Our next Diversity Dialogue is...
Risk Profile of New Exchange Entrants: Implications and Opportunities for Health Care Systems
Thursday, January 29, 2014
10:00 a.m. PT, 11:00 p.m. MT, 12:00 p.m. CT, 1:00 p.m. ET
Health insurance exchanges and other market reforms under the Affordable Care Act have expanded access to affordable insurance options while simultaneously restricting health plans’ controls used to manage risk (e.g., elimination of pre-existing condition restrictions and lifetime limits, community rating, etc.).
Critical to the success of these market reforms is risk adjustment, which is designed to ensure that health plans are compensated based on the health status of their members and are not disadvantaged for covering people with high cost conditions. While the risk adjustment transfer payment directly impacts health plans, it is critical for providers to understand the underlying principles of risk adjustment and the impact on provider-health plan relationships.
While enrollment efforts for 2015 are ongoing, plans’ experience in 2014 has yielded insights on the characteristics of these new, risk adjusted members, which are often different from traditional, commercial health plan membership.
Through this webinar, participants will:
- Understand the basics of commercial risk adjustment, including mechanics, funds flow and the major stakeholders involved;
- Become familiar with risk profiles of commercially risk adjusted populations, including the changing demographics and diversity of patients;
- Understand the implications of new populations, which include more diverse and ill patients, as well as patients unfamiliar with health insurance;
- Gain perspective on the financial importance of risk adjustment to health plans and the impact it will have on provider-health plan relationships;
- Review the emerging understanding of the risk profile of the risk adjusted populations and issues that may impact the delivery of health care services; and
- Understand how risk adjustment will impact health care systems and what opportunities exist for providers and delivery systems.
Institute for Diversity Members: FREE
Non-Institute for Diversity Members: $99 (Join the Institute and the webinar is free - click here for more information regarding membership.)
If paying by check, please contact Pamela Janniere at 312-422-2691 or by email at firstname.lastname@example.org.
The registration process for the Institute’s Diversity Dialogues allows you to sign up and receive dial-in instructions in one easy step. To view the registration instructions, please click here.
Note: Your organization's membership number and/or your individual member number are NOT needed for webinar registration, account creation or when you are accessing your account on eweb. Only your email address is required. Refer to the registration procedures by clicking here for additional information.
You may contact Pamela Janniere directly at (312) 422-2691 or email@example.com to receive the dial in and web link information, particularly if you would like to invite a large group of employees to the event. Thank you.
About Alexis Levy:
Alexis Levy has helped clients across the health care industry on a variety of strategic, operational and financial issues. Her consulting experience includes strategic planning, physician engagement and alignment strategies, operational due diligence, and corporate advisory services. With extensive expertise on the relationship between payers and providers, Levy has advised clients on issues including physician integration and alignment strategies, value based payment and reimbursement models, risk adjustment and Medicare Advantage Star Ratings. She has also assisted numerous organizations with their strategic and operational response to health care reform requirements, including medical loss ratio requirements, exchange readiness and evaluation of entry into Medicaid and Medicare Advantage markets. A frequent speaker at national conferences, including those sponsored by the Health Plan Alliance (HPA) and the National Association of Specialty Health Organizations (NASHO), Levy earned an MBA from Washington University in St. Louis and a B.S. in occupational therapy from Boston University.
About Brandon Solomon:
Brandon Solomon has over eight years of consulting experience providing a variety of financial and advisory services to companies in the health insurance, ancillary, and healthcare industries. He has assisted various clients with operational assessments, business strategy, and advising clients on government regulated markets, with particular expertise in helping health plan clients successfully operate in government markets. This includes business acquisition through new market entry strategies, bidding on government contracts and evaluating internal operations. Recently, Solomon has focused on commercial risk adjusted markets, implementing HealthScape’s revenue management software as a service solution, Pareto Intelligence™, for multiple clients. He is also working with clients to design new organizational structures and capabilities to effectively respond to the requirements of the Affordable Care Act. Solomon earned a B.S. in economics from Indiana University.
Upcoming Diversity Dialogues:
Tuesday, February 24, 2015, 12:00 p.m. CT - TBA
Duration: 90 minutes
Presenter: Patrick Horine, CEO - DNV Healthcare, Inc.
MEMBERS ONLY*: Wednesday, April 29, 2015, 12:00 p.m. CT - TBA
Duration: 90 minutes
Presenter: Ramanathan Raju, M.D. – President and CEO, New York City Health and Hospitals Corporation
*Webinar participation and recordings of this webinar are restricted to members of the Institute for Diversity. For more information about Institute membership, please click here.
For questions about the Diversity Dialogue series, please contact Pam Janniere, Manager of Membership, Marketing and Education, at (312) 422-2691 firstname.lastname@example.org.
Updated: January 20, 2014