ACO partners such as Memorial
Hermann Accountable Care Network (Houston), Baylor Scott & White Quality Alliance (North Texas), Seton
Health Alliance (Austin), Baptist/Health Texas (San Antonio), CHI in Omaha and Des Moines, INTEGRIS Health
Partners (Oklahoma City), St. John (Tulsa), Texas Health Resources in DFW, and Advocate/Rush in Chicago. In
late 2016, John has returned to a local market role to lead Aetna in Kansas, Nebraska, and Western Missouri.
~ 12 ~
Wichita Association of Health Underwriters
Presents the 7th Annual
HEALTHCARE SYMPOSIUM
Francie Ekengren, MD
Chief Medical Officer
Wesley Healthcare
Presents “Quality Outcomes in Today’s Healthcare Market”
Francie Ekengren, MD, received her medical education from University of Kansas School of Medicine in 1987.
She returned to Wichita and completed her medical residency in Family Practice at Wesley Medical Center
through the University of Kansas School of Medicine-Wichita. For over twenty years, she has worked as an
Emergency Department physician with Emergency Services, PA. She has served as the Chief Medical Officer at
Wesley Medical Center since 1999. She is also the President and CEO of Mid-Kansas Wound Specialists that is
located at Wesley.
She has served or is serving on: Wichita Eye Bank Board, the American Heart Association Board, and the
Cerebral Palsy Research Foundation, City-Wide Quality Health Collaborative, Kansas Health Ethics Board, WSU
AEGD Advisory Council Cabinet member, and KMS Kansas Healthcare Collaborative Steering Committee
member.
She has received the Kansas Health Ethics Award and HCA Frist Humanitarian Award.
She has provided a number of presentations to professional and community audiences.
Her community activities have included volunteer physician at Good Samaritan Clinic, Church Elder at Grace
Presbyterian, Medical Missionary Volunteer-Dominican Republic, and Susan G Komen Race for the Cure as a
survivor.
~ 13 ~
Wichita Association of Health Underwriters
Presents the 7th Annual
HEALTHCARE SYMPOSIUM
Lindy Garvin, MPA, CPHRM Division VP Quality Improvement and Patient Safety
HealthONE/HCA Continental Division
Presents “Quality Outcomes in Today’s Healthcare Market”
A seasoned leader with over 35 years of Experience in healthcare administration. Directed as Clinical Director
and Chief Nursing Officer, overall delivery of safe effective patient care while maintaining financial and
operations efficiencies. Coached and led organizations in Clinical, Quality and Patient Safety Improvement
Initiatives. Lindy has worked at several Denver area hospitals as Clinical Service Line Director, Chief Nursing
Officer and Quality, Patient Safety and Risk Management Leader. She has been the Continental Division Vice-
President of Quality, Risk and Patient Safety for eight years. Lindy is certified in Healthcare Risk Management.
~ 14 ~
Wichita Association of Health Underwriters
Presents the 7th Annual
HEALTHCARE SYMPOSIUM
Mark Fendler, President
MedTrakRX
Mark Fendler is the President of MedTrakRx, his most recent role since joining the company in 2011. His previous roles
included General Counsel and Chief Operating Officer. In all of these roles, Mark has drawn on 17 years of health care
industry experience: first, as a health care attorney in private practice, and then working for a national Fortune 50 PBM
before joining MedTrakRx. Mark’s new role as President will allow him to oversee the continued growth and expansion
of MedTrakRx’s brand to the national middle-market PBM segment, while leading the company’s 100+ employees and
also serving on the EnvisionRxOptions executive committee. Mark received his law degree from Saint Louis University
School of Law, and has a Bachelor of Journalism degree from the University of Missouri.
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Wichita Association of Health Underwriters
Presents the 7th Annual
HEALTHCARE SYMPOSIUM
Thanks to our Sponsors!
Aetna – Lunch Sponsor Allstate Blue Cross Blue Shield of Kansas Beneflex HR Cigna Companion Life Delta Dental of Kansas Empower Guardian – Snack Sponsor Health Partners of Kansas Hinkle Law Firm MetLife
Mutual of Omaha National General Surency Life & Health United Healthcare – Breakfast Sponsor UNUM Vision Care Direct Wesley
~ 16 ~
Wichita Association of Health Underwriters
Presents the 7th Annual
HEALTHCARE SYMPOSIUM
~ 17 ~
Wichita Association of Health Underwriters
Presents the 7th Annual
HEALTHCARE SYMPOSIUM
~ 18 ~
Wichita Association of Health Underwriters
Presents the 7th Annual
HEALTHCARE SYMPOSIUM
~ 19 ~
Wichita Association of Health Underwriters
Presents the 7th Annual
HEALTHCARE SYMPOSIUM
~ 20 ~
Wichita Association of Health Underwriters
Presents the 7th Annual
HEALTHCARE SYMPOSIUM
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Wichita Association of Health Underwriters
Presents the 7th Annual
HEALTHCARE SYMPOSIUM
Thank you for attending our symposium!
Visit our web site for coming events at
www.mywahu.org