Hospital And Physician Managed Care Contracting Update

Hospital And Physician Managed Care Contracting Update –
Reimbursement Models, Negotiation Trends, And Issues

Thursday, October 15th, 2009
1:00 p.m. to 2:15 p.m. Eastern (10:00 - 11:15 a.m. Pacific)
Click here to find out what time your event starts in your time zone.

Evolving Models encourage clinical integration & provider coordination
Trends & Issues representing major contracting priorities for 2010

Register for $225
Call 209.577.4888 or
Click here to register

Key contracting priorities, initiatives, and terms being negotiated nationally and regionally
Prevalent reimbursement models and key performance and efficiency drivers
Reimbursement structures that encourage coordination between hospitals, physicians, and plans
Key issues including risk, P4P, episode & care packaged payments, medical homes, & traditional structures

Faculty:
Terri L. Welter
Principal, ECG Management Consultants, Inc.

Faculty:
Charles A. Brown
Senior Manager, ECG Management Consultants, Inc.

Hospitals, physicians, and health plans are hard pressed to make important changes to their agreements in the next contracting cycle in response to economic pressures and pending healthcare reform. Recent reimbursement models have evolved to be more episode-based and to contain payment components tied to quality. Current methodologies, however, largely follow traditional Medicare models. Evolving methodologies are increasingly encouraging clinical integration and enhanced coordination between hospitals, physicians, and other care providers.

This presentation provides a comprehensive review of current hospital and physician reimbursement structures and evolving models that drive improved efficiencies and outcomes. The presenters will also discuss national and regional trends and issues that represent the major priorities for hospitals, physicians, and health plans in their contract negotiations.

Participants will gain an understanding of the following:

Key contracting priorities, initiatives, and terms that are being negotiated nationally and regionally.
Prevalent reimbursement models and the key drivers of financial and operational performance and efficiencies under these models.
Reimbursement structures that encourage coordination between hospitals, affiliated physicians, and health plans.
A discussion of key issues specific to past, current, and evolving reimbursement models including full and partial risk, P4P, episode based payments and care packaging, patient-centered medical home, and traditional Medicare-based and other payment systems adopted by health plans.

Interested attendees would include:

CEOs and CFOs
Planning and Strategic Executives and Staff
Managed Care Executives and Staff
Revenue Cycle Executives and Staff
Network Management Executives and Staff
Provider Relations Managers and Staff
Provider Contract Administrators
Health Benefit Managers
Contract and Payment System Solutions Staff
Business and Market Intelligence Staff
Other Interested Parties

Attendees would represent organizations including

Hospital Systems
Medical Groups
Provider Networks
Other Providers
Health Plans
Third Party Administrators
Contracting Organizations
Employers
Solutions Providers
Associations, Institutes and Research Organizations
Media

Individual Registration Fee: $225. Audio Conference CD-ROM: $40 for attendees; $285 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!

Terri L. Welter Principal, ECG Management Consultants, Inc.		Ms. Welter, Principal, works in ECG Management Consultants, Inc.'s Healthcare practice. Her experience in reimbursement and strategy gives her the skills necessary to address the issues facing today's healthcare leaders. Summary of Expertise Ms. Welter has extensive experience in the area of managed care, including strategy development, reimbursement, contract negotiations, and operations. She has assisted several hospitals and medical groups in the financial planning, assessment, and negotiation of their managed care contracts. Affiliations Ms. Welter served as a board officer and the managed care committee chairperson for the Healthcare Financial Management Association’s (HFMA’s) Washington Metropolitan Chapter. She is a current member of HFMA’s Virginia Chapter. Education She holds a master of healthcare administration degree from Villanova University and a bachelor of arts degree in preprofessional studies from the University of Notre Dame. Speeches and Articles Ms. Welter has been the featured speaker on managed care and provider reimbursement for a variety of national professional associations, including HFMA and the Medical Group Management Association (MGMA). She has also been published in several healthcare journals.

Charles A. Brown Senior Manager, ECG Management Consultants, Inc.		Mr. Brown, Senior Manager, works in ECG Management Consultants, Inc.'s Managed Care practice, where he focuses on strategic health plan contracting, negotiation, and revenue recovery. With more than 18 years of healthcare management and consulting experience, he has been successful in improving the bottom line of clients' financial and operational performance. Summary of Expertise Prior to joining ECG, Mr. Brown served as a Director at CHC Healthcare Solutions, a subsidiary of Computer Horizons Corp. (now TEKsystems Inc.), lending his deep knowledge of managed care operations to assist clients in complying with the intricacies of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and Sarbanes-Oxley §404 requirements. Mr. Brown also served as a Director at a national consulting firm, where he focused on managed care contracting, operations, and revenue recovery. In addition, he was Director of Managed Care/Vice President of Practice Operations at Founders Health Care (Allegheny Integrated Health Group), and Operations Manager/Medical Center Administrator at FHP Inc. Affiliations - Colorado Healthcare Strategy and Management. - Healthcare Financial Management Association (HFMA). Education Mr. Brown holds a master of business administration degree from the University of Utah and a bachelor of arts in biology from the University of Colorado.

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