Moving from Fee-For-Service to Value-Based Reimbursement within Managed Care Training

Tuesday, November 14, 2017 - 9:30am to 12:30pm
Assumption College (Hagan Hall)
500 Salisbury Street
Worcester, MA 01609
Training

Making the Most of Payer Partnerships: Why Marketing to Managed Care Organizations Matters – Forging New Paths in a Value Based Landscape

This training will guide you in developing relationships with health plan and MCO leaders, developing your value proposition and how to proactively position your organization for success. Dawn Kingsley, MSHA, Vice President of Payer Contracting & Strategy for national behavioral health provider, Centerstone, will discuss how to start these intentional dialogues, as well as how to secure and enhance service contracts with health plans. Additionally, there will be a discussion around data and infrastructure needs to support moving from volume to value and how to augment the geographic footprint and utilization of those agreements.

Purpose/Background

In this training participants will learn why marketing is everyone’s job and why it matters in managed care. Solving problems for payers is big step forward in forging new partnerships and these partnerships are more important than ever as record number of consumers are enrolling in manage care plans in new managed care markets. In today’s environment states are mandating a wide range of individuals including those with intellectual and development disabilities into managed care. Over 75% of consumers in the United States get their healthcare through a managed care organization and that number is increasing every month. Being prepared for this tsunami of managed care is critical to the success of your organization.

During this session you will hear from Dawn Kingsley, MSHA, Vice President of Payer Contracting & Strategy for national behavioral health provider, Centerstone, a company who is successfully creating new opportunities with payers while serving their clients in meaningful way. Centerstone staff live the company’s Noble Purpose-“Delivering Care that Changes People’s Lives” on a daily basis and every staff person, both clinical and non-clinical are driven by this mission. She will discuss how her work impacts the Noble Purpose and strategies around practice transformation initiatives rooted in quality and value based initiatives as well practical tactics and examples. You will hear successes, back steps and lessons learned as this organizations makes the transition from volume driven care to value driven care.

This training will guide you in developing relationships with health plan and MCO leaders, developing your value proposition and how to proactively position your organization for success. She will discuss how to start these intentional dialogues, as well as how to secure and enhance service contracts with health plans. Additionally, there will be a discussion around data and infrastructure needs to support moving from volume to value and how to augment the geographic footprint and utilization of those agreements.

Intended Audience

Senior leadership and management, payer contracting, finance and grant writing staff are encouraged to attend.

Learning Objectives

  • Education on Value Based and Alternative Payment Opportunities
  • Recommendations for development of strong partnerships with health plans & MCOs
  • Understanding of how marketing principles can enhance your managed care strategy.
  • Payer landscape in Massachusetts and opportunities for the IDD provider
  • Education on the Triple Aim and what it means to the IDD provider
  • Case Study on moving a contract from termination to value based partner

Speaker

Dawn S. Kingsley, MHSA
Vice President, Payer Contracting & Strategy
Centerstone America, Inc.

Dawn Kingsley serves as Vice President of Payer contracting & Strategy for Centerstone America, Inc, the nation’s largest community based behavioral and addictions healthcare provider. In her role, Dawn directs all payer contracting and strategy initiatives for Centerstone’s five affiliate states with responsibility and oversight for all payer contracts, supporting 200 locations and 4,500 staff. Under her leadership, she and her staff negotiate and review rates and language for all managed care contracts and new opportunities including fee for service, value based purchasing and alternative payment initiatives. In addition to providing support and leadership in payer contracting, Dawn works closely with Centerstone’s Grants and Business Development team to provide support around grant program sustainability. In her role, she is focused on enhancing revenue through the transformation of payer contracts to support the robust evidenced based clinical care programs offered in the Centerstone circle of providers.

Dawn has more than 25 years of experience in healthcare and has held executive contracting positions with large, national health plans as well as national provider organizations. She has extensive experience building networks, contracting with payers and providers, applying marketing principals to payer discussions and developing value based care strategies. Additionally she worked for a national consulting firm providing expert guidance in Medicare Advantage network expansion, payer strategy, and organizational management and reporting oversight.

Dawn has a Bachelor’s Degree in Journalism and Political Science from Eastern Illinois University and a Master’s of Science Degree in Healthcare Administration from the University of St. Francis in Joliet, Illinois. She lives outside of Nashville, Tennessee and is married to a local photographer and artist. Dawn is also a professional photographer, enjoys collecting and repurposing antiques and spending as much time as possible with her husband of 13 years and her 11 & 9 year old boys

Centerstone is non-profit organization, headquartered in Nashville, Tennessee and serves over 172,000 individuals and families annually throughout their five state footprint of Tennessee, Kentucky, Indiana, Illinois and Florida. In 2016 Centerstone provided nearly 3 million services and offers signature service lines in Health Homes, Integrated Primary Care, MAT/Addiction Services, Hospital and Crisis Services, Active Military and Veterans, and Intellectual and Developmental Disabilities.

Admission

EARLY BIRD ADMISSION (Special rate ends November 3rd!)

  • ADDP Member....$105
  • Non-Member.......$140

AFTER NOVERMBER 3RD

  • ADDP Member....$125
  • Non-Member.......$160

Registration Starts at 9:00 am

Admission fee includes training entrance, materials, coffee and light refreshments