Physician Engagement and Emerging Compensation Models

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Physician Engagement and Emerging Compensation Models

  1. 1. Healthcare Education Associates and RISE (The Risk Adjustment Initiative and Society for Education) Proudly Present Two Leading-Edge Events! Best Practices in Network Development & Contract Management Physician Engagement & Emerging Compensation Models To Register: Call 866-676-7689 or visit us at www.healthcare-conferences.com September 23-24, 2013 The Princeton Club, New York City Two Co-Located Events – Get the All-Access Pass for Both! Topics at a Glance • Staying Ahead of the Curve: Exploring the Evolution of Contracting Terms and Network Development • Managing the Impact of Provider Group Consolidation on Contract Development • Achieving Population Health Management Goals within New Network Designs • Legal Focus: Mastering the Nuances of Contract Management in a Changing Marketplace • Payer and Provider Quality Quest: Negotiating Mutually-Beneficial Contractual Terms for Quality Measurement • Managing the Unique Contracting and Network Building Strategies Required for ACOs • Impacting the Dual Eligibles Segment: Strategies for Contracting with Community-Based Organizations Topics at a Glance • Rules of Engagement– Gaining the Attention, Involvement, and Commitment of Providers • Finding Common Ground – Strategic Alignment of Payer/Physician Goals to Achieve Success in a Value-Based Model • Combining Financial Incentives and Support Tools with Increased Physician Accountability for an Effective Patient- Centered Medical Home • Provider Perspective Part I – Adapting Operational Structures to Meet the Demands of a Fee-for-Value Paradigm • Provider Perspective Part II – Best Practices for Identifying and Managing Risk • Improving Quality While Reducing Costs Through Bundled Payments and Episodes of Care • Shared Risk, Shared Reward - Innovative and Engaging Risk/Reward Sharing Arrangements • And more! Achieving Risk-Sharing, Quality Management and Access to Care Goals in an Evolving Marketplace Driving Quality and Cost Efficiency through Value-based Delivery and Payment Systems The PREMIER conference focused on contracting and network building strategies! Gain the tools to build productive payer/ provider partnerships! Conference Sponsor
  2. 2. RISE and Healthcare Education Associates are leading the way in payment/delivery system reform education with two side-by-side events covering some of the hottest issues affecting health plans and providers today: developing sound provider networks and contracts and engaging physicians in performance-based delivery systems and payments. Get a handle on these crucial issues that can make or break your organization’s revenue in the years to come! Best Practices in Network Development & Contract Management provides strategies your team must implement to navigate the new, complex landscape of managed care contracts and tailored network development. Featuring leaders from plans, health systems, and service providers experienced in innovative network development and the evolution of contract management, discussions and case studies will address: • How to stay ahead of the evolution of managed care contracts to reach your organization’s revenue and health management goals • Methods for accurately assessing the impact specific tailored networks may have on access to care and clinical outcomes • Identifying when contract outsourcing is necessary for your organization • Strategies for maintaining rate integrity amidst rampant provider consolidation • Techniques for attracting limited specialists into designer networks • Why you must first establish your clinical model before positive outcomes can result from contracting changes • Items your organization must address during year-two contract re-negotiations for the Exchanges to guard against potential, long-term revenue loss and/or compromised care quality • How to successfully contract with community-based organizations Physician Engagement & Emerging Compensation Models examines the incentives, payment models, risk/reward sharing arrangements, and support tools being used to drive physician engagement and acceptance in the shift to value-based healthcare. Learn what works, what’s new, and what to avoid from thought leaders and innovators on both the payer and provider sides. We’ll explore ideas like: • Innovative payment models being used to drive the new delivery system • How to drive physician engagement through personal and peer-performance data • Reimbursement models that promote collaboration and integration of care throughout the network • What strategies physicians can use for handling a higher volume of patients while providing higher level of quality • Defining the level