CD-ROMs of past events

 Upcoming Events

Track A: Industry Trends 

Ten Things to Know About Health Care Cost Trends

Bradley C. Strunk, Health Research Analyst

Center for Studying Health System Change

Provides a description of recent health care cost trends and provides analysis of the drivers of those trends.   

Providing Health Care Benefits in a Challenging Time: Recent Data Findings

Rich Ostuw, Senior Consultant

Towers Perrin

This presentation draws on recent plans and actions of large U.S. employers compiled through Towers Perrin surveys over the past 6 months. Findings from both the "TP Track" Health Care Survey and the 2003 Health Care Cost Survey will be highlighted. We will focus on the implications of this data for employers and what steps employers can take to cut costs and engage employees in health benefit decisions.

The State of the HMO Industry

Eric D. Coburn, Principal, 

Shattuck Hammond Partners LLC, 

The Shattuck Hammond Partners' Report is part of an ongoing series of reports on the HMO industry. The Report focuses on financial performance, trends, valuation, merger and acquisition activity and industry highlights primarily among the publicly-traded managed care industry, but also in the private and provider-sponsored sectors. It is a single source to know what is going on in managed care.

Cost Trends & Care Management, 2002 Market Survey Highlights

Geoffrey Baker, President

MedVantage

This presentation reviews overall medical expense trends, employer and healthplan responses, disease management program adoption, and discusses in further detail, the impact of disease management on commercial medical expense trends. 

Benchmarking to Manage Administrative Expenses

Doug Sherlock, Senior Health Care Analyst

Sherlock Company

This talk will focus on the Sherlock Expense Evaluation Reports, including their background and process, the financial metrics included, some of the financial metric results, the operational metrics included and some of the operational metric results. The studies analyze approximately four hundred expense / product cells and provide approximately 130 operational metrics.

Past, Present and Future, Evolution of the Health Plan through 2012

William J. DeMarco, President & CEO

DeMarco and Associates

This presentation is designed for newcomers to the managed care industry as well as veterans who are contemplating the long term vision for strategy expansion and resource planning of their organization. The participants will be able to link the original HMO movement to the transition to managed care and the moving targets of integration. In its future form managed care is driven by employers and physicians. This includes landmark legislation now proposed and a major change from provider reimbursement to health status based population based reimbursement. If properly linked local delivery systems may find an advantage in returning to community based health plans.

Pivot Points: Employer and Plan Solutions Most Likely to Moderate Costs

Arnold Milstein MD, MPH, National Health Care Thought Leader, Mercer Medical Director, Pacific Business Group on Health

This summary presentation addresses employer and plan solutions to managing costs in terms of "pivot points", and discusses incentives for consumers, cost insulation for highest risk consumers, and quantified projections of the premium impact on various consumer engagement pivot points.

Responding to the Challenge of Rising Health Care Costs: Employer and Health Plan Strategies
Robert Galvin, MD, MBA
Director, Global Health Care, General Electric Company

This presentation briefly examines various market based employer and plan approaches towards managing rising health care costs, with particular emphasis on engaging consumers and providers.

Track B: Case Studies

Tiered Networks / Tiered Benefits

Sam Ho, SVP & Chief Medical Officer

PacifiCare Health Systems

A discussion of PacifiCare's new tiered network and benefit strategy: starting with the current environment and consumer-aligned health care, and performance measurements including the Quality Index profiles, which serve as a platform for PacifiCare's new products. The presentation concludes with an overview of PacificCare's new Value Network product.

Direct Contracting, The Next Evolution of Managed Care

Max Jack, President & CEO

Direct Health Networks, Inc.

This presentation examines problems with the traditional insured managed care marketplace, and discusses the advantages of self insuring and direct contracting strategies, and briefly examines benefit design, disease management and actuarial issues.

The Hospitalist Movement: The Quiet Revolution in Healthcare

Joe Miller

Independent Healthcare Consultant

A first of its kind survey was conducted to determine the impact of hospitalist programs in a defined healthcare community, the state of Massachusetts. The results were surprising, indicating that hospitalist programs are already part of the mainstream of healthcare delivery in the state. This presentation will review the results of the survey research and characterize the hospitalist movement in Massachusetts -- past, present, and future.

The Continuing Evolution of an IPA: Hill Physicians Medical Group

Steve McDerrmott, CEO

Hill Physicians Medical Group

Update on current goals and initiatives of this large IPA-model medical group.

