Name
F13 - Bridging Gaps and Breaking Silos: Mastering Integrated Care Management and Improving Outcomes
Date & Time
Thursday, October 16, 2025, 2:45 PM - 3:45 PM
Location Name
306C
Description

This interactive workshop, featuring a panel of leaders from a North Carolina health plan, will provide participants with strategies and tools to enhance integrated co-management while fostering a healthy culture of vulnerability and learning. The session will highlight how the use of best practices, data solutions, and a cross-discipline co-management model streamlines communication, improves outcomes and creates an environment of balanced health and collaborative care. Attendees will gain a deeper understanding of how bridging gaps and breaking silos within healthcare systems is essential for mastering integrated care management and improving overall outcomes through person-centered approaches, technology, data-driven insights, and co-location of care management.

Speakers
Sara Wilson MSW, LCSW, Vice President, Care Management, Vaya Health, Asheville, NC
Tiffany Munday MBA, RN, CCM, Integrated Care Management Director, Vaya Health, Asheville, NC
Heather Cree PharmD, Vice President of Pharmacy Operations, Vaya Health, Asheville, NC
Lorena Wade MD, Deputy Chief Medical Officer, Vaya Health,
Sara Wilson Tiffany Munday Heather Cree
Content Level
All Audience
Tags
Collaborative Care Model of Integrated Care, Population and public health, Primary Care Behavioral Health Model
Session Type
Concurrent
SIG or Committee
Collaborative Care Model (CoCM)
Objective 1
Identify actionable strategies to dismantle silos within organizations and the broader healthcare system.
Objective 2
Examine integrated case examples to identify strategies that can be adapted to participants own organizations.
Objective 3
Understand challenges and consider potential solutions for integrated care management.
Content Reference 1

Integrate care reference: Kodner, D. L. (2025). Integrated care: A critical analysis. International Journal of Integrated Care, 25(1), 1-10. https://doi.org/10.5334/ijic.5652

Content Reference 2

Medication reconciliation reference: Zhu LL, Wang YH, Lan MJ, Zhou Q. Exploring the Roles of Nurses in Medication Reconciliation for Older Adults at Hospital Discharge: A Narrative Approach. Clin Interv Aging. 2024;19:367-373 https://doi.org/10.2147/CIA.S450319

Content Reference 3

Chronic conditions reference: Mills, W. R., Poltavski, D., Douglas, M., Owens, L., King, A., Roosa, J., Pridham, J., Dzina, D., & Weber, D. (2020). A Platform and Clinical Model to Enable Medicare's Chronic Care Management Program. Population health management, 23(2), 107–114. https://doi.org/10.1089/pop.2019.0053

Content Reference 4

Interdisciplinary teams reference: Warren, J. L., & Warren, J. S. (2023). The Case for Understanding Interdisciplinary Relationships in Health Care. Ochsner journal, 23(2), 94–97. https://doi.org/10.31486/toj.22.011

Content Reference 5

Care Manager experience reference: Knox, M., Esteban, E. E., Hernandez, E. A., Fleming, M. D., Safaeinilli, N., & Brewster, A. L. (2022). Defining case management success: a qualitative study of case manager perspectives from a large-scale health and social needs support program. BMJ open quality, 11(2), e001807. https://doi.org/10.1136/bmjoq-2021-001807