Accreditation The American Medical Directors Association (AMDA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Designation Statement: The American Medical Directors Association designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
AMDCP Credit Designation: This session has been approved for a total of management 1.0 credit hours toward certification as a Certified Medical Director in Long Term Care (CMD).
Session Description: Managed care programs for Medicare and/or Medicaid eligible individuals are increasing. A majority of states have enacted, or are considering, legislation that mandates or encourages enrollment of individuals with Medicaid into managed Medicaid programs as a method to better define and reduce state Medicaid costs. Nursing homes and other long term care providers will be impacted by these mandates. Medical Directors, attending physicians, nurse practitioners, physician assistants, and administrators need to understand how managed care programs are funded and measured. This presentation will help attendees prepare for and thrive in a managed care environment.
Describe how managed care programs integrate with Medicare and Medicaid programs, and interact with long term care providers.
Provide examples of managed care programs for the geriatric population and how they control costs.
Define measures and terminology needed to interact with managed care programs.
Prepare nursing home leadership for the introduction of managed care and risk contract.
Speaker(s): Brian Heppard, MD; Dallas Nelson, MD, CMD; Thomas V. Caprio, MD, MPH, CMD; Stephen Ryan, MD, PhD
Disclosure(s): Dr. Heppard - Employee: United Health Group, the parent company of Evercare
Reference(s): 1. Essentials of Managed Health Care, 5th edition. 2007 PR Kongstvedt 2. www.pohly.com/terms.html