Mike Scribner and Kelly Mooney recently presented to the Southeast Association of Orthopaedic Executives. They discussed market trends with Medicare and Medicare Advantage, and how to best position your provider organization as part of an overall Manage Care strategy. They also touch on payer performance, new carriers into the market, and negotiation tactics. See the PowerPoint here.
CMS released the Final Rule for Quality Payment Program for 2023 which will shape the way the whole mixed bag of acronyms (MIPS, APMs, & MVPs) work starting on Jan 1, 2023.
CMS released the Proposed Rule for Quality Payment Program for 2023 which will shape the way the whole mixed bag of acronyms (MIPS, APMs, & MVPs) work starting on Jan 1, 2023.
Georgia’s Department of Community Health (DCH) is preparing to reprocure its Medicaid managed care contracts (currently held by Amerigroup, CareSource and Peach State Health Plan). DCH’s selection process will begin later this year/early next year for new contracts to go-live on 7/1/2024. In addition to our existing payers, there are at least six new payors interested in the new Medicaid contract; which you have likely seen in ongoing outreach from those payors.
Since we are going to be working with a minimum of nine potential bidders and multiple moving pieces, SHP is pleased to announce an upcoming Medicaid Reprocurement webinar to discuss the following:
DCH’s Goals for their Next Medicaid Managed Care Cycle
Who are the new payors interested in Georgia?
What are our next steps to managing this reprocurement cycle?
We look forward to talking with you soon. Thank you as always for the opportunity to be of service. Click the button below to register.
Please join SHP’s Legislative Affairs Team for a recap of key legislation from the 2021 session and to understand what bills will impact you in the coming year!
Value-Based Care has finally come for the specialists……the first specialist based value models have arrived, primarily addressing bundled payments or site of care redirections. But beyond that, your primary care referral base are taking on more risk in managing the full direction and scope of care.
Their value models have matured and they are accessing data and quality results on your services; including unit reimbursement, cost, volume, case mix scenarios, quality results, and overall margin targets for your payer strategy.
So how do independent specialists and ASCs develop relationships as the preferred downstream provider in a value-based shared savings model?
Join us to learn more about this and how you drive increased volume by becoming the preferred value based partners for your primary care community. As usual, registration ahead of time is required. Please do so today!
To many, managed care is managed care. But with the leverage and bottom-line impact of an ASC to a physician group or hospital system, planning a specific strategy is essential to account for market forces that have significantly changed the landscape in the last twelve months. We will cover such managed care topics as:
How managed care differs for ASC’s to your practice revenue stream.
How does the No Surprises Act impact in- vs. out-of-network strategies?
Contract strategy and negotiation.
How the insurance market has changed; diminishing the big five payers.
New ASC reimbursement methodologies hitting the market
As follow up to recent updates and webinars, join us on February 17th as we discuss the latest on the ARP payments and HHS reporting guidelines. We will cover important items such as the reconsideration portal to what is required as part of your reporting guidelines. Please let us know of any questions as well beforehand, and we will be sure they are addressed.
The CMS Vaccine Mandate for Medicare certified facilities is moving forward. Please join us to learn more about how this will impact providers across the healthcare delivery system.
Today marks the start of the second-half of the 2021-2022 GA Legislative Session. Register today to join SHP and our partners at Capitol Strategy Group, for a GA Legislative Update on January 12th at 12:00 pm.
We will review 2021’s Legislative actions, what passed and what didn’t, then take a look at what is on the docket for 2022 to help you prepare for what the State Assembly is considering. A Q&A will follow the presentation, so come ready with your questions. Register now to save your seat!
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