Medical Tourism and Impact on Providers, Managed Care Contracting, Medical Practice Management, Physician/ Hospital Integration, HIPAA Compliance and more:
Managed Care Programs:
Managed Care Basics for New Employees
Managed Care Contracting
Contracted Reimbursement
Silent PPO Best Practices
Developing Case Rates for Outpatient Surgical Service Lines
Denials Management and Mitigation
Physician Integration
Physician Employment Contracting IPA, PHO, MSO Redesign
Developing Payer Report Cards
Overcoming ERISA Challenges
Consumer Driven Health Plans
Coordinating Third-Party Liability Claims Medicare Advantage
Contracting Managed Care
Medical Tourism Programs:
1) New & Must-See: Medical Tourism - Impact on US Healthcare Providers
With more than 2 million Americans traveling abroad for their medical care, patients are driving the next generation of health care. And with dozens of JCAHO/JCI accredited hospitals around the world offering first class medical care for 10% of the cost that is offered in the U.S., insurers, companies, and experts must explore the opportunities presented by this emerging industry. While the savings speak for themselves, implementing an international component to existing plans can be fraught with hurdles such as addressing liability, credentialing requirements, driving utilization, and more. Do the savings outweigh the costs for U.S. companies?
Medical tourism programs are the latest entry into the managed care and ERISA Self-funded employer markets, with health plans adding benefits to their policies for their members to seek and receive care out of the country. Plans are allowing medical benefits and the cost of travel to be covered "in-network". Many plans find members who have funded their CDHPs are using the funds to cover the costs and make their money go farther. This leaves fewer dollars for stateside providers and creates collections problems for U.S. providers as those with unfunded or underfunded savings accounts continue to seek local care, which may result in increased collections costs while the available cash floats across the sea. Learn what is happening worldwide and take home some ideas to build a strategic response to this growing trend.
2) Medical Tourism for Health Plans and Insurers
A non-commercial, unbiased and informative presentation on the development of medical tourism/global healthcare access for health plans, self insured employers, unions and healthcare purchasing groups. Learn about accreditation, liability and dispute resolution, credentialing, and privileging to NCQA standards, quality documentation, pricing transparency, network assessment, international reimbursement contracting, connecting the providers for preoperative and aftercare and international medical records exchange.
Market growth is no longer limited to the leisure component and some elective surgeries anymore. More than 150 networks have geared up to meet the rigors of US healthplan network inclusion to meet the needs of patients from abroad for elective and medically necessary care. Learn payer issues and multiple solutions to meet this growing trend.
About Maria Todd:
Maria Todd has more than 30 years in the healthcare industry as a paid professional speaker, author, and trainer. She has presented more than 2600 educational programs in 48 states and 16 countries to more than 5500 seminar participants. All total, she has presented more than 14,000 hours of Continuing Professional Education (CPE) hours of instruction. She is well-known in HFMA circles and has been delivering quality chapter and HFMA National education programs on managed care and related topics since 1993. Maria has been designated as a Distinguished Speaker at HFMA Annual National Institutes (ANI) for every year she has presented. She has clinical, administrative, health plan contracting and network development work experience. In addition, she is trained as a mediator and health law paralegal.
Maria’s understanding of contract analysis, negotiation, mediation of disputes and expertise with various health plan programs and reimbursement arrangements makes her the most sought after professional speaker in the industry on these topics. Maria is an advanced member of HFMA and has been a member since 1993. She has been awarded the Follmer Bronze, Reeves Silver, and Muncie Gold Service Awards. She is the author of nine industry books, including The Managed Care Contracting Handbook 1st and 2nd editions, The Physician Employment Contract Handbook, 1st and 2nd editions, IPA, PHO, MSO Development Strategies, Refocusing the Lens: The New Physician Integration , Medical Tourism Program Development, The Medical Tourism Facilitator’s Handbook, and The HIPAA Compliance Toolkit: Sample Forms, Policies and Procedures.
Maria was the first HFMA national presenter to incorporate hands-on learning at the educational seminar clusters in 1994. For staff level programs, she presents a variety of managed care contracting topics and includes take-home tools, insightful tips and practical checklists and techniques for rapid implementation after class. For line and executive-level participants, she generously shares practical, strategic concepts and planning tools for decision-makers to help them lead their staff through the maze of reimbursement challenges facing healthcare organizations worldwide. Participants take home reference tools, checklists, model strategies, model contract language and other materials in addition to her slide deck. She encourages the use of CD or USB medium for the generous supplemental course materials that she shares in addition to a printed copy of the slide presentation for note-taking.
As a member of the American Society of Training and Development (ASTD), Maria has understands adult learning theory, pedagogy and advanced curriculum design. As a professional presenter and trainer, she incorporates an Audience Response System (ARS) for use in some of her programs. This technology keeps the participant engaged and allows for the display of instant, meaningful results of audience survey questions, true false, Likert scale and other response metrics during the program. Maria maximizes its use and owns her own system with 80 response keypads. She includes the use of the system in select programs at no additional charge (a $1900 one-day rental value).
Maria is one of five founders and the president of the Council for the Global Integration of Healthcare, a non-profit association that supports education and development of globally integrated healthcare systems and medical tourism. She presents frequently on medical tourism industry development, contracted global healthcare reimbursement, medical tourism service line development and managed care contracting techniques. She explains the US healthcare systems to foreign healthcare providers who are currently contracting with US payers and employers for health services delivery abroad.
Maria can help you publicize your event on Twitter, Facebook, Ask, MSN, Yahoo, as well as event indexing sites such as Eventful, Zvents, Upcoming.org, Oodle, Googlebase, and anywhere else on the Web that reads HTML. The event will have its own web page, with course descriptions, its own event URL, early bird and late registration pricing, and can be added on your chapter website. With your approval, Maria will also cross-promote your event on her own Twitter, Facebook and other social networking sites as well as her website.
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