ADS and Managed Care: What You Need to Know to Thrive
May 31, 2017
3 PM EST, 2 PM CST, 1 PM, MST, 12 PM PST
$25 Members $49 Non-members
The Affordable Care Act accelerated the integration of Medicaid funded Long Term Services and Supports (MLTSS) into managed care. 19 states currently offer MLTSS through federal waivers and 13 states are approved for Medicare-Medicaid Integration Demonstrations, California among them.
This webinar will offer a brief overview of managed care and capitation principles; discuss the advantages and disadvantages of contracting with Medicaid Managed Care Organizations; readiness for contracting; lessons learned from California’s adult day services five-year experience in contracting with 21 Medicaid managed care plans for adult day health care; ideas for creating value-based purchasing contracts and the potential for Medicare as a payer as health insurance systems continue to evolve.
About the Speaker:
Russ Foster is a principal with the health care solutions group of Mazars USA, LLC, an independent U.S. member firm of the Mazars Group, an international accounting, audit, tax and advisory services organization. He has more than 30 years of experience in development and management of health care systems, including expertise in capitation agreements, rate development methodology, and business plan development. Previously, he was the founding partner of pmpm Consulting Group in Sacramento, with national clients. He also served as the California Health Plan of America’s Vice President & General Manager, directing all group and provider service activities for HPA’s Northern California region. Among other accomplishments, he also developed and implemented a capitated Medicaid program in Kansas City, Missouri and developed the first fully automated personal physician accounting system for MediCal providers. Mr. Foster also served for five years as Chief of the Financial and Management Evaluation Section of the California Department of Health Services Audits and Investigations Division where he planned, organized and directed the audits of all capitated MediCal provider organizations and developed and negotiated annual capitation rates for the State of California.