Exclusive meeting for Commercial Payors
August 23, 2023 | Sheraton Dallas Hotel – 400 Olive St. | Dallas, Texas
NHIA Home & Specialty Infusion Payor Summit
The goal of this interactive meeting was to benefit leaders from commercial payors with responsibilities for benefit structure, network decisions, value-based programing, and specialty infusion policy. Attendees heard from home and specialty infusion experts and executives about opportunities and challenges facing the industry today and into the future.
NHIA Home & Specialty Infusion Payor Summit
This interactive meeting will benefit leaders from commercial payors with responsibilities for benefit structure, network decisions, value-based programing, and specialty infusion policy. Attendees will hear from home and specialty infusion experts and executives about opportunities and challenges facing the industry today and into the future.
There is no fee to attend; however, attendees are responsible for their own travel arrangements and expenses. Join NHIA leadership and payor executives at a welcome reception the evening before. Breakfast and lunch are provided for meeting attendees during the summit. Space will be limited and reserved on a first come first served basis.
What to expect
The 2023 summit will focus on helping payors leverage the home and alternate site of care to manage drug spend; improve patient access; improve health equity by reaching rural, disabled and transportation-limited populations; improve quality and patient experience; and reduce administrative burden. This will include a review of the recommendations that resulted from the inaugural NHIA Payor Summit.
2023 summit Agenda
August 22, 2023
Join NHIA leadership and payor executives for an elegant networking reception upon arrival in Dallas.
August 23, 2023
We will kick off the morning with a full breakfast and ample time to network.
Introductions, meeting objectives, antitrust rules.
John Rademacher, CEO, Option Care Health, NHIA Board Chair
Connie Sullivan, BSPharm, President & CEO, NHIA
This session will review the post-pandemic trends in home and alternate site infusion, including how providers are diversifying their services and expanding access to a growing number of specialty biologics. Additionally, hear about NHIA’s efforts to position the industry to meet the needs of a growing Medicare Advantage population and participate in value-based programs.
Dee Grein, MBA, President & GM, OptumRx | Eric Ho, PharmD, Senior Vice President Pharmacy Services, Paragon Healthcare | Greg LoPresti, CEO, Upstate HomeCare | Robert Calway, President & CEO, New England Life Care
This moderated panel session of senior executives and CEOs from a cross-section of home infusion providers (hospital, independent, national) offers a window into the future direction of the industry. Panelists will share their experience navigating supply chain disruptions, staffing shortages, and why they are optimistic about the future of infusion.
Networking and refreshments
Linda Payne, Sr. Director Revenue Cycle, CarepathRx
Linda Payne, home and alternate site infusion business expert, will share NHIA’s recommendations for modifications to network structure and business practices to reduce the administrative burden for both the provider and payor while improving patient access and response times. These actionable recommendations will facilitate efficient transitions of care from facility-based settings to home and aid providers in building out redundancies to avoid disruptions in patient care.
Buffet lunch and networking time.
Erick Siegenthaler, PharmD, MHA, Senior Director, Hospital & Health System Services, Visante, Inc.
Site of care optimization programs have been proven to reduce costs and improve outcomes for a wide range of patients requiring specialty infused and injected products. This session will provide payors with recommendations for how to implement a successful program from the provider perspective.
Penny Allen, RD, CNSC, FASPEN, FNHIA, Vice President of Nutrition Support, Optum Infusion Pharmacy
Parenteral nutrition is the most complex therapy delivered in the home, requiring a skilled multidisciplinary team to manage nutrition needs that can change frequently. Penny Allen of Optum Infusion Pharmacy will offer insights and practical recommendations for improving outcomes and lowering the total cost of care in this clinically challenging population.
Beth Gore, PhD, President and Chief Executive Officer, OLEY Foundation
Hear from Beth Gore, parent of children reliant on enteral and parenteral nutrition and President and Chief Executive Officer of the OLEY Foundation, about real-world success stories as well as opportunities for improvement with a focus on health equity in nutrition therapy consumers.
Networking and refreshments
Bill Noyes, Sr. Vice President of Reimbursement Policy, NHIA
NHIA’s Bill Noyes, SVP of Reimbursement Policy, will review the 2023 Commercial Payor Recommendations and how to implement newly added and revised HCPCS codes for injectable immunotherapies.
How do we apply this information in a way that is beneficial to patients, payors, and providers?
