Veralon offers a series of presentations that respond to the biggest questions facing healthcare executives today. These talks are designed for and customized to your audience, whether it be a provider organization or a professional association. Each presentation includes practical takeaways that will continue to guide participants long after the meeting ends.
These are the major topics in the healthcare world that we’re talking about in the coming year:
Top 7 Methods to Improve the Financials of Your Physician Enterprise:
Optimizing Performance and Strategic ValueTop 7 Methods to Improve the Financials of Your Physician Enterprise: Optimizing Performance and Strategic Value
Healthcare organizations often look at reports of “losses” per owned physician practice and forget that their original rationale for acquiring the practices was strategic, not financial. Yet at the same time they are concerned about losses, many hospitals and health systems give little consideration to how the performance of the physician enterprise could be strengthened. With some attention, there is often significant opportunity to improve that performance.
This presentation will address the questions that management and board members should be asking about their owned practices, in relation to compensation models, quality of care, referrals, operations, and fee schedules, among others, and how they can respond to the answers they find.
Participants will learn:
- How to properly evaluate key aspects of practice performance
- Approaches to strengthening each key aspect of performance
- Ways to increase the strategic value of the physician enterprise
- Including how to make MIPS work for your physician enterprise
Ambulatory Care 2.0:
The Next Generation of Your Ambulatory Care NetworkAmbulatory Care 2.0: The Next Generation of Your Ambulatory Care Network
Health system growth will be driven by ambulatory care in upcoming years as value-based care models shift the focus from volume to value of care across populations. This presentation will discuss the design of a next-generation Ambulatory Care Network that sustainably integrates critical system components to enhance overall competitive advantage. Potential implications of value-based payment model proliferation will also be discussed within the context of network planning.
This session will cover:
- Comprehensive and strategic (rather than opportunistic) ambulatory care planning
- Network financial viability, given market dynamics and uncertainty
- Service and location portfolio
- Physician alignment and patient engagement
- Know the key components of a high-performing ambulatory care network
- Understand the models of care that support and enhance patient outcomes and value-based payment models
- Be able to fully integrate and optimize inpatient resources, physician network, and the ambulatory network in a sustainable model
- Understand what services are needed to support the population and enhance overall competitive advantage
The $10,000 Question:
Tackling the Complexities of Value-Based Physician CompensationThe $10,000 Question: Tackling the Complexities of Value-Based Physician Compensation
New revenue models for health systems call for new compensation models for physicians—models that provide incentives for quality as well as productivity. This presentation will discuss the design of value-based compensation models to minimize the pain of potential risks (disgruntled physicians, physicians who “take a hit,” lower productivity) while maximizing results. Potential implications of MIPS will be discussed as relevant.
This session will cover:
- How much of an incentive is enough
- How quality and cost-effectiveness should be measured
- Simulating compensation
- Phasing in the plan
- Understand the basic concepts in designing value-based compensation models
- Know how to set quality and cost-effectiveness targets in incentive models
- Be able to develop alternative incentive models for simulation testing
- Understand the factors to be simulated in testing incentive models
The Due Diligence Tightrope:
Getting the Right Deal DoneThe Due Diligence Tightrope: Getting the Right Deal Done
To achieve long-term financial viability and ensure continued provision of high quality care in a dynamic, increasingly consolidated environment, hospitals, health systems, physician enterprises, and other provider organizations are faced with the need to consider new opportunities to align, merge, grow by acquisition, or otherwise expand or diversify. Realizing the benefits of a merger or other transaction, however, requires that both parties successfully evaluate, structure, and negotiate the transaction prior to execution. When effectively executed, the post-LOI due diligence period should provide the insight needed to affirm the deal decision, refine deal terms, and lay the groundwork for integration.
