Navigating the Landscape - Trends and Challenges with Managed Care

OL1411  |  On Demand Course  |  Update  |  Self-Study

Description

This session will cover several important managed care topics, including site of service trends and reimbursement impact; provider and payer payment disputes related to claim denials and reimbursement reductions; how to become 'decision ready' using analytics in managed care contracting; and market trends in Medicare Advantage reimbursement and denials. The session will wrap up with an open discussion on emerging issues. 

  • Site of Service trends and the magnitude of the reimbursement impact
  • Provider and payer payment disputes related to claim denials and reimbursement reductions
  • PYA's approach to becoming 'Decision Ready' using analytics in managed care contracting
  • Market trends in Medicare Advantage reimbursement and denials
  • Open Discussion on Emerging Issues

This course is part of the 2024 Health Care Conference Bundle. Purchase the conference bundle here.

Credits

Number of Credits Type of Credits
1.00 Specialized Knowledge

Prices

Member (Early Bird)
$49.00
Non-Member (Early Bird)
$79.00
Member
$49.00
Non-Member
$79.00
Your Price: $79.00

This is your base price and does not reflect any additional session fees, optional add-ons, or guest registrations.

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Instructors

Jane Jerzak, RN, CPA

Jane brings three decades of audit and consulting experience to her work with PYA healthcare clients in the areas of financial modeling, clinical data analytics, and strategic advisory support. Along with the PYA Business Intelligence and Managed Care service lines, she assists health systems, hospitals, ambulatory surgery centers, and physician clinics to recognize appropriate reimbursement.

Jane is a recognized thought leader and has authored articles on a wide range of topics, including value-based care, strategic hospital analytics and pricing, clinical integration, population health, and more. She developed healthcare industry presentations on strategic, financial, and reimbursement topics, including: "Understanding the Impact of Value-Based Care," "Business Analytics for Critical Access Hospitals," and "Strategic Hospital Pricing."

Jane holds a Bachelor of Science in Nursing and a Master of Science in Business, Healthcare Fiscal Management from the University of Wisconsin-Madison and is a Certified Public Accountant (CPA) and Registered Nurse (RN) licensed in the state of Wisconsin. Jane is a member of the American Institute of Certified Public Accountants, the Wisconsin Institute of Certified Public Accountants, the American College of Healthcare Executives, the Healthcare Financial Management Association, and is a Leadership Green Bay Graduate.

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Jason Hardin, CPA

Jason leads PYA's Business Intelligence and Analytics service line and has been with the firm for more than 13 years. A certified public accountant, Jason leverages his strong foundation in accounting and finance to translate data into custom business intelligence solutions for clients. Jason has extensive experience in healthcare claims analytics, financial modeling/analysis, and dashboard development. Jason implements analytics to provide litigation support on a variety of complex cases related to payment disputes between payers and providers, Certificate of Need applications, and Civil Investigative Demands.

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