Podcasts about capg

Join us as we chat with learning strategist Carlos Pompa. Listen as he explains how a helicopter is a good metaphor for sustaining a successful business while moving between countries.

Don returns to the show to give the latest of APG's efforts with the 195,000+ physicians it supports through advocacy, education, and efforts towards taking responsibility for America's health.

Listen NowThis past week public comments were due in response to a CMS Request for Proposal (RFI) that would potentially lead to the agency fielding a Medicare a direct primary care (DPC) demonstration.  The demo would pay Medicare physicians directly a predetermined fixed per-beneficiary-per-month fee to provide primary care services to participating beneficiaries.  The demo would try to replicate private, commercial DPC contracts physicians have with individuals or through self-insured employers.  During this 27 minute conversation Ms. McDermott discusses, in part, both the potential positives and pitfalls should CMS field a DPC demonstration, whether the model would qualify as an Alternative Payment Model (APM) and whether fielding a DPC model would move the Medicare program closer to premium support.Ms. Mara McDermott is currently Vice President at McDermott + Consulting, a subsidiary of the DC-based law firm McDermott Will and Emory.   (Ms. McDermott is no relation to the McDermott partner.)  Previously, Ms. McDermott was employed as Senior Vice President of Federal Affairs at America's Physician Groups (formerly the California Association of Physician Groups, CAPG).  Previously still, Ms McDermott was counsel in the health care industry at a firm in Washington, DC.  Ms. McDermott received her JD with high honors from George Washington School of Law, her MPH from George Washington University and her BA from the University of California at Davis.  (Listeners may recall Ms. McDermott discussed the proposed MACRA rule via a June 14, 2016 podcast.)The DPC RFI is at: https://innovation.cms.gov/Files/x/dpc-rfi.pdf. For more on Qliance, the former DPC provider group based in Seattle mentioned during this discussion go to: https://www.seattletimes.com/business/qliance-closes-after-10-year-effort-at-new-approach-to-basic-medical-care/.  This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

The organization formerly known as CAPG has grown rapidly since we last had CEO Don Crane on the pod.  Re-branded as America’s Physician Groups (APG), the organization has expanded their influence nationwide and continued its rapid growth.  Ahead of their upcoming national conference in San Diego, Don sits down with the guys to discuss the “new” organization, his view for the future of healthcare and how APG is exercising its influence in Washington.

On the July 25th, 2017 broadcast our special guest is Don Crane, the CEO of CAPG: 'the leading association in the country representing physician organizations practicing capitated, coordinated care. Our membership currently comprises close to 300 multispecialty medical groups and independent practice associations (IPAs) across 42 states, the District of Columbia, and Puerto Rico.' Join National ACO co-founders Drs. Andre Berger and Alex Foxman as they engage Don Crane in an informative conversation about the state of value based care, CAPG's role advancing successful provider risk assumption and the general state of the market duing an unsettled period of survival of the ACA and it's likely replacement in the event of a successfu repeal.For more information on CAPG click here and for more on Don Crane, here. A featured piece on CAPG will be posted toi ACO Watch shortly. For more information on National ACO, click here.

On the July 25th, 2017 broadcast our special guest isDon Crane, the CEO of CAPG: 'the leading association in the country representing physician organizations practicing capitated, coordinated care. Our membership currently comprises close to 300 multispecialty medical groups and independent practice associations (IPAs) across 42 states, the District of Columbia, and Puerto Rico.' Join National ACOco-foundersDrs. Andre Berger and Alex Foxman as they engage Don in an informative conversation about the state of value based care, CAPG's role advancing successful provider risk assumption and the general state of the market duing an unsettled period of survival of the ACA and it's likely replacement in the event of a successfu repeal.For more information on CAPG click here and for more on Don Crane, here. For a featured piece on CAPG checkout 'The Value Pivot': The CAPG Story. For more information on National ACO, click here.  

With over 300 member physician groups that practice capitated and coordinated care across 44 states,  CAPG has been a long-time leader in advocacy for capitation, helping federal legislators transform the American healthcare system.  Longtime CAPG President Don Crane joins the podcast to shed light on the forward-thinking efforts of CAPG, which has been advocating on behalf of providers that practice coordinated care and capitation for many decades.