Through case studies and illustrative real-life examples, this presentation will explore strategies for:
- Leading a transaction-specific due diligence process
- Avoiding information overload when gathering data, and responding appropriately when the potential partner cannot or will not provide information
- Maintaining deal momentum when significant issues are identified early in the due diligence process
- Understanding your potential partner’s financial performance and position, and ultimately considering the likely post-transaction financial picture, including pressure-testing assumptions, exploring scenarios, and keeping eyes wide open on whether your capital commitments make sense
- Leveraging the due diligence process to begin building a foundation for integration
- Connecting potential risks across silos when considering the overall due diligence outcome
Setting Your BPCI Advanced Strategy:
Understanding the Key Drivers of SuccessSetting Your BPCI Advanced Strategy: Understanding the Key Drivers of Success
Medicare’s Bundled Payment for Care Improvement Advanced (BPCI Advanced) program is more than just a value-based payment contracting option. It has significant strategic implications for physician alignment, commercial payer contracting, and ACO strategy. It can also make physicians eligible for the MACRA Alternative Payment Model 5% bonus. Deciding about BPCI Advanced involves much more than a simple calculation of savings opportunities.
- Learn BPCI Advanced program requirements, financial opportunity, and risks
- Understand key drivers of success, including analytics, post-acute strategy, and physician engagement
- See how to evaluate episode options and determine which episodes are likely to be successful
- Assess whether BPCI Advanced will secure the MACRA 5% bonus
- Recognize strategic considerations
- How does BPCI Advanced look to physician groups – will they apply and outmaneuver hospitals?
- How can hospitals use BPCI Advanced to align with physicians?
- How does BPCI Advanced interact with ACOs and other value-based arrangements?
- Is there opportunity for commercial bundles as well?
- What are effective strategies for care redesign based on the bundles chosen?
Innovations in Primary Care Delivery:
Beyond the Patient Centered Medical HomeInnovations in Primary Care Delivery: Beyond the Patient Centered Medical Home
Primary care is an essential cornerstone of every evolving healthcare delivery system. Healthcare organizations must pursue three main initiatives in their primary care strategy: growing primary care, supporting new models that focus less on episodic patient care and more on care coordination and care management, and partnering with payers to share risk and reward for quality, outcomes, and cost of care.
This session will provide numerous examples of successful innovations in primary care delivery and care coordination, such as the blended concierge model, Primary Care Institute, CMS innovations pilots, chronic disease management among uninsured patients, the multi-payer comprehensive primary care initiatives, and others.
Participants will learn:
- The benefits and features of many innovative and successful models in primary care
- The context in which each of these models is appropriate
- Key requirements for success with each of these primary care delivery models
The Devil in the Valuation Details:
Top 10 Questions Lawyers and Healthcare Organizations AskThe Devil in the Valuation Details: Top 10 Questions Lawyers and Healthcare Organizations Ask
Every business enterprise is unique, no two health care transactions are exactly alike, and no one formulaic method can be consistently applied to determine FMV. The devil is in the details, and those details lead to questions we have heard repeatedly from clients and their counsel.
Why aren’t the buyer’s reimbursement rates reflected in the valuation? Why does the valuation include provision for taxes, when the buyer is tax-exempt? Why isn’t a partial ownership worth more? What about accounting for plans for business growth? This session provides straightforward answers to these and the other top 10 questions.
Participants will learn:
- How to critically evaluate the opinions of valuation experts, with an understanding of some of the subtler aspects of valuation
- How to explain to clients why a given valuation had to be performed in a certain way
- To set client expectations and explain why “back of the envelope” estimates of value are unrealistic
Retail, Urgent Care, Micro Hospitals and Beyond:
The Evolution, Promise, and Unknowns of Alternative Care SettingsRetail, Urgent Care, Micro Hospitals and Beyond: The Evolution, Promise, and Unknowns of Alternative Care Settings
Alternative care access points – retail clinics, urgent care centers, freestanding emergency departments, and micro-hospitals – have proliferated. In many cases these programs are thriving in a consumer-focused, value-based healthcare environment.
