UPCOMING MEETING
Wednesday, October 9, 2019
Opening Discussion Topic:
The Latest Trends in Value-Based Managed Care Contracting
Our Featured Speaker, Stephen Goff, King & Spalding’s ‘Best of the Bar’ healthcare negotiator, has been working with providers to negotiate capitated rates since the ’90s, and more recently, he’s developed a deep expertise in all aspects of value-based contracting. Thanks to the Affordable Care Act’s emphasis on ‘Value over Volume,’ through Alternative Payment Models and other Value-Based Programs, the percentage of CMS’s payments tied to value-based care rose from 23% in 2015, to 34% in 2017; with 50% targeted.
On the commercial side, The Health Care Transformation Task Force (a consortium of major providers, payers, and purchasers) late last year announced that its provider and payer members had converted 47% of their businesses to value-based payment arrangements in 2017. And for 2020, the Task Force’s members have a goal of reaching 75% value-based.
Following a Members Go-Round on your involvement with any of the growing list of ‘Value-based’ programs, we’ll introduce Stephen Goff to bring us up to date with – and answer your questions about – what he’s seeing on the national Value-based contracting front, and how it differs from ‘traditional’ managed care contracting, including:
- Premium sharing arrangements.
- New trends in Negotiating Shared-Risk agreements.
- Using analytics to determine the right financial responsibility matrix and capitation payments.
- The internal systems necessary to manage Value-based programs, and
- Combining plan provider joint ventures with ACO characteristics to dramatically compress costs.
RSVP today. And alert us to any particular questions you’d like Stephen to answer, so he can be sure to include them in his presentation!
Stephen L. Goff is a Healthcare Partner with King & Spalding, where he represents healthcare providers in a variety of high-profile matters, including multi-billion dollar managed care contract negotiations, litigation, and arbitration. Stephen also works with providers to: develop contracting and operational strategies, align these strategies with revenue-cycle improvements, and mitigate risks. Among his clients are CalPERS, which he has represented in its high-profile contract negotiations with major health plans; and for over 25 years, Sutter Health, in its development and contracting under the capitated/delegated model.
Upcoming Session Dates
Nov. 13 Dec. 11 Jan. 8 Feb. 12 Mar. 11
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