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Wednesday, June
1st,
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. |
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Register
for $195
Call 209.577.4888 or
Click here to register |
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Overview and Ongoing Impact and Implications of
Star Ratings System
Quality 2.0: Future Direction of Measuring
Quality under Stars
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Effective organizational management structure for the
Star rating system
Implications of changes in Stars for Medical management,
health services and HCC management
Action plans for provider networks and provider
leadership on Stars
Greatest domain challenges and opportunities for impact
on Stars
Updates on Star Ratings program and practical tips for
plan quality improvement |
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Faculty:
Nathan Goldstein
SVP, Strategic Development
Gorman Health Group |
Faculty:
Jane Scott
VP, Clinical Services
Gorman Health Group |
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While Medicare’s Quality Ratings are not new, successful management of the
program does require a new perspective on the “same old same old.” For
payers, there is revenue and competitive positioning at stake. For their
provider partners, the Medicare Advantage Star program provides a
testing ground for their own quality improvement activities as their
entire system of health care orients itself towards value-based
purchasing.
The CY 2012 Draft CMS Call Letter issued in February made clear that
despite the turmoil at the top at CMS, the agency is committed to
expanding the Star Ratings and changing the methodology with great
impact on health plans.
Two of the industry’s leading authorities on the CMS Star Ratings system
from Gorman Health Group will provide an overview tailored for both
plans and their provider partners. Join us for a webinar discussion that
will blend updates to the Star Ratings program with practical tips for
quality improvement within your plan.
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Key questions to be addressed in
the discussion include:
- What has been the impact and
implications of the CMS Star Ratings System?
- Which domains are health plans finding
the hardest to impact? Which present the greatest opportunities for
impact?
- What’s next for measuring quality
under the Star Ratings System? What does CMS tell us about its future?
- What does an effective organizational
management structure look like for the Stars?
- What do the changes in the Star
Ratings system mean for Medical management, health services and HCC
management?
- Why should health plans train
providers or provider leadership on the Star Ratings?
Participants will be able to 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.
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Interested attendees would
include:
- C-Suite Executives
- Physician Executives
- Strategy and Planning Executives and Staff
- Legal, Regulatory and Policy Executives and Staff
- Managed Care and Revenue Cycle Executives and Staff
- Business Development Executives and Staff
- Business Intelligence Staff
- Provider Network Executives and Staff
- Provider Contracting Executives and Staff
- Operations Executives
- Other Interested Parties
Attendees would
represent organizations including:
- Health Plans
- Provider Networks
- Solutions Providers
- Associations,
Institutes and Research Organizations
- Media
- Other Interested
Organizations
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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!
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In his role at Gorman Health Group, Nathan’s responsibilities include
the development of new business solutions and consulting capabilities
for the Government-sponsored health care industry. He also directs the
development of partnerships that allow GHG to maintain a full suite of
solutions for GHG clients. As a partner and member of GHG's senior
leadership team, he has been central to the transformation of the most
active professional services consultancy in the industry into a provider
of technology-based solutions that empower health plans to deliver
higher quality care to beneficiaries at lower costs.
With the recent shift by CMS towards value-based purchasing, Nathan’s
recent and continuing focus has been on GHG’s Star Ratings optimization
program and numerous related initiatives in GHG’s Clinical Innovations
practice. Other major development efforts have included OMT, a
Medicare-specific operations dashboard; Valencia, a membership and PDE
reconciliation software, Medicare eLead, a lead distribution and
management solution for the Medicare Managed care industry; Medicare
Sales Certification, a compliance certification program for Medicare
sales agents; and MDS, GHG's tool for tracking competitive developments
in the Medicare managed care industry.
Nathan also presents on behalf of GHG at numerous industry conferences
each year on topics including HCC management and realigning risk
adjustment with medical management.
Before entering the Medicare managed care marketplace, Mr. Goldstein's
communications company had clients including Presidential candidates,
members of the U.S. Congress, network news anchors, Fortune 500 CEOs and
one infamous Gonzo journalist. He specialized in writing on health care
related topics, and on behalf of his clients, his writings have been
syndicated in over 100 newspapers nationwide. Mr. Goldstein is the
former Director of Communications of the University of Hawaii
Foundation, where he oversaw fundraising communications for the ten
campus University systems. He is an avid jazz guitarist.
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Jane brings to Gorman Health Group clients more than 30 years of
experience in the health care industry. Her experience expands to the
areas of quality improvement, utilization and medical management, claims
operations, and provider/associate education. She also has an extensive
knowledge of federal regulations and health plan compliance. To
compliment her health plan background, Jane has 15 years of clinical
nursing experience.
In her role at GHG, Jane has provided her broad health industry
expertise to dozens of health plans and providers across the country.
Jane has guided new Medicare Advantage plans and ACOs on the development
of CMS applications and plan implementation processes. In addition, she
has helped to ensure health plan compliance with Medicare regulations
and CMS guidelines by performing audit readiness assessments and mock
audits. From leading plans through development and submission of CMS
applications and plan implementation to operational assessments and
audits, Jane has contributed to the success of many of GHG’s clients. As
one of the leaders of GHG’s Star Ratings optimization program, Jane
currently leads assessments and strategic plans to drive plan ratings.
Prior to joining GHG, Jane served as the Medicare Compliance Officer and
continued on as the Director of Medicare Program Management for
Government Programs for HealthNet of Arizona. Under her leadership,
HealthNet of Arizona experienced increased total revenue for their
Medicare programs of over six percent per year. Jane has held a number
of other senior positions in the Medicare managed care industry.
Jane is in demand as a speaker at industry conferences on such topics as
Prescription Drug Events, membership reconciliation, Medicare Part C and
Part D audits and Special Needs Plans.
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Phone 209.577.4888 |
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