Third Annual Contracting Web Summit

HealthcareWebSummit: Contracting Web Summit 2012

A wide-ranging menu of provider payment and contracting issues have taken center stage for stakeholders, driven by reform and marketplace forces. A continuing transition from volume-based to value-based payment structures underscores this new environment; with bundled payments and aligned incentives for management of hospital readmissions being significant issues to consider.

The Third Annual Health Plan Contracting Web Summit addresses how contracting stakeholders should position themselves for 2012 and beyond in this landscape, as value-based and other innovative models continue to progress, and health reform and marketplace forces combine to act as change agents requiring stakeholders to keep pace.

Join us for a live webinar, and download additional faculty pre-recorded sessions, featuring national experts providing key insights, trends, strategic recommendations, actionable intelligence and more on these critical topics.

Thursday, May 10th, 2012
1:00 p.m. to 2:30 p.m. Eastern (10:00 a.m. - 11:30 a.m. Pacific)
Click here to find out what time your event starts in your time zone.

1:00 pm - 1:30 pm Current Trends in Value-Based Contracting, by Terri L. Welter, Principal, ECG Management Consultants, Inc.
1:30 pm - 2:00 pm Evaluating Bundled Payment Contracting - Kathryn V. Fitch, RN, MEd, Principal, Healthcare Management Consultant, Milliman
2:00 pm - 2:30 pm Financial Incentives Model for Minimizing Readmissions-- Guy D'Andrea, President and Founder, Discern Consulting

Pre-Recorded Presentations in Windows Media Video format with audio and synchronized slide advancement:

ACO Capitation 101: Understanding Medicare ACOs’ Real Potential to Influence Patterns of Care, by William A. MacBain, MPS, Senior Vice President, Gorman Health Group
Transparent Cost Networks, a Consumer Driven Solution, by Will Fox, Principal and Consulting Actuary, Milliman
Provider Contracting Environment: ACOs, Value Based Purchasing, Practice Acquisition & More, by William DeMarco, President and CEO, Pendulum HealthCare Development Corporation
Plus other Web Summit features including a Contracting Article Library, and an exclusive Contracting e-poll

Participants will be able to:

Gain an overall sense of Value Based Reimbursement Methodologies and Models from contracting operational and strategic perspectives
Understand the parameters, components and recent developments regarding bundled payments, as well as an analysis of considerations in contracting for bundled payments
Consider a model for financial incentives for minimizing readmissions, with key process and outcome measures for transitions of care and a scoring system to compare providers' performance
Explore Medicare’s demonstration Pioneer ACO program’s experiment with three different approaches to capitation

Ascertain the strategic and marketplace forces that create the Transparent Cost Network opportunity and understand the components and implications of a Transparent Cost Network

Obtain relevant case experience and marketplace intelligence offered by the faculty.
Experience e-learning at the attendees' convenience, with downloadable pre-recorded sessions, article library, and other online Summit features available 24/7.
Engage in interactive learning through live webinar providing online question submission, attendee surveys, feedback and opportunity for follow up questions, and networking with attendees, faculty and other professionals through dedicated LinkedIn group.

Interested attendees would include:

CEOs and CFOs
Planning and Strategic Executives and Staff
Managed Care Executives and Staff
Revenue Cycle Executives and Staff
Network Management Executives and Staff
Provider Relations Managers and Staff
Provider Contract Administrators
Health Benefit Managers
Contract and Payment System Solutions Staff
Business and Market Intelligence Staff
Legal and Regulatory Affairs Executives and Staff
Other Interested Parties

Attendees would represent organizations including

Hospital Systems
Medical Groups
Provider Networks
Other Providers
Health Plans
Third Party Administrators
Contracting Organizations
Employers
Solutions Providers
Associations, Institutes and Research Organizations
Media

Individual Registration Fee: $295. Audio Conference CD-ROM: $40 for attendees; $335 for non-attendees after the event. Corporate Site licensing also available.

Click here to register or call 209.577.4888 We look forward to your participation in this event!

