Due to significant demand from our clients and partners we will be hosting a virtual Summit to bring together top managed care executives, legal experts, and renowned thought leaders to discuss the state of our industry and how we can chart a successful path through our challenges.
The virtual event will consist of a series of several webinars over the coming months. Each session will hit on the same theme: unprecedented challenges in the managed care space. This includes discussions around the contracting climate, constraints over how and where to deliver care, difficulty collecting on claims, rising labor and supply costs, and more.
Our next virtual session will take place on Tuesday, December 12th from 1:30 pm – 2:30 pm CT. Stuart Kilpinen, SVP of Payor Strategy & Product Development, and Bob Beverwyk, VP of National Payor Contracting, will share insights about the dynamics and trends they have experienced in recent negotiations with both national and regional payors.
Payor Games: Increased Denials, Underpayments, Non-Payment, and The Impact on Healthcare Providers
Payors are increasingly finding more ways to deny claims. Making matters worse, a lack of transparency leaves healthcare providers with little to no insight into the source of the denials, how to dispute them, or how to keep them from happening in the future. Meri Gordon and Adam Dietrich, Shareholders at Polsinelli, have devoted their practice to addressing these payor games head-on. In their roles, they’ve gained a deep understanding of the healthcare legal landscape and routinely represent clients in connection with an array of managed care disputes and litigation.
On Thursday, 11/9 from 11 am – 12 pm CT, Meri and Adam discussed recent trends in managed care contract denials, including an exploration of the underlying factors, effective strategies for addressing denials (from a contracting and litigation perspective), and the legal implications associated with these challenges.
Direct-to-Employer Relationships as a Catalyst for Growth
Health systems are facing increased financial and operational pressures driven by the lingering effects of the COVID-19 pandemic, rising costs to deliver care, evolving reimbursement models, and bad payer behavior. It’s important that we shift our collective thinking, adopt a proactive approach, and seriously consider revenue diversification and growth strategies that previously may have been considered too disruptive.
Nick Stefanizzi, CEO of Northwell Direct, shares some lessons learned in launching a leading health system owned direct-to-employer business and the benefits these relationships can provide to both employers and health systems. Not only can these relationships provide a valuable alternative revenue source, improve market share, and enable an alternative pathway to care for the community served by a health system, but they can also support a recalibration in the balance of power between health systems and the traditional insurance companies, which will be increasingly important as negotiations continue to grow more and more acrimonious.
Following this session, you’ll have with a fresh perspective on how to address the burdens the nationwide provider organizations have been grappling with and a new outlook on how health systems can have a transformative impact on how care is organized, delivered, and financed through direct-to-employer relationships.
Recap blog coming shortly.
Northwell Direct, CEO
Stuart Kilpinen and Bob Beverwyk — Trinity Health
Tuesday, 12/12, 1:30 pm – 2:30 pm CT
Flipping the Script On Negotiations
With 89 hospitals spanning 22 states, and thousands of physicians across primary and specialty practices, Trinity Health is one of the country’s largest not-for-profit health systems.
Mr. Kilpinen, SVP of Payor Strategy & Product Development, and Mr. Beverwyk, VP of National Payor Contracting, will share insights about the dynamics and trends they have experienced in recent negotiations with both national and regional payors.
They will also discuss Trinity Health’s effort proactively educate key audiences about the mounting challenges healthcare providers face, as well as the lack of real partnership and fair payments from payors that are essential to addressing them.
Trinity Health, VP, Payer Strategy and Product Development
Trinity Health, Vice President, National Payer Contracting
John Poziemski – Kaufman Hall
Wednesday, 1/10: 11 am – 12 pm CT
The Payer-Provider Reset: Building Relationships in a Shifting Landscape
In today’s challenging macro-economic environment, payer-provider partnerships are shifting away from aspirational goals of creating long-term value to more practical considerations. Organizations are asking each hard questions about value creation, the capabilities they seek in partner organizations, and the nature of joint opportunities. In this session, John Poziemski from Kaufman Hall will explore how health systems and health plans can craft effective, sustainable partnerships in an uncertain future. Registration for this session will be opening soon.
Managing Director, Practice Leader, Strategy, Kaufman Hall
Jeff Leibach – Guidehouse
Wednesday, 1/31: 12 pm – 1 pm CT
Contracting Tactics from the Other Side: What to Expect in your Negotiations
This session aims to provide healthcare providers with comprehensive insights into managed care contract denials, including an exploration of the underlying factors, effective strategies for addressing denials, and the implications associated with these challenges.
Session details and registration link coming soon.
Village Medical, Western Region President
These sessions will be ideal for:
Health system executives responsible for payor relations, networks, or employee relations, who want to learn the latest trends and successful strategies from across the country that can be adapted to your market.
Executives from health services and tech companies who want to deepen their understanding of their buying audience and gather candid feedback on what’s working and what’s not.
Management consultants, attorneys, and thought leaders who want to network with executives from some of the best hospitals and health systems in the U.S.
Communications executives inside healthcare provider organizations who are increasingly faced with navigating challenging public narratives surrounding negotiations, consolidation, and healthcare costs.