Breakout Sessions

Check back for updates on our other outstanding speakers and sessions.*

Best Practices in Rooting Out Fraud, Waste, and Abuse in Medicare and Medicaid

Fraud, waste, and abuse in Medicare and Medicaid cost U.S. taxpayers billions of dollars each year and undermine the integrity of programs that millions of Americans rely on for essential health care. This discussion brings together APG members and the federal policy team to examine effective strategies for detecting, preventing, and addressing improper activities within these programs.

Participants will explore best practices in program integrity that help identify suspicious billing patterns and reduce improper payments, as well as learn about APG's advocacy with policymakers to address needed tools and support. Attendees will gain actionable insights into building more resilient compliance frameworks while balancing program access, efficiency, and patient protection.

How To Govern Health AI To Ensure Clinical Excellence and Patients’ Trust

The rapid adoption of AI solutions raises multiple questions for physician groups beyond whether the solutions achieve their advertised goals. How should groups define the different operational roles between AI vendors and clinicians? Who ultimately is responsible for AI-based decisions, potential failures, and the resulting risks posed to both patients and physician organizations? How should these organizations communicate to patients about AI’s role in the provision of care, particularly amid evolving state regulations on this topic? This session will focus on creating governance structures that address these questions and build a “high trust” environment around adoption and use of AI tools.

When AI Systems Are Their Own “Agents”:  Benefits And Risks For Physician Groups

A relatively recent development in AI is creation of “agentic” systems designed to act autonomously as "agents" to achieve specific goals with minimal human intervention. Unlike traditional AI, which typically follows directions or prompts, agentic AI can perceive its environment, reason through complex problems, and create and execute multi-step plans – for example, by searching an electronic record to understand patients’ conditions, then surfacing real-world evidence to support treatment decisions before a clinician prompts the system to do so. In this session, panelists will discuss potential new applications for agentic AI in care delivery, especially in clinical and other processes prone to inefficiencies and bottlenecks.  They will also discuss creating needed guardrails around these agentic systems – for example, to block harmful or inaccurate information before the systems display it to clinical or other users.

Boosting Value-Based Care Amid Statewide Change Through The Rural Health Transformation Program

The federal Rural Health Transformation Program (RHTP) was created under the 2025 reconciliation law to blunt the effects of large, planned cuts in federal Medicaid spending by channeling $50 billion to states from 2026-2030.  The resulting plans that all 50 states submitted to receive the first tranche of funding make clear that statewide changes – including among providers and systems located well outside rural areas – will be a key component of these plans to improve access, quality, and population health outcomes.  Multiple states – including California, Utah, South Dakota, Minnesota, and others -- are also planning to shape new value-based care and payment approaches to help support care innovations in care delivery in rural areas.  In this session, speakers involved in multiple states’ RHTP programs will discuss the opportunities for new statewide partnerships among urban and rural providers, and the adoption of value-based care and payment models, to foster real change. 

Engaging More Specialists In Value-Based Care

According to a McKinsey analysis, total costs of care for patients seeing six types of specialists – in orthopedics, oncology, cardiology, women’s health, behavioral health, and nephrology – accounted for 68 percent of total Medicare and commercial spending in 2023, growing 35 percent faster than all other spending in those categories. Estimates are that applying value-based payment strategies to specialty care could save $100 billion or more per year.  In this session, APG will officially launch its new Specialty Advocacy Coalition, which will encompass the multiple avenues for bringing specialists into value-based payment arrangements. Speakers’ presentations will focus on the CMS Innovation Center’s strategy for specialty care and payment models; specific models in areas such as kidney care and oncology; and a new Optum technology-enabled system to help primary care providers refer patients to the most value-oriented specialists, coupled with incentives for those specialists to participate.