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Provider networks oversight trends across markets

Event Date: 5/31/2016

Event Overview

Webinar event: 1PM CT - 2:30PM CT

Session description: 

Health plan networks are narrowing. While there are good reasons for this, regulators across markets are moving to check this trend. 2016 is likely to be a year of unprecedented regulatory activity regarding provider networks.
 

Michael Adelberg, who oversaw and implemented provider network policy at CMS while serving as the Director of Medicare Advantage Operations and Acting Director of Exchange Policy and Operations, will discuss:

  • Evidence of network narrowing and reasons for this trend

  • Findings and concerns from government auditors and other researchers

  • New guidance and oversight tactics across the Exchanges, Medicare, Medicaid and commercial markets

  • Strategies that can be employed by health plans to stay on the right side of emerging oversight

 

This event is designed for:

Individuals with responsibility for provider network contracting and management, as well as marketing.  In addition, individuals with responsibility for bid submission and/or compliance will also find this information helpful.

This event is hosted on our Readytalk platform.

You must register for this event in order to receive the dial-in/log-in information. Click on the Registration tab on the event page.


Documents
5/31/2016

Presentation: Provider networks oversight trends across markets
Health plan networks are narrowing. While there are good reasons for this, regulators across markets are moving to check this trend. 2016 is likely to be a year of unprecedented regulatory activity regarding provider networks.

5/31/2016

Recording: Provider networks oversight trends across markets
Health plan networks are narrowing. While there are good reasons for this, regulators across markets are moving to check this trend. 2016 is likely to be a year of unprecedented regulatory activity regarding provider networks.

Attendees

Below is a list of all delegates registered to date for this event

  • Libba Yates
  • ALLIANCE GUEST
  • Chief Administrative Officer at VIVA Health
  • Angela Aragon
  • ALLIANCE MEMBER
  • Compliance/Quality Analyst at Presbyterian Health Plan
  • Abby Baldovinos
  • ALLIANCE MEMBER
  • Senior Provider Relations Representative at Santa Clara Family Health Plan
  • Tina Ballamis
  • ALLIANCE MEMBER
  • Products Development Partner at SelectHealth
  • April Barnes
  • ALLIANCE MEMBER
  • Actuarial Manager at Geisinger Health Plan
  • Pamela Bower
  • ALLIANCE MEMBER
  • Program Manager, Risk Adjustment at Presbyterian Health Plan
  • Marty Cerier
  • ALLIANCE MEMBER
  • Director Regulatory Audits and Investigations at Health Alliance Plan (HAP)
  • Greta Collins
  • ALLIANCE MEMBER
  • Quality Operations Manager at Baptist Health Plan
  • Jacqueline Crews
  • ALLIANCE MEMBER
  • Director, Public Policy & Benefit Contracts at AvMed
  • Mike Dooley
  • ALLIANCE MEMBER
  • Director of Provider Contracting & Engagement at Avera Health Plans
  • Carol Dornbush
  • ALLIANCE MEMBER
  • Credentialing Coordinator at Medical Associates Health Plans
  • Donna Ferrara
  • ALLIANCE MEMBER
  • Medicare Compliance Manager at Baptist Health Plan
  • Erin Heckethorn
  • ALLIANCE MEMBER
  • Director of Operations and Program Management at FirstCarolinaCare Insurance Company
  • Susan Herbert
  • ALLIANCE MEMBER
  • Director, Health Plan Integration & Development at AdventHealth (FHHS)
  • Gina Higley
  • ALLIANCE MEMBER
  • Contracting at Providence Health Plan
  • Kaleb Holt
  • ALLIANCE MEMBER
  • Director of Medicare Programs at SelectHealth
  • Kamal Jemmoua
  • ALLIANCE MEMBER
  • Chief Executive Officer at Prominence Health Plan
  • Erin Kavanagh
  • ALLIANCE MEMBER
  • Risk Adjustment Analyst at Samaritan Health Plans
  • Ryan Lown
  • ALLIANCE MEMBER
  • Network Strategies Executive at Adventist Health Plan
  • Lee Manzo
  • ALLIANCE MEMBER
  • Compliance Analyst at FirstCarolinaCare Insurance Company
  • Philip Masser
  • ALLIANCE MEMBER
  • Medicare Compliance Officer at Geisinger Health Plan
  • Tim Meier
  • ALLIANCE MEMBER
  • Provider Contracting at Providence Health Plan
  • Mark Mixer
  • ALLIANCE MEMBER
  • Chief Executive Officer at Alliant Health Plans
  • John Prince
  • ALLIANCE MEMBER
  • Provider Contracting Manager at SelectHealth
  • Greg Pugh
  • ALLIANCE MEMBER
  • Sr. Director, Service Development & Chief of Staff at Passport Health Plan
  • Bart Stead
  • ALLIANCE MEMBER
  • Vice President of Sales at Cox HealthPlans
  • Candace Toba
  • ALLIANCE MEMBER
  • Medicare Delegation Program Consultant at Providence Health Plan
  • Benjamin Trumbull
  • ALLIANCE MEMBER
  • Medicare/ Pharmacy Compliance Analyst at Health Alliance Medical Plans
  • Patricia Westcott
  • ALLIANCE MEMBER
  • Contract Manager at Sentara Health Plans (Optima)
  • Petra Wilson
  • ALLIANCE MEMBER
  • Provider Relations Manager at New West Health Services
Speakers