Terri L. Welter Principal ECG Management Consultants, Inc.		Ms. Welter is a Principal in ECG Management Consultant's Washington, D.C., office and head of ECG’s Contracting and Provider Performance practice. She has extensive experience in the areas of managed care and provider payment, including strategy development, reimbursement, contract negotiations, and operations. She has recently been closely involved in assisting hospitals, medical groups, payors, and industry associations with understanding the types of arrangements that will be needed to successfully react to healthcare reform and to establish contracting structures that facilitate hospital/physician alignment and clinical integration. Ms. Welter is a frequent national speaker on the topics of evolving provider payment vehicles and ACO development. Ms. Welter holds a master of science degree with a concentration in healthcare administration from Villanova University and a bachelor of arts degree in preprofessional studies from the University of Notre Dame.

Kathryn V. Fitch, RN, MEd, Principal, Healthcare Management Consultant, Milliman,		Kate is a principal and healthcare management consultant in the New York office of Milliman. She joined the firm in 1999. Kate's expertise is in the intersection of benefit design, disease processes, financing health benefits, and managing care. She leads teams of actuaries, benefits consultants, clinicians, and data analysts in projects for disease-management companies, hospitals, employers, HMOs, pharmaceutical companies, and healthcare industry trade organizations. As project lead, she is instrumental in designing data analytics and communicating the implications for clients, as well as managing Milliman resources. Kate leads projects that require analyzing quantitative and financial outcomes of benefit designs, therapies, processes, and care management, and converting these findings into measurable improvements in quality and financial outcomes. Kate's role typically includes promoting these findings in organizations through reengineering, training, and process improvement. Recent projects have included helping employers and payers evaluate disease management, wellness, and other vendors; groundbreaking work on value-based benefit design; the impact on employers of population-based cardiovascular risk programs; health plan medical management program assessments and redesigns; and inpatient process improvement at several hospitals focused on improved denial management and length-of-stay reduction. Prior to joining Milliman, she worked for a case-management company, where she developed the company's case manager training and education program. Kate was previously an instructor in the nursing program at Columbia University School of Nursing. Prior to that, she was a research assistant at Memorial Sloane Kettering, where she was involved in nursing research studies. She also worked as a research assistant in pharmaceutical research studies at Roosevelt Hospital. Kate's clinical background includes extensive experience as a registered nurse in emergency, adult inpatient, and ambulatory care units. Kate is a member, ERISA Industry Committee (ERIC), health policy committee; and serves on the Patient Care Primary Care Collaborative. She received her BSN at Villanova University and her MA, MEd at Columbia University.

Guy D’Andrea President and Founder, Discern Consulting		Guy D’Andrea founded Discern in 2004. Since that time, Mr. D’Andrea has worked with leading health care organizations nationwide – including The Leapfrog Group, Bridges to Excellence, and the National Business Coalition on Health – to design, implement and evaluate pay-for-performance and value-based purchasing strategies. Mr. D’Andrea specializes in assessing the return on investment from these programs and has built ROI models for several clients. Projects undertaken by Discern include the design and development of hospital and physician pay-for-performance programs, value analysis for HIT adoption, an interactive P4P decision tool for health care purchasers, quality standards for wellness programs and payment structures and quality measures for patient-centered medical home programs. Before starting Discern, Mr. D’Andrea spent seven years as Vice President at URAC, where he was responsible for the development of URAC’s accreditation programs, including quality standards for PPOs, utilization management organizations, case management organizations and consumer-directed health care. Prior to URAC, he spent five years working on managed care regulatory and policy issues with the American Association of Health Plans (now AHIP) and the Maryland Association of HMOs. Mr. D’Andrea has co-authored several papers on health care reform, including: “Should Health Care Come with a Warranty?” featured in Health Affairs, “Physicians Respond to Pay-for-Performance Incentives: Larger Incentives Yield Greater Participation” in The American Journal of Managed Care, and “Sustaining The Medical Home: How Prometheus Payment Can Revitalize Primary Care” for the Robert Wood Johnson Foundation. Mr. D’Andrea received an undergraduate degree in philosophy from Cornell University. He earned dual Master of Business Administration degrees from Columbia University and the London Business School, where he graduated as the valedictorian of his program. He is a member of the American Association of Health Care Consultants, the American College of Healthcare Executives and the Mid-Atlantic Business Group on Health.

