2018 Network Contracting Forum
October 25-26, 2018 * Loews Sapphire Falls Resort * Orlando, FL
2018 Network Contracting Forum
About the Conference
Network contracting is currently facing unprecedented challenges, as well as opportunities. It has become an imperative for payers, as well as providers, to respond to these challenges by making changes to their network contracting strategy, as well as taking advantage of the opportunities that currently arise within network management. The market has seen numerous changes within the relationship between providers and payers, and new techniques have been introduced to operate within this market – this has greatly impacted how payers approach network contracting. Specifically, we are now operating within a market where new regulations are being introduced for Medicaid and Medicare, and new technologies and solutions have been released to better enhance provider contracting and management. Furthermore, declining budgets are demanding new approaches to how we do network contracting, and to how new opportunities can become profitable for a payer. As the cost of doing business continues to rise and when every dollar is more important than ever, healthcare payers, as well as providers, are in greater need of solutions to lower costs and increase efficiency. By implementing cutting-edge network contracting solutions, many organizations have been able to achieve these goals.
This conference will guide you in the right direction – in addition to focusing on traditional, yet current, issues such as developing a strategic and transparent approach, this conference stands out in that it recognizes the need to effectively incorporate innovative network contracting strategies. We are bringing together leaders and innovators to share their insights and offer tested solutions on how to streamline the network contracting process. You will learn what others in your industry are doing to be prepared for the challenges that lie ahead.
Who Should Attend?
From Health Plans/Hospitals/Health Systems:
- Network Contracting
- Managed Care
- Provider Relations
- Network Management
- Network Development
- Provider Contracting
- Claims Management
- Contract Administration
- Patient Financial Services
- Medical Director
- Revenue Cycle Management
- Government Relations
- Payor Relations
- VP of Finance
Also of Interest to:
Vendors; Consultants; Solution Providers; Law Firms offering services in the healthcare industry and network contracting process.
Day One – Thursday, October 25, 2018
Conference Registration & Morning Breakfast
Chairperson’s Opening Remarks
Implementing Quality and Risk Assessment Programs
This session will discuss the importance of implementing quality and risk assessment programs into provider contracts. As the bar continues to rise for both payers and providers when it comes to health outcomes, it is imperative that priorities align. By outlining the “what’s in it for me,” provider-payer partnerships can form to collaborate on workflows that better address chronic condition management and preventive screenings all while reducing redundancy and waste, ultimately creating a better customer experience.
Implementing Effective Membership Growth Strategies for Network Contracting: Focusing on Innovation and Medical Cost Trends
This session will examine membership growth strategies that improve performance for a health plan and offer hospitals with the most innovative and medical cost trend focused strategies.
- Achieving sustained membership growth – understanding what motivates members
- Empowering consumers with more choice and control
- Effective positioning and marketing of options
- Utilizing IT for effective communication tools
Networking Break & Refreshments
Innovative Network Contracting Strategies to Establish Effective Partnerships with Large Primary Care Practices and Multispecialty Groups
This session will focus on how to establish effective partnerships with large primary care practices and multispecialty groups through innovative network contracting strategies.
Examining Strategies to Create and Manage High Performing Networks
This session will examine strategies on creating and managing high-performance networks. Topics to be discussed will include:
- Tiered versus narrowed
- Incorporating service category or specialty network designs
- Analytics to support provider stratification
- How alternative payment models fit within the strategy
- Managing the disruption
- Operational consideration
Behavioral Economics and Patient engagement: Examining Network Contracting Applications for a New ACO Model
Effective risk-sharing contracts are only part of the story. In this session, you’ll learn how to apply behavioral economics and new patient engagement approaches to increase PCP selection and adoption. Plus, hear how a new statewide PCP based ACO is changing the traditional ACO approach. Topics to be discussed will include:
- Bending the cost-curve, improving patient care and population health
- Collaboration strategies
- ACO payer arrangements
- Upside-only shared savings (savings are split evenly between insurers and providers with no penalties)
- Creating consumer engagement and acceptance around ACOs in a PPO world
- Market and value positioning that works
- Increasing PCP selection and effective onboarding
- Using behavioral economics to drive engagement
- Attribution models for risk sharing with PPO products
- Narrow network product offerings with integrated network partners
Luncheon for All Attendees & Speakers
Creating and Implementing Innovative Pay-For-Performance Programs in Provider Contracting to Improve Quality and Manage Costs
Innovative incentive programs are vital in maintaining provider relationships. This session will present strategies on developing such incentive programs and implementing them with success. Learn about how pay-for-performance can create an overall improvement in quality, and provided an opportunity to better manage costs for the population. Additional topics to be discussed will include:
- Incorporating quality and efficiency data transparency into your network contracting and claims management
- Implications of data-sharing, value-based or risk-shared contracts
- Data demands of providers
- Consolidating and normalizing data files from multiple payers
Ensuring Provider Network Adequacy and Directory Accuracy Through Effective Compliance Programs
Two managed care trends – the desire to focus on high-value providers and the increasing scrutiny of provider networks – are pulling health plans in opposite directions and putting a growing number of health plans at risk for regulatory problems. Responding to concerns from advocates and providers about narrow networks, regulators are implementing new initiatives to measure network adequacy, and discovering an industry-wide pattern of inaccurate provider information. From Medicare Advantage to Medicaid to commercial markets, federal and state regulators, as well as provider groups and researchers, are looking at provider networks in new ways, and health plans are facing increasing risks over network adequacy and provider directory accuracy. In this session, you will learn about regulatory developments related to network adequacy and directory accuracy across health insurance markets.
