Highlights on this Page

Webinar Details

  • Pub Code: C2A12-11WEB
  • Tues., March 6, 2012
  • Speakers
    • Patrick Dunks
    • William A. MacBain

3 Easy Ways to Order

  1. Secure Shopping Cart
  2. Call 800-521-4323
  3. Print a form to fax or mail

Medicare Advantage Payment Rates and Changes for 2013: Strategies for Health Plans

March 6, 2012 Webinar - Listen On-Demand or Get a CD!

The preliminary 2013 Medicare Advantage payment rates and call letter that CMS unveiled Feb. 17 contained some good news for MA plans but also left a host of uncertainties. While payment rates stand to go up more than most expected, CMS has not yet addressed how the 2% payment cuts under the congressionally mandated sequestration will be applied. Moreover, MA sponsors won’t know till April the 2013 fee-for-service rates that affect MA plan payments. With all these hanging issues, find out what MA plans need to do now to plan for the payment climate in 2013 and beyond.

Place your order through our secure shopping cart

$329.00
$329.00

The On-Demand recording will be available immediately upon purchase* as a link within a PDF file of the accompanying written materials. CDs and printed materials are shipped via USPS.

Sponsored by Atlantic Information Services, Inc., publisher of Medicare Advantage News, AIS’s Health Reform Week and Health Plan Week

Medicare Advantage plans and their partners got some key information about 2013 plan payments in the CMS “45-day notice” and call letter Feb. 17, but they still face a lot of uncertainties. The good news of an estimated annual growth rate of above 2% and no change in the coding intensity adjustment in the preliminary notice has to be put in the context of what still is not known about rates for 2013 and beyond. This includes how CMS will implement the 2% payment cuts resulting from the failure last year of the congressional “supercommittee” to find budget cuts. Also unknown is how the “rebasing” of counties that CMS said it will do again this year will affect payments for counties in 2013, which in turn may affect plan bids due on June 4.

But there are some important things that became known — and need to be factored into strategies — as a result of the 45-day notice. It is clear, for instance, that CMS will be using more up-to-date data in evaluating coding by MA plans. Also, CMS separately on Feb. 24 released the long-delayed risk adjustment data validation (RADV) audit extrapolation methodology, and MA plans also must take that into account in their planning.

Get a thorough analysis of the preliminary 2013 rate notice and what it means for business strategies of Medicare Advantage plans, with reliable strategic information on such key topics as:

  • What the increased weighting of the new payment methodology versus the old in the blended payment rate for 2013 means for plan payments;
  • How to adjust strategy, in light of the new county “rebasing,” to reflect the different impact of the health reform law in various counties in 2013 and beyond;
  • Whether the coding-intensity adjustment is likely to stay at 3.41% in the final 2013 rates, or whether CMS may move it up closer to the minimum 4.71% it must be at for 2014;
  • How to account for the continuing uncertainties surrounding the “doc fix” in your financial planning for 2013 and future years;
  • What CMS is likely to do in the final rate notice for 2013 regarding the 2% payment cuts called for under sequestration, and what their impact will be;
  • How to figure in possible reforms and the new RADV audit extrapolation methodology affecting payments in future years; and
  • Overall strategic implications of the preliminary payment rates for MA benefits and premiums in 2013 bids.

Speakers

PATRICK DUNKS is a principal and consulting actuary in the Milwaukee office of Milliman, Inc. He specializes in managed Medicare products, especially Medicare Advantage, and has assisted the firm’s clients with Medicare contracting, risk adjustment, medical cost estimates and projections, provider reimbursement strategies, product development, risk-sharing arrangements, and experience and trend analysis. Mr. Dunks joined the firm in 1985 after earning a bachelor’s degree from Saint Norbert College and a master’s in mathematics from Purdue University. He is a fellow of the Society of Actuaries and a member of the American Academy of Actuaries.

WILLIAM A. MACBAIN is senior vice president, finance of Gorman Health Group, LLC. He has more than 25 years of experience in senior management positions in the health care industry, including serving as chief financial officer of Capital District Physicians’ Health Plan in Albany, N.Y., and senior vice president and chief operating officer of Geisinger Health Plan in Danville, Pa. He has been a board member of the American Association of Health Plans (the predecessor to AHIP), a member of the Medicare Payment Advisory Commission and president of the Managed Care Association of Pennsylvania.

Moderator: Jim Gutman, managing editor of Medicare Advantage News and AIS’s Health Reform Week

Designed Especially For

  • Health plan CEOs, CFOs, chief operating officers, product development and sales and marketing executives, government affairs and compliance directors, market research executives, contracting directors, accountants and actuaries.
  • Insurance agents, brokers and third-party administrators
  • Pharmaceutical company executives
  • Executives of pharmacy benefit management companies
  • Provider group CEOs, administrators and directors of managed care contracting
  • Attorneys, consultants and actuaries

Shipping Information

CDs (and accompanying written materials) are shipped via UPS. Please give us your street address when you order (UPS does not deliver to PO boxes). You should receive your order within two weeks.* Shipping and handling cost is $12.

The On-Demand Recording will be delivered as a link within a PDF file of the accompanying written materials. Shipping will NOT be charged for this item.

  • If you order the On-Demand Recording before the conference date (by itself or in combination with the live Webinar), you will be sent an e-mail with the PDF file attached once the recording is available.*
  • After the On-Demand Recording is available*, if you order on this website through our secure shopping cart, you will receive an e-mail, immediately after submitting your order, with a link directing you to download the PDF file. If you order through our customer service department (by phone, mail, fax or e-mail), you will be sent an e-mail with the PDF file attached.

Rush Orders: Please call us at 800-521-4323 to place a rush order.* We will overnight your order for an additional charge of $30, or you can give us your FedEx or UPS account number and we will charge the shipping to your account. Rush orders placed after 3:00pm EST will not be shipped out until the next business day.

*On-Demand recordings will be available within a week of the conference and CDs will be available within two weeks.

Written Materials

Listeners will also receive practical written information to supplement information covered by the Webinar speakers. A copyright release in the Printed Materials will permit you to make photocopies for each person listening to the Webinar and/or the On-Demand Recording.

Medicare Advantage Payment Rates and Changes for 2013: Strategies for Health Plans

Place your order through our secure shopping cart

$329.00
$329.00

MarketPlace Search

View All AIS Products By

Missed a Live Event?

Listen at your convenience to recent webinars with On-Demand or CD options!

Renewal Center

Renew your subscriptions to AIS newsletter and looseleaf publications at the Renewal Center

Featured Medicare Advantage and Part D Products