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Webinar Details

  • Pub Code: C2R07-11WEB
  • Speakers
    • Mark Lutes
    • Colleen Matthews

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Overcoming the Challenges of Bundled Payments: Health Plans’ Strategies and Results to Date

February 28, 2012 Webinar - Listen On-Demand or Get a CD!

To improve quality of treatment and reduce costs, government and private payers alike are showing great interest in testing bundled payments for episodes of care. A federal health reform initiative is under way to align payments for services delivered across an episode of care, such as heart bypass surgery or hip replacement, rather than paying for services separately. States are looking to pilot this payment model as well. In one of several efforts under way on the commercial side, Horizon Healthcare Innovations, a subsidiary of Horizon Healthcare Services, Inc., New Jersey’s largest and oldest health insurer, is partnering with five physician practices to ultimately design a bundled payment program for certain types of orthopedic procedures. The episode-of-care model shows great promise for reforming the payment delivery system. But what are the main challenges with this model and strategies that industry pioneers are taking to overcome them? What types of bundled payment arrangements will have the highest degree of success in improving care and lowering costs for your organization?

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$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 ACO Business News, AIS’s Health Reform Week and Health Plan Week

Hear two knowledgeable industry observers discuss the challenges that are being overcome to develop a bundled payment model of care. You’ll get reliable answers to these and other important questions:

  • What goes into the negotiation process of a bundled payment for an episode of care?
  • How can health plans respond to challenges in developing a bundled payment model, such as avoiding cherry picking more healthy patients and avoiding administrative hurdles? What strategies are being employed in an attempt to address them? With what success?
  • What can be learned from the experience of states that are already taking an interest in testing these models of care?
  • What are the prospects for adoption by self-funded employers?
  • What can health plans learn from CMS’s bundled payment demonstration?
  • What procedures and episodes will be an early focus for plans and employers?
  • What outcomes-based payments, technologies, reporting requirements and quality metrics are being considered for use in bundled payment models?
  • What are the pros and cons of bundled payments in relation to other value-based payment methodologies, such as accountable care organizations?

Speakers

MARK LUTES is a member of the health care and life sciences practice division of law firm Epstein Becker & Green, P.C. (EBG), serving on the firm’s board of directors. He has practiced with the firm for 26 years. Previously, he was a legislative adviser to the Federal Trade Commission (FTC). He also offers strategic counsel in health policy and on reimbursement strategy through the firm's affiliates EBG Advisors, Inc. and National Health Advisors, LLC. He is broadly experienced in managed care contracting from both the payer and provider perspective, as well as in insurance and managed care licensing and compliance.

COLLEEN MATTHEWS is the director of episode of care programs at Horizon Healthcare Innovations. She has extensive experience in health care, including managed care contracting and relations and in provider reimbursement methodologies, as well as medical management issues. She is the former director of network hospital relations at Horizon Healthcare Services, Inc., where she was responsible for the overall relationship management of network hospitals, including identification and implementation of specific collaboration plans. Her far-reaching health care experience properly positions her work at Horizon Healthcare Innovations to improve the health care system and to focus on quality improvements.

Moderator: Jennifer Lubell, editor of AIS's ACO Business News

Designed Especially For

  • Health plan CEOs, CFOs, chief operating officers, product development and sales and marketing executives, government affairs and provider relations directors, contracting executives, medical and clinical service directors, and market researchers
  • Medical group and hospital administrators and contracting directors
  • Benefits executives at large employers
  • Physicians
  • Insurance brokers and agents
  • Pharmaceutical and PBM executives and marketing directors
  • Attorneys, consultants and actuaries

Shipping Information

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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.

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*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.

Overcoming the Challenges of Bundled Payments: Health Plans’ Strategies and Results to Date

Place your order through our secure shopping cart

$329.00
$329.00

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