In no other area of our economy do consumers receive services where they do not know the cost in advance and are not able to make comparisons to alternative suppliers. As a result, healthcare provider costs have remained immune from the economic forces that could control them. This immunity has contributed to greatly increasing provider costs, a major component in today’s rising healthcare costs.
The lack of price information stems from the confidential nature of negotiations between providers and payors. Providers compete with each other trying to get the highest payment from payors, and payors compete with each other trying to set the lowest payments to providers. In hopes of getting the best deal, both providers and payors want their negotiated rates to be kept confidential. Information is kept from the consumer that is necessary to make the best choices and drive an improved market.
A transparent cost network is designed to break down this limitation, giving consumers the price information they need to make informed decisions. Payors that can deliver this valuable product offering to consumers will likely gain market share for this lower-cost product.
Join Milliman's Will Fox as he discusses the issues, implications and components of a transparent cost network, and the specific approach and steps involved in implementing the network.
- Explore the strategic and marketplace forces that create the Transparent Cost Network opportunity
- Understand the components and implications of a Transparent Cost Network
- Examine how the relative cost of each provider can be communicated using a single number (the multiplier of the base schedule) and this relativity will apply regardless of the service
- Ascertain the six step approach for implementing a Transparent Cost Network
- Consider how Transparent Cost Networks can align with Medical Homes and Accountable Care Organizations
- Engage in interactive learning through online question submission, attendee feedback and opportunity for follow up questions, and networking with attendees, faculty and other professionals through a dedicated LinkedIn group
- C-Suite Executives
- Provider Contracting Executives and Staff
- Provider Network Executives and Staff
- Strategy, and Planning Executives and Staff
- Consumer Driven and Consumerism Product Executives and Staff
- Product Development Executives and Staff
- Actuarial Executives and Staff
- Business Development Executives and Staff
- Marketing and Business Intelligence Executives and Staff
- Other Interested Parties
Attendees would represent organizations including:
- Health Plans
- Provider Networks
- Hospitals
- Medical Groups
- Consumer Driven Care Organizations
- Third Party Administrators
- Employers
- Government Agencies
- Pharmaceutical Organizations
- Solutions Providers
- Associations, Institutes and Research Organizations
- Media
- Other Interested Parties
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Individual Registration Fee: $195. Audio Conference CD-ROM: $40
for attendees; $285 for non-attendees after the event.
Corporate Site licensing also available. Click here to register or call 209.577.4888 We look forward to your participation in this event! |
Will Fox Principal and Consulting Actuary Milliman |
Will Fox is a principal and consulting actuary with the
Seattle office of Milliman. Will focuses on improving the provider contracting analytics for both insurers and hospitals. This includes: more accurate contract comparisons for both hospitals and payers using a proprietary fee schedule—RBRVS for Hospitals; developing contract provisions that reduce administrative costs by simplifying negotiations and adjudication; tiered network evaluations and creating provider ranking reports; training sessions for negotiation staff. Will developed the HECS™ (Hospital Evaluation and Comparison System) so that clients can create their own reports to benchmark their contracts on a case mix and severity-adjusted basis and benchmark the results vs. operating costs and Medicare allowables. Will believes that insurers and hospitals can work together to reduce the cost of healthcare. He has authored several research reports on provider contracting and is a frequent speaker on the subject for a variety of organizations. In addition, Will has significant experience and proficiency in medical underwriting, rate setting, and underwriting process improvement. He developed the RenewalMUGs software to help health plans improve their renewal underwriting process and has worked with many clients to automate some or all of the underwriting process. Mr. Fox is a Fellow in the Society of Actuaries, a Member of the American Academy of Actuaries, and worked for a major insurance company prior to joining Milliman in 1992. He received his BS, with honors, in Mathematical Sciences from Oregon State University. |
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