William A. MacBain, MPS, Senior Vice President, Gorman Health Group		Bill has more than thirty years’ experience as a senior executive or strategic consultant to some of the nation’s most progressive health plans. In his role at Gorman Health Group, Bill’s client engagements include strategic planning, financial planning and feasibility analyses, due diligence reviews, and operational assessments. He provides guidance for health plans in developing and executing sustainably profitable business models, saving valuable resources with his operations experience and knowledge of CMS regulations. Since the passage of health care reform in 2010, Bill’s work has focused on provider entities considering becoming Accountable Care Organizations (ACOs). This work has included developing business models, risk sharing arrangements, feasibility studies, model contracts and operational studies. Most of Bill’s prior management experience has been in executive positions in health insurance finance and operations, primarily in provider-owned health plans. Bill also has more than ten years of experience in management consulting, where his financial management and analysis, business planning and budgeting, contract negotiations, product design, and government affairs skills have become invaluable to GHG clients. Prior to joining GHG, Bill served as CFO for a large regional health plan, chief operating officer for one of the largest rural-based health plans in the nation, and held senior finance and operations positions with several start-up health plans. He also contributed to federal and state health insurance policy as a member of two federal Medicare advisory commissions (MedPAC and ProPAC), and as president of the Managed Care Association of Pennsylvania. Bill has also served as a board member of the American Association of Health Plans and the Group Health Association of America, predecessors of today’s AHIP. Bill also coauthored and published a series of successful HIPAA privacy rule policy templates. Bill earned his BA and Master of Healthcare Administration degrees from Cornell University.

Will Fox Principal and Consulting Actuary Milliman		Will Fox is a principal and consulting actuary with the Seattle office of Milliman. Will focuses on improving the provider contracting analytics for both insurers and hospitals. This includes: more accurate contract comparisons for both hospitals and payers using a proprietary fee schedule—RBRVS for Hospitals; developing contract provisions that reduce administrative costs by simplifying negotiations and adjudication; tiered network evaluations and creating provider ranking reports; training sessions for negotiation staff. Will developed the HECS™ (Hospital Evaluation and Comparison System) so that clients can create their own reports to benchmark their contracts on a case mix and severity-adjusted basis and benchmark the results vs. operating costs and Medicare allowables. Will believes that insurers and hospitals can work together to reduce the cost of healthcare. He has authored several research reports on provider contracting and is a frequent speaker on the subject for a variety of organizations. In addition, Will has significant experience and proficiency in medical underwriting, rate setting, and underwriting process improvement. He developed the RenewalMUGs software to help health plans improve their renewal underwriting process and has worked with many clients to automate some or all of the underwriting process. Mr. Fox is a Fellow in the Society of Actuaries, a Member of the American Academy of Actuaries, and worked for a major insurance company prior to joining Milliman in 1992. He received his BS, with honors, in Mathematical Sciences from Oregon State University.

William DeMarco President & CEO Pendulum HealthCare Development Corporation		William J. DeMarco MA CMC is the President & Chief Executive Officer of Pendulum Health Development Corporation, and DeMarco & Associates, Inc., a national, independent healthcare consulting firm specializing in healthcare delivery system redesign and transformation. The firm specializes in research and strategy development, organization development of successful provider owned enterprises and marketing management including product design and promotion. Mr DeMarco is recognized as a leader in the research, design and implementation of community based health plans. Since his involvement in several startup health plans in Minnesota in the early 1970s Bill and his team of management consultants clinical specialists and reimbursement analysts have assisted employers and physicians in developing better relationships with insurers up to and including developing local solutions to deliver and finance care. Using Health Services Research from its affiliate Pendulum HealthCare Development Corporation (www.pendulumhealth.com), DeMarco and Associates assists both provider and employer clients in addressing prospective payment approaches in order to build Pay for Performance models to develop direct employer/provider contracting entities, benchmarking collaboratives under the new value purchasing legislation as well as Accountable Care organization development and management.. Mr. DeMarco is a well-known author having written or contributed to over a dozen books on managed care topics. His most recent book Performance Based Medicine will be released in January 2011. He holds a master’s degree in organizational development from DePaul University. He a past faculty member of Loyola Law School’s graduate program and DePaul University MBA program on entrepreneurial management.

1101 Standiford Ave. Suite C-3 Modesto, CA 95350 Phone 209.577.4888 | e-Mail infohws@healthwebsummit.com | Fax 209.577.3557