of physician accountability in an ACO • Best practices for establishing episodic payment structures across care settings • Risk/reward sharing arrangements that work • Evaluating behavior and risk for various member populations This is the PREMIER industry event addressing the challenges both plans and providers will face on the road to healthcare payment and delivery system reform! Don’t miss this cutting-edge event – Register now! Call 866-676-7689 or register online at www.healthcare-conferences.com. Sincerely, Lori Medlen Christine Marez Lori Medlen, President Christine Marez, Conference Director HEALTHCARE EDUCATION HEALTHCARE EDUCATION ASSOCIATES ASSOCIATES and Executive Director THE RISK ADJUSTMENT INITIATIVE & SOCIETY FOR EDUCATION P.S. Customize your attendance with the All-Access Pass! Bounce back and forth between all sessions being offered and receive conference documentation from BOTH events! P.P.S Send your team at a significant discount! Call Whitney Betts 704-341-2445 or email wbetts@healthcare-conferences.com To Register: Call 866-676-7689 or visit us at www.healthcare-conferences.com The Conference Sponsors Healthcare Education Associates is a division of Financial Research Associates, LLC. HEA is a resource for the healthcare and pharmaceutical communities to improve their businesses by providing access to timely and focused business information and networking opportunities in topical areas. Offering highly targeted conferences, Healthcare Education Associates positions itself as a preferred resource for executives and managers seeking cutting-edge information on the next wave of business opportunities. Backed with over 26 years of combined conference industry experience, the producers of HEA conferences assist healthcare professionals, actuaries, attorneys, consultants, researchers and government representatives in their professional endeavors. See www.healthcare-conferences.com for more information on upcoming events. RISE began as the first national association totally dedicated to enabling healthcare professionals to meet the challenges of risk adjustment. Now, RISE has expanded its focus in recognition of the fact that risk adjustment, quality, revenue management and Star ratings are inexorably linked and that education in each of these areas is essential for plan and provider success. We strive to serve our members on three fronts: networking, education and industry intelligence. Through meaningful networking opportunities, roundtables, cutting- edge conferences and webcast presentations, RISE brings together multiple perspectives and facilitates highly interactive discussion between professionals and provides our members with the crucial information they need to stay ahead of the curve. To learn more about RISE, or to join, visit us online: www.rasociety.org Who Will Attend? Senior Managers from Medicare, Medicaid, and Commercial plans, hospital and health system leaders, consultants, and service providers with responsibilities in the following areas: • Contract Management & Administration • Provider & Payer Contracting/Relations • Managed Care Contracting • Network Management/Development • Accountable Care • Product Development • Clinical Analytics • Quality Measurement/Improvement • Care Management • Physician Engagement • Legal & Regulatory Affairs • Financial Management & Operations Top Reasons to Attend • Learn what new payer-provider contract language you must incorporate to avoid costly clinical and financial mistakes • Gain techniques for attracting limited specialists into designer networks • Identify items your organization must address during year-two contract re-negotiations for the Exchanges • Discover methods for accurately assessing the impact specific tailored networks may have on access to care and clinical outcomes • Gain strategies for effectively contracting with community-based organizations • Get a thorough overview of payment models being used to drive the new delivery system • Devise reimbursement models that promote collaboration and integration of care throughout the network • Physicians – hear strategies for handling a higher volume of patients while providing higher level of quality • Learn best practices for establishing episodic payment structures for hospital care • Examine risk/reward sharing arrangements that work Our Renowned Speaking Faculty Best Practices in Network Development & Contract Management Michele Fisher, UW MEDICINE Dhyan D. Lal, PROVIDENCE WA REGIONS AND SWEDISH HEALTH SYSTEM Shirley Lemmons, REDLANDS COMMUNITY HOSPITAL Cathy Neiman, CENTERLIGHT HEALTHCARE Anne O’Hagen Karl, MANATT, PHELPS & PHILLIPS, LLP Justin Sampson, OVERLAKE HOSPITAL MEDICAL CENTER; OVERLAKE MEDICAL CLINICS Stephanie Winer-Schreiber, Esq., BUCHANAN INGERSOLL & ROONEY PC John M. Kirsner, SQUIRE