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AAOE Webinar: Understanding CMS Bundled Payment Programs and Implications for Orthopaedic Practices
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AAOE Webinar: Understanding CMS Bundled Payment Programs and Implications for Orthopaedic Practices

10/7/2015
When: Every Wednesday
12:00 - 1:30 p.m. ET


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On January 1, 2016, CMS proposes to implement a new, mandatory program known as the Comprehensive Care for Joint Replacement Model (CCJR).  This program is expected to have far reaching repercussions for orthopaedic practices and surgeons throughout the country. AAOE is pleased to offer a webinar series presented by staff with Signature Medical Group to educate orthopaedic executives on the implications of the CCJR and the impact existing programs such as CMMI’s Bundled Payment for Care Improvement (BPCI) are already having on orthopaedic care. 

 

Cost:     Free for AAOE Members

              $149 for Non-Members


Series Courses:

Overview of CCJR – September 30, 2015

  • Webinar provides an overview and explanation of the CCJR initiative. It covers the proposed CCJR initiative design, key components of the initiative, geographic areas affected, and impact on orthopaedic practices.

Bundled Payments (CCJR, BPCI and others) – October 7, 2015

  • Webinar provides an overview of bundled payments and episodes of care.  Comparison is made between commercial bundled payment arrangements, BPCI and CCJR including the differences between prospective and retrospective bundled payments, case rates and total cost of care programs. 

Gainsharing and Risk-Sharing – October 14, 2015

  • Webinar provides an explanation of the gainsharing and risk-sharing opportunities and rules within the CCJR program.  Also explains how an orthopaedic physician group and other vendors can engage in financial arrangements with a hospital.  The webinar covers the rules of gainsharing and risk-sharing, compliance, payments and how these arrangements interact with co-management and service line agreements. 

Care Redesign – October 21, 2015

  • Webinar provides information on the what, who, how and why of care redesign.  It provides an explanation of the scope of care redesign, current approaches, obstacles and barriers, and impact of orthopedic physicians.  This webinar provides orthopaedic practices with an enriched understanding of their value within the care redesign process and enables orthopaedic practices to enhance negotiations with hospital partners.

Total Joint Program and Post-Acute Care (PAC) Network – October 28, 2015

  • Webinar provides information on how to develop, standardize and optimize a total joint program and a post-acute care network.  The webinar offers an overview of post-acute care providers and how orthopedic practices can improve post-acute care.

Data and Quality Metrics – November 4, 2015

  • Webinar provides information on CMS data available to hospitals in the CCJR initiative. Highlights what data is available, how the data is useful and what questions to ask.

Advocacy and Future Impact of CCJR – November 11, 2015

  • Webinar provides information on the current and future impact of CCJR.  It focuses on the messages to counter bundled programs designed around a hospital-centric model and efforts to advocate for maintaining and expanding physician-led management for financial and clinical responsibility in bundled payment initiatives.

Strategy for Success – November 18, 2015

  • Webinar focuses on defining the orthopaedic practice’s “value proposition”.  What value does the orthopaedic practice provide? How does the orthopaedic practice approach and/or respond to a hospital? What choices and opportunities are available?  How does an orthopaedic practice best position itself for now and the future?

Webinar objectives:

CMS has made it very clear that it expects providers to move away from fee-for-service and adopt alternative payment methodologies, such as bundled payments, over the next several years.  This webinar series will help you:

  • Understand the evolution of bundled payment programs and what is driving their adoption
  • Gain a deep understanding of both the CCJR and BPCI programs
  • Recognize the key differences between CCJR, BPCI and other alternative payment programs
  • The infrastructure requirements practices need to consider in developing/participating in a bundle payment program
  • How to compete effectively in markets where bundles or CCJR hospitals are or will be established
  • How your physician group can work with a hospital in CCJR or BPCI
  • Policy and legislative considerations for physicians and practices to remain at the center of patient care redesign and financial control

 

About the Presenter – Signature Medical Group (SMG):

SMG is an independent multispecialty physician organization based in St. Louis, MO, and is a Convener under the CMS Bundled Payments for Care Improvement program.  As the only physician group practice acting as an awardee convener in the Centers for Medicare and Medicaid Innovation’s Bundle Payments for Care Improvement Model 2 program, SMG has organized the largest clinically integrated orthopedic program in the country. This effort is comprised of 2,000 physicians in 60 cities across 26 states. The surgeons in the SMG BPCI program are managing 50,000 joint replacements annually. 


 

Jim Gera, MBA
SVP of Business Development,

Signature Medical Group, Inc.

