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The Financial Impact of Post-Acute Care in Medicare Advantage

  • February 22, 2018
  • 2:00 PM – 3:00 PM ET
  • Online
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Many Medicare Advantage plans are beginning to recognize the need to reduce costs associated with post-acute care, particularly to optimize their Medicare bids – but most don’t have the expertise to identify the best areas for potential cost reduction. This is unfortunate, as post-acute care accounts for up to 25 percent of a Medicare Advantage plan’s total spend.

Every post-acute care journey is characterized by transitions – from hospital to a Skilled Nursing Facility (SNF), or to an Inpatient Rehabilitation Facility (IRF), or to recovery at home. At each transition, the path splits, but providers may have incomplete information at the point a decision is needed. Often, Medicare Advantage plans do not have the specialized resources to manage the complexity of the post-acute care continuum. This results in increased risk for adverse patient outcomes, waste, and additional costs.

Participants will learn how to: 

  • Identify the 3 key areas that can drive down post-acute care costs and lower Medicare bids
  • Choose the right metrics for cost-savings analyses and benchmarks for comparison
  • Understand the roles that Home Health and DME play in reducing readmissions
  • Refine Fraud, Waste and Abuse processes and translate that into savings for your plan

Speakers


Steve Wogen, Chief Growth Officer, CareCentrix

Steve Wogen brings more than 25 years of experience in healthcare leadership to CareCentrix. As Chief Growth Officer, he is responsible for growth strategy, medical economics, Sales, and Marketing.

Steve comes to CareCentrix from Express Scripts, formerly Medco Health Solutions, where he was the SVP/GM for Prescription Drug Plan and Retiree Solutions, and led the integration of the companies’ retiree business lines. He led the launch of Medco’s Prescription Drug Plan and employer sponsored retiree products, which he grew to a $4 Billion business; became CFO of the Retiree Division and directed the cross-functional team responsible for launch of Medco’s Medicaid strategy and operational model. Previously, Steve was Regional Director of Medical Economics at Cigna.

Steve holds a bachelor’s degree in economics and medical ethics from Davidson College in Davidson, NC, and a master’s in health administration from the Medical College of Virginia, in Richmond, VA. He has published and presented his work on electronic prescribing, the value of pharmaceuticals in care management, Medicare Part D and efficiency in healthcare delivery.

 

Dr. Michael Cantor, Chief Medical Officer, CareCentrix

Dr. Cantor is a geriatrician and attorney with extensive experience in designing and implementing population health and quality improvement programs for health plans and healthcare providers.

Most recently he served as Chief Medical Officer (CMO) for the New England Quality Care Alliance (NEQCA), the 1,800-physician network for Tufts Medical Center in Boston, where he managed network-wide population health and quality improvement programs. He also served as founding Medical Director for the NEQCA Medicare Shared Savings Accountable Care Organization (ACO), and was the first CMO for Minuteman Health, a CO-OP insurance plan, where he developed and implemented medical management programs. Prior to that he served as a medical director for Evercare of New England, a division of United Health Group, where he managed care managers and nurse practitioners, and led quality efforts for the Senior Care Options (SCO) program for people over 65 with Medicare and Medicaid coverage. He also held positions at the VA Boston Healthcare System, Brigham and Women’s Hospital, and the Hebrew Rehabilitation Center for Aged, where he was responsible for developing new clinical programs for older people, and provided geriatrics assessments, primary care, long term care, palliative care, and made house calls.

Dr. Cantor still sees hospital inpatients on weekends. He trained in internal medicine at Beth Israel Hospital in Boston, and did his geriatrics fellowship at Harvard Medical School. His degrees in law and medicine are from the University of Illinois.