Staying on top of rapid change in the medical industry is a major challenge for our clients, and the American Health Lawyers Association does an incredible job of tracking trends so we can keep our clients up to speed. I’m honored to have been asked to present at its conference, “Institute on Medicare and Medicaid Payment Issues,” at the Baltimore Marriott Waterfront Hotel. The panel session is titled, “ACOs, Medical Homes and Related Integration Initiatives.”
The key take home for ACO purposes is that the Primary Care Medical Home model is a fabulous predicate for an effective ACO — that you need to have an innovative and working primary care solution if you want to see savings throughout the system.
If this interests you, I hope you’ll join. Full session description follows:
ACOs, Medical Homes and Related Integration Initiatives
James A. Cannatti, III, John M. Kirsner, Terri L. Postma, Chris E. Rossman
- Key aspects of Medicare shared savings program for accountable care organizations (“ACOs”)
- Key aspects of Medicaid Patient Centered Medical Homes (“PCMHs”) program
- Possible future Medicare payments ACOs and PCMHs
- Payments by Medicaid and other payors to ACOs and PCMHs
- Ability of ACOs and PCMHs to influence or negotiate rates of payment for items and services from governmental and private payors
- Strategies for ACOs and PCMHs to negotiate directly with employers, including payment methodologies
- Future of payments to ACOs and PCMHs if PPACA is found unconstitutional
- Organizational “touchpoints” of ACOs and PCMHs that raise Federal healthcare regulatory issues
- The Stark Law, Anti-Kickback Statute, and Civil Monetary Penalties Law in connection with ACOs participating in the Medicare Shared Savings Program
- Potential impact of payment changes on providers
