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ForwardManaged Care Contracting Strategies in an Era of Value-Based Payment
Many health centers mistakenly believe that they lack leverage to negotiate fair provisions in contracts with managed care organizations (health plan/health maintenance organizations), overlooking legal protections available under state and federal law. Furthermore, many health centers are very well-positioned to participate in value-based payment arrangements, either individually or in combination with other providers as part of IPAs, CINs, and ACOs.
This three-day intensive training on managed care contracting offers health center leadership an opportunity to gain insights and develop strategies for negotiating favorable managed care contracts.
Negotiation Session Topics Will Address:
- Identifying and assessing potential leverage points;
- Common contract terms and favorable provisions; and
- Negotiating strategies and tips.
Payment Methodologies, Legal Protections, and Joint Contracting Session Topics Will Address:
- Payment methodologies from fee-for-service to value-based payment;
- FQHC payment protections applicable to Medicare and Medicaid patients; and
- Participating in provider networks such as IPAs, CINs, and ACOs.
Target Audience
- Health Center Executives and Leadership
- Health Center Controlled Networks / ACOs / IPAs Executives and Leadership
- Primary Care Association Executives and Leadership
Learning Objectives
After this training, you will be able to:
- Negotiate favorable managed care contracts
- Participate in value-based payment arrangements
- Minimize legal risks under managed care
Agenda
Day 1 | |
Wednesday, December 4, 2024 | 11:00 a.m. ET - 5:00 p.m. ET |
11:00 - 11:15 a.m. | Welcome and Overview |
11:15 a.m. - 12:45 p.m. | P.E.N. (Prepare, Evaluate, Negotiate) Managed Care Contracting Strategies |
12:45 - 1:15 p.m. | Break |
1:15 - 2:30 p.m. | Value-Based Payment Arrangements |
2:30 - 3:00 p.m. | Break |
3:00 - 4:00 p.m. | Key VB Contracting Issues |
| 4:00 - 4:15 p.m. | Break |
| 4:15 - 5:00 p.m. | PPS as a Value-Based Payment |
Day 2 | |
Thursday, December 5, 2024 | 11:00 a.m. ET - 5:00 p.m. ET |
11:00 - 11:15 a.m. | Day 1 Recap & Quiz |
11:15 - 12:45 p.m. | FQHC Payment Protections in Managed Care |
12:45 - 1:15 p.m. | Break |
| 1:15 - 2:30 p.m. | Key MCO Contract Terms and Legal Protections |
2:30 - 3:00 p.m. | Break |
| 3:00 - 4:00 p.m. | Key MCO Contract Terms and Legal Protections, continued |
| 4:00 - 4:15 p.m. | Break |
| 4:15 - 5:00 p.m. | Small Group Exercises: Contract Review |
Day 3 | |
Friday, December 6, 2024 | 11:00 a.m. ET - 4:30 p.m. ET |
11:00 - 11:15 a.m. | Day 2 Recap & Quiz |
11:15 - 12:45 p.m. | Provider Networks (IPAs, CINs, and ACOs) |
12:45 - 1:15 p.m. | Break |
| 1:15 - 2:30 p.m. | Joint Contracting Activities |
| 2:30 - 3:00 p.m. | Break |
| 3:00 - 4:00 p.m. | Small Group Exercises: Simulated Negotiation |
4:00 - 4:30 p.m. | Wrap-Up and Discussion |
Feldesman Training Solutions Virtual Classroom
This live, interactive training will take place in the Feldesman Training Solutions Virtual Classroom, hosted by Zoom. Should you have any technical questions or would like more information, please contact us at training@feldesman.com or 1-855-200-3822.
Adam J. Falcone
Adam Falcone is a Partner in the firm's national health care practice group, where he counsels a diverse spectrum of community-based organizations that render primary and behavioral healthcare services. Adam counsels clients on a wide range of health care issues, with a focus on fraud and abuse, reimbursement and payment, and antitrust and competition matters. [Full Bio]
Kathy S. Ghiladi
Kathy Ghiladi is a Partner in the firm's health care practice group. Her practice focuses on government-sponsored health care programs such as Medicaid, CHIP, Medicare, and the Affordable Care Act, with an emphasis on payment/reimbursement and compliance related issues. Kathy also represents clients in government investigations and audits, litigation before federal and state courts, as well as in administrative appeals with the U.S. Department of Health and Human Services Departmental Appeals Board (DAB) and Provider Reimbursement Review Board (PRRB). She provides reimbursement counseling (including identification, reporting, and repayment of overpayments) with respect to Medicare, Medicaid, and private third-party payors. [Full Bio]
Participants can earn up to 13.8 CPE credits in Specialized Knowledge and Applications upon completion of all course requirements.
ADDITIONAL INFORMATION
- Prerequisites: None
- Target Audience: Health center executives and leadership, Health Center Controlled Networks/ACOs/IPAs executives and leadership, Primary Care Association executives and leadership
- Advanced Preparation: None
- Program Level: All
- Delivery Method: Group Internet Based
Feldesman Leifer LLP is registered with the National Association of State Boards of Accountancy (NASBA) as a sponsor of continuing professional education on the National Registry of CPE Sponsors. State boards of accountancy have final authority on the acceptance of individual courses for CPE credit. Complaints regarding registered sponsors may be submitted to the National Registry of CPE Sponsors through its website www.nasbaregistry.org (formerly www.learningmarket.org).
Available Credit
- 11.50 Certificate of Attendance
Price
Training is Not Recorded
This training will not be recorded for later viewing, as we would like attendees to be comfortable and candid, sharing their experiences and asking scenario-based questions. The discourse between the attorneys and participants is a valued part of each training.
Registration Fees
Early Registration(Through September 30) | Regular Registration(October 1 and later) |
| $1,799 | $1,999 |
Group Discounts
Bring your team! Discounts are available for groups of three (3) or more individuals from the same organization. Please contact us to process your registration.
Groups of 3 - 6 | Groups of 7 - 10 | Groups of 11 - 15 | Over 15 attendees |
| 10% off | 15% off | 20% off | Call us! |
Registration Instructions
Each registration must be in the name of the individual(s) who will attend. This allows us to communicate important course information to the actual attendee(s), add training materials and handouts to the right account, and properly assign certificates of attendance or CPE credits.
To register for this training:
- For yourself: login to your account and register with your personal information
- For someone else: login with the ATTENDEE’S login information or create an account for the ATTENDEE and register from the ATTENDEE's account
- For a group: email training@feldesman.com to complete group registration
If you encounter problems or have questions contact us.
Payment Policy
We accept the following forms of payment: American Express, Mastercard, Visa, ACH, PayPal, electronic check, and check. For information about the methods of payment we accept, please review our Payment FAQs.
Refunds/Cancellations
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Required Hardware/Software
Google Chrome or Mozilla Firefox are the preferred browsers.