AMGA 2018 Institute for Quality Leadership Medicare Advantage and Risk: Delivering on the Promise of Value

AMGA 2018 Institute for Quality Leadership Medicare Advantage and Risk: Delivering on the Promise of Value

AMGA 2018 Institute for Quality Leadership Medicare Advantage and Risk: Delivering on the Promise of Value

1 AMGA 2018 Institute for Quality Leadership Medicare Advantage and Risk: Delivering on the Promise of Value November 13-15, 2018 Hyatt Regency San Antonio Riverwalk San Antonio, Texas amga.org/IQL18

AMGA 2018 Institute for Quality Leadership Medicare Advantage and Risk: Delivering on the Promise of Value

Making the shift from fee-for-service to value-based care is perhaps the most transformative change a healthcare organization will ever make. It impacts every aspect of operations: governance, technology, human resources, compensation, care processes, and beyond. And with escalating costs and patient health on the line, it’s essential to get it right. This year’s Institute for Quality Leadership (IQL18) focuses on strategies for succeeding in risk-based payment models, including Medicare Advantage. Wherever you are on the risk continuum, IQL18 delivers the resources and relationships for managing risk.

Meeting participants will depart San Antonio with methodologies and tactics to address: • Risk-based contracting • Payer contracting alignment • Change management and transformation • Physician burnout • Clinical and quality improvement • Data analysis and evidence-based medicine • And more Important Registration and Housing Dates • Friday, September 28 Last day to register at the Early Bird rate • Friday, October 12 Last day to guarantee a hotel reservation • Friday, October 26 Last day to register at the Advance Rate For more information or to register, please visit amga.org/IQL18. 2

AMGA 2018 Institute for Quality Leadership Medicare Advantage and Risk: Delivering on the Promise of Value

3 Agenda at a Glance Monday, November 12 5:00 p.m. - 7:00 p.m. Leadership Council Welcome Event Tuesday, November 13 7:30 a.m. - 8:30 a.m. Joint Leadership Council Breakfast 8:30 a.m. - 5:00 p.m. AMGA Leadership Council Meetings • Chief Administrative Officers / Chief Operating Officers • Chief Executive Officers / Chairs / Presidents • Chief Medical Officers / Medical Directors • Chief Nursing Officers • Chief Quality Officers / Directors 5:00 p.m. - 7:00 p.m. Welcome Reception with the Platinum Host and Gold Contributors Wednesday, November 14 7:00 a.m. - 8:00 a.m. Breakfast with Platinum Host and Gold Contributors 8:00 a.m. - 9:00 a.m. Opening General Session: Redefining Health Care: Improving Outcomes and Simplifying the Experience Bruce D. Broussard, President and Chief Executive Officer, Humana 9:15 a.m. - 10:15 a.m. Peer-to-Peer Breakout Sessions 10:15 a.m. - 10:45 a.m. Refreshment Break with Platinum Host and Gold Contributors 10:45 a.m. - 11:45 a.m. Peer-to-Peer Breakout Sessions 11:45 a.m. - 1:45 p.m. Networking Lunch with Platinum Host and Gold Contributors 1:45 p.m. - 2:45 p.m. Peer-to-Peer Breakout Sessions 2:45 p.m. - 3:15 p.m. Refreshment Break with Platinum Host and Gold Contributors 3:15 p.m. - 5:00 p.m. General Session: Direct Contracting Takes Flight: Boeing and MemorialCare’s Innovative Partnership Regina Berman, R.N., M.A., Vice President for Population Health Management and Accountable Care, MemorialCare Health System, and Linda Brady, Health Care Strategy and Policy, Provider Network Strategy and ACO Portfolio Manager, Boeing 5:00 p.m. - 6:00 p.m. Happy Hour with Platinum Host and Gold Contributors 6:00 p.m. - 7:00 p.m. Women in Leadership Networking Reception Thursday, November 15 7:00 a.m. - 8:00 a.m. Continental Breakfast with Platinum Host and Gold Contributors 8:00 a.m. - 9:30 a.m. Facilitated Hot Topics 9:30 a.m. - 10:00 a.m. Refreshment Break 10:00 a.m. - 11:30 a.m. Closing General Session: A Foot in Two Canoes: Navigating Risk When Both Value and Volume Are Rewarded Beth Averbeck, M.D., Senior Medical Director, Primary Care, HealthPartners Medical Group; Ruth Benton, Chief Executive Officer, New West Physicians, P.C.; and Jaewon Ryu, M.D., J.D., Executive Vice President and Chief Medical Officer, Geisinger Moderated by Jerry Penso, M.D., M.B.A., President and Chief Executive Officer, AMGA Separate fee $ $