Pat Clarey, Chief State Health Programs & Regulatory Relations Officer, HealthNet, Don Crane, Chief Executive Offiver, CAPG and Diana Dooley, Secretary, California Health and Human Services made up our Lunch Executive Keynote Panel at our 2017 Northern California State of Reform Health Policy Conference. What does the path ahead look like for California within the context of the changing federal policy landscape, both in Congress and the administration? Is there a unique role that California can play – in terms of leading other states but also in local implementation – where California can continue to innovate beyond (or in spite of) the federal policy discussion? This panel of experts took up the topic during our lunch program on April 27.

The national provider directory discussion is clearly focused on the patients and health plans. It focuses on the patients because they're the consumer of this information and without it, they can't make educated decisions when buying health insurance. The conversation focuses on health plans because they're the ones being held accountable for making the information available to consumers. To effectively address this issue, we also need to take a good hard look at things from the providers' point-of-view. That's what this episode is all about. We'll talk with Bill Barcellona, Sr. VP for Government Affairs at CAPG, which is a national association that represents physician organizations who practice capitated, coordinated care.  Bill does an excellent job of sharing the providers point-of-view on the provider directory issue and shows us how provider groups can take the lead on cleaning things up. Bill also tells us about California's SB-137 and explains how it's putting pressure on both health plans and provider groups. It's a fascinating discussion that will expand your understanding of this increasingly complex issue. You'll learn: What is SB-137? (1:20) Where do all the provider directory errors come from? (3:19) Who's responsible for provider directory accuracy? Who's accountable? (5:00) What does SB-137 call for specifically? (7:45) How have providers responded to the accountability placed on them by SB-137? (11:00) What is the SB-137 timeline (12:45)? Why can't health plans pull accurate provider demographics from the claims? (13:25) Why is it beneficial to address this problem on the provider side? (17:30) How else are providers impacted by this problem? (19:30) When should the health plan go directly to the provider for info? When should they go to the group? Why is there a distinction? (20:40) How can inaccurate provider directories lead to FTC/anti-trust scrutiny? 24:50 How is CAPG working with Gaine Solutions (Sanator) to help providers address the issue? (26:45) What is the California Provider Directory Collaborative? (30:30) Can a California-based solution scale nationally, or are California's problems unique? (33:00) What are the risks associated with a state-wide or nation-wide solution? (34:27) How SB-137 and other rules have killed the idea that narrow network details are proprietary information (37:15) Defining a public API for master and metadata needed to share information about contracts, networks, products, and providers nationwide. Or, listen right here: Prefer to read it? Transcription coming soon! About Bill Barcellona Bill Barcellona serves as the Senior Vice President for Government Affairs for CAPG, overseeing state and federal legislative and regulatory activities for the association in Sacramento and Washington, DC. Bill is the former Deputy Director for Plan-Provider Relations for the Department of Managed Health Care in Sacramento. In that capacity, he oversaw health plan operational issues and handled policy matters for the DMHC. Bill has a Masters in Healthcare Administration from the University of Southern California and serves as an adjunct faculty member at USC and also holds a B.A. in political science and a J.D. He enjoys teaching and lecturing across the country on health care management, operations and policy matters. He has practiced law for 28 years in California and prior to his service at the DMHC he spent 16 years at two major law firms in Newport Beach and Sacramento, primarily as a civil litigator. His current legal experience includes general health law matters with an emphasis in Knox-Keene Act and managed care issues. Bill is a former Judge Pro Tem in the El Dorado County Superior Court and served as an appointed member of the California State Bar Association Insurance Law Committee. He was previously awarded the 2009 Alumnus of the Year by the USC Health Services Administration Alumni Association, and a 2-year term as a board member of the Health and Human Services Privacy and Security Advisory Board. He lives in Folsom, a small town in the foothills of the California Gold Rush. He has been active in the community for over 20 years, serving as a Planning Commissioner for the City of Folsom, chairing bond measure campaigns to build new schools, serving as an officer of the Folsom Economic Development Corporation and in the past as a Director of the Folsom Chamber of Commerce. Bill currently serves as a member of the USC Price School Health Advisory Board. About CAPG CAPG is the leading association in the country representing physician organizations practicing capitated, coordinated care. Their membership currently comprises close to 300 multispecialty medical groups and independent practice associations (IPAs) across 42 states, the District of Columbia, and Puerto Rico. Learn more: http://www.capg.org @CAPGVoice Register now for the CAPG Annual Conference 2017 - June 22-24 in San Diego, CA - CAPG's Annual Conference attracts national industry leaders from top medical groups, independent practice associations, hospitals, health plans, and government who come together to learn about the latest and greatest in capitated, coordinated healthcare. Also mentioned on the show: California Provider Directory Collaborative - The California Provider Directory Collaborative Community of Practice is an online forum dedicated to supporting a statewide dialogue on critical provider data and directory issues and to inform regulators as they implement SB 137. Please contact us at ProviderDirectory@manatt.com if you have any questions or would like to learn more. CAPG White Paper: Provider Directories - Driving Accurate Lists for Consumers Sanator Provider Registry by Gaine Solutions   SB-137 California's SB-137, which took effect on July 1, 2017, is one of the most aggressive pieces of legislation addressing the provider directory issue at the state level. It also became the first legislation that holds providers directly accountable for reviewing and updating their records with the health plan. If providers fail to share updates in a timely manner then health plans can remove them from the directory, withhold full or partial payments for up to 1-month (the so-called "hammer provision"), or even terminate their contract.  This bill has real teeth and it's gotten people's attention. About the Provider Directory Podcast Series This episode is part of our ongoing Provider Directory series that aims to dissect the issue from all perspectives, including provider, payer, patient, and regulator. Our goal is to help facilitate an expanded national conversation that drives us towards an open, collaborative industry solution. Check out all our Provider Directory posts and episodes here! Weekly Updates If you like what we're doing here, then please consider signing up for our weekly newsletter. You'll get one email from me each week detailing: New podcast episodes and blog posts. Content or ideas that I've found valuable in the past week. Insider info about the show like stats, upcoming episodes and future plans that I won't put anywhere else. The question of the week. Plain text and straight from the heart :) No SPAM or fancy graphics and you can unsubscribe with a single click anytime. The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media. Music by StudioEtar

