Maximizing the 2017 Changes to Dual             Eligibles Reimbursement

Thursday, March 9, 2017 
1:00-2:00 pm ET


 Thursday, March 9, 2017, 1-2 PM ET

Brian Smith, Director of Human Arc’s Premium Assist Solutions, directs the division with P&L responsibility,  developing  short and long range plans regarding service line operations, personnel, financial performance and growth.  He also directs tactical alignment of cross-functional resources to establish and manage external client and vendor relationships.  

 Brian holds a Bachelor’s degree in Business Administration, with a major in Quantitative Business Analysis (Statistics) from Cleveland State University.   Prior to joining Human Arc in 2006, he held positions in various analyst roles within the insurance industry, including the Westfield Insurance Group. 

Linda joined Human Arc in 2008, bringing to its health plan clients 20 years of diverse health care industry experience. She plays a lead role in ensuring Human Arc’s products and services meet current and emerging needs of the market.  She also leads a team of client relations professionals, overseeing client implementations and ongoing client servicing.

Prior to joining Human Arc, she served for more than 10 years as President and Chief Executive Officer of her own health provider companies; these focused on serving Medicaid and Medicare beneficiaries in both fee-for-ser­vice and disease management programs. In this capacity, she created programs to serve the chronic special needs populations; which utilized both tech­nology and clinical best practices to achieve operational cost reductions. 

 Throughout her career, Linda also has been actively involved in the development and application of technology advances in telemedicine, personal and electronic health records, integrated claims and clinical processing and analytics. 

 As a past President of the Kan­sas Healthcare Association, she served as a lobbyist and advocate, working extensively with the National Library of Medi­cine, National Institute of Health, Centers for Medicare and Medicaid Services and congres­sional leaders. Linda has a bachelor’s degree in health care administration and a master’s degree in business administration.  She also is certified in Lean Six Sigma. 

Effective January 1, 2017, the CMS March 2016 CMS announcement changes the way Medicare Advantage Plans are reimbursed for their dual eligible members.  Now plans are being paid differently for full dual members versus partial dual members. Not only did the capitation rates change but the timing of the increased capitation for dual status has moved from retrospective to a more concurrent model.  Add to this the more important impact of HCCs to the dual member capitation, forcing plans to reconsider their dual member engagement and retention strategies.

This free webinar is designed to give you a full understanding of the scope and impact of the CMS ruling and help you formulate strategies to maximize reimbursement from your full and partial dual members.  You will gain key insights into:

  • The Background on CMS changes to capitation payments for dual eligible
  • Impacts on full dual versus partial dual members
  • Changes to timing of capitation payments for duals
  • Impact of HCCs on dual capitation for members
  • Retention strategies for ongoing member engagement and retention of dual status


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If you do not receive confirmation within 2 business days, please call: 
Aron Barkan at 561-674-0082

Speakers: Brian Smith, Director,  Premium Assist Solutions, Human Arc, Linda Roman, Vice President, Human Arc