Understanding Medicare’s Use of Episode-Based Alternative Payment Models

      
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Understanding Medicare’s Use of Episode-Based Alternative Payment Models 
 
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Overview
There has been a great deal of uncertainty in recent months surrounding the use of episode-based payment models at CMS. The voluntary Bundled Payments for Care Improvement (BPCI) models have been operational since 2012, and the mandatory Comprehensive Care for Joint Replacement (CJR) program was implemented in April of 2016 and has hundreds of participants nationally. However, since the beginning of 2017 CMS has issued proposed and final rules that created and subsequently cancelled three new Medicare Parts A and B episode payment models. Milliman has analyzed the major provisions of these final rules and considered the potential implications for affected providers.

Despite the recent cancellation of the three EPMs, CMS has still signaled strong support for episode-based payment models. There continues to be a large number of participants in the voluntary BPCI models, and CMS has signalled that they intend to introduce a new version of that model by the time it expires in October 2018. Furthermore, a large number of episode-based payment models are being submitted to the Physician-Focused Payment Model Technical Advisory Committee (PTAC), which has been tasked with considering models submitted by stakeholders for possible implementation by CMS. In this session, we will consider the future of episode-based payment models at CMS. We will discuss the factors that may have led to the cancellation of the EPMs, as well as signals of what may be to come in forthcoming episode-based payment models.

Please join us Wednesday, August 30th, 2017 at 1 PM Eastern as Milliman's Daniel Muldoon and Pamela Pelizzari discuss this topic in the HealthcareWebSummit event: Understanding Medicare’s Use of Episode-Based Alternative Payment Models.
Learning Objectives

After attending this webinar, attendees will be able to:

  1. Understand the major provisions of the most recent proposed rule to cancel the Medicare EPMs and the cardiac rehabilitation incentive model and adjust the CJR model.
  2. Examine factors that CMS may have considered in cancelling the EPMs.
  3. Consider implications of current market forces on the potential for future CMS episode-based payment models.
  4. Explore the potential for models submitted to the PTAC to affect providers .
  5. Engage in interactive learning through online question submission, attendee feedback and opportunity for follow up questions, and networking with attendees, faculty and other professionals through dedicated LinkedIn group.
Who Should Attend

Interested attendees would include:

  • C-Suite Executives
  • Value Based Payment Executives and Staff
  • Provider Network Operations Executives and Staff
  • Analytics Executives and Staff
  • Actuarial Executives and Staff
  • Finance Executives and Staff
  • Managed Care Executives and Staff
  • Planning and Strategic Executives and Staff
  • Business Intelligence Staff
  • Regulatory and Compliance Executives
  • Other Interested Parties

Attendees would represent organizations including:

  • Hospital and Health Systems
  • Provider Networks
  • Medical Groups
  • Other Providers
  • Health Plans
  • Government
  • Life Science Organizations
  • Solutions Providers
  • Associations, Institutes and Research Organizations
  • Media
  • Other Interested Organizations
Registration
Understanding Medicare’s Use of Episode-Based Alternative Payment Models
 
  Individual Registration Fee: $195. Post-event materials, with video of slides synchronized with speaker audio, plus presentation pdf file: $45 for attendees; $260 for non-attendees after the event. Register online or download the event flyer.
 
 
 
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Faculty
 
L. Daniel Muldoon, MA

L. Daniel Muldoon, MA
Healthcare Consultant
Milliman, Inc.

  Daniel is a healthcare consultant with the New York office of Milliman. He joined the firm in 2017. Daniel has extensive background in healthcare payment reform and value-based contracting. Daniel has expertise designing and implementing episode-based payment risk adjustment and pricing methodologies and analyzing administrative health insurance claims data.

Prior to joining Milliman, Daniel worked as a technical advisor at the Centers for Medicare and Medicaid Innovation (CMMI), implementing and developing payment methodologies for CMMI’s episode-based payment models, including BPCI, OCM, CJR, and EPM.

Daniel has a BA, Quantitative Economics, from Tufts University, and a MA, Economics, from the University of Virginia..
 

 
Pamela M. Pelizzari

Pamela M. Pelizzari, MPH
Healthcare Consultant
Milliman, Inc.

 

Pamela is a healthcare consultant with the New York office of Milliman. She joined the firm in 2014. Pamela has a broad background in integrated delivery system administration and healthcare payment reform. She has worked in both clinical and payer settings and has extensive experience in alternative risk contracting strategies. Pamela has particular expertise in analysis of healthcare claims and the development of episode-based payment definitions and benchmarking methodologies.

Prior to joining Milliman, Pamela held a technical advisory role in the U.S. federal government. She was responsible for developing and implementing novel payment methodologies to transform healthcare delivery and payment nationwide. Previously, Pamela also worked in quality improvement at an academic medical center.

Pamela Education has an ScB in Applied Mathematics and an AB, Community Health from Brown University, and a MPH from Johns Hopkins Bloomberg School of Public Health.

  
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