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AAMCN Pre Conference Learning Objectives At the conclusion of the Pre Conference sessions, you should be able to: Discuss the need for intensive case management of the Medicaid behavioral health population Describe AmeriGroup’s Rising Star Program Recognize methods that could be used in other populations Identify issues associated with early PD diagnosis and management through end of life care Describe the role of the managed care nurses, including case managers, in working with the PD patient through the life continuum List and implement nursing strategies in the care of PD patients and their caregivers Recognize the challenges of PD pharmacologic therapy in managed care. Define the issue of providing nursing/case management services across state lines Identify existing barriers to the Nurse Licensure Compact (NLC) Describe nationwide efforts and initiative support state by state adoption of the NLC Describe how and why the state of OH determined the need for a UM Consortium Discuss the role of the managed care nurse in a UM Consortium Discuss the impact on patient care of a UM Consortium Define social media Identity the role a managed care nurse can play in social media Recognize the potential impact of social media on patient outcomes Use social media websites such as www.aamcn.org Fall Forum Learning Objectives Depending on what track session you attend, at the end of the Forum, you should be able to: Explain the mechanics of Medicare’s Value-Based Purchasing and Shared Savings Programs, including the risk/reward tradeoffs in the various models and the types of health care institutions most likely to be successful in them. Describe the similarities and differences between the approaches taken by five groups of payers: Medicare, Medicaid, commercial insurers, employers, and patients. Identify and provide a rationale for treating patients with clinically isolated syndrome who are likely to progress to clinically definite MS (CDMS); and, achieve reduction of EDSS that accompanies early initiation of therapy; Understand how the likely approval of new MS therapies—including both oral and injected agents—may change the risk-to-benefit analyses and influence long-term treatment decisions for MS treatment regimens implemented in the managed care setting; Analyze and project the clinical risks and benefits of emerging agents under evaluation for MS, and how the safety profiles of new agents compares to established platforms with documented long-term safety and LTFU studies showing EDSS stabilization and reduction in relapse rates; Understand the barriers to stronger hospital-physician relationships Understand key components necessary for improved hospital-physician relationships Provide proven strategies and practical methods that can improve hospital -physician relationships. Analyze clinical data evaluating the safety and efficacy of immunotherapies in the treatment of metastatic melanoma Review agents recently approved for the treatment of metastatic melanoma Discuss mechanisms of immune tolerance and the rationale for using immunotherapy to treat patients with metastatic melanoma Incorporate strategies for anticipating, recognizing, and treating immune-related adverse events associated with immunotherapies for metastatic melanoma Review the changes in the AJCC staging system Detail the criteria for determining progression to castrate-resistant prostate cancer (CRPC) Discuss the efficacy, safety, and anticipated outcomes for recently approved agents in the treatment of CRPC Define the criteria by which patients with CRPC should be considered for either immunotherapybased treatment or chemotherapy Identify strategies for managing side effects and maintaining quality of life in patients with CRPC Review NCCN and ASCO guidelines for the treatment of CRPC Identify comorbidities and risk factors associated with OAB Identify appropriate screening tools for discovering patients with OAB symptoms Discuss diagnosis methods to find the cause for the symptoms Discuss treatments plans, including behavioral/lifestyle changes and medication Identify key drivers of medical spend and areas of opportunity within general surgery and certain diagnostic procedures Learn how value based benefit designs can be used to lower medical costs Understand how to design a surgical value based benefit program Learn how engagement at precertification drives better decisions around surgical procedures Identify resources and opportunities to reduce medical spending within your organization. Discuss the efficacy and safety of targeted therapies currently used in the treatment advanced RCC Develop individualized treatment plans incorporating biologically targeted therapies in treatment plans for patients with RCC to improve survival rates Review the NCCN and ASCO treatment guidelines for advanced RCC Analyze therapies currently undergoing late stage clinical trials and how they might affect the future of advanced RCC treatment Identify and manage adverse events associated with RCC therapies Measure efficacy of PCMH implementation through well-being improvement Correlate cost productivity and work withdrawal to well-being Address health risks before they become conditions as a significant sources savings Review risk factors, symptoms, clinical and functional classifications and the importance of early diagnosis of PAH Recognize that appropriate clinical classification diagnosis of PAH is imperative to apply treatment algorithms accordingly and determine the best combination treatment strategy Understand the current prevalence and economic burden of PAH and how misdiagnosis of the patient’s classification can affect both the patient’s risk and healthcare costs Analyze the current and prospective pharmacologic and lifestyle treatment options Identify the role of the Medical Director and Nurse Case Manager in managing a PAH population Describe what an ACO is Identify who should consider participating in this type of delivery system Discuss what technology is available to support care