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Recently
Presented Teleconferences
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| The new health reform legislation
presents many challenges and opportunities for all sectors of
the healthcare industry. Based on the timing of a number of the
law’s initiatives, some demands are immediate and some
challenges and opportunities await. There is no question that
over the next two years, physicians and hospitals, in particular,
should be positioning themselves for the changes that will come.
The law aligns many of their interests in ways which have not
been so clear to date. To provide useful information to our constituency,
we will be offering a series of three teleconferences (with handouts)
on three successive Tuesdays in June addressing different aspects
of the law: (1) Fraud and Abuse in Health Reform; (2) Payment
and Quality Opportunities and Challenges for Hospitals and Physicians;
and (3) How the PROMETHEUS Payment® Model Can Help Now. (See
below). We offer discounts for signing up for more than one;
and if you cannot join us on the specified date, there will be
MP3 recordings available as well. |
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| Tuesday, June 22, 2010 |
How
The PROMETHEUS Payment® Model Can
Help Now
• The difference between bundled payment
and bundled budgets
• Where Potentially Avoidable Complications fit in health reform
• How PROMETHEUS Evidence-informed case rates® are constructed
• How the PROMETHEUS Payment model can sustain the patient-centered medical
home
• The pilot sites and how they differ
• How PROMETHEUS Payment fosters clinical collaboration
• The role of provider impetus to change
IMPORTANT:
Your access is limited to 24 hours after you sign
up. So, you can download the recording and the handouts
to your desktop or other device and save them for
your convenience or wait until you want to listen
to purchase.
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| Tuesday. June 15, 2010 |
Payment
and Quality Challenges and
Opportunities for Physicians and Hospitals
• What will really be so different?
• The new payment opportunities without payment reform
• The payment pressures on hospitals and what that will create
• Where hospitals and physicians will find common cause
• The real story on the ‘shared savings’ Accountable Care Organization
provisions
• The demonstration projects: bundled payments, episode grouper, chronic
care, medical homes and more
• What the changes in Medicaid payment and measurement might mean
Purchase a recording of this audioconference
with Q and A and the handouts that were distributed --- $325
for a downloadable MP3. Credit Card only.
[Teleconference account holders, login to purchase.]
IMPORTANT:
Your access is limited to 24 hours after you sign up.
So, you can download the recording and the handouts
to your desktop or other device and save them for your
convenience or wait until you want to listen to purchase. |
| Tuesday, June 8, 2010 |
Fraud and Abuse
in Health Reform
• What the changed intent standard for
antikickback means
• The new obligation to report overpayments in 60 days
• The Stark in-office ancillary services disclosure requirement
• Enhanced screening of providers and suppliers
• Expansion of false claims liability
• Special DME and home health certification rules
• Expanded government agency sharing of data…and more
IMPORTANT:
Your access is limited to 24 hours after you sign up.
So, you can download the recording and the handouts
to your desktop or other device and save them for your
convenience or wait until you want to listen to purchase. |
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| Comments from the teleconference
Que FERA, FERA: The Need for Upgraded compliance Programs -
"Informative
and well presented" "Alice does a great job. We trust
her information and enjoy her delivery." "I always
enjoy listening to Alice present. She is very entertaining,
informative and has practical experiences that can be used
immediately." HIghlight of the session for you: "Alice's
colorful comments! Actually, it was the examples provided." |
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Tuesday, February 9, 2010
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Que FERA, FERA: The
Need for Upgraded Compliance Programs
With the budget crisis and health reform,
the government will be increasingly focused on recouping
overpayments from providers and enforcing the fraud and
abuse laws. The Fraud Enforcement and Recovery Act of 2009
(FERA) makes their jobs easier. It also expands the targets
for whistleblowers. This law turns mere overpayments--including
under the Stark regulations -- into false claims. In addition,
the government has made it clear that there are new forms
of fraud and abuse hidden in Medicare and Medicaid claims.
All compliance programs should be revisited to take these
changes into account. Anyone without a compliance program
had best wake up and create one! This teleconference is
intended to provide a practical understanding of these
changes.
Purchase a recording of this audioconference
with Q and A and the handouts that were distributed
--- $325
for a downloadable MP3.
Credit Card only.
[Teleconference account holders, login to purchase.]