2023 Panel Speakers
2023 Session Speakers
John C. Rademacher possesses nearly two decades of experience in the healthcare industry, successfully deploying technology solutions and expanding professional services capabilities. Rademacher held various executive-level positions at leading healthcare companies, including Cardinal Health where he served as President and General Manager for both the Ambulatory Care Division and the Nuclear and Pharmacy Services divisions. He also acted as president of CareAllie sand Chief Operating Officer for the CIGNA Behavioral Health business at Cigna Corporation, where he had responsibility for the development and delivery of care management and population health programs.
Rademacher joined Option Care in 2015 when he was appointed Chief Operating Officer, and after serving as interim CEO, was named CEO in January 2018.
As Senior Director, Revenue Cycle, Linda Payne oversees and coordinates all CarepathRx Specialty Pharmacy & Infusion Solution revenue cycle activities. Payne is an experienced reimbursement executive with over 30 years of experience in home infusion/specialty revenue cycle management. She has a diverse background in revenue management, software implementation, compliance, and development/training of revenue cycle best practices.
Prior to joining CarePathRx, Payne was the founder and former president of a successful outsourcing company for more than 16 years. Under her leadership and strategic planning, her teams were able to produce positive bottom-line results. She prides herself in the ability to cultivate a professional, results-driven team to assist CarePathRx clients on their road to success.
Erick Siegenthaler (PharmD, MHA) is a Senior Director at Visante with a vast amount of experience in home infusion start up services, business planning, specialty infusion, payer strategy around site of care, and prior authorization and patient assistance programs. Erick most recently worked at Froedtert Health in Milwaukee, WI serving as the Director of Pharmacy – Home Infusion Services. While at Froedtert, Erick had the opportunity to start up a home infusion service line from scratch, partnering with a third-party vendor.
Penny Allen, RD, CNSC, FASPEN, FNHIA is Vice President of Nutrition Support for Optum Infusion Pharmacy. Allen began her nutrition support career at Beth Israel Hospital in Boston and has spent over 30 years in home infusion in a variety of roles, currently serving as a program director leading clinical, operations and sales teams to provide state of the art care based on ASPEN standards and excellence in home nutrition support. She is a Certified Nutrition Support Clinician, serves as Chair of NHIA’s MCAC and Past Chair of the ASPEN Public Policy Committee. Allen is a published subject matter expert in Medicare PN policy and other home nutrition support related topics. Her career passion is improving access to quality nutrition support therapies for all patients.
Beth Gore, PhD, is a national patient safety advocate, author, and speaker who represents patientsthrough patient associations, serving on boards, and being a voice of the patient on nationalcommittees and task forces with over a decade of direct vascular access and parenteral andenteral focus. She has a PhD in Training and is a mother to six children with special needs,including a son who lives with a central line for lifetime nutrition support.
Bill Noyes is the Senior Vice President of Reimbursement Policy at NHIA. He joined NHIA in 2012as Vice President of Health Information Policy, focusing on reimbursement and regulatory issues affecting providers’ ability to do business and collect payment for their services. Noyes sits on four Medicare Contractor Advisory Councils and is the liaison to NHIA’s reimbursement-focused committees. He also works closely with the NHIA government relations team to gain more meaningful Medicare coverage for home infusion. He served as Interim CEO of the association from July 2018 to November 2018. Prior to joining NHIA, Noyes spent 20 years as Vice President of Operations for a multi-state home infusion provider where he was responsible for purchasing, distribution, facilities, revenue cycle management, and pharmacy operations.
Connie Sullivan, B.S.Pharm, is the President and CEO of NHIA. Sullivan has over 25 years of infusion industry leadership, management, and clinical practice experience. Sullivan is responsible for NHIA’s advocacy initiatives and developing resources that support the infusion industry to foster innovation and promote the delivery of high-quality care. Sullivan also oversees the National Home Infusion Foundation, a 501c3 devoted to infusion research and developing future leaders. Sullivan is a member of the United States Pharmacopeia (USP) Sterile Compounding Expert Committee and currently Chairs the <797> Subcommittee. Sullivan earned her pharmacy degree from The Ohio State University in 1994.
The Venue
Policies and Statements
The antitrust laws of the United States prohibit agreements, combinations and conspiracies in restraint of trade. Because NHIA and other trade and professional associations are, by definition, combinations of competitors, one element of a possible antitrust violation is always present, and only an action by the association that unreasonably restrains trade needs to occur for there to be an antitrust violation. Consequently, associations are common targets of antitrust plaintiffs and prosecutors. Attendees at NHIA events must avoid discussing certain subjects when they come together for meetings, conference calls, and other joint activities. While there is an important exception to the antitrust laws that permits coming together to influence policies and regulations, as a rule, attendees of meetings where competitors are present must adhere to the following guidelines:
Do not discuss prices, fees or rates, or features that can impact (raise, lower or stabilize) prices such as discounts, costs, terms and conditions of sale, warranties, or profit margins.
