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Understanding Medicare DSH Changes - Implications for Hospitals and Medicare Advantage Plans 
 
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Overview
For fiscal year 2014, Medicare overhauled the methodology for determining the Disproportionate Share Hospital (DSH) payment component of the Inpatient Prospective Payment System (IPPS), which Medicare uses to pay acute care hospitals for inpatient services.

Under the new methodology, operating DSH payments are reduced by 75% to create the “empirically justified” DSH payment. The changes to the DSH payment methodology are estimated to reduce total IPPS payments by about 0.4%, but the changes by area and by provider can be significant. Medicare Advantage plans may see a slightly lower reduction in DSH payments to providers, which is due to the methodology used by the Centers for Medicare and Medicaid Services (CMS) to calculate prospective Uncompensated Care payments.

Please join Milliman's Charlie Mills and Edward Jhu on Tuesday, June 24th, 2014 at 1PM Eastern as they address the implications of these changes for hospitals by area, provide details of the mechanics of the new DSH and Uncompensated Care payments, and discusses issues specific to Medicare Advantage plans.
 
Learning Objectives
Participants will be able to:
  1. Understand FY2014 Disproportionate Share Hospital Payment mechanics, including Empirically Justified DSH payments and Uncompensated Care payments
  2. Consider the payment impact implications by hospital and by area
  3. Examine various Medicare Advantage plan issues relating to DSH payment changes
  4. Explore illustrative DSH changes for FY2015
  5. 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
  • Finance and Accounting Executives and Staff
  • Revenue Cycle Executives and Staff
  • Regulatory and Compliance Executives and Staff
  • Provider Network Executives and Staff
  • Provider Contracting Executives and Staff
  • Medicare Operations Executives and Staff
  • Managed Care Executives and Staff

Attendees would represent organizations including:

  • Hospitals
  • Healthcare Systems
  • Provider Networks
  • Medicare Advantage Plans 
  • Government Agencies
  • Solutions Providers 
  • Associations, Institutes and Research Organizations 
  • Media
  • Other Interested Parties


Registration
Understanding Medicare DSH Changes - Implications for Hospitals and Medicare Advantage Plans 
 
  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
Charlie Mills

Charlie Mills, FSA, MAAA
Consulting Actuary Milliman
 

Charlie is a consulting actuary with the Seattle office of Milliman. Charlie’s experience as a healthcare consultant includes: Medicare Advantage bid preparation; Rate filings; Small and large group pricing; Network and ACO development; and Provider contracting and reimbursement.

Charlie focuses on providing clients the tools and expertise needed to leverage data in their decision-making processes. He has played a key role in the development of a number of Milliman products, including the Health Cost Guidelines (HCG) Grouper, GlobalRVUs, and Medicare Repricer.

Charlie is a Fellow with the Society of Actuaries, and a Member, American Academy of Actuaries. He received his BS, in Applied and Computation Mathematical Sciences, from the University of Washington.


Edward Jhu

Edward Jhu, FSA, MAAA
Principal, Consulting Actuary
Milliman
 

Ed is a consulting actuary specializing in healthcare consulting in the Seattle office of Milliman. He joined the firm in 1999. Ed's expertise is in group healthcare, with an emphasis on government sponsored programs, (including Medicare and VHA) and provider contracting.

His experience covers a broad spectrum including payers, providers, and purchasers. His consulting assignments have included: Medicare Advantage bid support for both Part C and Part D; Evaluation and comparison of provider contracts including development of the Hospital; Evaluation and Comparison System (HECSTM), a Medicare-based contract comparison tool; Comparison of provider reimbursement for contract parity analyses Development of Reasonable and Customary charge model; Analysis of utilization patterns for insured lives covered under multiple sources; Review and implementation of risk adjustment algorithms and relative morbidity analyses; Projecting liabilities for claims incurred but not paid; Preparation and certification of annual actuarial opinions; and  Projecting contribution rates for Multiple Employer Welfare Arrangements. In addition to his experience in healthcare, Ed also has extensive employee benefits experience at Milliman and at other consulting firms.

Ed is a Fellow with the Society of Actuaries, and a Member of the American Academy of Actuaries. He received a BA in Mathematics, Actuarial Science, from the University of Waterloo, Waterloo, Ontario.

 

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