IMPORTANT:
Your access is limited to 24 hours after you
sign up. So, you can download the recording and
the handouts to your desktop or other device
and save them for your convenience or wait until
you want to listen to purchase.
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This focused, one hour teleconference, with
a 10 page handout including an outline and a list
of resources, will offer 45 minutes of presentation and 15
minutes of Q & A addressing:
• How the current
context is different
• What FERA did and how it affects providers
• Reverse false claims
• Quality fraud
• Quality reporting fraud
• The new pitfalls under Stark
• Critical compliance program questions
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| Comments from the teleconference
Clinical Integration: It's Not About Atnitrust -
Very good presentation" "A very well organized
and presented teleconference |
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| Tuesday, September 22, 2009 |
Clinical Integration: It’s Not About
Antitrust
From ‘accountable care organization’ proposals,
to demands for decreased waste and cost throughout the system,
as health reform roils the political landscape, the term ‘clinical
integration’ has resurfaced with renewed vigor. The FTC
has settled a host of price fixing cases against physicians
based on the fact that the competitors bargaining for fees
were not clinically integrated. They have issued only three
Advisory Opinions approving clinical integration schemes. All
of that is essentially beside the real point, though. The purpose
of clinical integration is for providers to come together around
quality and standardize their behavior to improve care. Clinical
integration is about improving quality and efficiency. It has
merit regardless of whether anyone pays more money to the engaged
physicians; but if the integration is real, those physicians
can bargain for fees together. Of greater importance in some
ways though, is the fact that many physician groups themselves
aren’t even clinically integrated within their own operations
and they ought to be!
What is clinical integration? This
one hour teleconference will look at clinical integration from
the perspective of quality, efficiency, transparency, cost
savings and improved margins. Still further, physician groups
need to look inward and figure out how to clinically integrate
within the group. Legal pitfalls exist, but they should
not be the driving force for this.
Purchase a recording of this audioconference
with Q and A and the handouts that were distributed --- $325
for a downloadable MP3.
Credit Card only.
[Teleconference account holders, login to purchase.]
IMPORTANT:
Your access is limited to 24 hours after you sign
up. So, you can download the recording and the
handouts to your desktop or other device and save
them for your convenience or wait until you want
to listen to purchase.
|
This focused, one hour teleconference,
with a handout including an outline and a resource list, will
offer 45 minutes of presentation
and 15 minutes of Q & A addressing:
- Forms of clinical integration
- What the FTC has said
- Avoiding legal pitfalls
- Who are your competitors?
- Going beyond antitrust notions
- Benefits from doing it: with others or within
your group
- Suggested techniques
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| Comments from the teleconference
on But Do We Have To Get Married?: Physician-Hospital Financial
Relationships
2009 - "The most useful lecture I have heard
in the last twelve months", "Very good discussion
of options" "Handouts very helpful" "Excellent
presentation. practical and at the right level". |
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May 12, 2009
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But Do We Have To Get Married?: Physician-Hospital
Financial Relationships 2009
The economic crisis is affecting everyone. Physician
groups ask hospitals to buy them—for financial
security and relief from running the practice. Hospitals
buy and employ physicians to follow “the Clinic
model” with ‘full integration’ in the
hopes that this will secure their revenue streams and
enhance their ability to improve delivery of care. Whether
these tight bonding strategies will work is yet to be
seen, but there are many other ways hospitals and physicians
can assist each other with their business case that are
far short of these marital strategies.
This crisp presentation (with written handout)
will, in 45 minutes, elucidate diverse innovative non-acquisition
strategies that (1) respond to the business case for hospitals
and physicians both, (2) are compliant with Stark and anti-kickback
principles, with special attention to improving quality
for both parties, (3) while maintaining physician independence.
Many of these strategies are far more liberal and can have
broader impact than many think. There will then be 15 minutes
of Q & A.
This session will not discuss joint
ventures, “under arrangements” or similar creations
of new business structures.
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Comments from the teleconference
on Anti-MarkUp and Under Arrangements: Stark Beyond Stark
- "Great
job of translating CMS language"; "Good show"; "To
the point and clearly presented"; "Excellent teleconference."
