Jan. 21 Webinar to Review Strategies for Insurers, Providers in Narrow-Network Medicare Advantage Plans

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In a Jan. 21 webinar from Atlantic Information Services, three industry experts with hands-on experience in designing and implementing MA insurer/provider collaborations will address the critical success factors (and pitfalls to avoid) in bringing payers and providers together in MA or having providers go into MA alone.

There are many new provider-payer narrow-network Medicare Advantage (MA) plans for 2015 — and quite a few new provider-owned MA plans as well. Insurers have recognized for some time that providers want a bigger share of the fast-growing MA market. But insurers and providers just recently have come to realize the extent to which MA payment levels now depend on results that only providers can achieve. “Narrow-Network Medicare Advantage Plans: Strategies for Insurers and Providers,” the Jan. 21 webinar from Atlantic Information Services, will detail what strategies health insurers are pursuing to facilitate win-win payer-provider collaborations in MA and how providers are responding to them.

Participants will hear from Gary Jacobs, managing director for health policy in the Health Industries Advisory practice of PricewaterhouseCoopers, Leeba Leesin, president and CEO of the CareMore Health System subsidiary of Anthem, Inc., and Juan Serrano, senior vice president of payer strategy and operations at Catholic Health Initiatives. In 60 minutes of expert presentations followed by 30 minutes devoted to individual questions, participants will get valuable strategic insights on key questions such as:

  • What are the key elements a provider group has to master to assume global risk for MA?
  • How are MA insurers helping provider groups overcome the obstacles and structuring new win-win collaborations? How are some provider systems going down this path alone without insurers?
  • How does provider risk — if done correctly — align incentives and facilitate new-product creation in Medicare?
  • How are new provider-payer convergence models enabling the MA “toolkit” in such areas as the analytics engine, population management techniques and documenting the disease burden?
  • Which “build versus buy” decisions are providers making in MA in areas such as IT systems, use of third-party administrators, and coding tools and strategies?
  • How are plans and provider groups deciding to measure quality in joint MA plans? How successful are those efforts likely to be?
  • How can provider groups meet MA risk-management needs, such as capital and reserve requirements, with or without the help of insurers? What should be the role of reinsurance for them?

Visit http://aishealth.com/marketplace/c5a02_012115 for more details and registration information.

About AIS
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.

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Shelly Beaird-Francois
Atlantic Information Services
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