Shifts in Payment Policy: Threat or Opportunity? It Depends on Where You Sit
Medical and pharmacy benefit payment policies are changing quickly. Each change can shift incentives for sites of care (hospitals, physician offices, and home infusion), payers, manufacturers, and patients, so the same policy can be a threat to one entity and an opportunity for another. This session explores how revenue cycle and business development teams can read these shifts together. Learn how to meet the payment requirements that matter and manage policy changes across your organization to inform growth strategies.
Medical and pharmacy benefit payment policies are changing quickly. Each change can shift incentives for sites of care (hospitals, physician offices, and home infusion), payers, manufacturers, and patients, so the same policy can be a threat to one entity and an opportunity for another. This session explores how revenue cycle and business development teams can read these shifts together. Learn how to meet the payment requirements that matter and manage policy changes across your organization to inform growth strategies.
Learning Objectives
Identify the payment policy details, qualifying criteria, and documentation requirements needed to secure payment and withstand audits, takebacks, and repayment demands, and outline a change management process for putting policy updates into practice across your organization.
Analyze how evolving payment policies shift incentives for key stakeholders and evaluate where those shifts create growth opportunities or challenges for your business.
Describe how revenue cycle and business development teams can share policy insight, vet new referrals and payer contracts together, and build processes that generate revenue and protect it over the long term.
Speaker(s)
Bill Noyes
SVP of Reimbursement Policy
NHIA
Brett Benfield PharmD, MS, FNHIA
Vice President of Infusion Consulting
Fairview Pharmacy Solutions
Glenel Tillich FNHIA
VP, RCM New Business and Process Optimization
Pentec Health
