How to Thrive in the Current Health Care Ecosystem: Recommendations for Providers to Address Payer Challenges

Chapter 1: Optimizing Patient Management Through Payer/Provider Communications
Chapter 2: Advancing Overall Value through Multiple Stakeholder Collaborations

Distinguished Faculty
Vanita Pindolia, PharmD, BCPS, MBA
Vice President, Ambulatory
Clinical Pharmacy Programs_PCM
Henry Ford Health System/Health Alliance Plan of Michigan

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Mark T. Reding, MD
Associate Professor of Medicine
Division of Hematology, Oncology, and Transplantation
Director, Center for Bleeding and Clotting Disorders
University of Minnesota Medical Center

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Edmund Pezalla, MD, MPH
Enlightenment Bioconsult, LLC

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Jay Bryant-Wimp, RPH
Accurate Rx Pharmacy

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Target Audience

Statement of Need/Program Overview
As the nation’s health care system continues to seek quality improvement and cost reduction, hemophilia providers require enhanced skills to succeed in a changing health care ecosystem.  Furthermore, rapidly evolving payer strategies, including medical necessity guidelines and benefit designs, are affecting patient access and out-of-pocket expenses, which can impact long-term health outcomes for patients with hemophilia.

This activity is designed for both hemophilia treatment center (HTC) and non-HTC physicians, nurses, social workers, and other health care professionals to improve collaboration with various managed care, specialty pharmacy providers, and payer professionals to provide appropriate access and receive adequate reimbursement, and comprehensive care for their patients with hemophilia.

Educational Objectives

Chapter 1
After completing this activity, the participant should be better able to:

Chapter 2
After completing this activity, the participant should be better able to:

Joint Accreditation Statement

In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine, the National Hemophilia Foundation, and Impact Education, LLC.  Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Physician Continuing Medical Education
The Postgraduate Institute for Medicine designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Continuing Nursing Education
The maximum number of hours awarded for this Continuing Nursing Education activity is 1.4 contact hours.

Social Worker Continuing Education
This program is Approved by the National Association of Social Workers for 2.0 continuing education contact hours.

Postgraduate Institute for Medicine (PIM) requires instructors, planners, managers and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest (COI) they may have as related to the content of this activity. All identified COI are thoroughly vetted and resolved according to PIM policy.  PIM is committed to providing its learners with high quality CME activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.

The faculty reported the following financial relationships with commercial interests whose products or services may be mentioned in this activity:

Name of Faculty Reported Financial Relationship
Vanita K. Pindolia, PharmD, BCPS, MBA Consulting fees from Amgen Population Health Advisory Board
Mark T. Reding, MD Consulting fees from Bayer, Shire, Bioverativ, Novo Nordisk, Inc.
Fees for Non-CME/CE Services Received Directly from a Commercial Interest or their Agents (e.g., Speaker Bureaus) from Bioverativ and Shire
Edmund Pezalla, MD, MPH Consulting fees from Alynlam, Genetech
Ownership Interests from Scientific Advisory Board Memberships, Naia Pharmaceuticals, Temple Therapeutics, Vivio Health
Jay Bryant-Wimp, RPH Ownership Interest from Accurate Rx Pharmacy Consulting, LLC

The PIM planners and managers, Trace Hutchinson, PharmD, Samantha Mattiucci, PharmD, CHCP, Judi Smelker-Mitchek, MBA, MSN, RN, and Jan Schultz, MSN, RN, CHCP have nothing to disclose. Impact Education, LLC and the National Hemophilia Foundation planners and managers have nothing to disclose.

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners.  Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

There are no fees for participating and receiving CME/CE credit for this activity. During the period March 26, 2018 through September 30, 2019, participants must 1) read the learning objectives and faculty disclosures; 2) study the educational activity; 3) successfully complete the post-tests with a score of 75% or better; 4) and complete the evaluation forms. Upon completion of each CME/CE activity, your certificate will be made available immediately to download and print.


There is no fee for this educational activity.