AMGA 2018 Institute for Quality Leadership Medicare Advantage and Risk: Delivering on the Promise of Value

Keynote Sessions Broussard Redefining Health Care: Improving Outcomes and Simplifying the Experience Bruce D. Broussard, President and Chief Executive Officer, Humana During this engaging opening session, Humana President and Chief Executive Officer Bruce Broussard will discuss approaches to improving care and lowering cost, including partnering with providers, integrating lifestyle and health care, and improving customer engagement and healthcare system navigation. Humana, which currently has more than 3 million seniors enrolled in their Medicare Advantage plans, collaborates with medical groups and health systems across the country to achieve these goals. In addition, Broussard will share perspectives from a wide range of executive leadership experience in publicly traded and private organizations within a variety of healthcare sectors, including oncology, pharmaceuticals, assisted living/senior housing, home care, physician practice management, surgical centers, and dental networks. Direct Contracting Takes Flight: Boeing and MemorialCare’s Innovative Partnership Regina Berman, R.N., M.A., Vice President for Population Health Management and Accountable Care, MemorialCare Health System, and Linda Brady, Health Care Strategy and Policy, Provider Network Strategy and ACO Portfolio Manager, Boeing As out-of-pocket healthcare costs climb, employers are seeking ways to negotiate lower rates and improve access, quality, and expenses. Large employers—such as Intel, Wal-Mart, Lowe’s, and GE—are bypassing insurers and turning directly to healthcare providers to negotiate contracts. This model offers employers the ability to control expenses, while health systems benefit from the opportunity to capture additional revenue, increase patient volume, and achieve better patient outcomes.

Executives from MemorialCare Health System and Boeing will discuss their “preferred partnership” health plan arrangement for the aerospace giant’s nearly 37,000 employees and dependents in the southern California area. Boeing, one of the earliest adopters of direct-to-employer contracting, has previously negotiated similar arrangements with other providers in Seattle, St. Louis, and Charleston, SC. The speakers will also address the infrastructure (including data), clinical innovation, and leadership needed to excel in direct contracting; pitfalls to avoid; and the outlook for a model that helps providers remain competitive in an ever-evolving marketplace. 4 Berman Brady

AMGA 2018 Institute for Quality Leadership Medicare Advantage and Risk: Delivering on the Promise of Value

A Foot in Two Canoes: Navigating Risk When Both Value and Volume Are Rewarded Beth Averbeck, M.D., Senior Medical Director, Primary Care, HealthPartners Medical Group; Ruth Benton, Chief Executive Officer, New West Physicians, P.C.; and Jaewon Ryu, M.D., J.D., Executive Vice President and Chief Medical Officer, Geisinger Moderated by: Jerry Penso, M.D., M.B.A., President and Chief Executive Officer, AMGA Balancing competing priorities in a challenging payer environment where value and volume are rewarded is a constant challenge for medical groups and health systems. During this interactive panel discussion, leaders will discuss how their organizations are navigating the move to value. You’ll hear from a rural integrated delivery system, a medical group not affiliated with a hospital, and an urban-based, consumer-governed, non-profit integrated delivery system. Panelists will candidly discuss the successes and challenges they’ve encountered during the transition to value, including garnering buy-in from providers and payers alike, building the competencies needed for success, collaborating with community partners, and addressing patient access, satisfaction, and, ultimately, outcomes. Averbeck Benton Ryu 5

AMGA 2018 Institute for Quality Leadership Medicare Advantage and Risk: Delivering on the Promise of Value

Peer-to-Peer Shared Learning Wednesday, November 14, 9:15 a.m. - 10:15 a.m. Nuts, Bolts, and Lessons Learned in the Design and Implementation of a Model Medicare Advantage Contract Julie Day, M.D., Medical Director, Quality Improvement and Population Health Management, and Annie Sheets Mervis, M.S.W., Director, Quality Improvement and Population Health Management, University of Utah Health Community Physician Group Structuring an effective Medicare Advantage contract is the cornerstone to successful collaboration with payers and taking on risk. In a market with limited value-based contracts, the University of Utah Health Community Physician Group created a model Medicare Advantage contract to move the organization further along the continuum to value-based care. The effort culminated in a successful contract and positive working relationship with a major payer.