SANDERS (US) LLP Paul T. Gallese, ALVAREZ & MARSAL HEALTHCARE INDUSTRY GROUP, LLC Rebecca Kohl, HEALTH PARTNERS OF PHILADELPHIA, INC. Todd M. Husty, D.O., F.A.C.E.P, MEDICAL AUDIT RESOURCE SERVICES INC. (MARSI) Alan D. Lash, LASH & GOLDBERG LLP Glen A. Reed, KING & SPALDING LLP James W. Boswell, KING & SPALDING LLP JJ White, BLUE CROSS and BLUE SHIELD OF TEXAS Physician Engagement & Emerging Compensation Models Kavita Patel, BROOKINGS INSTITUTE Guy D. Guarige, ALTA BATES MEDICAL GROUP - A DIVISION OF BROWN & TOLAND PHYSICIANS Kristen Miranda, BLUESHIELD OF CALIFORNIA Cary Sennett, IMPAQ INTERNATIONAL Sharlene A. Scott, CODING ACADEMY OF AMERICA Randall Krakauer, AETNA Jennifer Winchester, BLUECROSS BLUESHIELD OF SOUTH CAROLINA Stuart Levine, ACCRETIVE HEALTH Simeon A. Schwartz, WESTMED MEDICAL GROUP David Shulkin, MORRISTOWN MEDICAL CENTER/ATLANTIC HEALTH Marcia James, HUMANA Tricia Nguyen, BANNER HEALTH NETWORK Howard Tepper, SAINT JOSEPH’S HEALTHCARE SYSTEM Karen L. Ashline, CHAMPLAIN VALLEY HEALTH NETWORK Sarah Spillane, KAISER PERMANENTE
  3. 3. To learn more about sponsorship opportunities, please contact Kevin Weigel at 704-341-2448 or email kweigel@healthcare-conferences.com Best Practices in Network Development & Contract Management DAY ONE: Monday, September 23, 2013 8:00 – 8:45 Registration & Continental Breakfast 8:45 – 9:00 Chairperson’s Welcome and Opening Remarks 9:00 – 10:15 Staying Ahead of the Curve: Exploring the Evolution of Contracting Terms and Network Development As the industry undergoes some of the greatest changes it has ever seen, several contracting and network building nuances are emerging. In order to stay ahead of the changes, this session will provide tools for: • Recognizing distinct contracting variations, from both the provider and payer perspective, for emerging care delivery and payment models: - Bundled payments - PCMH contracting - ACO contracting - Value-based purchasing • Ensuring you know how to make the most of your risk-sharing opportunities before entering contract negotiations • Understanding what the road to the Exchanges has revealed about the state of our industry • Weighing essential factors into new contract management strategies: - Organizational culture - Access to data - Existing staff and financial resources Moderator TBA Panelists: Anne O’Hagen Karl, Associate MANATT, PHELPS & PHILLIPS LLP Shirley Lemmons, Director of Managed Care Contracting REDLANDS COMMUNITY HOSPITAL JJ White, Director of Value Based Contracting BLUE CROSS AND BLUE SHIELD OF TEXAS 10:15 – 11:00 Payer and Provider Quality Quest: Negotiating Mutually-Beneficial Contractual Terms for Quality Measurement • Determining whether you should use an internal or external quality measurement system - Should you structure measures after existing standards? - Is establishing a measurement platform unique to your payer-provider agreement a feasible alternative? • Agreeing on specific measures to be evaluated • Establishing measures for Centers of Excellence • Setting contractual language to reflect how quality measures will be evaluated and reported • Implementing quality measurements specific to Exchange products and network provider members Stephanie Winer-Schreiber, Esq., Shareholder BUCHANAN INGERSOLL & ROONEY PC 11:00 – 11:15 Morning Break 11:15 – 12:30 Recognizing the Differences Between Health Plan and Provider ACO Contracts • Defining a ‘health plan ACO’ vs. ‘provider ACO’ - - Governance structure - Network structure(s) - Types of arrangements - Scope of care • Strategies for when the two types of ACOs intersect • Understanding the importance of a clear “Governing Agreement’ • How to avoid confusion when, as a Provider ACO, you are a participant in a health plan ACO • Examining how different vernaculars may cause confusion and the importance of term definition in a contract - (“Member”/”Affiliate”/”Participant”/”Partner”/”Provider”) • Determining how providers will be paid - for the provider ACO and for the payer ACO • Why payer-provider collaboration is critical to success Michele Fisher, Director, Contracting and Payer Relations UW MEDICINE 12:30 – 1:30 Networking Luncheon 1:30 – 2:30 Recognizing Potential Legal Obstacles to Tiered and Narrow Networks • Provider rankings: How legal and regulatory challenges to provider tiering have fared • Challenges to provider exclusions: Antitrust and any willing provider-based challenges • How the Affordable Care Act addresses provider “discrimination” • Practical and policy ramifications of limiting networks in markets with high payor concentration Glen A. Reed, Partner KING & SPALDING LLP James W. Boswell, Partner KING & SPALDING LLP 2:30 – 3:30 Meeting the Costs vs. Quality Performance Challenge: Building a Robust Limited Network • Why having a large provider member base