Description: This session reviews the importance of using benchmarks in healthcare utilization management to improve organizational and patient outcomes and increase efficiency. It highlights how benchmarks can inform decisions about utilization management strategies and benefit members, payers, and providers. The presentation includes best practices, successful examples, and solutions to challenges, focusing on claim utilization, risk adjustment efficiency, quality metrics, and overall performance. Additionally, insights into the future of benchmarks and the value of analyzing the entire distribution of data for deeper insights will be shared.

Description: "Direct medical costs for cancer care topped $209 billion nationally in 2020, accounting for a significant proportion of all health care expenditures in the U.S. Indirect costs are also significant, encompassing loss of productivity, wages, leisure time and decreased quality of life. The way cancer programs deliver and are reimbursed for care is rapidly changing. As the cost of cancer care continues to rise, several new value-based care programs - both public and private - have attempted to curb these rising costs. Learn about the current landscape of VBC oncology programs, several key challenges and opportunities with oncology analytics, as well as anticipated evolution of cancer care in the near future. Topics include: Current VBC oncology landscape, including a more detailed discussion on CMS' latest oncology program, Enhancing Oncology Model (EOM) Discussion on current challenges and opportunities with oncology analytics, including some advanced methodologies that have been developed based on documented clinical pathways to better understand cost drivers Future state of oncology care including emerging pharmaceuticals and novel therapies, personalized care regimens, and other clinical innovations"