Agenda:
– Welcome and introduction of presenters and purpose of the session
– Blue Cross and Blue Shield Minnesota presentation (20-25 minutes)
– Questions & Answers – Questions submitted at time of registration or via function in ZOOM meeting
– Payment Committee response and call to action
Blue Cross Blue Shield is the leading health plan in Minnesota. About one in three Minnesotans have a health plan with BCBS-MN, which equates to over 2.5 million covered lives. Part of the BCBS-MN mission is to see that members have better access to affordable healthcare. Dianna Terry, Director of Provider Relations, and Rebecca Harden, Director of Provider Relations will provide a brief presentation on the work that they have done to promote access to physical therapist services and about the management of physical therapy services by Blue Cross. After the brief presentation there will be a Q & A time.
Learn more about BCBS-MN on their website: www.bluecrossmn.com
Agenda:
– Welcome and introduction of presenters and purpose of the session
– Blue Cross and Blue Shield Minnesota presentation (20-25 minutes)
– Questions & Answers – Questions submitted at time of registration or via function in ZOOM meeting
– Payment Committee response and call to action
Blue Cross Blue Shield is the leading health plan in Minnesota. About one in three Minnesotans have a health plan with BCBS-MN, which equates to over 2.5 million covered lives. Part of the BCBS-MN mission is to see that members have better access to affordable healthcare. Dianna Terry, Director of Provider Relations, and Rebecca Harden, Director of Provider Relations will provide a brief presentation on the work that they have done to promote access to physical therapist services and about the management of physical therapy services by Blue Cross. After the brief presentation there will be a Q & A time.
Learn more about BCBS-MN on their website: www.bluecrossmn.com
Agenda:
– Welcome and introduction of presenters and purpose of the session
– HealthPartners presentation (20-25 minutes)
– Questions & Answers – Questions submitted at time of registration or via function in ZOOM meeting
– Payment Committee response and call to action
Participants will hear from Shaun Frost, MD, Health Plan Medical Director for Care Delivery Systems, and Tasha Nembhard, Health Plan Provider Relations and Network Management Contract Manager about HealthPartners efforts to help physical therapists understand and manage cost of care for members attributed to their practice. Discussants will review an interactive data reporting tool that enables isolation of service price and resource utilization at overall and condition specific service levels while permitting cost of care comparisons among providers in the community. Following the presentation there will be opportunity to interact with HealthPartners representatives through open discussion and Q & A time.
About HealthPartners: Founded in 1957, HealthPartners is the largest consumer-governed, non-profit health care organization in the nation. The organization is dedicated to improving health and well-being in partnership with members, patients and the community, and provides a full range of health care delivery and health plan services including insurance, administration and health and well-being programs. HealthPartners serves more than 1.8 million medical and dental health plan members nationwide. The care system includes more than 1,900 physicians, more than 350 PT’s and PTA’s, nine hospitals, 53 primary care clinics, 19 urgent care locations, 23 dental clinics and numerous specialty practices in Minnesota and Western Wisconsin. HealthPartners also provides medical education and conducts research through HealthPartners Institute. For more information, visit healthpartners.com
Agenda:
– Welcome and introduction of presenters and purpose of the session
– PreferredOne presentation (20-25 minutes)
– An overview of the PreferredOne business
– Operational updates/changes that pertain to our physical therapy provider partners
– Highlight initiatives promoting physical therapy services to PreferredOne members
– Payment Committee response and call to action
– Questions & Answers
PreferredOne was founded in 1984 and located in Golden Valley MN. It is a wholly owned subsidiary of Fairview Health Services. This partnership between payer and health provider provides a unique opportunity to impact the quality and value of services provided. Participants will hear from Jason Woods, Director, Clinical Operations and Kristopher Klinger, Director, Provider Relations, on work that has been done to promote physical therapy services and have an opportunity to interact with PreferredOne representatives through a time of open discussion and Q & A time.
Agenda:
– Welcome and introduction of presenters and purpose of the session
– SecureCare presentation (20-25 minutes)
– Payment Committee response
– Questions & Answers (Questions submitted at time of registration and via “Chat” function within Zoom)
SecureCare was selected as the credentialing and utilization management partner for BCBS MN in 2018. In this role, they have interacted with many therapists and provider practices to provide feedback on their performance compared to a SecureCare established benchmark. There continues to be confusion around the SecureCare benchmark, what it means to be an “outlier”, and overall utilization management process. APTA MN continues to meet with SecureCare on a regular basis. Based on feedback we received at a Payment Committee Listening Session in November, we reached out to SecureCare and invited them to meet with Physical Therapists, Physical Therapist assistants and practice administrators regarding their approach to utilization management. Participants will hear from Mark Knoll, DC, Chief Medical Officer and Erick Alvarez, PT, Physical Therapy Medical Director and have an opportunity to interact with SecureCare representatives through a time of open discussion and Q & A time.
Watch the previously recorded session here: November 19, 2020 Payment Committee Listening Session
The past several months have been challenging for therapists personally and for employers, whether an independent private practice, or a large health organization. There continues to be uncertainty about the overall community response to the public health emergency and whether consumers of therapy services will choose to receive these services the way they have in the past. Regardless of these factors, physical therapists and physical therapist assistants need to receive payment for the life changing services we provide.
Your input and feedback will be used to inform future agendas for the Payer Advocacy Workgroup meetings with the largest payers in the state.
