Whose Patient Is It? Patient Attribution in ACOs

ACOs: Whose Patient is it? Patient attribution

	Wednesday, May 11th, 2011 1:00 p.m. to 2:00 p.m. Eastern (10:00 - 11:00 a.m. Pacific) Click here to find out what time your event starts in your time zone.		Register for $195 Call 209.577.4888 or Click here to register
ACO Attribution - Core Concepts, Methodologies & Development Issues Considerations and Implications of Alternative Attribution Methods

Components, Alternative Methodologies, Development Considerations and Implications

Relevant components driving patient attribution for Accountable Care Organizations

Alternative methods: patient-based vs. element-based; single vs. multiple; & prospective vs. retrospective

Development considerations including duration, credibility, unit size, and members with no claims history

Time allotted for attendee question and answers

Faculty:
Susan E. Pantely, FSA, MAAA Principal, Consulting Actuary Milliman, Inc.

The foundation of the ACO model, similar to an HMO, is provider accountability for care coordination; providers are incentivized via reimbursement based on their ability both to reduce costs through achieving efficiencies and to meet certain quality metrics. However, ACOs do not utilize a primary care gatekeeper and members are able to seek care from any provider they choose. Therefore, in order to measure a provider's performance, members must be attributed, or assigned, to a provider through an analysis of healthcare claims.

This session examines the issues surrounding patient attribution for Accountable Care Organizations, starting with relevant components driving patient attribution, and then focusing on the considerations involved in selecting and developing a specific attribution method.

The discussion will address elements including: patient-based vs. element-based attribution; single attribution vs. multiple attribution; prospective vs. retrospective attribution; hybrid multiple methods; and development considerations including duration, credibility, family unit vs. member, and members with no claims history.

Please join Susan E. Pantely, FSA, MAAA, Principal and Consulting Actuary with Milliman, Inc. on Wednesday, May 11, 2011, as she provides expert guidance for organizations that must grapple with this critical issue in developing, or doing business with ACOs.

Participants will be able to:

Understand the key concepts and drivers regarding ACO patient attribution
Identify the core alternative attribution methods
Explore the implications of adoption of each alternative attribution method
Examine additional considerations in development of attribution methodology
Engage in interactive learning through online question submission, attendee feedback and opportunity for follow up questions, and networking with attendees, faculty and other professionals through dedicated LinkedIn group

Interested attendees would include:

C-Suite Executives
Strategy and Planning Executives and Staff
Legal, Regulatory and Policy Executives and Staff
Operations Executives and Staff
Actuarial Executives and Staff
Membership Accounting Executives
Managed Care and Revenue Cycle Executives and Staff
Provider Network Executives and Staff
Provider Contracting Executives and Staff
Medical Directors

Attendees would represent organizations including:

Hospitals
Provider Networks
Medical Groups
Health Plans
Business Process Organizations
Solutions Providers
Care Management Organizations
Associations, Institutes and Research Organizations
Pharmaceutical Organizations
Media
Other Interested Parties

Individual Registration Fee: $195. Audio Conference CD-ROM: $40 for attendees; $255 for non-attendees after the event.

Corporate Site licensing also available. Click here to register or call 209.577.4888 We look forward to your participation in this event!

Susan E. Pantely, FSA, MAAA Principal, Consulting Actuary
Milliman, Inc.

Susan is a principal and consulting actuary with the San Francisco office of Milliman. She rejoined the firm in 2002. She previously worked for the New York office of Milliman from 1988 through 1999.

Susan provides actuarial and consulting services to a broad range of clients, including Blue Cross/Blue Shield plans, HMOs, commercial insurers, government agencies, and healthcare providers. Her work includes rate development, provider contract review, reserve certification, capitation development, Medicare risk feasibility studies, HMO start-ups, HMO due diligence, and development of risk-sharing and reimbursement arrangements for physician groups, PHOs, and other integrated delivery systems.

In addition, Susan has extensive experience with the valuation, financial analysis, and projection of healthcare services for several state public health insurance (Medicaid) programs. Prior to rejoining Milliman, Susan worked at Andersen LLP and Ernst & Young, LLP.

Susan serves on the Society of Actuaries' Education and Examination Committee, and as chair of the SOA's Health Section Council. Susan is also a member of the American Academy of Actuaries' Health Care Quality Workgroup.

Her presentations and publications include: "An Electronic Prescription for Health Care Efficiency" (Society of Actuaries HealthWatch, January 2009) "Employer-Paid Nonmedical Costs for Patients With Diabetes and End-Stage Renal Disease" (Preventing Chronic Disease, July 2006); "How Savvy are Employees (and Employers) about Their Health Benefits?" (Milliman Benefits Perspectives, Winter 2008); "Medicaid Program Redesign: The Long-Term Care and Developmentally Disabled Programs" (report for Wyoming Health Care Commission, September 2006, co-author). Susan received a BS in Mathematics from the University of Pittsburgh.

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