Adjusting to 100 Risk Adjustment
|Event Date/Time: Jun 27, 2007||End Date/Time: Jun 27, 2007|
A Webinar & Audio Conference with David Bach, CEO of Leprechaun, LLC
Wednesday, June 27th, 2007 at 1PM Eastern
Risk adjustment management is the #1 strategic priority for Medicare managed care organizations today. This risk adjustment webinar & audio conference will describe how the CMS-HCC (Hierarchical Condition Category) risk adjustment system works, the strategic and financial implications of the system and specific tactical requirements for effectively managing a Medicare plan under risk adjustment. Join Dr. David Bach, a leading national expert on HCC Management, for this presentation on how to optimally operate under this new system.
Individual Registration Fee: $195: Web Summit 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.
HCC (Hierarchical Condition Category) management
In an era of accelerating medical costs and flat payments from CMS, accurately reflecting the health status Medicare plan members through proper HCC (Hierarchical Condition Category) management is the only way for Medicare Advantage plans to remain financially viable in the Part D era. The Medicare risk adjustment payment system uses clinical coding information (HCCs) to calculate risk premiums for Medicare Managed Care Organizations. After a lengthy phase-in, risk adjustments on payments have reached 100% this year.
CMS's new HCC (Hierarchical Condition Category) risk adjustment system calculates Medicare managed care premiums based on diagnostic information documented by and reported from providers. However, provider documentation of diagnostic codes is often less than perfect - which creates multiple challenges to plans from both a financial and compliance perspective. As such, Medicare plans today face and urgent need to build comprehensive, wholly new management programs that ensure correct and complete diagnostic coding from providers. These programs, in addition to their compliance and quality impact, serve as a critical strategic differentiator for plans because of their economic impact on plan's revenues.
This session has been designed to position those operating, contracting, monitoring or doing business with Medicare Advantage plans to adapt their operations to the new HCC environment.
This session will address the following six topics, plus allow time for your questions and answers:
7. How does the HCC (Hierarchical Condition Category) risk adjustment system work?
8. What are the strategic and financial implications of the HCC system for Medicare plans - and why is HCC management the #1 strategic priority for plans today?
9. What programmatic initiatives are required to effectively manage under the risk adjustment payment system?
10. What are the key success factors associated with these initiatives?
11. What metrics should be used to measure success?
12. What are the practical next steps to be pursued?
• Develop a baseline understanding of how the Medicare managed care HCC risk adjustment system works
• Explore the strategic and financial implications of the HCC system for Medicare plans
• Learn the critical success factors for successfully managing under the risk adjustment system
• Hear case examples of how plans are adapting their Medicare operations to this system
WHO SHOULD ATTEND
• Health Plan C-Suite Executives
• Health Plan Medicare Program Executives and Operating Managers
• Health Plan Strategy, Planning and Development Managers
• Health Plan Financial Managers
• Health Plan Medical Directors
• Health Plan Medical Management
• Hospital and Provider Network Staff contracting with Medicare Plans
• Third parties monitoring or doing business with Medicare Plans
Dr. David Bach, Founder and Chief Executive Officer of Leprechaun, LLC - the country's preeminent HCC Management Outsourcing agency.
Prior to founding Leprechaun, Dr. Bach founded and built two other prominent healthcare companies: Touchstone Health Partnership, a New York City-based Medicare Advantage plan, and Empyrean Benefit Solutions, a Houston-based consumer-directed healthcare organization. Dr. Bach has also worked as a healthcare venture capitalist with TA Associates, a Boston-based mezzanine private equity firm, and as a management consultant with APM, Inc., which, at the time, was the country's largest healthcare management consulting firm.
Dr. Bach attended Harvard College and Harvard Medical School, and conducted his residency training in Internal Medicine at the Mount Sinai Hospital in New York City.
Prior to his medical career, Dr. Bach was a professional cellist.
LIVE QUESTION AND ANSWER SESSION
Get your questions answered! Session participants will have an opportunity to email questions in advance of the session or ask the speaker their questions during the "live" session.
• Individual Registration: $195. Covers a single phone line. Multiple persons may listen via speaker phone for the individual fee.
• Web Summit CD-ROM: $40 for attendees; $255 for non-attendees after the event
• Each individual receives a unique dial-in ID
• Corporate Group Pricing is available when registrations are desired for more than one phone line. Call 209.577.4888 for details
DIAL-IN INSTRUCTIONS AND SESSION MATERIALS
Two business days prior to the event, registrants will receive a copy of the dial-in instructions and a link to the speaker presentation. The dial-in instructions will include a unique dial-in ID Participant code that can only be used for a single phone line and not shared. Session participants will also have an opportunity to email speaker questions in advance of the live session.
1. Online: https://www.managedcarestore.com/summit.htm
2. Call: Healthcare Web Summit office at: 209.577.4888
3. Fax: Print off registration form at: https://www.managedcarestore.com/hwsorder.pdf and fax to: 209.577.3557
4. Mail: Print off registration form at: https://www.managedcarestore.com/hwsorder.pdf and mail to:
Healthcare Web Summit Office
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