December 7, 2022
Inland Empire Health Plan
Rancho Cucamonga

Update: Due to unforeseen circumstances, this course has been cancelled. 

Overview

The Medi-Cal managed care rate-setting process establishes the foundation on which local health plans provide services to more than 7 million Californians. How plans leverage this process can prove critical to their operational and financial success. 

Diving deeper into concepts introduced in the Medi-Cal Managed Care Finance 101 course, expert faculty will provide an in-depth look at the Medi-Cal managed care rate-setting process. Attendees will learn how rates are established, how the process is structured, the key components of the Rate Development Template (RDT) and implications for local plans’ day-to-day and strategic operations.

*Note: The course is not designed to be a training on how to complete the RDT. The intent is to provide a closer look at the fundamental elements and considerations that factor into the RDT and the
rate-setting process as a whole.

Who should attend:
Plan staff working in finance, planning, data analytics, provider network, medical management and information technology. To get the most benefit from the course, interested individuals should have some level of knowledge and/or experience in plan financing, or perform functions that are connected to or impacted by plan financing.

Agenda

*May be subject to change

9:30 a.m. – Noon

Key Financing Issues in Medi-Cal Managed Care

• Medi-Cal and the budget
• New financing changes due to CalAIM
• Implications of the Public Health Emergency (PHE) expiration

Inside the Rate Development Black Box

• Review of the rate-setting process — purpose, key players and their roles
• Understanding the RDT — a walkthrough of key components, timelines
• Data used in the rate development process and how it’s collected
• Critical role of encounter data
• Supplemental data requests — what they are and why they’re important

Noon – 1:00 p.m. | Hosted Luncheon

1:00 – 4:00 p.m.

Operational Implications for the RDT

• Operational and financial processes for supporting RDT submissions
• Common issues with the RDT
• How the RDT may change in the future
• The RDT and implications for plan operations
• Role of the RDT in rate development discussions with the State

Understanding Non-Federal Matching Revenue Streams

• Non-federal revenue streams and plans’ responsibilities under each program
  • Directed payments
  • Intergovernmental Transfers (IGTs)
  • Certified Public Expenditures (CPEs)
• How counties and plans are using these programs
• Implications for plan revenue strategies

Site

Inland Empire Health Plan
Dr. Bradley P. Gilbert Center for Learning & Innovation
9500 Cleveland Avenue
Rancho Cucamonga, CA 91730

Faculty

Jonathan Freedman
Vice President
Health Management Associates

Jonathan Freedman works with plans, providers, associations, and governmental and non-governmental entities in the areas of public health, safety net health care, and public policy. His work focuses on strategic planning, public health improvement and transformation, and the health care safety net. Prior to joining HMA, Mr. Freedman held a variety of management and leadership roles at L.A. Care Health Plan and with the County of Los Angeles, and led a number of high-profile health- and health care-related initiatives.

Keenan Freeman
Chief Financial Officer
Inland Empire Health Plan

Keenan Freeman joined Inland Empire Health Plan (IEHP) as Chief Financial Officer in 2016. With nearly 30 years of professional finance experience, Mr. Freeman is responsible for the overall financial management of IEHP, its financial reporting and transparency, and for multiple plan financial functions including accounting, purchasing, capitation, cost recovery, risk management, and the coordination of fiscal and other operational audits.

Jennifer Lopez
Director, Health Plan Financing
Local Health Plans of California

Jennifer Lopez joined LHPC in October and has a longstanding background in the public sector and the Medi-Cal program. During her time as Chief of the Capitated Rates Development Division at the California Department of Health Care Services (DHCS), Lopez acquired a deep knowledge base in Medi-Cal managed care financing and rate development. At the California Department of Finance, she played an instrumental role in major State Budget initiatives, developing public policy positions and advising administration officials on critical policy matters affecting millions of Californians. 

Registration

Note: Due to unforeseen circumstances, this course has been cancelled. 

NOTE: Health plan staff interested in participating should adhere to their respective plan’s process for LHPC Institute event registration where applicable.

Registration Fees: $50 per registrant

Registration Details: The course will accommodate up to 80 participants. Each plan may elect to send no more than five (5) participants. If more than five individuals from a plan are interested in attending, they are encouraged to sign up for the waitlist. Waitlisted individuals will be admitted should space become available.

Registration Deadline: Registration closes Dec. 1 at 5:00 p.m. or once capacity is reached.

Registration Confirmation: Registrants will receive an email notification confirming their registration.

Presentation Materials: Presentation materials will be made available electronically only via the program resources web page that will be provided to confirmed registrants. Attendees are encouraged to download the materials in advance to their mobile device or print a copy to bring to the event. 

Special Accommodations: Please contact the LHPC Institute at institute@lhpc.org should you require special accommodations pursuant to the Americans with Disabilities Act.

Cancellation Policy: Cancellation notification must be submitted in writing to institute@lhpc.org seven or more days prior to the course date. Refunds will not be given after that date. Substitutions are encouraged. Payment will be due for registered individuals that do not attend or participate in the event, and for which a cancellation notice is not received.