Presenters will describe the evolution of the contract, including collaboration with its hospital contracting team, basic payment structure, pitfalls and errors in the first year, and revisions made to the contract. The session also will highlight strategies for succeeding with a Medicare Advantage contract, including Hierarchical Conditional Category (HCC) coding management, centralized outreach calls, and timely analytics. Peer-to-Peer Breakout Sessions and Interactive Discussion Groups Discover innovative strategies and groundbreaking processes from your fellow medical group and health system leaders who are facing similar challenges and opportunities in the value-based world. Different session formats, ranging from didactic case studies to interactive discussion groups, allow you to learn from colleagues at organizations like yours and gain new perspectives from peers at organizations of different structures and sizes.

Leadership Council Meetings The following role-based Leadership Councils will meet on Tuesday, November 13. Due to the intimate nature of these meetings, participation is open only to AMGA member medical groups and health systems. Agendas for each Council, including topics and speakers, are available at amga.org/IQL18. Please note, registration requires a separate fee. • Chief Administrative Officers / Chief Operating Officers • Chief Executive Officers / Chairs / Presidents • Chief Medical Officers / Medical Directors • Chief Nursing Officers • Chief Quality Officers / Directors $ Separate fee $ 6

AMGA 2018 Institute for Quality Leadership Medicare Advantage and Risk: Delivering on the Promise of Value

7 Meaningful Collaboration Between Pharmacists and Physicians to Improve Quality and Meet Patient Needs Jamie Reedy, M.D., M.P.H., Chief of Population Health, and Laura Balsamini, Pharm.D., BCPS, National Director of Pharmacy Services, Summit Health Management and Summit Medical Group (NJ) As payment models move toward risk-based payment, medical groups are looking for new ways to create changes that engage and empower the entire care team. Pharmacists are often an overlooked part of the care team, despite their ability to impact quality measures, address rising pharmacy costs, and improve medication-related patient safety.

Leaders from Summit Medical Group (NJ) will discuss all aspects of their clinical pharmacy practice model, including the business case and value proposition, primary care integration and workflow, pharmacist/physician collaboration, data transparency, patient education, and outcomes measurement. Participants will depart the session with actionable strategies and tactics that resulted in the achievement of top tier medication adherence for their Medicare Advantage population, along with a 14% reduction in high-risk medication utilization and 17% improvement in generic utilization.

Implementing an Evaluation Framework to Support the Evolution of Value- and Team-Based Care Dominick L. Frosch, Ph.D., Chief Care Delivery Evaluation Officer and Senior Scientist, and Edward M. Yu, M.D., Medical Director for Quality, Palo Alto Medical Foundation/ Sutter Health Team-based approaches are paramount as organizations work to implement new care models to support value-based care. However, these new approaches often create challenges for organizations as they shift away from fee-for-service and begin identifying and implementing sustainable team structures. Evaluation and measurement of these models is critical, particularly before spreading them across a large, geographically dispersed organization. In its continued move to value, Palo Alto Medical Foundation is hiring a growing number of allied health professionals (e.g., nurse practitioners, physician assistants, clinical pharmacists, social workers) in primary care to support population health. The presenters will detail their framework to systematically and consistently evaluate the clinical and economic impact of this model, before describing a case study that focuses on the deployment of allied health professionals across 21 primary care departments at Palo Alto Medical Foundation.

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AMGA 2018 Institute for Quality Leadership Medicare Advantage and Risk: Delivering on the Promise of Value

Peer-to-Peer Shared Learning (continued) Patient-centric Care: Closing Care Gaps Through Technology, Transparency, and the Payer-Provider Nexus Ashok Rai, M.D., President and Chief Executive Officer, Prevea Health, and Jordan Pisarcik, Vice President, Account Management and Business Development, DocASAP Significant gaps in care along ethnic, geographic, and socioeconomic lines have driven patient satisfaction down while costs continue to rise. Creating digital connection points across healthcare providers, payers, and patients can help stakeholders to identify and reduce gaps while improving the patient experience and managing costs, particularly in value-based contracts. By employing online appointment scheduling and patient access solutions, Prevea Health has been able to intelligently match patients with available providers to better manage population health in rural Wisconsin markets. Experts will discuss how these technologies have increased patient volume, improved access to care, impacted appointment bookings via payer channels, and closed gaps in care. Wednesday, November 14, 10:45 a.m. - 11:45 a.m. Rethinking Primary Care from the Ground Up Robert E. Matthews, Vice President, Quality and Care Redesign, PriMed Physicians, and President and Chief Executive Officer, MediSync For medical groups and health systems focused on increasing value revenues or improving quality scores, achieving concrete results becomes more and more urgent. Many of the outcomes driving costs and tied to public reporting in value-based contracts—chronic disease management, wellness and prevention, and acute care access—fall predominantly to primary care. These requirements represent a major hurdle for primary care at a time with significant PCP shortages and burnout.