Self Funding: Emphasis on Benefits and Costs

Dan Rhodes, Vice President, Sales & Marketing

Delta Health Systems

This presentation will explain how self-funded employers can emphasize the Benefits of their health plan and still address key Cost issues. Self-funding allows employers to take back control of their benefit plans by offering customized benefit plans and service to its employees. Self-funding eliminates health plan high overhead and profit margins, while custom reporting combined with benefit and network design options provide opportunities to identify and control key cost drivers.  This presentation includes a case study of a California employer that chose to switch from an HMO benefit program in 2002 to a self funded program in 2003. The presentation concludes with some of the features and services available through a third party administrator (TPA).

A Case Study in Health Plan Responses: Wellpoint

Dana E. McMurtry, Vice President, Health Policy & Analysis 

WellPoint Health Networks Inc.

This presentation discusses current costs trends, the challenges it presents to serving health plan customers, Wellpoint's strategic responses to these challenges, and future issues to address.

Tiering Approaches for Health Plans: Incentives and Information for Consumers

Allan Baumgarten

A. Baumgarten and Associates

This presentation provides discussion and summary information regarding numerous examples of tiered provider network initiatives undertaken by health plans in the California and Minnesota markets.

Track C Provider Issues

The Disease Management Value Equation: Reducing Costs, Improving Quality

Vince Kuraitis, Principal

Better Health Technologies

Describes the purchaser market shift toward demanding VALUE in health care; Reviews the evidence: DM as a cost savings tool, DM as a quality improvement tool; and Predicts next generation DM business and clinical models: value creation opportunities.

Benchmark Study - Empowering physicians to improve quality

Paul M. Katz, President

Intelligent Healthcare

The Benchmark Study collected and benchmarked medical groups and IPAs on quality, cost, utilization, and access care measures. The results show that physicians can improve their quality and reduce costs by making better use of information to anticipate the care needed by their patients.

Provider Reimbursement

Catherine M. Murphy-Barron, FSA

Milliman USA

This presentations discusses some of the new methods of provider reimbursement; successes and failures; and the future.

eVisits Benefit Patients, Physicians and Payors

Jerry Reeves, President and CEO

WorldDoc, Inc.

More than 110 million Americans use Internet for health information. More than 75% of US physicians use Internet in their practices. A recent Harris Poll of U.S. adults using Internet found that 90% want online communication with their doctor and 37% are willing to pay for it out of pocket. This presentation provides a case study of WorldDoc Inc., offering employees secure online eVisits combined with self-directed interactive health decision support developed by physicians. 

Using carve outs, reinsurance and data analysis to manage healthcare costs

Charles Crispin, President

Evergreen Re

This presentation addresses the scope of involvement in capitation by hospitals and physician groups, and reinsurance ramifications.  Trends and issues including carve outs and data analysis are discussed.

The Results are In: webVisit a Win for Doctors, Patients and Payors

Eric Zimmerman, Vice President, Product Marketing

RelayHealth

The presentation will review the findings of a landmark independent study of doctor-patient online communication and discuss the impact of payor-reimbursed "webVisits" on patient satisfaction, physician satisfaction, and overall cost of care.

Track D  Consumer Centric Issues

Roundtable Discussion on The Impact of Increased Consumer Cost Sharing

Moderator: Claire Thayer, Vice President Research and Development

MCOL 

Various members of the faculty exchange perspectives on key questions regarding the impact of increased consumer cost sharing.

Consumerism Drives Disease Management Initiatives

Laura Carabello, Principal

CPRi Communications

The trend toward consumer-driven healthcare is impacting the DM industry. Consumers are taking on more responsibility for self-care management, appropriate utilization of resources, and a broader role in disease management initiatives. The DM industry is supporting these strides and in turn, delivering greater value to their employer and health plan customers.

Designing and Implementing a Consumer-Driven Health Care Strategy for Cost Containment

Linda Cushman Ruth, Senior Health Care Strategist

Hewitt Associates

This 80 slide presentation discusses the current cost increase and managed care environment, and then addresses designing and implementing a consumer-driven health care strategy, and other plan design considerations as well, for cost containment. Numerous case studies are explored. 

Scope of The Health Care Cost Challenge

Professor James C. Robinson
University of California, Berkeley

This presentation addresses the short and long term drivers behind health plan cost increases, the decline of managed care and the emergence of consumer oriented health care.