Thursday, April 20, 2017
2:00 p.m.—3:00 p.m. EST
How Payers and Providers are Responding to the new Quality Payment Program
The Medicare Access and CHIP Reauthorization Act (MACRA) puts providers and payers on a value-based journey that is only now coming into focus. Commercial payers are focused on establishing and enhancing value-based payment models, and are adding services to support performance under MACRA and MIPS in a way that drives clinical and financial improvements on a sustainable level for their provider network. Providers are looking to respond to the various performance objectives they are now being asked to consider.
This session will focus on a discussion of quality management, revenue cycle management, and alternative payment model (APM) issues and the overall impacts of MACRA and MIPS to the commercial payer and provider market. The session will specifically focus on how payers are adopting more data-driven approaches to MACRA by marrying clinical collaboration and financial analytics. Successful approaches to MACRA include physician engagement, improved decision-making, and results that impact both patients and the bottom line.
In this discussion you will learn more about:
1. Various financial elements of MIPS scoring and the different categories providers will be measured on, so that you clearly understand the financial implications that go along with MACRA
2. Innovative ways that payers can use actionable data to manage clinical and financial risk, including strategies for curating high-performing provider networks, tracking key performance indicators and predicting cost and resource utilization
3. Methods to accurately price risk and communicate desired outcomes with physicians who are positioned to drive results under MIPS. The decisions made regarding MACRA will have far-reaching implications on the potential profitability of payers and physicians, and the financial success of small practices, medical groups, and large health systems
Presented by: Erik Pupo, Managing Director, North America Clinical & Health Management Services, Accenture
Erik has worked for over 20 years in healthcare, including senior positions in federal, state, and commercial healthcare programs and initiatives, and served in key leadership roles within the healthcare community. He holds leadership advisory positions within the American Health Information Management Association (AHIMA), the Healthcare Information and Management Systems Society (HIMSS), and the Healthcare Financial Management Association (HFMA), and regularly speaks at industry conferences on trends influencing the healthcare industry. Previously, he worked at Deloitte where he led several health IT initiatives for the Office of the National Coordinator for Health IT (ONC), the Department of Defense (DoD) and the Department of Veteran Affairs (VA).