Session 1  |  December 6, 2023
Session 2  |  December 12, 2023
1:30 – 3:00 p.m., Pacific Time​
An LHPC members-only program

Registration is now closed.

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 
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.

Session 1 Agenda

The Rate Development Black Box —​ Understanding the RDT
December 6, 2023 | 1:30 – 3:00 p.m.

• 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

Session 2 Agenda

Operational Implications for the RDT
December 12, 2023 | 1:30 – 3:00 p.m.

• 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

Faculty

Afzal Shah
Chief Financial Officer
L.A. Care Health Plan

Afzal Shah is a credentialed actuary with expertise in Medi-Cal rate setting, risk-adjustment and risk-sharing methodologies. His work has focused on provider reimbursement, contracting strategy and value-based purchasing. Afzal has more than 27 years of strategic health care experience with Medicaid and Medicare products and has served as Vice President for Actuarial Services at Health Net and Centene, giving him knowledge about the Los Angeles County market.

Afzal holds a bachelor’s degree in physics and mathematics from Franklin & Marshall College in Pennsylvania. He earned a master’s degree in applied mathematics from the University of Southern California.

Registration

This is an LHPC members-only program.

Fees* (per connection)
Individual session                    $40
Full series                                $80
Plan series registration^       $180
*Special registration pricing will be offered while health plan staff work remotely. Standard pricing will resume once staff return to work
on-site.
^ Select this option if plan staff will view the webinars communally on-site. Plans with multiple sites must register each site separately and identify whom at each site should receive the webinar access information upon registering. When registering, please enter unique email addresses for each additional site as the system may not allow duplicate logins.​

Registration closed Nov. 30 at 5:00 p.m.

Registration Confirmation: Registrants will receive two emails — a registration confirmation email and a separate email that contains access information for the webinar. 

Participating in the Webinar: You will only need a computer with an updated web browser (Google Chrome, Microsoft Edge, Mozilla Firefox or Safari are recommended). Participants may opt to listen to the webinar via telephone or device. 

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.