Hospitals and health systems are recognizing the potential value of developing and integrating these alternative care sites. In addition to supporting population health management, these access points can be profitable, and can provide a relatively low-cost approach to new patient acquisition and the potential for downstream revenue.
Will one or more of these settings benefit your organization? The answer requires a nuanced understanding of the niche the alternative setting fills, the likely rate of acceptance and adoption, and the business case for the alternative(s) being considered. This presentation will explore the emerging spectrum of alternative care settings and provide a framework for evaluating how development and integration of one or more of them might benefit your organization.
Participants will learn:
- Differentiate among these alternative care settings, including patient populations and care needs best served, limitations and potential risks, regulatory and payment considerations, and other factors
- Describe the business case for integration of these alternative care settings, including typical financial results and organization-level financial implications, such as potential role in new patient acquisition
- Communicate the likely value of these alternative settings, including citing organizations that have successfully integrated these new care settings
- Begin evaluating the potential fit of alternative settings into their organization’s overall ambulatory care strategy
Amazon and Other Disruptors are Transforming Healthcare:
What You Must DoAmazon and Other Disruptors are Transforming Healthcare: What You Must Do
Is your organization ready to address the implications of powerful new industry disruptors?
Veralon can help jump-start leadership dialogue and exploration of these issues by familiarizing your executives, management, and board members with the competitive innovations and opportunities posed by these formidable industry entrants. Our presentation covers:
- How Amazon, Apple, Google, Optum, CVS/Aetna and others are disrupting healthcare
- How their skills—providing consumers with direct access to services, artificial intelligence, predictive analytics, and remote monitoring technologies—will shape healthcare’s future
- What role they will play in delivery and financing care
- Where traditional providers will fit in this new environment
- Whether the disruption will be an opportunity or a threat to hospitals and health systems
- The potential for strategic partnerships with these disruptors
This thought-provoking presentation is followed by a facilitated discussion that will:
- Engage the attendees in exploring what the disruption will mean for your organization
- Start your team brainstorming on the opportunities: How can your senior staff and board prepare for this change? How can your organization set strategies that will lead to success?
The session can be customized for the needs of your organization. Click here to find out more!
Using Data Analytics for ACO Performance Improvement:
Act Upon Opportunities to Improve Population HealthUsing Data Analytics for ACO Performance Improvement: Act Upon Opportunities to Improve Population Health
Analyzing integrated claims and clinical data is a powerful tool for elevating performance under value-based payment contracts. Yet the majority of healthcare organizations struggle to produce the reports needed to act upon opportunities to improve population health and reduce costs of care.
To gain the most value from claims analysis, hospitals and physician practices need the tools and skill sets to spot high-level trends and identify top cost drivers and opportunities for improvement. They also must be able to track performance against payer-specific metrics, compare performance to appropriate benchmarks, and create customized reports that drive action for individual service lines, practices, and physicians.
This session will focus on using a data analytics tool to address these issues, and on what is required for implementation. We will use a case study example of how data analytics led to improvements in an underperforming ACO.
Participants will learn:
- The importance of reconciling back to payer reports, utilizing benchmarks, and appropriately risk-adjusting data
- How to use claims data analytics to:
- Optimize the participant roster
- Uncover performance improvement opportunities
- Select performance improvement initiatives to maximize impact on financial results
- Develop physician report cards to track process.
You can find biographies of Veralon speakers in our Team section. Contact Dayana Rapoport at (877) 676-3600 or firstname.lastname@example.org to discuss arranging a speaker for any of the topics above. Of course, if you are interested in addressing a different topic, we would be delighted to explore the possibilities with you.
Veralon’s directors, principals, and managers are widely recognized speakers and instructors at “name brand” healthcare organizations, including:
- American Association of Integrated Healthcare Delivery Systems
- American Health Lawyer’s Association
- American College of Healthcare Executives
- Healthcare Financial Management Association (HFMA) chapters
- National Association of Certified Valuators and Analysts, Consultants Training Institute
- Society for Healthcare Strategy and Market Development of the American Hospital Association (SHSMD)