Quality Payment Programs in 2018: Medicare, MA Plans and Medicaid

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Quality Payment Programs in 2018: Medicare, MA Plans and Medicaid 
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Where are Quality Payment Programs established under MACRA headed in 2018? What is the role that Medicare Advantage and other Medicare and Medicaid managed care programs can play in future years of the QPP, and the criteria that such plans must meet to be considered an Advanced APM? What is the CMS perspective for Medicare Quality Payment Programs in 2018?

The Medicare Access & CHIP Reauthorization Act of 2015 (MACRA) altered Medicares approach to physician payment by focusing on paying for value rather than paying for volume. The Centers for Medicare & Medicaid Services (CMS) is implementing the MACRA physician payment reforms through the new Medicare Part B Quality Payment Program (QPP). The QPP has two tracks: (1) the Merit-based Incentive Payment System or MIPS and (2) Advanced Alternative Payment Models (APMs). MIPS consolidates key components of several existing Medicare quality programs: the Physician Quality Reporting System (PQRS), the Value-based Payment Modifier Program (VBM), and the Medicare Electronic Health Record (EHR) into a single quality program that assesses performance across four categories: Quality, Resource Use, Clinical Practice Improvement, and Advancing Care Information. Advanced APMs provide a new approach to paying for medical care that incentivizes quality and value through care coordination.

Epstein Becker Green's Helaine Fingold and Lesley Yeung will provide an overview of the MIPS and Advanced APM programs. They will also discuss the role that Medicare Advantage and other Medicare and Medicaid managed care programs can play in future years of the QPP, and the criteria that such plans must meet to be considered an Advanced APM. CMS' Neal Logue will then discuss Medicare QPP in 2018 from the CMS perspective.

Please join us Tuesday, December 5th, 2017 at 1 PM Eastern as Epstein Becker Green's Helaine Fingold and Lesley Yeung, and CMS' Neal Logue discuss the state of Quality Payment Programs going into 2018, in the HealthcareWebSummit event: Quality Payment Programs in 2018: Medicare, MA Plans and Medicaid.
Learning Objectives

After attending this webinar, attendees will be able to:

  1. Identify physician payment reforms included in MACRA, components and differences in the MIPS and Advanced APM tracks, and the entities considered to be Advanced APMs
  2. Examine the criteria for Advanced APM Status, including Quality Measures; EHR Utilization; Risk Arrangements
  3. Explore the role that Medicare Advantage and other Medicare and Medicaid managed care programs can play in future years of the QPP.
  4. Ascertain the CMS perspective on Medicare Quality Payment Programs for 2018.
  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
  • Medical Directors
  • Medicare and Medicaid Executives and Staff
  • Provider Contracting Executives and Staff
  • Provider Network Executives and Staff
  • Analytics Executives and Staff
  • Managed Care Executives and Staff
  • Finance Executives and Staff
  • Planning and Strategic Executives and Staff
  • Business Intelligence Staff
  • Other Interested Parties

Attendees would represent organizations including:

  • Provider Networks
  • Accountable Care Organizations
  • Hospitals and Health Systems
  • Integrated Delivery Systems
  • Medical Groups
  • Medicare Advantage Plans
  • Medicaid Plans
  • Life Science Organizations
  • Solutions Providers
  • Associations, Institutes and Research Organizations
  • Media
  • Other Interested Organizations
  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.
Register Now   Click here to register or call 209.577.4888. Corporate Site licensing also available. We look forward to your attendance!
Helaine I. Fingold

Helaine I. Fingold
Senior Counsel, Health Care and Life Sciences
Epstein Becker Green

  Helaine Fingold is a Senior Counsel in the Health Care and Life Sciences practice, in the Baltimore office of Epstein Becker Green. She has more than 20 years of broad health law and regulatory experience, including prior government experience in both the legislative and executive branches of the federal government.

Ms. Fingold advises on issues involving the Medicare Program Parts A, B, C, and D, Medicare Innovations, Medicare Dual Eligibles, Medicaid, and Veterans' health care programs. She counsels on issues related to products offered on public and private health insurance exchanges and related health insurance reform issues, and provides interpretative and practical advice regarding oversight and compliance requirements of the Medicare Advantage and Medicare Prescription Drug programs. She also advises on the development of business arrangements to assure compliance with federal and state fraud and abuse laws; and counsels companies on legislative and regulatory strategies involving government health programs including health insurance reform.