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| December 16, 2008 |
Anti-MarkUp
and Under Arrangements: Stark Beyond Stark
The Medicare Fee Schedule and Inpatient Prospective Payment System rules
for 2009 both have changed some basic reimbursement rules for diagnostic
testing payment amounts and whether services can be paid for and to whom
when they are “under arrangements”. Both sets of rules create
new challenges where physician groups either provide or obtain professional
or technical components and pieces of all Medicare diagnostic
testing of any type (anti-markup), as well as when they provide any kind
of Stark DHS to another entity who bills for it (“under arrangements”).
Rules which used to apply only to DHS now are even more restrictively
applied to diagnostic testing relationships. Entities which provide non-DHS
on their own become DHS entities when they are “under arrangements.” In
this teleconference, Alice will elucidate:
- When the markup prohibition applies
- How to analyze whether Alternative 1 or 2 is
yours
- The amount you can charge when the prohibition
pertains
- The special rules for mobile diagnostic testing
- The restrictions on site of service
- The required degree of physician supervision
- Concepts which no longer matter
- How you can unbundle to avoid the prohibitions
- How rules first applied only to DHS now affect
all diagnostic testing
- How “under arrangements”, which
was a hospital-only reimbursement concept, now applies
to all DHS
- Who is the DHS entity in “under arrangements” situations
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Comments from the teleconference
on Compensating Physicians for Quality Performance From Within
- "A
lot of information crammed into 60 minutes" "Unique
information" "A really excellent program".
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| September 16, 2008 |
Compensating Physicians for Quality
Performance From Within
Quality measurement, report cards and pay-for-performance
are a growing reality for physicians. Whether pay-for- performance
is present or not, for optimal success, physicians and their
employers, whether hospitals, systems or physician groups --
should consider deploying consistent physician compensation
within their groups based on quality performance. The Stark
regulations permit this. Some organizations are already doing
it. There is virtually no published information about
this. We have data from almost 20 groups around the
country doing this. Learn what they have learned. Learn about
compensating physicians for quality performance from within.
Purchase a recording of this audioconference
with Q and A and the handouts that were distributed --- $325
for a downloadable MP3.
Credit Card only.
[Teleconference account holders, login to purchase]
IMPORTANT: Your access is limited to
24 hours after you sign up. So, you can download the
recording
and the handouts to your desktop or other device and
save them for your convenience or wait until you want
to listen to purchase.
|
- Traditional physician compensation models
- Where payment is headed
- What new payment models reward
- Data about the experience of groups already paying
their physicians for quality
- The choice of metrics
- Lessons learned
- How Stark matters
- What employment contracts should say
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| Comments from the teleconference
Physicians and Diagnostic Testing in medicare: So Where Are
We Now? - "Great handouts and good examples." "Excellent
presentation as usual." "This was one of the best
teleconferences I have attended." |
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No recordings for these
teleconferences are available, but each handout may be purchased
for $175. Click here
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| March 11, 2008 |
Physicians
and Diagnostic Testing in Medicare: So Where Are We Now?
With the delay in the anti-markup rules, there is considerable confusion
over what, precisely, Medicare permits now with respect to physicians billing
for diagnostic testing; and then the Stark regulations confuse the issue
further. This session will unravel the Gordian knot of the distinctions
between diagnostic testing rules generally, and the complications created
by Stark.
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| October 30, 2007 |
Stark
III:
Hospital-Physician Relationship Issues
Sophisticated, quick, in-depth guidance with an emphasis on practical applications
in the real world. Different focus in each program, including special
attention to physician-hospital engagement for quality. |
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| October 23, 2007 |
Stark
III: Physician Group Issues
Sophisticated, quick, in-depth guidance with an emphasis on practical applications
in the real world. Different focus in each program, including special
attention to physician-hospital engagement for quality. |
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Comments from the first
teleconference on Stark Compensation within Groups - "Great
process, very informative." "Excellent program." "Excellent
presentation. Well worth the fee". "Frank, factual,
no nonsense presentation". "Good information."
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July 17, 2007
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Stark
Physician Compensation Within Groups
Sophisticated, quick, focused, in-depth guidance with an emphasis on
practical applications in the real world. Participants will receive an
exclusive, electronic handout with citations supporting the information
offered.
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Alice G. Gosfield
and Associates, P.C.
2309 Delancey Pl., Philadelphia, PA 19103
(215) 735-2384
Fax (215) 735-4778
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