no longer makes sense in the landscape of accountable care • Methods for achieving a quality network with fewer provider members • Strategies for attracting limited specialists into designer networks - Evaluating the costs vs. benefits of building narrow networks for certain specialties • Leveraging limited networks to establish a more collaborative provider relationship Rebecca Kohl, Vice President, Network Management HEALTH PARTNERS OF PHILADELPHIA, INC. 3:30 – 3:45 Afternoon Break 3:45 – 4:45 Legal Focus: Mastering the Nuances of Contract Management in a Changing Marketplace For many contract managers, this is the first time risk and quality terms are being included in payer-provider agreements. In this session, legal experts well-versed in the complex landscape of contract language will explore reform updates your team must know in order to keep up with a shifting market: • Why it is imperative your entire team understands the minute variances required for this new wave of contracts • The truth behind anti-patient-steering contractual language • Ensuring ACO contracts detail FWA, Anti-Kickback and Stark adherence • Seamlessly adapting to contracting changes resulting from health reform mandates • Planning ahead to ensure deadlines for specific ACA mandates are acknowledged and met • New contract language and review protocol for safeguarding against costly mistakes John M. Kirsner, Partner SQUIRE SANDERS (US) LLP Paul T. Gallese, Director ALVAREZ & MARSAL HEALTHCARE INDUSTRY GROUP, LLC 4:45 – 5:45 Cocktail Reception Immediately Following To sponsor this Cocktail Reception please contact Kevin Weigel at kweigel@healthcare-conferences.com or 704-341-2448
  4. 4. To Register: Call 866-676-7689 or visit us at www.healthcare-conferences.com Best Practices in Network Development & Contract Management DAY TWO: Tuesday, September 24, 2013 8:00 – 8:45 Continental Breakfast 8:45 – 9:00 Chairperson’s Recap of Day One 9:00 – 10:00 Achieving Population Health Management Goals within New Network Designs • Measures you must take to accurately assess the impact specific tailored networks may have on patient care and access: - Narrow Networks - Local Networks (vs. traditionally national networks) - Tiered Networks - Employer-Specific Networks - Centers of Excellence • Why you must first understand the provider perspective before achieving optimum alignment • Communication methods for aligning network provider members with cost management goals • Exploring the revenue impact of moving beyond large hospital systems and toward contracting with ancillary outpatient care facilities and home health providers Shirley Lemmons, Director of Managed Care Contracting REDLANDS COMMUNITY HOSPITAL 10:00 – 10:45 Provider Focus: Provider Profiling Focus: Physician Documentation and its Impact on Quality Health Delivery • Evaluating the most important metric of the primary care provider matrix • Moving beyond traditional data-driven profiling strategies • Taking a hands-on approach to incorporating in-depth analysis of physician/ patient interaction • Recognizing the relationship between quality documentation and quality care • Building an internal team to support documentation improvement and quality improvement Todd M. Husty, D.O., F.A.C.E.P., President/CEO MEDICAL AUDIT RESOURCE SERVICES INC. (MARSI) 10:45 – 11:00 Morning Break 11:00 – 12:00 Preparing for Contract Re-Negotiation: Learning from Year-One Exchanges Contracting Given the tremendous unknowns surrounding the Exchanges, many payer- provider agreements are being left open-ended with the opportunity for either payers or providers to revisit terms after year-one of the Exchanges marketplace. This session will explore key considerations when revisiting your Exchanges contracts: • Rate negotiations on the Exchanges - Modeling after Medicare rates vs. commercial rates • How are networks and provider practices going to be impacted by the Exchanges in the long-term? • What items should your organization address during re-negotiations in order to protect against potential, long-term revenue loss and/or compromised quality performance? Justin Sampson, Director of Managed Care Payor Contracting OVERLAKE HOSPITAL MEDICAL CENTER OVERLAKE MEDICAL CLINICS Dhyan D. Lal, Director, Payor Contracting PROVIDENCE WA REGIONS AND SWEDISH HEALTH SYSTEM 12:00 – 1:00 Networking Luncheon 1:00 - 2:00 Impacting the Duals Eligibles Segment: Strategies for Contracting with Community- Based Organizations • Establishing a well-planned approach to successfully contract with community-based organizations • Agreeing upon quality benchmarks and reporting guidelines specific to the resources and administrative culture of locally-based organizations • Exploring the benefits of non-traditional clinical programs • Establishing on-going