Health Plan Contracting from a Position of Strength!

3-Part Virtual Learning Community Series

We invite you to participate in our Learning Community to learn to strategically position your organization as a vital provider of behavioral health care for children in the state of California.  

Through this dynamic three-part learning series, participants will learn to negotiate managed care contracts with commercial and Medicaid payors. The trainings will address structures and tools to support organizational readiness, negotiation strategies, contract terms, and contracting arrangements without regard to the specific scope of an agency’s services. Based upon level of experience and stage of change, participants can elect to attend one webinar or the entire series. Each webinar will be followed by a one-hour “office hour” session where participants can engage in deeper discussion and Q&A with the trainer, hear from others in the field, and develop peer connections.

About the trainer: Based in Pittsburgh, PA, Adam Falcone is a partner in Feldesman Tucker Leifer Fidell’s national health law practice group, where he counsels a diverse spectrum of community-based organizations that render primary and behavioral healthcare services. Drawing on his extensive knowledge of health care policy and markets, Mr. Falcone regularly speaks to groups across the country on managed care contracting and value-based payment methodologies. In particular, he brings strategic counsel to clients that are responding to changes in their local marketplace, negotiating participating provider agreements, and seeking to establish provider networks such as Accountable Care Organizations.

Session 1: The P.E.N. Strategy for Negotiating Managed Care Contracts  
July 21, 2020 from 9:00 AM to 12:00 PM
Engage in an intensive step-by-step training to raise your capacity to assess market/need in your own communities, regulatory and value leverage, and deepen your understanding of your organization’s unique advantages. Finally, the session will prepare you to participate in effective managed care contract negotiation including training on how to read a managed care contract, understand leverage points, and integrate key contract provisions.

Session 2: Key Terms and Legal Protections in Managed Care
July 23, 2020 from 9:00 AM to 12:00 PM
This session is a more advanced training, building upon the initial session, on issues such as payment terms, including value-based payment methodologies, upside and downside risk, attribution of patients for performance measurement purposes; and joint contracting arrangements under IPAs, ACOs, and CINs.

Session 3: Payment and Contracting Arrangements
July 27, 2020 from 9:00 AM to 12:00 PM
The series culminates focusing on issues including payment methods, value-based payment methodologies, types of provider networks, privacy law considerations, and federal antitrust law.

Each participating agency can invite up to three executive/managerial leaders to participate.

For California Alliance members, the fee for the entire series is $525, and for nonmembers $600. To attend one of the sessions, for California Alliance members, the fee is $200/session, and for nonmembers $225/session.

To apply, complete this form by Tuesday, June 30, 2020.

For any questions, contact info@catalyst-center.org.