To help them succeed in their value-based arrangements, PriMed Physicians conducted an analysis and concluded that their current primary care model is incapable of meeting quality and cost goals. This presentation will detail their analysis and describe their efforts to fundamentally redesign primary care from the ground up. Participants will learn about design principles, methods, and progress to date, as well as some of the most common adaptations made to primary care teams that can actually worsen problems.

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AMGA 2018 Institute for Quality Leadership Medicare Advantage and Risk: Delivering on the Promise of Value

9 Lather, Rinse, Repeat: A Systematic Methodology to Improve Value- Based Performance in HCC Coding and Cost-Effective Prescribing Jonathan Nasser, M.D., Chief Clinical Transformation Officer, Crystal Run Healthcare; Nicole Karchner, Pharm.D., Director of Pharmacy Management, Crystal Run Health Plans; and Meghan Brunelle, CCS, CRCR, HCC Revenue Specialist and Educator, Crystal Run Healthcare The expansion of alternative payment models over the past decade has created demand for a growing number of competencies that are critical to an organization’s value-based successes, many of which rely on engaged physicians. Leaders from Crystal Run Healthcare will demonstrate how they’ve maximized physician participation and performance in two areas that heavily impact performance in risk contracts and shared savings: Hierarchical Conditional Category (HCC) coding and cost-effective prescribing. In this interactive seminar, they will share how they have deployed a repeatable, systematic methodology that increased submitted HCC scores by 45% and resulted in $2.1 million in drug cost savings while total prescriptions rose 5%.

Participants will depart with change management strategies, actionable interventions to improve key competencies, and essential lessons gleaned from nearly a decade of engaging physicians in risk. As a supplement to the presentation, session attendees will receive Crystal Run Healthcare’s gaps in care reports, details behind their novel coding performance measure, value-based prescription formulary, and educational handouts used to engage physicians. Navigating the Data Triangle of Value-Based Care: Value, Attribution, and Risk Kim Clements, Manager, Population Health Management Systems, The Polyclinic Physician Care Alliance and Physicians Care Network; and Mary Anderson, M.D., FACP, Chief Clinical Integration and Quality Officer, The Polyclinic Physician Care Alliance and Physicians Care Network Governmental and commercial payers are transitioning to increasing risk arrangements with incentives for high-quality and efficient care. In order for providers to succeed under this new paradigm, they will need to understand how quality, cost, and risk for their patient populations are measured and how to use and validate this data to transform care and perform well in value-based arrangements. This transformation to value-based requires that all participants understand how value-based care is defined and measured. Key components of the data triangle are attribution, value, and risk. This session, led by experts from The Polyclinic and Physicians Care Network, its managed care subsidiary, will highlight four steps needed to understand these components, how to effectively use data to improve value-based performance gaps, and examples and data from organizations ranging from a large integrated delivery system to a small single specialty practice.

AMGA 2018 Institute for Quality Leadership Medicare Advantage and Risk: Delivering on the Promise of Value

10 Reaching for the Stars: Implications and Strategies for Success with CMS’ 5-Star Program Irene Chen, M.D., Associate Executive Director, The Permanente Medical Group, Inc. Under the Centers for Medicare & Medicaid Services’ (CMS’) Medicare 5-Star Quality Rating System, it is essential for plans and their providers to demonstrate a high quality of care, not only to receive bonus payments to improve benefits but also to retain membership enrollment and ensure a robust presence in the market. Kaiser Permanente Medicare plans have consistently received high ratings since the program began in 2007, and have maintained high performance in all states in which the health plan operates. Learn firsthand about the structure and significance of the Medicare 5-Star Program, calculation of star ratings, and strategies to achieve superior performance and outcomes related to five broad categories—outcomes, intermediate outcomes, patient experience, access, and process—that are replicable for your medical group or health system.