communication practices to monitor progress of your combined efforts • Seamlessly incorporating behavioral health and substance abuse programs into network development Cathy Neiman, Vice President, Provider Relations & Network Development CENTERLIGHT HEALTHCARE 2:00 – 2:45 Best Practices, Recent Developments and Trends in the Alternative Resolution of Healthcare Payor-Provider Disputes • Litigation vs. arbitration of healthcare payor-provider disputes • Best practices in using ADR to resolve payor-provider disputes • Recent developments: The AAA’s Healthcare Payor-Provider Arbitration Rules • Prescriptions for drafting ADR clauses in payor-provider contracts Alan D. Lash, Partner LASH & GOLDBERG LLP 2:45 – 3:30 Managing the Impact of Provider Group Consolidation on Contract Development • Maintaining rate integrity in spite of provider group consolidation trends • Identifying provider consolidation developments and preparing for the potential impact region-by-region • Exploring whether new trends toward narrow networks are actually driving provider consolidation • Establishing re-evaluation terms to protect against potential revenue loss • Evaluating the potential impact provider consolidation may have on specific markets prior to network building Dhyan D. Lal, Director, Payor Contracting PROVIDENCE WA REGIONS AND SWEDISH HEALTH SYSTEM 3:30 Summit concludes
  5. 5. To learn more about sponsorship opportunities, please contact Kevin Weigel at 704-341-2448 or email kweigel@healthcare-conferences.com Physician Engagement & Emerging Compensation Models DAY ONE: Monday, September 23, 2013 8:00 – 8:45 Exhibits Set-Up, Registration, & Continental Breakfast 8:45 – 9:00 Co-Chairs’ Opening Remarks 9:00 – 10:15 Rules of Engagement Gaining the Attention, Involvement, and Commitment of Providers • Encouraging physicians to take a leadership role in the transition to value- based heath care • Physician and staff education and emphasis on the importance of quality, patient health, and core measures in P4P • Utilizing clinical and performance measures as tools to improve care • Encouraging evidence-based decision making and best practices • Getting physicians to see value in the quality of the patient experience • Holding physicians and their teams responsible for achieving the best possible outcomes • Driving physician engagement through personal and peer-performance data • Communicating the advantages of adapting to change – and the cost of resistance Kavita Patel, Managing Director BROOKINGS INSTITUTE Marcia James, Director, Provider Engagement HUMANA 10:15 – 11:00 Finding Common Ground Strategic Alignment of Payer/Physician Goals to Achieve Success in a Value-Based Model • Aligning payer/provider goals along the triple aim of better care, better health, and lower costs • Working with providers in a partnership role to foster positive payer/provider relations and mutual trust • Helping providers manage risk with infrastructure and support in case management, disease management, and risk management tools - Strategic placement of nurses and case managers - Sharing analytics and data across your provider network • Population health management – managing large and small populations of members in your provider networks • Trend-watch: Health plan-owned provider groups and provider-owned health plans - The blurring of clear payer/provider roles Guy D. Guarige, Chief Operating Officer ALTA BATES MEDICAL GROUP Kristen Miranda, Vice President, Strategic Partnerships BLUESHIELD OF CALIFORNIA *Pending final confirmation 11:00 –11:15 Morning Break 11:15 – 12:30 Combining Financial Incentives and Support Tools with Increased Physician Accountability for an Effective Patient-Centered Medical Home • Evaluating the cost of operating a Patient-Centered Medical Home • What is the business case for creating a Patient-Centered Medical Home? - What payer incentives have worked to move providers to this model? - What other support do providers need to help them understand that PCMH is more than a checklist? - What is the expected ROI to become a PCMH? From the payer perspective? From the provider perspective? • Creating incentives to generate improvements in access, quality, and efficiency • Reengineering the primary care practice • Engaging the primary care physician in a PCMH setting • Providing sufficient non-monetary support tools • Reimbursement models that promote collaboration and integration of care throughout the network • What about the patient? How can you really incorporate patients into PCMH? What’s worked? David Shulkin, MD, President MORRISTOWN MEDICAL CENTER/ATLANTIC HEALTH Cary Sennett, MD, PhD, President IMPAQ INTERNATIONAL Karen L. Ashline, Director, Northern Adirondack Medical Home Project CHAMPLAIN VALLEY HEALTH NETWORK 12:30 – 1:30 Networking Luncheon