Bundled Payment: Practicalities, Governance, and Contractual Issues

Duration: 60 Minutes
Instructor: Alice G. Gosfield
Webinar Id: 800187


One Attendee


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:

  • Defining the bundle, breaking the bundle
  • Provider-Plan disputes and Provider-Provider disputes
  • Governance issues: avoiding food fights among providers
  • Dispute resolution options

Who Will Benefit:
  • 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

Educational Objectives(S)
Upon completion of this activity, participants will be able to:
  • Discuss the practicalities, governance and contractual issues regarding bundled payment models.

CME Credit Statement
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 Creditâ„¢. 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.

Disclosure Statement
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.

Speaker Profile
Alice G. Gosfield Esq, of Philadelphia’s Alice G. Gosfield and Associates, PC, has a national practice devoted to health law and healthcare regulation with a special emphasis on physician representation, managed care, quality, fraud and abuse, and medical staff issues. A graduate of Barnard College and NYU Law School, she has been named as one of the top twenty-five health lawyers in the country in 2007 and 2009 and has been a Best Lawyer in America (Health Law) for more than twenty years. She served as Chairman of the Board of Directors of the National Committee for Quality Assurance for five terms (1998-2002) and was President of the National Health Lawyers Association (now the American Health Lawyers Association) from 1992-93.

She was the founding Chairman of the Board of PROMETHEUS Payment Inc., and a member of the original and continuing Design Team. She is the first Chairman of the Board of the Healthcare Incentives Improvement Institute, Inc, (HCI3) the merger of PROMETHEUS Payment Inc and Bridges to Excellence, Inc.

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