management efforts of an ACO Describe the current algorithm and economical impact of hyperthyroidism Discuss the impact of an adjustment in the algorithm could benefit the healthcare system Recognize the ‘silent’ HIV epidemic and its underestimated need Describe recent updates on protocols and guidelines for HIV/AIDS treatment, prevention and screening services Understand the disease management success when using ART and its potential long-term savings Identify strategies for ensuring ART coverage for HIV/AIDS patients, particularly with lacking state funds for ADAP programs Review the economic and societal impact of HIV/AIDS and the importance of addressing internal quality assurance Understand the importance of early diagnosis and aggressive treatment in the management of RA Review the diagnosis criteria for RA per the American College of Rheumatology guidelines Analyze the clinical efficacy and safety data for the current and emerging RA therapies Discuss possible strategies to decrease or avoid a patient’s risk for RA-associated comorbidities Recognize the value of patient education to improve quality of care, optimize disease outcomes, and increase patient satisfaction Explore new models of care that promote a coordinated approach to healthcare, dedicated to genuine improvement in quality and outcomes while better managing costs Discuss how technology can be used to enable the level of collaboration necessary for care coordination Discuss case-study information about the tactics SCCIPA has adopted to being achieving higher levels of care coordination Review specific areas and opportunities where participants might begin to recast the traditional roles of stakeholders in their own organizations in order to achieve long-term goals. Compare the efficacy & safety of GLP-1 agonists, DPP-4 inhibitors, & insulin analogues in the treatment of type 2 Diabetes Review the morbidity & cost burdens associated with inadequate treatment and management of type 2 diabetes Discuss the Type 2 diabetes treatment guidelines and goals from the American Diabetes Association Identify the pharmacological properties and clinical data on new and emerging type 2 diabetes therapies Analyze the difficulties and strategies for managing patients with multiple cardiovascular risk factors Describe the risk factors most highly associated with non-healing, delayed healing or improper healing in patients experiencing fractures Discuss the trade-offs in treatment options that balance likelihood of healing, time to heal and cost effectiveness Analyze how to use current evidence and effectiveness data to manage costs associated with various treatment options for patients experiencing fractures Discuss the future of patients who have poor outcomes in conjunction with the costs associated with continued care Examine the current trends in physician-hospital alignment and explore various alignment models Understand the typical process that a practice/hospital goes through to align Define fair market value and discuss key factors of the FMV process Discuss pharmacologic treatment options available for patients with major depressive disorder Review diagnosis strategies from the Diagnostic and Statistical Manual of Mental Disorders Discuss strategies for initial treatment of MDD and for treatment after therapeutic failures as recommended by recently updated APA guidelines Identify follow-up tools and communication strategies to improve management of major depressive disorder Analyze the economic burden that major depressive disorder has on the healthcare system Discuss current challenges in the diagnosis of hyperthyroidism Identify tools now available for better recognition and diagnosis of hyperthyroidism Describe how the new tools available affect the time to diagnosis and reduced morbidity Understand the risks for CINV and its prevalence across the cancer treatment spectrum Identify the properties and optimal use of current agents available for the prevention of CINV Compare the recommendations for managing CINV from updated clinical practice guidelines of NCCN and ASCO Describe treatment options for a patient at various risk levels for developing CINV and patients experiencing CINV Realize the potential issues surrounding non-compliance and the risks/consequences of untreated CINV Summarize current, new and emerging treatment options for Multiple Myeloma (MM) Assess the evidence for the use of novel agents in the first-line setting Discuss current therapeutic options for patients with relapsed/refractory MM Outline factors to be considered in diagnosis, staging and risk assessment for MM and explain how they influence treatment decisions Review NCCN and ASCO practice guidelines for MM Understand glaucoma progression and patient demographics Discuss the treatment algorithm of glaucoma Discuss new technologies in treating glaucoma such at EX-PRESS® Discuss the cost savings of new technologies when compared to current treatments Review the updated practice guidelines from the American Association for the Study of Liver Diseases (AASLD) Describe the four main genotypes found in the US Discuss screening measures to take to improve diagnosis Describe treatment strategies for HCV Discuss patient education for both avoiding HCV and to prevent spreading of HCV Identify payers' top utilization management interventions and those they wish to implement in the future Describe steps oncologists are taking to manage their business in light of ASP reimbursement trends Quantify the major financial barriers faced by patients Review the safety and efficacy of currently available chemotherapeutic treatments and targeted biologic therapies for advanced NSCLC Examine ASCO and NCCN's latest guidelines on the treatment of advanced NSCLC Discuss how treatments for NSCLC can be individualized, based on tumor histology, molecular markers, clinical factors, and patient characteristics Analyze treatment regimens available for maintenance therapy and their role in advanced NSCLC Identify patients with advanced NSCLC who are most likely to benefit from maintenance therapy