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We are entering into a period of scarce health care resources, with less funding to support new developments but higher focus on cost control. Many reimbursement vehicles, both governmental and private health plans, will adopt risk-based reimbursement.
How do providers manage the transition to risk payment models? Is it still prudent to create or join an ACO? If there is downside risk, how do I assess our chances of gains or losses? If we have a high volume of specialists, how do we manage our Medicare and private health plan reimbursements?
“Creating Your Risk Reimbursement Strategy in a Time of Scarcity” will help you consider all the factors and options available and consider how your own organizational factors match up to the various market options. Let us help you create a plan of action to tackle the market.
Issues we address in the session:
· A synopsis of the latest changes to CMS, private health plan actions that affect scarcity and risk
· How to construct your risk adaptability profile
· Your current payer contracting and participation strategies, and how to assess them in new light of scarcity.
· Is your VBC strategy multi-payer, or only one segment of the market? Pros and cons of each method.
· ACOs – Do you own or participate? Examine criteria to evaluate existing and future options.
· CINs – How are your providers participating in vehicles that are not direct to you, such as specialty CINs?
· The infrastructure and tools for managing risk – What do you have and what more is needed? How does greater interoperability enhance your options?
· Your Demand List in health plan negotiations – If it is only about money, what else you need.
· Your transition plan to mandatory risk payment models – how to predetermine where you will spend resources
Speakers:
- Theresa Hush, CEO
- Dave Halpert, Client Team Chief, Roji Health Intelligence LLC.