Washington, DC (PRWEB) April 14, 2014
To keep premium rates affordable and competitive, health insurers have turned to narrow networks inside and outside of insurance exchanges. They also are partnering with provider groups on accountable care organizations (ACOs), which raises other questions of network size and provider rates. There are various dangers lurking in how provider networks are structured and paid, and carriers are confronting significant legal and public relations problems as a result. “How to Avoid Narrow-Network Landmines and Set Rates for Out-of-Network Providers,” the April 24 webinar from Atlantic Information Services, Inc. (AIS), will detail what strategies can be used to defuse potential provider-network landmines related to narrow networks and ACOs.
Participants will hear from Thomas Bartrum, a shareholder at the law firm Baker Donelson and member of the firm's health law group, William J. DeMarco, MA, CMC, president and CEO of Pendulum HealthCare Development Corporation, and Debbie Farringer, J.D., an assistant professor of law at Belmont University College of Law. In 60 minutes of expert presentations followed by 30 minutes devoted to individual questions, participants will gain valuable insights on these and related issues:
- Why quality metrics must be considered when building ACOs and narrow networks
- How narrow networks can migrate care away from high-cost settings
- Why it’s critical to understand how provider groups are structured
- How narrow networks and ACOs can help providers to differentiate themselves as efficient health care providers
- What steps carriers should take to avoid discrimination claims from providers
- How any-willing-provider laws may impact ACOs and narrow networks
- How to use incentives to maximize efficiencies
- Reasonable payment under a “quantum meruit” theory
Visit http://aishealth.com/marketplace/c4m12_042414 for more details and registration information.
Atlantic Information Services, Inc. (AIS) is a publishing and information company that has been serving the health care industry for more than 25 years. It develops highly targeted news, data and strategic information for managers in hospitals, health plans, medical group practices, pharmaceutical companies and other health care organizations. AIS products include print and electronic newsletters, websites, looseleafs, books, strategic reports, databases, webinars and conferences. Learn more at http://www.AISHealth.com.