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Wednesday, May 14, 2008
In an environment of rapid change, it’s critical you know what operational metrics deserve your attention — and what will only cause "analysis paralysis." Join senior consultants from industry leader Gorman Health Group for a half-day seminar that presents solutions to the key financial challenges that plans are currently facing.
1:00pm - 5:00pm
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The complexities of the Medicare managed care program and the numerous variables that can affect plan financial performance make it challenging for most organizations to get a clear picture of how changes to their plan (such as benefit design, enrollment numbers, or risk adjustment scores, to name just a few) will affect the bottom line in both the short and long term. In this session, participants will be introduced to unique financial models that can be used to predict the financial outcomes of various “what if” scenarios for your plan – so you will have a financial road map to guide your strategic planning efforts. Whether you are a new Medicare Advantage plan or an existing plan, you’ll gain insight into how to assess specific variables that can have critical financial implications for your plan and your overall strategy, including:
- Tools for measuring plan performance against "expected" performance in a given service area
- Strategies for testing new products, new service areas, and the impact of changing your current service area
- Gauging the financial impact of changes in benefit design and charging different premium levels over time
- How to predict the financial impact of changes in your Medicare Risk Adjustment Factor (RAF) score
- Utilizing different enrollment and disenrollment assumptions to measure the financial value of improving your member retention rates
- Testing the financial impact of other cost reductions (i.e., changes in commissions and SG&A;)
- Evaluating the impact of different trend assumptions for Part C benchmarks
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William MacBain
Senior Vice President, Finance
Gorman Health Group, LLC
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In this session you will:
- Discuss the role of Medical Management in the MA World: What are plans doing (and not doing!)?
- Assess why the approach needs to change: Learning from the landscape of the recent past
- Why are preventative care and self care programs of critical importance?
- Why must your organization consider utilization management?
- Gain an understanding of coverage rules and how to educate your staff: Why are operational areas affected by Medical Management?
- Learn about the new quality indicators and their impact on Special Needs Plans (SNPs)
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