Private fee-for-service (PFFS) plans are the most popular and controversial
Medicare Advantage products. The private fee-for-service plans were primarily
developed for rural areas with poor coverage; however, the reimbursement structure
has made them popular with all regions with current enrollment estimated at
1.3 million. Succeeding in the Medicare PFFS Market will take an in-depth
look at the rapid growth of the Medicare private fee-for-service specifically
focusing on effective benefit design strategies and compliant marketing efforts
required when developing a PFFS product.
In this 90-minute webinar, you will hear proven cases studies from healthcare
leaders: Daniel C. Lyons, senior vice president government programs for
Independence Blue Cross, and Barth Kevin, vice president of operations
for Veridign Health Solutions, who will give first-hand accounts on how
their organizations have successfully implemented private fee-for-service
plans and gained market acceptance from providers, brokers and beneficiaries.
Formal presentations will be followed by an approximately 30-minute
Q&A to answer your most pressing Medicare private fee-for-service
questions.
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Daniel C. Lyons has been a key contributor to the health insurance
industry for the past two decades, following a distinguished career in
clinical practice. He serves as Senior Vice President, Government Programs
for Independence Blue Cross, a large regional health insurer in southeastern
Pennsylvania. In his role, Dan is responsible for IBC's insured government
and social mission programs. These include Medicare Advantage, Medigap,
CHIP, and AdultBasic insurance programs, and the Caring Foundation social
mission activities. Collectively these programs provide comprehensive
benefits to over 500,000 members through a variety of health plan options.
He serves on a variety of industry councils, is a member of the Board
of Visitors of Temple University School of Medicine, and holds a federal
appointment to the CMS Advisory Panel on Medicare Education, which he
also Chairs. Dr. Lyons holds a Master's Degree in Public Health from
the Medical College of Wisconsin, an M.D. degree from Temple University,
and a B.A. from the University of Virginia. During his clinical career,
he was a board-certified family practitioner and geriatrician, practicing
in central Pennsylvania. He served on physician quality committees for
several health plans, and was a physician reviewer for Pennsylvania's
QIO.
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Kevin Barth is the Vice President of Operations for Veridign Health
Solutions. Kevin is responsible for the oversight of all operational
areas, including member and provider services, account implementation,
claims payment, and systems development and production.
He leads a cross-functional team of business and IS professionals in
defining, developing, and successfully implementing PFFS products & processing
capabilities for both insured and ASO markets.
Prior to joining Veridign Health Solutions, Kevin worked for CIGNA Corporation
in a variety of executive positions, most recently as the Vice President
of Customer Service. In this capacity, he was responsible for a wide
range of operational activities, such as account implementation and management,
call center operations, claims processing, premium accounting, site consolidation,
and information systems. Over the course of his career, Kevin has led
a number of strategic reengineering initiatives in both operations and
sales that produced significant improvements in customer satisfaction
and productivity. He also served with distinction in the United States
Marine Corps.
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