1 / 17

Fall Member Summit 2012

Fall Member Summit 2012. The LP Payment Method Forecast: Projecting the FFS Payment T ransition. October 16, 2012. A Starting Assumption. FFS Payment will increasingly be replaced by risk based payment. . Strategist’s Dilemma :. How quickly will it occur?. Needed:.

enrico
Download Presentation

Fall Member Summit 2012

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Fall Member Summit2012

  2. The LP Payment Method Forecast:Projecting the FFS Payment Transition October 16, 2012

  3. A Starting Assumption FFS Payment will increasingly be replaced by risk based payment.

  4. Strategist’s Dilemma: How quickly will it occur?

  5. Needed: Sophisticated methodology to systematically track and project the pace of the transition between FFS payment and risk based payment

  6. The LP Payment Method Forecast • Predictive of: • The percentage of care within a medical market that will be paid through non FFS arrangements • Percentage of providers participating in a medical market • Uses both quantitative and qualitative analysis combined with locally gathered intelligence

  7. The Deliverable The ability of a Chief Strategy Officer to present to the Board of Directors or senior management a defendable estimate each quarter of how quickly the payment model within a geographic medical market will change. The ability to develop customized forward looking scenarios illustrating how various potential developments could change the pace of the transition of FFS payment to risk base payment.

  8. How It Works • Focuses on a rolling seven year period • Year -1 historical • Year +1 and +2 negotiated contracts • Year +3 through +7 projected by model • Identifies dozens of indicators, highlighting the most sensitive • Allows modeling scenarios based on externalities • Economic • Political • Regulatory • Consumer reaction to care models • Etc. • Base year calculation is coupled with systematic intelligence gathering • Quarterly recalibration drawn

  9. Characteristics of the Model • Collaborative Intelligence • Historical client data • Existing contract data • Locally and nationally gathered intelligence • Comparable market behavior • Customized by market and need • Continuously improving • Compliments our monitoring of ACOs, insurance exchanges, Medicaid and Medicare

  10. Status • Team working for 15 months • Structure of the model is sufficiently complete • Baselines are still developing • National model is functional • Ready to Beta Test local markets • Five to eight local markets

  11. Beta Development • Five to eight markets of various sizes • Non competing participants • Client participation in collaborative development process • Fees will vary by size and complexity of market • Beta Market fee structure

  12. Illustration Projected Historical Contracted

  13. Our Payment Forecast: Month One

  14. Our Payment Forecast: Month Six

  15. Our FFS Transition Model: Today (Month Fifteen)

  16. Our Payment Forecast: A Year From Now

More Related