Funder Rate Setting and How Providers Can Respond matters because it changes what a BCBA notices when decisions have to hold up in clinical documentation, payer communication, supervision records, and leadership review. In Funder Rate Setting and How Providers Can Respond, for this course, the practical stakes show up in service continuity, accurate reporting, and defensible clinical decisions, not in abstract discussion alone.
Provider: BehaviorLive — via Jade Health
Take This Course →Including ethics, supervision, and topics like this one. New live CEU every Wednesday.
Join Free →Funders of all types (health plans, Medicaid programs, Tricare, and Self-Insured) manage cost through utilization management and rate setting. In this webinar, we will discuss the rationale behind how funders establish rates and how providers can be equipped to successfully negotiate rates.
| Certification Body | Credits | Type |
|---|---|---|
| BACB® | 0 | — |
| COA | 1 | — |
| QABA | 0 | — |
| IBAO | 0 | — |
| BICC | 0 | — |
James was formerly the Corporate Vice President for Autism Services at Beacon Health Options, the largest autism services managed care provider in the US with over 11,000cases and covering 13 million lives. In this role he was responsible for product development, program design and implementation, network strategy and continuous improvement of clinical services delivered to children diagnosed with autism spectrum disorder and their families and supported the Beacon clinical teams throughout the United States. James has held numerous positions in managed behavioral health care including the Director of Behavioral Operations at Accolade, a then start-up concierge company specializing in integrated approaches to support medical and behavioral health decision-making for consumers. Prior to that, he served as General Manager for Behavioral Health at Aetna for the eastern United States where he was responsible for health plans and self-insured customers. In this capacity, James developed the first Autism case management model in fulfillment of the emerging state mandates. James has developed a wide range of behavioral health programs designed to improve quality and effectiveness that have led to behavior change for those with medical and behavioral issues. These have included telehealth coaching, online social media resources and member and provider engagement strategies.
Dig into the research behind this topic — plain-English summaries written for BCBAs.
231 research articles with practitioner takeaways
224 research articles with practitioner takeaways
147 research articles with practitioner takeaways
You earn CEUs from a dozen different places. Upload any certificate — from here, your employer, conferences, wherever — and always know exactly where you stand. Learning, Ethics, Supervision, all handled.
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All behavior-analytic intervention is individualized. The information on this page is for educational purposes and does not constitute clinical advice. Treatment decisions should be informed by the best available published research, individualized assessment, and obtained with the informed consent of the client or their legal guardian. Behavior analysts are responsible for practicing within the boundaries of their competence and adhering to the BACB Ethics Code for Behavior Analysts.