<0> Ross Goldberg, 818-597-8453, x-1 </0>
Pam Klugman, chief operating officer of , will be one of the featured speakers at the annual ICE meeting, December 3–4, in San Francisco. ICE is healthcare’s Industry Collaboration Effort, which brings together providers, health plans, associations, state and federal agencies, and accrediting bodies to work collaboratively to improve healthcare regulatory compliance and efficiencies.
A nationally renowned speaker in her field, Klugman will discuss at ICE the changes the Center for Medicare and Medicaid (CMS) is making relative to determining how – and how much – it pays Medicare Advantage plans. Klugman will outline the new methodology and what health plans can do to make sure they have the right systems, skills, people and quality controls in place.
Historically, the rate CMS pays Medicare Advantage plans has been based on age of members, geographic area and likelihood of expenditures to serve these enrollees given their “risk factors.” Going forward, however, plans will be paid based on actual care provided, or “encounter” data. While all of the ramifications of this changeover are not yet clear, health plans and physician groups stand to collectively lose billions of dollars in revenue if they don’t learn how to adapt to the new environment.
Klugman brings to her presentation more than 20 years of experience in healthcare working with providers and health plans. Prior to co-founding Clear Vision in 2006, Klugman was manager of information technology, Medicare revenue improvement and recovery for Blue Shield of California. She has also held leadership roles in the reimbursement/financial areas at Blue Cross of California, Cedars-Sinai Medical Center and Northridge Hospital. Klugman currently serves as co-chair of the ICE team.
Clear Vision Information Systems provides Medicare Advantage risk adjustment solutions and strategies to health plans and providers nationwide. Leveraging decades of experience at the forefront of Medicare policy, the Clear Vision team provides an integrated mix of risk adjustment analytics, continuity-of-care strategies and compliance consulting tailored to the individual needs of each client. The “20/20 clarity” and easy-to-implement, high-impact tools Clear Vision brings results in revenue optimization and improved quality of care. For further information, visit .