Prior to rejoining the firm, Ms. Fingold worked at the Center for Medicare & Medicaid Services' ("CMS's") Center for Consumer Information and Insurance Oversight (CCIIO) in the Exchange Policy and Operations Group. As both a Senior Technical/Policy Lead and as the Acting Director, Rates & Benefits Branch, Division of Plan Management, Ms. Fingold was responsible for defining and interpreting requirements relating to the qualification of qualified health plans and stand-alone dental plans in both state and federally-facilitated exchanges, oversight of these plans, essential health benefits, and market-wide cost sharing limitations.

From 2004 to 2012, Ms. Fingold worked in a range of capacities at CMS with responsibility for areas of the Medicare Advantage program, including plan application review and approval, application denials and appeals, contracting, plan surveillance, oversight, and marketing. She also is experienced in the Medicare Advantage and Prescription Drug audit and sanction process.

Ms. Fingold began her professional career as an attorney in the Office of the General Counsel of the Department of Health and Human Services assigned to CMS's predecessor agency on legal issues arising under Medicare Parts A and B and Medicaid. Ms. Fingold then was a team lead within Office of Research and Demonstrations at CMS's predecessor agency, working on Medicaid waiver and Medicaid demonstration programs. She later spent two years as a health care attorney in the DC office of Epstein Becker Green. Ms. Fingold left the firm to serve as General Counsel for the Medicare Payment Advisory Commission before rejoining CMS in 2004.

Ms. Fingold received her J.D. from the Northeastern University School of Law and her B.A. from the University of Massachusetts. She is admitted to the Bar in the state of Maryland.

Lesley R. Yeung

Lesley R. Yeung
Epstein Becker Green

  Lesley R. Yeung is an Associate in the Health Care and Life Sciences practice in the firm's Washington, DC, office. Ms. Yeung has been selected to the Washington DC Rising Stars list (2014 to 2016) in the area of Health Care.

Ms. Yeung: Advises health care providers and health-related companies, financial institutions and investors of industry trends and policy developments; Advises hospitals, health systems and other health-related companies on legal and regulatory matters arising under Medicare, Medicaid and other third-party reimbursement programs; Advises clients regarding federal and state health care regulatory issues, including licensing and reimbursement matters associated with change of ownership; and Assists health care providers with government investigations relating to health care fraud and abuse arising under anti-kickback laws, the Stark Law and the False Claims Act.

Ms. Yeung recently served as a law clerk at a large nonprofit membership organization, where she supported litigation efforts related to the provision of long-term care services under the Americans with Disabilities Act. Prior to attending law school, Ms. Yeung was a health insurance specialist at the Centers for Medicare & Medicaid Services. She also previously worked as a program analyst at the Department of Health and Human Services and as a presidential management fellow at the National Institutes of Health.

Ms. Yeung received her J.D. from The George Washington University Law School; her M.P.A. from New York University, Robert F. Wagner Graduate School of Public Service and her B.A. from Boston University. She is a member of the American Bar Association and New York State Bar Association.

Neal Logue

Neal Logue
Health Insurance Specialist
Rural Health Coordinator
Consortium for Financial Management and Fee for Service Operations
San Francisco Regional Office, Centers for Medicare & Medicaid Services

Neal Logue currently serves as a Health Insurance Specialist with the Division of Financial Management and Fee for Service Operations, CMS San Francisco Regional Office.

Mr. Logue began his federal service in Washington, D.C. working as a Legislative Assistant for a Member of Congress; a Researcher for the Bankers Association for Foreign Trade; a Writer/Editor for the Office of Governmental Relations with the Resolution Trust Corporation, Treasury Department; a Writer/Editor for the Office of Legislation with CMS; and a Health Insurance Specialist for the CMS Atlanta Regional Office.

Mr. Logue earned a BA from Mercer University; MA from Georgia College and State University; and a Graduate Diploma from the London School of Economics
and Political Science.
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