Aug 8 Webinar: Gorman Health Group Executives Discuss How Provider Groups Can Transition into MA Programs
Washington, DC (PRWEB) July 30, 2013 -- A rapidly growing number of provider organizations, especially those involved in accountable care organization (ACO)-type arrangements, are deciding to get into Medicare Advantage. But finding the best path to take can be complex, with the choice varying based on the kind of organizations and markets involved. In an Aug. 8 webinar co-hosted by Atlantic Information Services, Inc. (AIS) and Gorman Health Group (GHG) — “How Provider Groups Can Move Into Medicare Advantage: Right and Wrong Ways to Do It,” — three top GHG executives will give practical advice on making that transition.
Among the many decisions provider groups face are whether and how to convert an organization to MA. If they do decide to convert, they need to gain the reserves and expertise for obtaining and using an insurance license, learn risk adjustment and enrollment reconciliation, meet federal compliance requirements for MA plans, process transactions, and develop relationships with agents and brokers. And there are avenues short of operating MA plans that could meet many of the providers’ objectives, such as via “shadow capitation” arrangements and partnerships.
During the Aug. 8 webinar, GHG’s Chief Development Officer Aaron Eaton, Senior Vice President of Finance William MacBain, and Senior Director of Compliance Solutions Regan Pennypacker will provide specific suggestions on how to rapidly and most efficiently take the needed steps for getting into the MA market in areas such as:
- Obtaining an insurance license, including meeting the requirements for substantial reserves;
- Setting up effective MA-specific sales and marketing operations, including broker training;
- Gearing up for enrollment reconciliation;
- Handling risk adjustment;
- Processing transactions for capitated entities and getting the actuarial expertise needed for setting rates for capitation or shadow capitation;
- Understanding what documents are necessary for the MA plan application and how to proceed with a successful submission;
- Developing 24/7 audit readiness via policies and procedures, training and documentation;
- Meeting and exceeding standards for customer service and handling of complaints, appeals and grievances; and
- Conceptualizing and implementing effective programs for star quality ratings that will qualify for bonuses from CMS.
Visit http://aishealth.com/marketplace/c3ag33_080813 for more details and registration information.
AIS has partnered with GHG on an exclusive series of webinars designed to deliver timely and meaningful information the government health care industry needs to implement health reform. From expert analysis on the latest regulatory updates to war stories and best practices, these webinars will provide the tools and guidance necessary to transform regulatory policy into operational reality.
About Atlantic Information Services
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.
About Gorman Health Group
Gorman Health Group (GHG) is a national health care professional services and software company staffed by subject-matter experts, former health plan executives and seasoned regulators. For more than 16 years, hundreds of clients serving millions of beneficiaries have leveraged the strategic counsel and technology solutions of GHG to maintain compliant operations, improve market position and advance growth objectives. Learn more at http://www.gormanhealthgroup.com.
Shelly Beaird-Francois, Atlantic Information Services, http://aishealth.com, 202-775-9008 Ext: 3064, [email protected]
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