Networking Break & Refreshments
Panel: Ensuring Network Adequacy for Medicare Managed Care Plans
Topics to be examined include:
- CMS standards “time and distance”
- Health service delivery table challenges
- Building processes for continuously monitoring existing networks
Understanding and Solving the Complexities in Medicaid Provider Network Contracting
Medicaid has seen its share of troubles as a result of recent regulatory changes pertaining Medicare and Medicaid. This session will discuss solving some of the complexities surrounding provider network management when it pertains to Medicaid. Topics to be discussed will include:
- Effectively selecting provider partners to optimize network management and examining optimal attributes and market dynamics
- Creating operational efficiency through cross-departmental collaboration in areas that impact network management
- Developing Medicaid value-based contract relationships that drive performance and quality care
- Narrowing networks to establish the right Medicaid medical home
- Understanding the risks when restructuring Medicaid networks
- HEDIS – why it should be a part of your VBC contract
- Managing provider performance and expectations
End of Day One
Day Two – Friday, October 26, 2018
Chairperson’s Recap of Day One
Optimizing Network Contracting: Provider Payment Innovation Strategies as a Path to Provider Collaboration
This session will examine policies that impact network contracting. Talking points will also focus on strategies on implementation, provider collaboration, payment innovation strategies, performance and communication with providers, and having an alternative strategy to network contracting
Optimizing Value-Based Network Contracting Through Effective Shared Savings and Care Coordination Strategies
This session will examine how to effectively optimize value-based network contracting through effective shared savings and care coordination strategies. Learn what works, lessons learned and successes. Topics to be discussed will include:
- Defining the structural components of the network
- Discussing the contracting and reimbursement models that were utilized to support the strategy
- Exploring the approaches to encourage individual providers to accept and support value-based arrangements
- Cooperating with governmental value-based payment initiatives
- Data sharing transparency
Networking Break & Refreshments
Optimizing Network Contracting/Management Through innovative Market Disrupting Payment Strategies for Ancillary Suppliers
This session will address how combining forces with procurement and supply departments and representing all care settings across the continuum (acute, post-acute and home independent care) can create a market leading payment methodology and industry impact which will fully leverage enterprise purchasing power and improve continuity of care as patients transition from different levels of care in the continuum. Learn different strategies to maximize cost containment opportunities.
Why Competitive Reimbursement is Elusive in Hospital Contracting
Hospitals want to be market competitive while still meeting their revenue expectations from private payers. Learn about site-of-service neutrality in reimbursement for services common to both hospitals and freestanding providers. Additionally, understand the opportunities and pitfalls in achieving the balance between demonstrable price-relief for hospital-based services versus price shifting, with no net savings, across service lines.
Workshop – Thursday, October 25, 2018
05:30pm – 7:30pm
Implementing an Effective Network Strategy: Optimizing Your Health Plan’s Largest Asset
Loews Sapphire Falls Resort
6601 Adventure Way
Orlando, FL 32819
“Mention BRI Network to get a discounted rate of $189/night”
Sponsors and Exhibitors
Are there group discounts available?
- Yes – Register a group of 3 or more at the same time and receive an additional 10% off the registration fee
Are there discounts for Non-Profit/Government Organizations?
- Yes – please call us at 800-743-8490 for special pricing
What is the cancellation policy?
- Cancellations received 3 weeks prior to the event will receive a refund minus the administration fee of $185. Cancellation received less than 3 weeks prior to the event will receive a credit to a future event valid for one year.
Can the registration be transferred to a colleague?
- Yes – please email us in writing at email@example.com with the colleague’s name and title
Where can I find information on the venue/accommodations?
- Along with your registration receipt you will receive information on how to make your hotel reservations. You can also visit individual event page for specific hotel information. The conference fee does not include the cost of accommodations.
What is the suggested dress code?
- Business casual. Meeting rooms can sometimes be cold so we recommend a sweater or light jacket
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