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While most physician organizations are still being reimbursed or incentivize on a productivity basis, the more advanced physician organizations are moving toward total cost of care reimbursement or incentive models.
On the path to total cost of care reimbursement, provider organizations are challenged to engage physicians in these emerging reimbursement models while ensuring transparency of patient data, providing peer comparison and helping physicians understand population health management and its impact on the total cost of care.
Listen to pre-conference comments from Cynthia Kilroy.
During Accountable Care Reimbursement Models: Moving from Productivity to Population-Based Incentives, a January 29th webinar, now available for replay, Cynthia Kilroy, senior vice president of provider strategy and business development at Optum, explores the key structure, issues and challenges in these evolving reimbursement models.
You will learn:
- How physicians are gaining efficiencies and incentives around high-risk patients by identifying and managing the risk;
- How to use real-time EHR data to identify risk, manage gaps in care and analyze performance to manage population health and total cost of care;
- From withholds to capitation how to determine which payment method and adjustment will work for each practice; and
- Tying upside and downside risk for physicians to the medical loss ratio.
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You can attend this program right in your office and enjoy significant savings — no travel time or hassle; no hotel expenses. It's so convenient! Invite your staff members to gather around a conference table to listen to the conference.
WHO WILL BENEFIT FROM THIS CONFERENCE?
Presidents/CEOs, chief financial officers, chief operating officers, medical directors, reimbursement executives, physician practice leaders, quality improvement executives, care and management executives, business development and strategic planning directors and consultants.
ABOUT OUR PANELIST:
Cynthia C. Kilroy is the senior vice president of provider strategy for Optum Accountable Care Solutions, where she is responsible for business development, go-to-market strategy, strategic consulting, solution design and cross-company relationships. Her focus is on helping providers navigate the transformation to value-based reimbursement and accountable care models. She is currently leading the Provider Value-Based Transformation Strategy, a consultative approach that assists providers in moving to new care models and reimbursement models. The strategy focuses on movement of the market, organization structure, physician alignment, population health management capabilities, financial projections, contract modeling and transformation roadmap.
||There are three key benefits to systematic sharing of performance data among physicians.
Ms. Kilroy has over 20 years of experience as a healthcare professional focused on helping clients conceive and implement strategic decisions that change the concept of the business they are in to meet emerging challenges and market needs. She has experience working in managed care, hospitals, physician organizations including products and services. Ms. Kilroy has in-depth knowledge of the healthcare industry including revenue cycle, product development, member engagement, network development, population management and information technology. She has assisted organizations in strategic planning, financial analysis, product development, operations restructuring and program management.
Prior to her career at Optum, Ms. Kilroy was responsible for the development and execution of an Accountable Care Organization (ACO) strategy for a large payer in California. She led the development of an ACO between a large managed care organization, hospital system and IPA to improve integration of care delivery and reduce healthcare costs by 10%. The strategy focuses on shared responsibilities and risks in the areas of acute care utilization, chronic patient management, population management, pharmaceutical utilization, physician variation, and information integration. The ACO save $37 million during the first year, exceeding the original target of $15.5 million. In addition, utilization outcomes improved by reducing readmissions by 15 percent, reducing length of stay by 0.5 days, improved patient discharge follow-up and reduced inpatient stays of 20+ days by 15 percent.
From 2006-2008 she worked for a large health plan where she was responsible for developing and implementing a corporate-wide cost of healthcare strategy to drive cost reductions in the areas of network management, product and benefit design, utilization management, patient channeling and generic pharmaceuticals. The program exceeded the goal by 300 percent resulting in savings of over $90 million in healthcare costs.
Previously, Ms. Kilroy was a Senior Manager at Andersen Consulting where she was charged with developing a healthcare services venture, in partnership with NationsBank, targeted at physician practice groups. The venture was funded and provided consolidated administrative and financial services to physician networks. From 1995-1997, Ms. Kilroy worked with KPMG Peat Marwick as a Senior Consultant where she provided expertise in business process redesign and system planning to provider clients nationwide. In addition, she assisted in defining the strategic direction of the practice and supporting partners in identifying market opportunities. Prior to her career in consulting, Ms. Kilroy worked in healthcare organizations including El Camino Hospital, U.S. Healthcare (Aetna), Mercy Health Plan and McKesson HBO & Company.
Ms. Kilroy received her MBA from Duke University, Fuqua School of Business with a certification in Health Sector Management. She received her B.S. in Computer Science from DeSales University. Ms. Kilroy is a Dignity Health – St. Francis Hospital Board Member in San Francisco. She is a frequent speaker and writer on value-based transformation and healthcare trends.