Wednesday, November 14, 1:45 p.m. - 2:45 p.m. Using Proven Management Techniques to Transform Provider Engagement and Care Outcomes Richard Whittaker, M.D., Chief Medical Officer, WellMed Medical Group, part of OptumCare As medical groups and health systems transform from chaotic fee-for-service operations to value-based care practices that build engagement and focus on care outcomes, closing performance gaps between clinics or locations can yield significant dividends. In a time of rapid growth and expansion, WellMed Medical Group sought to design a scalable approach to allow and incentivize clinics to practice value-orientated medicine—and ultimately close a 30% gap in performance metrics (including engagement, quality, and affordability). The network with over 14,000 doctors’ offices in Texas and Florida created Practice Transformation Groups (PTGs) that use evidence-based management techniques to implement best practices, build care team engagement, and produce breakthrough results with predictability and order.

This practice transformation effort has dramatically reduced healthcare costs per member per month by 24% (a decrease of $179 PMPM), as well as significantly impacted rates of admissions, readmissions, and emergency room visits. Savings from decreased utilization in 2016 was $3.2 million, based on an average membership of 14,800 members. Session attendees will learn more about the design principles and approach, PTG selection process, five pre-implementation processes and four implementation stages, results, and lessons learned.

Peer-to-Peer Shared Learning (continued)

11 Using Mental Health Integration to Manage Chronic Conditions at Lower Costs to the Community Brenda Reiss-Brennan, Ph.D., APRIN, Medical Health Integration Director, Intermountain Healthcare; and C. Chris Thornock, Vice President, Intermountain Healthcare, and Chief Operating Officer, Intermountain Medical Group This presentation will review the specific mental health integration (MHI) delivery strategies that have improved the efficient management and outcomes of chronic diseases and complex comorbid conditions at Intermountain Healthcare. This includes promoting “whole health” and well-being in the management of chronic disease in the primary care setting. Results will describe the cost benefit of collaborative primary and mental health care that leads to improved functional status in patients, and improved satisfaction and confidence among physicians in managing mental health problems as part of routine medical care at a neutral cost, with specific reduction in emergency room utilization. Attendees will understand how Intermountain’s full clinical integration model can be adapted to help local primary care redesign advance beyond specialty co-location challenges in managing the social process and cost of multiple complex chronic diseases (e.g., depression, diabetes, asthma, substance abuse, bipolar disorder, heart disease, chronic heart failure, obesity, chronic pain). During the session, presenters will share current results of descriptive and comparative analyses related to factors that promote or deter improved outcomes across medical group clinics in various stages of MHI implementation.

A Journey to Improve Panel Risk Adjustment Scores Philip Chan, M.D., Associate Medical Director, Population Health, and Denise Bender, Manager, Health Promotions, UW Medicine/Valley Medical Center Under value-based reimbursement models, resource allocation is determined by the risk adjustment factor (RAF) score. With value-based contracts now accounting for nearly 50% of its business, UW Medicine/Valley Medical Center steadily improved its RAF score from 0.638 in 2014 to 0.787 in 2017, as their Medicare Advantage panel proportion also grew drastically. Experts will share lessons learned and best practices, including how provider education and on- boarding, incentives, improved data reporting efficiencies, and other activities and strategies can improve your own organization’s RAF scores. As part of this breakout session, participants will come away with tools that can be used to better RAF scores at your medical group or health system, including an understanding of how to adapt the tools based on the unique culture and practice environment.

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12 Peer-to-Peer Shared Learning (continued) Taking Diabetes to Heart: Finding Value in the Medicare Population Parag Agnihotri, M.D., Medical Director, Sharp Rees-Stealy Medical Group; Jeffrey Galles, D.O., Chief Medical Officer, AHS Oklahoma Physician Group, LLC dba Utica Park Clinic; and Carolyn Koenig, M.D., Medical Chair, Quality Department, Mercy Clinic - East Communities Moderated by: John W. Kennedy, M.D., Chief Medical Officer, AMGA; President, AMGA Foundation More than 25% of Americans over the age of 65 have diabetes, representing 12 million seniors who are at increased risk for cardiovascular disease (CVD). Join leading medical groups and health systems participating in the AMGA Foundation’s Together 2 Goal® campaign’s Innovator Track’s CVD Cohort to discover best practices for managing CVD for seniors with Type 2 diabetes. The panel will share proven strategies to improve medication adherence, leverage CVD risk tools, and promote smoking cessation for the Medicare population living with diabetes.

Thursday, November 15, 8:00 a.m. - 9:30 a.m. Facilitated Hot Topics Facilitated discussion will provide interactive, instant feedback around specific strategies that medical group and health system leaders are using to confront common challenges in risk and value-based care.

