Bundled payment models are proliferating despite almost no experience with them. This crisp and focused session will elucidate some basic concepts about bundled payment and distinguish it from other payment models. How bundles are created, triggered, and broken will be addressed. Critical issues which are often overlooked will be described.
What should be in the contract amendment which creates most of these programs will be presented. Issues which should be subject to appeals and those that likely will not be will be described. How to avoid disputes among the providers who are now at financial risk with each other will be presented.
Why Should You Attend: Bundled payment models offer different challenges from traditional reimbursement. Understanding how bundles are constructed is essential to being able to respond to their incentives. Signing contracts without a clear appreciation of the potential problems is foolhardy. Because this payment links otherwise unrelated providers' financial fates to each other, the risks are increased. There are unappreciated pitfalls that should be addressed before signing or accepting anything.
Areas Covered in the Session:
Who Will Benefit:
- Defining the bundle, breaking the bundle
- Provider-Plan disputes and Provider-Provider disputes
- Governance issues: avoiding food fights among providers
- Dispute resolution options
- Managed Care Contracting Officers
- Network Development Officers
- Health Plan Contracting Personnel
- Health Plan CFOs
- Health Plan Medical Directors
- Medical Group Administrators
- Health System CFOs and Finance Directors
- Health System Physician Group Managers
- Health System and Group Practice Compliance Officers
- In-house Counsel of Physician Groups and Health Systems
Upon completion of this activity, participants will be able to:
CME Credit Statement
- Discuss the practicalities, governance and contractual issues regarding bundled payment models.
This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of CFMC and MentorHealth. CFMC is accredited by the ACCME to provide continuing medical education for physicians.
CFMC designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Other Healthcare Professionals Credit Statement
This educational activity has been planned and implemented following the administrative and educational design criteria required for certification of health care professions continuing education credits. Registrants attending this activity may submit their certificate along with a copy of the course content to their professional organizations or state licensing agencies for recognition for 1 hour.
It is the policy of CFMC and MentorHealth that the faculty discloses real or apparent conflicts of interest relating to the topics of the educational activity.
All members of the faculty and planning team have nothing to disclose nor do they have any vested interests or affiliations
Obtaining Certificate of Credit
Colorado Foundation for Medical Care (CFMC) hosts an online activity evaluation system, certificate and outcomes measurement process. Following the activity, you must link to CFMC's online site (link below) to complete the evaluation form in order to receive your certificate of credit. Once the evaluation form is complete and submitted, you will be automatically sent a copy of your certificate via email. Please note, participants must attend the entire activity to receive all types of credit. Continuing Education evaluation and request for certificates will be accepted up to 60 days post activity date. CFMC will keep a record of attendance on file for 6 years.