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Provider Contracts and Quality Measurement 
 
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Overview
Evolving provider payment methodologies, innovations advancing analytics, and transformation of health care delivery through collaborative arrangements have aligned to create the opportunity and demand for provider contracts that address quality measurement.

This webinar will discuss this changing world of reimbursement and the use of quality measurements in provider contracts. Specifically, this webinar will highlight changes in the reimbursement landscape, through: (i) analyzing quality reimbursement models utilized in various communities and other methodologies utilized in structuring provider based contracts focused on payment for quality; (ii) examining issues for consideration when negotiating quality and risk based provisions; and (iii) discussing ACO contracts, benefits and risks.

Please join Stephanie Schreiber and Robert Ramsey from Buchanan Ingersoll & Rooney on Thursday, June 19, 2014 at 1PM Eastern as they discuss Provider Contracts and Quality Measurement.
 
Learning Objectives
Participants will be able to:
  1. Analyze quality reimbursement models and other methodologies utilized in structuring provider based contracts focused on payment for quality
  2. Understand issues for consideration when negotiating quality and risk based provisions
  3. Explore whether to use an internal or external quality measurement system
  4. Consider if measures should be structured on existing standards, or if a measurement system should be created that’s unique to the provider contract
  5. Ascertaining specific measures to negotiate into agreements
  6. Examine setting contractual language that clearly shows how quality measures will be reported and evaluated
  7. Address establishing measures for Centers of Excellence in contracts
  8. Scrutinize which quality measurements relate specifically to Exchange products and their network provider members
  9. 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 a dedicated LinkedIn group.
Who Should Attend
Interested attendees would include:
  • C-Suite Executives
  • Medical Directors
  • Provider Contracting Executives and Staff
  • Provider Relations Executives and Staff
  • Managed Care Executives and Staff
  • Quality Management Executives and Staff
  • Strategy, and Planning Executives and Staff
  • Innovation and Transformation Executives and Staff
  • Business Intelligence Executives and Staff
  • Provider Performance and Analytics Staff
  • Legal Counsel
  • Other Interested Parties

Attendees would represent organizations including:

  • Health Plans
  • Hospitals and Health Systems
  • Provider Networks
  • Accountable Care Organizations
  • Third Party Administrators
  • Employers
  • Pharmaceutical Organizations
  • Solutions Providers
  • Associations, Institutes and Research Organizations
  • Media
  • Other Interested Parties


Registration
Provider Contracts and Quality Measurement 
 
  Individual Registration Fee: $195. Post-event materials, with video syncing slides and recorded audio, plus presentation pdf file: $45 for attendees; $260 for non-attendees after the event. Register online or download the event brochure.
 
 
 
Register Now   Corporate Site licensing also available. Click here to register or call 209.577.4888 We look forward to your participation in this event!
 
 
Faculty
Stephanie W. Schreiber

Stephanie W. Schreiber
Shareholder
Buchanan Ingersoll & Rooney PC

 

Stephanie W. Schreiber regularly advises profit and nonprofit hospitals, health care systems, nonprofit organizations, physicians and physician groups, as well as corporations and other business entities, on substantial merger and acquisition transactions.

She is regularly involved in assisting health care entities with their affiliations, negotiating and drafting software licensing and other agreements and counseling nonprofit and other business entities regarding organizational and operational matters.

Stephanie regularly advises health care clients on compliance and regulatory matters, including those involving HIPAA and HITECH.

She often speaks on corporate and health care matters, including presentations to boards of directors and senior managers of health care and nonprofit organizations on such matters as governance, HIPAA, HITECH and regulatory compliance. She has also written a number of articles on health care topics for the Pennsylvania Bar Institute.

Prior to attending law school, Stephanie served her community as a social worker.

 


Robert B. Ramsey, III

Robert B. Ramsey, III
Shareholder
Buchanan Ingersoll & Rooney PC

 

Robert B. Ramsey, III represents a variety of health care entities. Much of his practice focuses on regulatory issues including Medicare and Medicaid fraud and abuse prevention and investigation, the Stark law, EMTALA, HIPAA and issues related to federal and state laws regarding the privacy and confidentiality of medical records.

Bob represents clients in a variety of legal matters including managed care contracting, medical staff issues, tax matters and general corporate representation. His clients include health care systems, hospitals, long-term care and assisted living facilities, pharmaceutical companies, home health agencies, medical device manufacturers, and physician groups.

Bob has experience regarding Medicare reimbursement principles and has represented clients before the Provider Reimbursement Review Board. A significant portion of his practice involves representing clients in matters involving the Medicare and Medicaid Fraud and Abuse Law, the Stark Law and the False Claims Act. He has experience in other areas of federal and state health care regulation.

In recent years, Bob has been actively involved in many corporate compliance projects. He has designed a number of compliance programs for hospitals, long-term care facilities and other health care providers. Bob has also represented clients in many transactional matters including joint ventures, mergers and acquisitions, physician contracting, management agreements, and various sales and acquisition arrangements. Examples of his experience include:

  • Provided advice to a medical equipment company regarding options and strategies to address fundamental changes in Medicare reimbursement for power wheelchairs.
  • Represented a medical equipment manufacturer in its attempts to have the federal government revise its reimbursement code to include a product that provided not only traditional value, but also therapeutic value. Within two weeks of the engagement, the change in reimbursement coding was announced by the head of the administration at an annual industry conference.
  • Represented a health care provider in a $14 million Medicare administrative appeal before the Provider Reimbursement Review Board.
  • Designed, implemented and audited a corporate compliance program for a chain of long-term care facilities designed to ensure compliance with Medicare/Medicaid regulations and to minimize financial risk for inadvertent lapses in compliance.
  • Represented a long-term care provider in responding to a subpoena from the Office of Inspector General. His knowledge of the Inspector General's historical investigations and processes allowed him to narrow the focus of the subpoena and ultimately negotiate a settlement satisfactory to the company, the Inspector General and ultimately the Department of Health and Human Services.
  • Represented a specialty pharmacy company in negotiations of a managed care contract valued at more than $100 million

Bob is a member of the firm's Advisory Committee. He is also a frequent speaker and writer on health care topics and has spoken on issues such as the Stark Law, intermediate sanctions, and physician/hospital joint ventures.

In 2012 and 2013, Bob was selected to the Pennsylvania Super Lawyers® list in field of health care law, a distinction given to only the top 5 percent of attorneys in the state. Additionally, he has been named to the The Best Lawyers in America list since 2009.

After completing his undergraduate studies, Bob was in a graduate program in physiology, where he was actively involved in biomedical research.

 

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