Two-Part Provider Perspective 1:30-2:30 Provider Perspective Part I Adapting Operational Structures to Meet the Demands of a Fee-for-Value Paradigm • How do you function with one foot in FFS and one foot in VBR (value-based reimbursement)? • The importance of determining your role in the network of your paying entities • Handling a higher volume of patients while providing higher level of quality • Utilizing nurse practitioners and physician assistants to take up the slack • Assembling appropriate administrative and clinical staff to handle the workload • Rewards and incentives for office staff • Patient engagement – the key to successful outcomes • Utilizing provider evaluations as a tool for improvement • Taking on more non-reimbursed activities Simeon A. Schwartz, M.D., President and CEO, Westmed Medical Group WESTMED MEDICAL GROUP 2:30 – 3:30 Provider Perspective Part II Best Practices for Identifying and Managing Risk • Determining fiscal risk – both downside and upside • Operational risk – managing fixed payments • Utilizing administrative data and predictive modeling to estimate risk • Identifying and tracking key patients who are vital to meeting incentive goals • Negotiating episodic and capitated payments across the provider continuum • Physician risk from within a private practice vs. salaried • Utilizing health plan partnerships and support to avoid downside risk and maximize rewards Sharlene A. Scott, Regional Coding Education Senior Manager, HIMS KAISER PERMANENTE, MID-ATLANTIC STATES Tricia Nguyen, Chief Medical Officer BANNER HEALTH NETWORK 3:30 – 3:45 Afternoon Break 3:45 – 4:45 Alignment of Fiscal and Clinical Accountability to Drive Physician Engagement and Quality in an ACO Setting • What exactly is an ACO? A payment model, a delivery system model, both? • Payer-provider collaboration in the ACO model • Levels of accountability for PCPs in the ACO model • Encouraging strong PCP leadership within the provider network • Engaging IPAs and specialists in an ACO setting • Negotiating with medical groups to engage and incentivize PCPs • ACOs and CMS’ shared savings arrangements • What kinds of shared savings incentives are health plans using with ACOs? Guy D. Guarige, Executive Director, East Bay Operations ALTA BATES MEDICAL GROUP - A DIVISION OF BROWN & TOLAND PHYSICIANS Randall Krakauer, MD, FACP, FACR, National Medical Director, Medicare AETNA 4:45 End of Day One 4:45 – 5:45 Cocktail Reception Immediately Following To sponsor this Cocktail Reception please contact Kevin Weigel at kweigel@healthcare-conferences.com or 704-341-2448
  6. 6. To Register: Call 866-676-7689 or visit us at www.healthcare-conferences.com Physician Engagement & Emerging Compensation Models DAY TWO: Tuesday, September 24, 2013 8:00-8:45 Continental Breakfast 8:45 – 9:00 Recap of Day One 9:00 – 9:45 Improving Quality While Reducing Costs Through Bundled Payments and Episodes of Care • Structure, pricing, and implementation for bundled payments • Employer purchasing and episodic payment structures • Bundled payments for specific disease states • Establishing episodic payment structures for hospital care • Population-based payment systems Jennifer Winchester, Senior Director, Provider Network Innovations and Partnerships BLUECROSS BLUESHIELD OF SOUTH CAROLINA Cary Sennett, MD, PhD, President IMPAQ INTERNATIONAL 9:45 – 10:45 Session Title TBD Speaker, Title TBD COMPANY To sponsor this session please contact Kevin Weigel at kweigel@healthcare-conferences.com or 704-341-2448 10:45 – 11:00 Morning Break 11:00 – 12:00 Shared Risk, Shared Reward Innovative and Engaging Risk/Reward Sharing Arrangements • The benefits of linking clinical risk to financial risk • Is downside risk an essential driver for efficiency? • How do you structure a graduated risk-taking program for providers? • How much risk are providers taking on? Is it too much? • Commercial ACO-based models and shared savings arrangements • Outcomes and comparison information from the CMS Pioneer Pilot programs • Other risk sharing arrangements being used to drive quality and value Kristen Miranda, Vice President, Strategic Partnerships BLUESHIELD OF CALIFORNIA *Pending final confirmation Stuart Levine MD MHA, Chief Innovation Officer, Executive Vice President Quality ACCRETIVE HEALTH 12:00 -1:00 Networking Luncheon 1:00 – 1:45 Technology Spotlight The Role of Technology in Facilitating Efficient Coordination Between Care Settings • The importance of heightened transparency between stakeholders • Can meaningful use apply here? • Using outcomes data to drive provider performance • Technologies that can help measure and manage risk • What kinds of technology can facilitate communication between different software systems? Sarah Spillane RN MBA, Senior Manager for Extended Services KAISER