May 17, 2011

Episode Payment: Private Innovation and Opportunities for Medicare - Special Meeting on Episode Payment Features with CMMI Chief Rick Gilfillan

The Health Industry Forum hosted this meeting to contribute to the efforts of the Center for Medicare and Medicaid Innovation to develop new episode payment pilot programs. Innovation Center Chief Rick Gilfillan and his Care Models team began the meeting by establishing broad goals for the new pilot programs. Four different panels then described private sector episode payment initiatives in various stages of implementation. The goal of these panels was identifying real-life lessons about design and implementation that could help guide future program development. The group then synthesized recommendations for the Innovation Center to consider in its efforts to design episode payment programs that are feasible, sustainable, and scalable.

Agenda

Participants

Conference Report

Presentations

Acute Care Episode Demonstration - Baptist Health System
Michael Zucker, Senior Vice President, Baptist Health System (San Antonio, TX)

CaroMont Health's Path to Accountable Care
Betty Herbert, Director, Managed Care, CaroMont Health (Gastonia, NC)

Spectrum Health: Episode of Care Payment as a Driver of Integration
Joseph Fifer, VP Finance, Spectrum Health System, and Jim Byrne, VP, Priority Health

Retrospective and Prospective Bundled Payment Analytics and Engine Overview
Gilbert D’Andria, Vice President, MedAssets

The Automation of Episode of Care Payments
Jay Sultan, AVP, Value-Based Reimbursement, The TriZetto Group