Payer-Provider Roundtables | Kisaco Research

Payer-Provider Roundtables

Engage in focused, small-group discussions where payers and providers connect over specific topics, share perspectives, and explore solutions from both sides—offering a balanced, holistic view of key challenges and opportunities.
  • Price Transparency 4 Years In: Navigating Compliance, Challenges, and Opportunities for Providers and Payers
    Join us for a dynamic roundtable at the Healthcare Payment and Revenue Integrity Congress, where providers and payers will explore the impact of price transparency. Led by Dave Cardelle (SIIA Price Transparency Committee), the session will examine key challenges and strategies around the CMS Final Rule on Hospital Price Transparency and TiC MRFs, four years on. Discussion topics include compliance, penalties, costs, rate setting, contract negotiations, and using transparency data for analysis. Don’t miss this chance to share insights and shape the future of price transparency.
    Dave Cardelle, Chief Strategy Officer, AMS
  • Payment Integrity 101
    Join us for Payment Integrity 101 at the Healthcare Payment and Revenue Integrity Congress, a foundational session designed for those new to or expanding their role in payment integrity. This session will break down the key components of payment integrity, from pre-pay to post-pay strategies, common fraud, waste, and abuse (FWA) schemes, to how plans and providers can align on reducing improper payments. Whether you're building a team, refining your approach, or just starting out, this session offers a practical roadmap and terminology primer to help you navigate the space with confidence.
    Simi Binning, Responsible AI Lead, HCSC
    Charlie Jensen, Head of Payment Integrity Strategy,  Blue Cross Blue Shield, Illinois

  • Provider Contracts Uncovered: From Fine Print to Financial Power

    Contracts are more than legal fine print. They decide whether your organization thrives or just survives. In this session, we’ll pull back the curtain on contract language, expose common traps that drain revenue, and share negotiation tactics that actually move the needle. Expect real talk, practical tips, and a fresh look at how providers can flip contracts into cost-containing, revenue-protecting assets.

    Quick-Hit Takeaways
    Spot the traps: Know the clauses that cost you most.
    Negotiate smarter: Tactics payers don’t want you to know.
    Stay compliant: Align terms with today’s rules.
    Think strategic: Make every contract work for your bottom line.

    Maya Turner, Executive Managing Director, Turner Expert Consulting Services, LLC

Session Topics: 
Medical Cost Containment
Sponsor(s): 
Machinify
AMS Intelligent Analytics
Speaker(s): 

Author:

Maya Turner

Owner/Executive Managing Director
Turner Expert Consulting
... read more

Maya Turner

Owner/Executive Managing Director
Turner Expert Consulting

Author:

Dave Cardelle

Chief Strategy Officer
AMS
... read more

Dave Cardelle

Chief Strategy Officer
AMS

Author:

Charlie Jensen

Head of Payment Integrity Strategy
Blue Cross Blue Shield, Illinois
... read more

Charlie Jensen

Head of Payment Integrity Strategy
Blue Cross Blue Shield, Illinois

Author:

Simi Binning

Responsible AI Lead
HCSC

Simi Binning is an accomplished healthcare professional with over a decade of experience in developing and executing successful strategies that drive business growth. Currently serving as a Responsible AI lead at HCSC, her focus is on AI governance and innovative problem solving.

... read more

Simi Binning

Responsible AI Lead
HCSC

Simi Binning is an accomplished healthcare professional with over a decade of experience in developing and executing successful strategies that drive business growth. Currently serving as a Responsible AI lead at HCSC, her focus is on AI governance and innovative problem solving.

Session Type: 
General Session (Presentation)