Listen NowIn an extremely busy year for Medicare delivery and payment reform,  regulatory implementation of the 2015 Medicare Access and CHIP Reauthorization Act (MACRA) stands out.   This past April CMS published the agency's 960-page proposed rule to implement the law.  The proposed rule, that will go final this fall, will change the way Medicare physician payments (Medicare Part B) are annually updated beginning in payment year 2019.   Payment updates, either at the individual provider or at the group level, will be calculated either by the Merit-based Incentive Payment System (MIPS), a composite score based on four, differently weighted, component scores, or via provider participation in what CMS defines as an "advanced" Alternative Payment Model (APM) pathway, e.g., Track 2 and 3 ACOS and Patient Centered Medical Homes that meet certain financial risk criteria.During this 22-minute discussion Ms. Mara McDermott evaluates how CMS proposes to define APM nominal risk, how the agency has defined the MIPS composite score, the effect MACRA will have on small practices, how Medicare Advantage plans and physicians can be included in MACRA, and several inter-related issues.   (While the introduction to this discussion provides some brief explanatory information, our conversation assumes the listener has some familiarity with Title I of the MACRA law.)    Mara McDermott is the Vice President of CAPG (formerly the California Association of Physician Groups) where she leads the organization's federal legislative and regulatory activities in Washington, D.C.  Prior to joining CAPG, Mara was Counsel in the health industry practice of Akin Gump Strauss Hauer and Field.  Mara received her JD with high honors and her MPH from George Washington University School of Law in 2007.  She received her BA in 2003 from the University of California, Davis.The CMS MACRA proposed rule is at: https://www.federalregister.gov/articles/2016/05/09/2016-10032/medicare-program-merit-based-incentive-payment-system-mips-and-alternative-payment-model-apm Information concerning CAPG is at: http://www.capg.org/ This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com