Bundled Payment 2013 - Bundled Payment: Practicalities, Governance, and Contractual Issues

Overview: Bundled payment models are proliferating despite almost no experience with them. This crisp and focused session will elucidate some basic concepts about bundled payment and distinguish it from other payment models. How bundles are created, triggered, and broken will be addressed. Critical issues which are often overlooked will be described.
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What should be in the contract amendment which creates most of these programs will be presented. Issues which should be subject to appeals and those that likely will not be will be described. How to avoid disputes among the providers who are now at financial risk with each other will be presented.
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Why Should You Attend: Bundled payment models offer different challenges from traditional reimbursement. Understanding how bundles are constructed is essential to being able to respond to their incentives. Signing contracts without a clear appreciation of the potential problems is foolhardy. Because this payment links otherwise unrelated providers’ financial fates to each other, the risks are increased. There are unappreciated pitfalls that should be addressed before signing or accepting anything.
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Areas Covered in the Session:
Defining the bundle, breaking the bundle
Provider-Plan disputes and Provider-Provider disputes
Governance issues: avoiding food fights among providers
Dispute resolution options
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Who Will Benefit:
Managed Care Contracting Officers
Network Development Officers
Health Plan Contracting Personnel
Health Plan CFOs
Health Plan Medical Directors
Medical Group Administrators
Health System CFOs and Finance Directors
Health System Physician Group Managers
Health System and Group Practice Compliance Officers
In-house Counsel of Physician Groups and Health Systems
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Alice G. Gosfield Esq, of Philadelphia’s Alice G. Gosfield and Associates, PC, has a national practice devoted to health law and healthcare regulation with a special emphasis on physician representation, managed care, quality, fraud and abuse, and medical staff issues. A graduate of Barnard College and NYU Law School, she has been named as one of the top twenty-five health lawyers in the country in 2007 and 2009 and has been a Best Lawyer in America (Health Law) for more than twenty years. She served as Chairman of the Board of Directors of the National Committee for Quality Assurance for five terms (1998-2002) and was President of the National Health Lawyers Association (now the American Health Lawyers Association) from 1992-93.
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