BLOOMBERG BNA WEBINAR EVENT: Current Trends and Developments in Physician Tiering
Thursday, July 18, 2013
1:00 PM - 2:30 PM ET
Providers, payors, and federal and state governments continue to experiment with methods to increase the quality of healthcare while simultaneously reducing its cost. In addition, the increasing focus on “patient-centered care” highlights the need for patients to be provided more information – and choices – about who provides their healthcare.
“Physician tiering” has emerged as one approach to meet these goals. Through tiering, payors make distinctions between physicians in their networks, generally based on a combination of quality and cost factors. Such distinctions may result in physicians in a network being “tiered” or designated, for example, as “excellent,” “good,” or “standard.” These designations are generally transmitted to the payor’s subscribers, who may be offered financial incentives such as lower co-payments to use physicians with a higher tier.
Not surprisingly, such approaches can be controversial and can lead to regulatory scrutiny, challenges from organized medical societies, and individual physicians. These challenges can include claims from physicians for defamation, breach of contract, unfair business practices, and others. This program will address some of those challenges and will offer practical guidance as to how tiering programs can be developed to reduce such risks.
- Learn what tiering programs are and how they differ from each other.
- Discover in which states tiering programs have been challenged and what claims have been asserted during those challenges.
- Understand how tiering programs can be developed to reduce regulatory and litigation risk.
Who would benefit most from attending the program?
In-house counsel for payors and providers interested in tiering; outside healthcare regulatory attorneys and healthcare litigators.
Program Level: Intermediate
Credit Available: This program’s CLE-credit eligibility varies by state.