Webinar Archives

We were honored to present to a group of ASC Orthopedic Executive associations in GA, SC, TN, AL, FL, MO, KS, AR, and OK on May 1st – Managed Care Tactics and Strategy. Topics including creating and assessing a managed care strategy can be overwhelming due to market nuances, products, and provider shifts; just to name a few obstacles. We will outline how best to simplify your approach and dive into the key pillars of such planning. This includes key components such as provider enrollment, contract language review, negotiation tactics, and analytics to best develop a manageable plan by payor and product. We will also highlight trends in policy, revenue cycle analysis, relationship management, and performance review necessary to assess your payors. Afterwards, you should have more tactics to build leverage and level the playing field.

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.

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.

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