Planning And Strategy Development For Managed Care Contract Renewals

Duration: 90 Minutes
Instructor: Maria K Todd
Webinar Id: 800345


One Attendee


Healthcare providers often overlook leverage they don't realize they have because they don't know how to research the market properly. In other instances, providers fail to maintain their contracts until the rate or other problems become untenable.In still other instances, they simply "expect" economic adjustments to rates without a corresponding defined value proposition.

Why should you attend: Chances are, you or your boss would love to see increased rates of payment on managed care contract renewals and renegotiations this year. But why should you expect them? Have you done your part to articulate your brand value in a way that the health plan or purchaser (employer group, union, or some other entity) can easily identify why they don't want to go to market without you? Have you researched who their customers are and how those customers feel about your brand?

It costs plans about $15,000 for every contract that they negotiate or renegotiate. In an age of increasingly more narrow networks, would you be prepared to respond to a refusal if the shouldn't the plan simply tell you "Thanks, but no thanks. We've got enough suppliers who are not asking for raises and changes. Don't call us; we'll call you."?

Join us as Maria Todd, author of The Managed Care Contracting Handbook leads this webinar that covers planning for contract renegotiation strategies, just in time for you to take back what you learned and start planning your 2015 managed care renegotiation strategy.

Areas Covered in the Session:

  • Explain how plans build their rate setting strategies
  • Discuss the steps, timing and renegotiation opportunities available in contracte reimbursement
  • Discuss the process to determine "if" they should renew the old contract
  • Demonstrate ways that participants can determine if a discount is warranted, or an adjustment higher or lower should be considered
  • Explain how to model alternative realities What if you terminate? Will the world end?
  • Explain how to evaluate provider leverage Even if you decide not to use it

Who Will Benefit:
  • Contract Analysts and Negotiators
  • Revenue Cycle Managers and Directors
  • Billing Staff
  • Refund Analysts and Processors
  • CFOs and Patient Financial Services Managers
  • Healthcare Business Managers
  • Hospitalists and Private Practice Physicians
  • Medical Group Administrators
  • ACO Executive Directors
  • ACO Executive Directors

Speaker Profile
Maria K Todd Contracting strategy and organizational development (OD) for integrated health delivery systems has been a passion and a pursuit of our workshop leader since 1983. Maria Todd started her career in health administration in the multi-specialty group practice setting, and later designed and developed more than 150 IPAs, PHOs and MSOs during the Clinton Administration. In 1995, McGraw Hill and HFMA co-published her book, The Managed Care Contracting Handbook, and then in 1997, her book, title IPA, PHO, MSO Development Strategies was released. Both how-to books were written to help providers develop reimbursement strategies and design, plan and launch integrated health systems. Each sold more than 4000 copies. Considering there are about 7500 licensed hospitals in the USA, that number is considered a smashing success. In 2009, the sequel to ththe Contracting Handbook was updated and in 2012, her book, Physician Integration and Alignment: IPA, PHO, MSO ACOs and Beyond, was published by CRC | Productivity Press Both are once again, breaking industry sales records. She's been analyzing and negotiating managed care contracts and practicing organizational development as a facilitator since the 1980s.

In 2010, the US Patent and Trademark Office (USPTO) granted Maria Todd the registration of a new term of art, the Globally Integrated Health Delivery System® for her application of the integrated health system concept and operations to the medical tourism and health travel arena. She built the first and only globally integrated health delivery system which combined all the elements of ACO accountability, predictive modeling, case management, provider credentialing and privileging, quality, safety, clinical outcomes and patient satisfaction metrics, telehealth and telemedicine technology applications, electronic medical records, international cloud-based data and privacy security, and TPA operations for provider claims settlement and bill audit. To this, she added a fully-documented system to manage complex and specialized health travel logistics coordination to the mix.

Maria has professional work experience as an HMO Provider Contracting Manager, IPA Executive Director, Health Law Paralegal and Mediator, OR Nurse, Multi-Specialty Practice Administrator, Hospital & Surgicenter Administrator, and Care Navigator. As a professional speaker and trainer for various event sponsors, conference organizers, and trade associations, she has presented more educational programs (>2700) in managed care and integrated health delivery systems development than any other presenter in the world. She is also the author of 14 commercially-published handbooks.

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