 

Jim Gera is the Senior Vice President of Business Development for Signature Medical Group a 125 physician-owned multi-specialty group in St. Louis, Kansas City and Southwest Missouri.  Signature has 63 orthopedists providing services in all orthopedic sub-specialties including total joint replacement, sports medicine and pediatric. Jim received his MBA from Southern Illinois University at Edwardsville.  Over the past 14+ years, Jim has worked in a variety of areas of health care developing and managing physician group practices, outpatient facilities and has worked in development for managed care companies in Medicare Advantage and Special Needs Plans.  Over the past five years Jim has focused on programs and opportunities within Health Reform and the Affordable Care Act.  He and Jerry Rupp successfully co-authored an Advanced Payment Medicare Accountable Care Organization application.  They also authored a successful $1.3 million grant award for Strong Start for Mothers and Newborns and presently oversees a Maternity Care Home care management program operating throughout Signature.  In addition, Jim has served as a Chairperson for several Centers of Medicare/Medicaid Innovation Center (CMMI) grant reviews.  Jim presently oversees Signature’s Awardee Convener Bundled Payment for Care Improvement program which encompasses 2,000 orthopedic physicians and 50,000+ clinical episodes throughout 26 states in 60+ cities and totals $1.8 billion in Medicare costs.  He can be contacted at jgera@signaturehealth.net or on Twitter @jimgera.

   

Gerald (Jerry) Rupp, Ph.D.

Director of Research Programs,

Signature Medical Group, Inc.

 

Dr. Gerald Rupp is the Director of Research Programs at Signature Medical Group, Inc., a multi-specialty physician group practice based in St. Louis, MO.  He is currently developing and administering programs focused on healthcare delivery and payment model reforms consistent with the Affordable Care Act.  He and Jim Gera successfully co-authored an Advanced Payment Medicare Accountable Care Organization application.  They also authored a successful $1.3 million grant award for Strong Start for Mothers and Newborns and presently oversees a Maternity Care Home care management program operating throughout Signature. The overall scope of these projects is to generate efficient and effective programmatic changes that result in enhanced care delivery based on individual patient needs and safety while achieving improved quality of care with improved outcomes at a lower cost.

Prior to joining Signature, Jerry was the Executive Director at the Institute for Science and Health, a St. Louis based not-for-profit organization that funded health-science research across the globe.  Before that, Dr. Rupp was a professor of anatomy, teaching the core anatomical sciences (gross anatomy, cell biology/microanatomy, embryology/development, and physiology) to first-year medical students.  For over twenty years Jerry has been involved in health-science research utilizing broad-based approaches derived from the disciplines of cell and molecular biology, genetics, genomics, and high-resolution optics.  His research work has included various aspects of microtubule-mediated motility, ranging from the mechanisms involved in cell division to the regulation of ciliary/flagellar motility. 

Dr. Rupp holds Bachelor of Science and Master of Science degrees from the State University of New York at Albany.  He also holds a Doctor of Philosophy degree in Cell Biology and Anatomy from the State University of New York at Buffalo. He can be contacted at grupp@signaturehealth.net.

 

Sue Caito, RN, BSN, CCM, MSCC, CLCP, LNCC

National Director of Case Management,

Signature Medical Group, Inc.

 
 

Sue is the National Director of Case Management at Signature Medical Group, Inc. a multi-specialty physician group practice based in St. Louis, MO. Sue has successfully managed the development of the BPCI embedded case management program focused on care redesign and measurable quality outcomes for 50,000 annual Medicare patients, implemented in 58 Orthopedic practices across the United States. Sue has 20+ years of nursing experience in managed care, high risk, complex catastrophic case management and Medicare Secondary Payer Compliance and maintains certifications as a Certified Case Manager, Certified Life Care Planner, Legal Nurse Consultant Certified and Medicare Set Aside Consultant.  She can be contacted at scaito@signaturehealth.net.

   Joel James, Director of  Public and Government Affairs, Signature Medical Group, Inc.
 

Joel James is Director of Public and Government Affairs for Signature Medical Group, Inc., an independent multi-specialty physician group based in St. Louis, Missouri.  Joel joined Signature in Oct. 2013 and oversees external communications, marketing, media and government relations. He previously headed external and government relations for the Federal Reserve Bank of St. Louis and also managed congressional and media relations for the Resolution Trust Corporation in Dallas, Texas and in Washington, D.C.  Joel’s experience in healthcare began in the military, where he served in the U.S. Army Medical Corps and graduated from the Army’s clinical specialist program at William Beaumont Army Medical Center, El Paso, Texas.  Stationed at the Fort Carson Military Hospital in Colorado Springs, Joel worked as a nurse in Pediatrics and managed the Allergy, Immunology and Dermatology Clinic. He holds a B.A. from Buena Vista University and an M.A. in Economics and Public Policy from the University of Texas. He currently serves as chair of the Federal Legislative Subcommittee for the American Association of Orthopaedic Executives; is a member of the Advocacy Council for the OrthoForum, and serves on the board of the Asthma and Allergy Foundation of America, St. Louis Chapter.  Joel can be contacted at jjames@signaturehealth.net


 

  

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