Value-Based Payor Contracting and Reimbursement

OL1126  |  On Demand Course  |  Update  |  Self-Study

Description

Learn how to achieve additional value-based reimbursement without sacrificing you fee for service reimbursement.  We will discuss four critical steps in developing a value-based payor contracting strategy that is vital to building a solid foundation for incremental value-based reimbursement.  The strategy includes Operational Readiness, Value-based Contracting Prioritization, Financial Modeling, and Operational Support Structure.  We will also discuss the primary elements of value-based contracts that 1) incrementally link to your fee for service contracts, as well as 2) add reimbursement through an Accountable Care Organization and a Clinically Integrated Network.

This course is part of the 2023 Health Care Conference Bundle. Purchase the conference bundle here.

Credits

Number of Credits Type of Credits
1.00 Specialized Knowledge

Prices

Member (Early Bird)
$49.00
Non-Member (Early Bird)
$79.00
Member
$49.00
Non-Member
$79.00
Registration for this event has closed. If you have any question or concerns please give us a call at 615-377-3825 or send us an e-mail at registrar@tscpa.com

Instructors

Marc J. Miller, MBA, FACHE, FACMPE

Marc is the Director of Population Health Services at LBMC. Marc's expertise is generally in the areas of population health, physician practice management, payor contracting, and interim management.

Marc is a highly accomplished and nationally recognized Population Health Executive and Practice Management CEO, and Contracting Consultant. His responsibilities included multi-state leadership of health system physician enterprises, Accountable Care Organizations, Clinically Integrated Networks, and other healthcare services organizations in the non-profit, for-profit, and private equity backed environments. He was recently awarded "2018 Senior Healthcare Executive of the Year" by the American College of Healthcare Executives Alabama chapter.

He is one of a few healthcare executives with the credentials of an MBA, and a Fellowship in the American College of Medical Practice Executives (FACMPE), and a Fellowship in the American College of Healthcare Executives (FACHE). He has led practice management, value-based strategy, payor contracting reimbursement, and population health management for multi-billion dollar health systems. In addition, he has experience in managing though private equity backed healthcare transactions.

Mr. Miller has a successful track record in developing physician practices, ACOs and CINs in five different states, and is an expert in forming strategic coalitions among health systems, physicians, payors, employers, and post-acute facilities. He has a reputation for discerning future environments, and capitalizing on emerging trends.

His payor contracting expertise includes Commercial, Direct to Employer, Medicare Advantage, Medicare Standard, and Medicaid contracts involving fee for fee for service, and value-based, and ACO/CIN advanced payment models. He is also a contracting expert for Physician Practices, Accountable Care Organizations and Clinically Integrated Networks including formation, operating agreements, medical staff, by-laws, physician participation agreements, incentive distribution models, etc.

He previously served as the CEO of Southeast Health Statera Network, a physician practice and ACO/CIN in Dothan Alabama. Prior to joining Statera Network, he served as the business development executive at Vanderbilt Health Affiliated Network in Nashville, Tennessee, one of the largest ACO/CIN organizations in the Southeastern US with over 4,500 physicians and 59 health systems across a five state region.

Prior to joining Vanderbilt, Mr. Miller was the Corporate Vice President, Physician Services, at Ardent Health Services in Nashville, Tennessee, a private equity backed $4 billion health system representing 31 hospitals across an eight state region. He has also held senior executive healthcare positions with other major health systems in Ocala, Fla., and Asheville, N.C.

He earned his undergraduate degree in general business with a concentration in marketing from Stetson University in Deland, Fla. And he completed his MBA in marketing at Sam Houston State University in Huntsville, Texas.

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