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Presented by the ISBA Health Care Section

The current changes in reimbursement methodologies have resulted from the desire to control health care costs, many of which have involved moving from fee-for-service as the predominant means of payment to risk-based reimbursement methodologies. This half-day seminar helps you advise your provider clients on healthcare reimbursements and includes over 350 pages of electronic materials for your reference. Healthcare attorneys, in-house council for hospitals, and lawyers advising physician practices - with intermediate practice experience - who attend this seminar will better understand:
  • How healthcare reimbursements are calculated;
  • The different types of payment models;
  • The need for Risk Adjustment in Exchanges;
  • How changes in the reimbursement methodologies have affected insurance and health systems;
  • How providers should plan ahead;
  • The key attributes of contracts from a statistical perspective;
  • How to identify and explain risks to providers;
  • What to do when the contract isn't producing results; and
  • Much more!

Program Coordinator:
Alice R. Kush, Attorney at Law, Winfield

Program Moderator:
Carolyn V. Metnick, Barnes & Thornburg, LLP, Chicago

Program Information
Date Presented:
January 31, 2014 12:00 PM Central
Length:
4 hours
Reimbursement Changes: Definitions and the Physician's Perspective
Join us for a better understanding of how healthcare reimbursements are calculated, as well as a discussion on the new Payment Models, why Risk Adjustment is so important, and the key questions that must be covered in any risk-based managed care contract. Offered from the perspective of the physician, this segment examines the need for Risk Adjustment in Exchanges, how to evaluate reimbursement based on population (including guidance in obtaining data and reinsurance), the need to be able to terminate contracts, and shadow fee schedules. Questions will be answered at the end of the segment.
Approved Credit for Illinois State Bar Association
Total General MCLE Hours: 0.75
Speaker Information
Catherine I. Hanson   [ view bio ]
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Streaming
ISBA Member Price:$22.50
Non-Member Price:$37.50
Podcast
ISBA Member Price:$22.50
Non-Member Price:$37.50
CD-ROM (Win)
ISBA Member Price:$22.50
Non-Member Price:$37.50
Reimbursements
Relationship Realities
  • Gain a better understanding of the real meaning behind industry labels, such as "reimbursement" rather than "payment," "charge" vs. "price," and "patient" instead of "consumer." Learn how these labels obscure the real nature of payer-provider contractual relationships and needs, as well as the payers' interests and needs in crafting contractual arrangements with healthcare providers to obtain quality, cost-effective healthcare services for health plan enrollees.
Reimbursement: Strategies
  • Get the information you need on reimbursement strategies from the perspective of a strategic consultant. Topics include: key contract attributes; the trend toward partnering or collaboration between payers and providers; the role of MSOs for small and solo practices; and important statistical data. 
Approved Credit for Illinois State Bar Association
Total General MCLE Hours: 1.25
Speaker Information
Kathryn Roe   [ view bio ]
Jack Rovner   [ view bio ]
Steve Young CPA   [ view bio ]
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Streaming
ISBA Member Price:$37.50
Non-Member Price:$62.50
Podcast
ISBA Member Price:$37.50
Non-Member Price:$62.50
CD-ROM (Win)
ISBA Member Price:$37.50
Non-Member Price:$62.50
Drafting and Negotiation: Nuts and Bolts
The new Managed Care Models create new risks and obligations for providers, in addition to the old "traps" found in managed care contracts. This comprehensive overview offers a practical nuts-and-bolts approach to drafting and negotiating contracts, as well as a discussion on what to do when the healthcare provider is not benefiting from the bargain. Learn how to identify and explain risks to providers, propose revisions to contract language, minimize payment risks for providers, identify "Sheep's Clothing" provisions, and prevent the misuse of rate agreements.
Approved Credit for Illinois State Bar Association
Total General MCLE Hours: 0.75
Speaker Information
Thomas P. Conley   [ view bio ]
Elias N. Matsakis   [ view bio ]
ProductAddPrice
Streaming
ISBA Member Price:$22.50
Non-Member Price:$37.50
Podcast
ISBA Member Price:$22.50
Non-Member Price:$37.50
CD-ROM (Win)
ISBA Member Price:$22.50
Non-Member Price:$37.50
Panel Discussion: Contracts That Aren't Producing
This panel presentation discusses what to do when the contract isn't producing the anticipated results. Audience questions are encouraged.
Approved Credit for Illinois State Bar Association
Total General MCLE Hours: 0.50
Speaker Information
Thomas P. Conley   [ view bio ]
Catherine I. Hanson   [ view bio ]
Elias N. Matsakis   [ view bio ]
John A. Roberts   [ view bio ]
Kathryn Roe   [ view bio ]
Jack Rovner   [ view bio ]
Steve Young CPA   [ view bio ]
ProductAddPrice
Streaming
ISBA Member Price:$15.00
Non-Member Price:$25.00
Podcast
ISBA Member Price:$15.00
Non-Member Price:$25.00
CD-ROM (Win)
ISBA Member Price:$15.00
Non-Member Price:$25.00
Individual topic purchase: Selected
Illinois State Bar Association
Total General MCLE Hours: 3.75
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Products
Streaming
ISBA Member Price:$112.50
Non-Member Price:$187.50
Podcast
ISBA Member Price:$112.50
Non-Member Price:$187.50
CD-ROM (Win)
ISBA Member Price:$112.50
Non-Member Price:$187.50
Audio CD
ISBA Member Price:$112.50
Non-Member Price:$187.50
DVD
ISBA Member Price:$112.50
Non-Member Price:$187.50