13 Destination San Antonio Overlooking the historic Alamo mission, the host hotel is located steps from the legendary San Antonio Riverwalk. After you receive your conference registration confirmation email, you will be eligible to reserve your hotel room at the Hyatt Regency San Antonio Riverwalk. In order to receive the special AMGA room rate of $199 per night, please make reservations using the dedicated link by Friday, October 12. After this date, rate and availability cannot be guaranteed. For groups sending 10 or more attendees, please contact AMGA directly to discuss options for special room blocks and registration assistance. Bruce Hadloc, meetings and education assistant, can be reached at bhadloc@amga.org or 703.838.0033 ext. 366.

Your Meeting Experience

• Group Discounts: Provider organizations are encouraged to bring their administrative and clinical leadership teams to IQL18. Four or more registrants from the same organization will receive a $100 discount per registration. • Cancellation Policy: Cancellations must be submitted in writing by Friday, October 5 in order to receive a refund, less a $100 processing fee. No-shows are not eligible for refunds. Substitutions are welcome and will not incur a processing fee. • Americans with Disabilities Act Statement: AMGA is committed to making each of its educational activities accessible to all participants so they may be actively involved in the meetings and conferences. If you have special physical, dietary or communication needs that require auxiliary aids or services identified in the Americans with Disabilities Act, please call us at 703.838.0033 ext. 333 so that we can accommodate your requests.

• Code of Ethics: AMGA’s Code of Ethics, available at amga.org/IQL18, applies at all AMGA meetings, conferences, forums, and meeting-related events, including those sponsored by organizations other than AMGA but held in conjunction with AMGA events in which they participate. Attendees should familiarize themselves with our code of ethics. • Privacy Statement: Per AMGA policy, we do not distribute attendee emails to sponsors/exhibitors for this event or at any time. 14 Meeting Policies Continuing Education Credits AMGA’s continuing education program delivers high-quality learning activities to respond to the educational needs of medical group leaders. Medical group leaders who participate in activities offered by AMGA can apply for credits to complete their requirements in CME, CPE, and ACHE. Please visit amga.org/IQL18 for specific credit hours, learning objectives, and additional details.

Registration Form AMGA’s 2018 Institute for Quality Leadership November 13–15, 2018 • Hyatt Regency San Antonio Riverwalk • San Antonio, Texas Please print or type all information. One individual per form please. This form may be photocopied for additional registrants. Registrant’s Full Name and Degree (if applicable _ _ Job Title _ _ Organization Name _ _ Mailing Address _ City _ _ State _ _ ZIP _ _ Telephone _ Email _ _ Assistant’s Name & Email _ _ First Name/Nickname (to appear on badge _ _ Emergency Contact Name and Telephone _ _ National Provider Identifier (NPI) Number (if applicable _ _ IQL (November 14-15, 2018) By September 28 September 29-October 26 After October 26 Includes IQL General Sessions, Peer-to-Peer Breakouts, and meal functions with exhibitors.

AMGA Member or Corporate Partner o $ 825 o $ 925 o $ 1,025 AMGA Non-Member or Non-Corporate Partner o $ 1,650 o $ 1,850 o $ 2,050 Leadership Councils (November 13, 2018) Participation in the AMGA Leadership Councils is limited to the members of the Councils only. If you are unsure of your status, please contact Joe DeLisle at jdelisle@amga.org or 703.838.0033 ext. 355. Leadership Council Meeting o $ 275 o $ 275 o $ 275 Please select which council you are attending: o CAO/COO o CEO/President/Chair o CMO/Medical Directors o CNO o CQO/Director Other Fees Spouse/Guest of IQL This fee covers the Welcome Reception on Tuesday, November 13, as well as breakfasts, lunches, and receptions in the Exhibit Hall November 14-15. Spouse/Guest Fee o $ 175 Spouse/Guest of Leadership Council Reception This fee covers the Council welcome event on Monday, November 12. Spouse/Guest Fee o $ 50 Name of Spouse/Guest _ _ Spouse’s/Guest’s First Name/Nickname (to appear on badge _ _ Cancellations must be submitted in writing by Friday, October 5 in order to receive a refund, less a $100 cancellation fee. After this date, cancellations will receive a Letter of Credit for the amount paid, less a $100 cancellation fee. Payment Information o Check, in the amount of , is enclosed. o Please charge _ to my o Visa o MasterCard o American Express Card number Expiration date Security Code Name (please print) Signature Questions? Contact Bruce Hadloc at bhadloc@amga.org or 703.838.0033, ext. 366. For more information, visit amga.org/IQL18 Total Amount Due:

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