PERMANENTE 1:45 – 2:45 Utilizing Predictive Modeling and Outcomes Research to Establish Population-Based Payment Structures • Utilizing population-based payment systems • Evaluating behavior for various patient populations - Medicaid Expansion - Duals - Employer sponsored - Public exchange • Evaluating risk and tailoring payment structures for each revenue stream Speaker, Title TBD COMPANY 2:45 –3:30 One Size Does Not Fit All Customized Engagement and Compensation for Specific Provider Groups • Engaging independent primary care physicians and IPAs • Working with medical groups and salaried physicians • Hospital compensation and engagement - Encouraging hospital transparency • How to best communicate and engage specialists • Compensation structures for nurse practitioners and physician assistants • Hybrid value-based/fee-for-service payments that incentivize different provider groups Stuart Levine MD MHA, Chief Innovation Officer, Executive Vice President Quality ACCRETIVE HEALTH Howard Tepper, Vice President for Physician Practices and Ambulatory Services SAINT JOSEPH’S HEALTHCARE SYSTEM 3:30 End of the Summit
  7. 7. Important Information To Register: Fax: 704-341-2640 Mail: Healthcare Education Associates 18705 NE Cedar Drive Battle Ground, WA 98604 Phone: 866-676-7689 Online: www.healthcare-conferences.com Best Practices in Network Development & Contract Management And Physician Engagement & Emerging Compensation Models September 23-24, 2013 The Princeton Club 15 West 43rd Street, (between 5th & 6th Avenues) New York, NY 10036 (212) 596-1200 If you require overnight accommodation for this conference, please contact any of the following nearby hotels to check their best available corporate rate over this time frame, or consult your local travel agent. Please note that HEA has not negotiated rates with any of these hotels. Area Hotels: Mansfield Hotel – (212) 944-6050 Algonquin Hotel – (212) 840-6800 City Club Hotel – (212) 921-5500 Royalton Hotel – (212) 869-4400 Iroquois Hotel – (212) 840-3080 Sofitel Hotel – (212) 354-8844 Fees and Payments: The fee for attendance at Best Practices in Network Development & Contract Management And Physician Engagement & Emerging Compensation Models is: Standard Registration - $1895/$2095 All Access Plan/Provider Registration - $1495/$1695 All Access Non-profit and Government Registration - $895/$995 All Access (Non-profit health plans do NOT Qualify) All Access Pass: Customize your attendance and maximize your time with the All-Access Pass! Bounce back and forth between all sessions being offered and receive conference documentation from BOTH events! Please make checks payable to Healthcare Education Associates, and write code H183 on your check. You may also pay by Visa, MasterCard, Discover, or American Express. Purchase orders are also accepted. Payments must be received no later than September 16, 2013. Team Discounts: • Three people will receive 10% off. • Four people will receive 15% off. • Five people or more will receive 20% off. In order to secure a group discount, all delegates must place their registrations at the same time. Group discounts cannot be issued retroactively. For more information, please call Whitney Betts at 704-341-2445 or email wbetts@healthcare-conferences.com Cancellations: If we receive your request to cancel 30 days or more prior to the conference start date, your registration fee will be refunded minus a $250.00 administrative fee. Cancellations occurring between 29 days and the first day of the conference receive either a 1) $200 refund; or 2) a credit voucher for the amount of the original registration fee, less a $250.00 administrative fee. No refunds or credits will be granted for cancellations received after a conference begins or for no-shows. Credit vouchers are valid for 12 months from the date of issue and can be used by either the person named on the voucher or a colleague from the same company.Please Note: For reasons beyond our control it is occasionally necessary to alter the content and timing of the program or to substitute speakers. Thus, the speakers and agenda are subject to change without notice. In the event of a speaker cancellation, every effort to find a replacement speaker will be made. To learn more about sponsorship opportunities, please contact Kevin Weigel at 704-341-2448 or email kweigel@healthcare-conferences.com Get Answers to These Key Questions • Why is it financially and legally imperative that your team stay abreast of the slight, yet essential, variances of new managed care contracts? • What new provider profiling techniques can you use to support network development? • What is the financial impact of looking beyond traditional hospital contracting to ancillary out-patient facilities, home health, and Centers of Excellence? • What steps