Do not personalize any discussion about payment rates, i.e., “this payment is not enough for me.”
Do not exchange data concerning fees, prices, production, sales, bids, costs, customer credit, or other business practices unless the exchange is made pursuant to a well-considered plan that has been approved by NHIA’s legal counsel.
Do not discuss your customers with your competitors.
Do not discuss or implement a plan to boycott any public program or another entity – this is not protected by the exception that permits competitors to influence legislation and regulations.
Do ensure that if questions arise about the legal aspects of NHIA’s activities or your individual responsibilities under the antitrust laws, you seek advice and counsel from your own counsel or from the staff and counsel of NHIA.
NHIA is committed to holding a safe event and meeting all federal, state, and local rules and regulations. Attendees are strongly encouraged to test for COVID-19 prior to attending and will attest that they will not attend if they test positive or if any symptoms are present.
Registrants will be asked to sign off on the following liability waiver:
Liability Waiver
I understand that travel and gathering involves risk of sickness, including sickness from COVID-19. I waive and release NHIA and their employees and agents, from and against claims, liabilities, and expenses arising from injury, sickness, or death from contraction or spread of COVID-19 or other communicable disease due to travel to or attendance at the NHIA Fall FIAC Meeting.
I understand it is my responsibility to determine whether to undertake common recommended precautions at the meeting including, but not limited to: taking a COVID-19 test prior to travel, wearing a mask in public areas, or maintaining distance from others.
I agree that if I develop any of the symptoms of COVID 19 (including but not limited to fever, chills, cough, shortness of breath, difficulty breathing, fatigue, muscle or body aches, headaches, new loss of taste or smell, sore throat, congestion, runny nose, nausea, vomiting, or diarrhea) at any time during the Fall FIAC Meeting, I will return to my hotel room immediately and notify NHIA team member, Jennifer Charron via email (jennifer.charron@nhia.org) or phone 603.234.0175.
The antitrust laws of the United States prohibit agreements, combinations and conspiracies in restraint of trade. Because NHIA and other trade and professional associations are, by definition, combinations of competitors, one element of a possible antitrust violation is always present, and only an action by the association that unreasonably restrains trade needs to occur for there to be an antitrust violation. Consequently, associations are common targets of antitrust plaintiffs and prosecutors. Attendees at NHIA events must avoid discussing certain subjects when they come together for meetings, conference calls, and other joint activities. While there is an important exception to the antitrust laws that permits coming together to influence policies and regulations, as a rule, attendees of meetings where competitors are present must adhere to the following guidelines:
Do not discuss prices, fees or rates, or features that can impact (raise, lower or stabilize) prices such as discounts, costs, terms and conditions of sale, warranties, or profit margins.
Do not personalize any discussion about payment rates, i.e., “this payment is not enough for me.”
Do not exchange data concerning fees, prices, production, sales, bids, costs, customer credit, or other business practices unless the exchange is made pursuant to a well-considered plan that has been approved by NHIA’s legal counsel.
Do not discuss your customers with your competitors.
Do not discuss or implement a plan to boycott any public program or another entity – this is not protected by the exception that permits competitors to influence legislation and regulations.
Do ensure that if questions arise about the legal aspects of NHIA’s activities or your individual responsibilities under the antitrust laws, you seek advice and counsel from your own counsel or from the staff and counsel of NHIA.
The 2023 summit will focus on helping payors leverage the home and alternate site of care to manage drug spend; improve patient access; improve health equity by reaching rural, disabled and transportation-limited populations; improve quality and patient experience; and reduce administrative burden. This will include a review of the recommendations that resulted from the inaugural NHIA Payor Summit.
Topics will include:
- Infusion industry trends and implications of regulatory changes on access and utilization
- Addressing home infusion access for Medicare Advantage enrollees
- Reducing NOC: A review of new HCPCs for specialty injectables and infusions
- Reducing administrative work/burden when submitting commercial secondary claims for non-covered Medicare infusion therapies
- Empowering infusion providers to prevent costly hospitalizations and complications in the home parenteral nutrition patient
In November of 2022 the National Home Infusion Association (NHIA) was pleased to hold a one-day summit exclusively for leaders from commercial payors. The summit provided education, described current trends, and aimed to help payors leverage infusion services to lower the total cost of care.
The goal of this interactive meeting was to benefit leaders from commercial payors with responsibilities for benefit structure, network decisions, value-based programing, and specialty infusion policy. Attendees heard from home and specialty infusion experts and executives about opportunities and challenges facing the industry today and into the future.
