San Francisco

Healthcare CEO Peer Group

2nd Wednesday of the month  |  8:30 – 11:30 am  |  San Francisco, CA


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

Past Round Tables

Meet Susan Ehrlich, MD, CEO, Zuckerberg San Francisco General Hospital and Trauma Center

"Covering California"
Kathy Keeshen, is General Counsel for Covered California

What Healthcare Leaders Can Do to Create a Cyber-Secure Organization
M. K. Palmore, FBI's San Francisco Cyber Security Branch, is Assistant Special Agent-in-Charge

Meet Ed Heidig, Regional Director for U.S. Dept. of Health & Human Services - Region 9

Understanding Single Payer Health Systems Around the World
Walter Kopp, President and CEO of Medical Management Services

The 'Disrupters' Are Here: Are You Embracing or Ignoring Them? How?
Harry Soza, President and CEO of CAREMINDr

The Making of Kaiser Permanente's 5-Star MA Plan
Agnes Strandberg, Sr. VP of Medicare for Kaiser Permanente

Lessons from Marketing in Healthcare
Eric Neuner, CEO of Health Coach Institute

Weaving a Stronger Social Safety Net for Infants to Seniors
Al Gilbert, CEO of Felton Institute

Beyond the EHR: Using Technology for Patient Engagement & Data Management
Joshua Newman, MD, Chief Medical Officer for Salesforce

New Approaches for Controlling Healthcare's "Unsustainable" Spending Growth
ABL Member Jack Asher, MD, VP and Chief Medical Officer for Anthem Blue Cross and Jamie Robinson, PhD, is Professor of Health Economics at UC Berkeley

FIELD TRIP: Laguna Honda Hospital & Rehabilitation Center

Giving a Lyft to Healthcare – and Other Helpful New Technologies
Dan Trigub, Regional VP at Lyft-Business

Getting into the Weeds: The Implications of Legalized Marijuana
Paul Armentano, Deputy Director, of NORML, the National Organization for the Reform of Marijuana Laws

Introducing the Greater Bay Area's Super Provider Network
Joel Criste, CEO, Canopy Health

Meeting Seniors' Social and Economic Needs to Better Health
Maya Altman, CEO, Health Plan of San Mateo and Janet Van Deusen, Manager of the Health Insurance Counseling and Assistance (HICAP) program in Alameda County, at Legal Assistance for Seniors

Benefits of ABL

Members are able to stay abreast of industry trends that affect their business and keep ahead of the curve in their rapidly changing industry.  Connections made within the Round Tables – and throughout the  ABL Organization – further accelerate business growth, Members experience full value and a solid return on their investment of time and fees when attending Round Tables on a regular basis. .

Industry “Insider” Insights0%

Leveraged Connections0%

Cutting-Edge Ideas0%