Speaking Engagement:

Live Webcast | Physician Integration Strategies: What You Need to Know in 2015

 
 
Event Information

Date:

Wednesday, June 3, 2015

Time:

12:00 - 2:00

Sponsored by:

The Knowledge Group

Speakers:

Lawrence B. Garcia

Presentation Overview:

As we have passed the 5th anniversary of the adoption of the Affordable Care Act (“Act”), it is appropriate that we focus on a particular goal of the Act which is less controversial than the individual mandate, the expansion of the Medicaid program or the implementation of the health insurance exchanges.  A specific goal of the Act is the implementation of the “triple aims” of health care reform which include: (i) improving the individual experience of care, (ii) lowering the total cost of care and (iii) improving clinical outcomes for coverage patient populations.  A key program in achieving the triple aims is a conversion of patient care payments from volume based fee-or-service payments to value-based contracting.

Both governmental payment programs and health insurance companies are charting a path of value-based contracting.  This session will address many of the complex legal and regulatory issues that must be evaluated by a clinically integrated network of providers (“Network”) to participate in a value-based contract which may include incentive payments for clinical performance that helps to achieve the triple aims.  Key issues that will be addressed are as follows:

  • What are the key antitrust issues that a Network must address to enter into joint contracting negotiations for a value-based contract?
  • What is the legal structure “of choice” that is being used to form a Network?
  • What role should physicians and hospitals play in the design and operation of a Network?
  • What are the most common clinical performance standards used by a Network?
  • What are the key regulatory issues that must be addressed for a Network to contract with participating physicians and medical groups in its service area?

Registration:

To register, please visit The Knowledge Group website