Managing Medicare Advantage Costs through Better Post-Acute Care

  • March 14, 2017
  • 1:00 PM – 2:00 PM ET
  • Online
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Most health plans have keen insight on curbing costs for hospitalizations and emergency department use. Far fewer have the knowledge needed to tame the costs associated with post-acute care, such as reducing dependence on Skilled Nursing Facilities (SNFs), limiting the variability in home care quality and rates, and making sure members have what they need to be self-sufficient as they heal at home. Guiding care to the home is the single best way for health plans to bend the cost curve.

  • Post-acute care accounts for 1 of every 4 dollars spent by a Medicare Advantage plan
  • 20 – 25% of that is waste that can be eliminated through better management
  • Payers absorb $17.5 billion in wasteful spending while patients face unnecessary medical risks and costs[1]
  • 75% of hospital readmissions are caused by preventable errors[2]

With the low-hanging fruit for cost reductions long picked over, integrated solutions – and particularly post-acute care integration – offer significant potential for savings for Medicare Advantage plans.

Learn how to control the variability of cost in home health and post-acute care and watch that translate into a direct financial impact on your Medicare bid.

Webinar participants will learn how to:

  • Discover best practices on how to use home health to drive down costs and lower your Medicare bid
  • Use advanced analytics to identify the appropriate setting and level of care
  • Analyze data of practice patterns and use it to choose preferred providers
  • Understand benchmarks for SNF use and how to manage length of stay
  • Evaluate your post-acute care program, determine pain points and areas of cost variability
  • Reduce readmissions through collaboration with the patient, family caregivers, home health nurses, and primary care and specialist providers
  • Refine Fraud, Waste and Abuse and translate that into savings for your home health and post-acute care programs

Who should attend:

  • VP or Directors of Medicare
  • VP or GM of Government Programs
  • VP or Division Presidents
  • Medical Economics
  • Underwriting / Pricing
  • Actuaries / Finance

Speaker:


ashley-youngAshley Young, FSA, MAAA, Chief Actuary and VP of Medical Economics, CareCentrix
Ashley Young brings more than a decade of experience to CareCentrix in the field of medical economics and issues related to efficiency, effectiveness, value and behavior in the production and consumption of health and healthcare. As Chief Actuary and VP of Medical Economics, she is responsible for medical economics, pricing, and underwriting.

Ashley comes to CareCentrix most recently from Tampa-based WellCare Health Plans, Inc., where she was the Qualified Reserving Actuary. She was responsible for reserving, forecasting, Medicaid pricing and rate setting, as well as RFP pricing and proforma development. Before WellCare, Ashley was an actuary at one of Florida’s leading health plans, Florida Blue. While there she was responsible for reserving and pricing.

Ashley holds a bachelor’s degree in mathematics with a minor in statistics from the University of Florida in Gainesville, Florida. She is designated by the Fellow of the Society of Actuaries (FSA) and a member of the American Academy of Actuaries (MAAA).

 

christina-mainelliChristina Mainelli, SVP Post-Acute Care Strategy & Market Development, CareCentrix
Christina Mainelli is an entrepreneurially-spirited senior executive with over 15 years of experience in all facets of healthcare delivery from pay or to patient, with direct experience growing and scaling businesses. Currently, Christina is the SVP Post-Acute Care Strategy & Market Development at CareCentrix. Christina is responsible for product design, development and launch, as well as profitability, across the CareCentrix suite of products. She also leads the firm’s “incubator” operations to test new product concepts prior to commercialization.

Prior to this role, Christina was the Chief Operating Officer for Sleep Management Solutions (SMS), a wholly owned subsidiary of CareCentrix. As COO, Christina had P&L ownership and led the company’s clinical, non-clinical and vendor resources. Through Christina’s leadership the organization grew from supporting 1M to over 7M members and from $4M to $40M in revenue in an 18-month period.

Christina has also played a variety of leadership roles at WellPoint, Inc., a $60B healthcare company. In her most recent role, she was Vice President of Strategy and Governance where she directed the development of Information Technology, eBusiness and Service Operations strategies for the enterprise. Christina also led the governance of WellPoint’s $1B IT budget with the C-level team. Before joining WellPoint, Christina played leadership roles in Product Development and Account Management at ChannelPoint, Inc., a healthcare technology start-up, and served as a Senior Manager in Accenture’s healthcare practice where she provided strategy, change management, and technology consulting to national and regional health insurance companies.

Christina holds a B.S. from the University of Vermont and an MBA from Yale University, where she serves on the School of Management Alumni Association Board of Directors. She also is a member of the Advisory Board for Eliza Corporation, a recognized leader in Health Engagement Management, and is a trustee at St. Patrick-St. Anthony Parish in Hartford, CT.


[1] – https://www.carecentrix.com/Our-Products/HomeStar#_ftn2

[2] – https://www.carecentrix.com/Our-Products/HomeStar#_ftn3