can providers take to achieve peak clinical and administrative preparation and performance for risk-sharing agreements? • What can we learn from year-one contracting for the Exchanges to prepare for year-two re-negotiations? • What is the best way to gain the attention, involvement, and commitment of physicians? • What will engage the primary care physician in a PCMH setting? • How do you function with one foot in FFS and one foot in VBR (value- based reimbursement)? • What is the true level of accountability for the PCP in an ACO model? • What is the best way to engage specialists? Conference Sponsor MARSI, a 22 year old document and coding audit company with an excellent reputation and track record. MARSI has been innovative in developing processes at least five years ahead of our competitors, such as: pre-billing auditing, comprehensive review compliance and physician documentation improvement . . . that actually works. MARSI is a known expert among healthcare attorneys. We have never lost a case. MARSI is known for education which we have broadened into on-line HCC training and experiential training for all the areas of coding. MARSI is a proven leader with a wide range of successful programs for documentation and coding. Sponsorship and Exhibit Opportunities Enhance your marketing efforts through sponsoring a special event or exhibiting your product at this event. We can design custom sponsorship packages tailored to your marketing needs, such as a cocktail reception or a custom-designed networking event. To learn more about sponsorship opportunities, please contact Kevin Weigel at 704-341-2448 or email kweigel@healthcare-conferences.com Other Upcoming Events The 3rd Annual Star Ratings Leadership Summit Improving Quality of Care with Renewed Engagement Strategies, Data Management and Advance Planning June 20 - 21, 2013 * The Four Seasons - Westlake Village, CA 3rd Annual RISE CALIFORNIA SUMMIT Integrating Risk Adjustment and Quality Measures July 14-16, 2013 * Loews Coronado Bay, San Diego, CA Medicare Advantage Member Accounting & Reconciliation Ensure Accurate Revenue Forecasting and Management through Best-Practice MA Member Accounting & Reconciliation! July 25-26, 2013 * W Washington, D.C.
  8. 8. Healthcare Eductaion Associates 200 Washington St. Ste. 201 Santa Cruz, CA 95060 PRSRT STD U.S. POSTAGE PAID BURLINGTON,VT PERMIT NO. 21 Attention Mailroom: If undeliverable, please forward to the Chief Operations Officer Best Practices in Network Development & Contract Management And Physician Engagement & Emerging Compensation Models To Register: Fax: 704-341-2640 Call: 866-676-7689 Online: www.healthcare-conferences.com q Standard Registration q Network Development & Contract Management ONLY q $1895 q $2095 All Access pass q Physician Engagement & Emerging Compensation Models ONLY q $1895 q $2095 All Access pass q Plan/Provider Registration: q Network Development & Contract Management ONLY q $1495 q $1695 All Access pass q Physician Engagement & Emerging Compensation Models ONLY q $1495 q $1695 All Access pass q Non-profit and Government Registration: (Non-profit health plans do not qualify) q Network Development & Contract Management ONLY q $895 q $995 All Access pass q Physician Engagement & Emerging Compensation Models ONLY q $895 q 995 All Access pass q Please contact me: I’m interested in a Group Discount Rate for my team. q Please contact me: I’m interested in Marketing Opportunities at this event. q I wish to receive updates onHEA’s upcoming events via fax, email & phone. Signature: ________________________________ Name Title Company Dept. Address City State Zip Telephone: Fax: Email Please bill my: q MasterCard q Visa q Amex q Discover Card Number Exp.Date Name on Card Signature q Check enclosed q Please bill me later Make checks payable to Healthcare Education Associates and write H183 and attendee(s) name on your check. Conference Code: H183 Please Mention This Priority Code When Registering Mail: Healthcare Education Associates 18705 NE Cedar Drive Battle Ground, WA 98604 Healthcare Education Associates and RISE (The Risk Adjustment Initiative and Society for Education) Proudly Present Two Leading-Edge Events! Best Practices in Network Development & Contract Management To Register: Call 866-676-7689 or visit us at www.healthcare-conferences.com September 23-24, 2013 The Princeton Club, New York City Two Co-Located Events – Get the All-Access Pass for Both! Achieving Risk-Sharing, Quality Management and Access to Care Goals in an Evolving Marketplace The PREMIER conference focused on contracting and network building strategies! Physician Engagement & Emerging Compensation Models Driving Quality and Cost Efficiency through Value-based Delivery and Payment Systems

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