2013 FORUM West Workshops
The Institute for Healthcare Consumerism has long promoted our mission statement:
- TO LEARN collectively, think innovatively, and drive change cooperatively with actionable solutions,
- TO CONNECT with forward-thinking experts and industry professionals on leading practices and successful strategies, and
- TO valuable insights and ideas, opinions and research, and more on the latest topics and current trends
……. as a Collective Voice for Innovative Health and Benefit Management and Enlightened Consumerism
For FORUM West 2013, and beyond, our FORUM workshop format will mirror our mission statement. The IHC heard your feedback and is responding by adding a fourth Workshop Track to satisfy early speaker demand AND to respond to FORUM East evaluations feedback. Workshop Tracks will now include two LEARN sessions per track – for introducing innovative solutions (the workshop leaders will usually be vendors), two CONNECT sessions per track – for presenting industry strategies, best practices and case studies (the workshop leaders will usually be users of the services being discussed), and two sessions per track – for open discussions on the most current industry topics of interest (the workshop leaders will usually be employers).
Track # 1 – Workshops
Thursday, December 5th, 2013 • 10:30 a.m. – 11:30 a.m.
LEARN SESSION 101 – Engaging Employees in the Evolving Healthcare Market
As the healthcare market evolves with the growth of high-deductible and defined contribution plans, and health exchanges, employers will look for new ways to engage employees as they bear greater responsibility for their own health care. Prime Therapeutics’ Michael Showalter, an industry leader in CDHPs and private exchanges, will discuss health care consumerism in a post-reform market and more specifically, the value of pharmacy in this new landscape. He will share best practices for engagement, especially relating to pharmacy benefits.
Why is employee engagement so critical in this area? Pharmacy is the most commonly used health benefit with approximately 10.8 member touch points annually compared to a health plan’s average 1.5 touch points. The pharmacy benefit represents a growing percentage of overall medical spend and is utilized by a high percentage of an employee population. Cost drivers include brand name drugs, specialty drugs (complex biotech drugs), and the prevalence of chronic disease.
Come join in the discussion and LEARN, too!
Speaker: Michael Showalter, Chief Marketing Officer, Prime Therapeutics
LEARN SESSION 102 – Obamacare Search and Rescue: Search for HSAs and Rescue your Clients
This session explores strategies for employing political intelligence to explain plan design changes with EB clients. Learn the legislative and regulatory reasons why HSAs will be available in the Exchanges and the private market for the foreseeable future from the ABA’s top healthcare lobbyist and from one of the industry’s top brokers.
Speaker: J. Kevin A. McKechnie, Executive Director, ABA HSA Council
CONNECT SESSION 103 – Bringing a Mobile Retail Experience to Health Care
Consumers are taking on more of the burden of navigating today’s complex health care system, including understanding eligibility, co-payments, co-insurance, multiple bills, EOB’s and other payment-related aspects of care for themselves and their families. Managing the administrative side of even simple procedures can drag on for months and become a time-consuming, exhausting drain. This session will include:
- Extensive qualitative research on current obstacles to consumers taking control of their care
- Specific feedback on support and tools needed by consumers
- A demonstration of a secure, consumer-facing app that answers consumers’ needs
Join the discussion about a simple mobile app that cuts out complexity and confusion and brings a retail experience to health care; Consumers’ benefits are verified instantly and out-of-pocket payments can be made at time of service, enhancing productivity and reducing costs for all stakeholders.
Speaker: Hanny Freiwat, Business Co-founder and President, Wellero, Inc.
CONNECT SESSION 104 – Five Chronic Wellness Program Problems and How to Beat Them
Despite the surge in wellness program popularity, there hasn’t been an equal surge in healthier employees. So if your wellness program results are disappointing, you’re not alone. And your problem is most likely found in our short list of the most common wellness program flaws. Fortunately, these flaws are easy to diagnose, avoid and correct. Learn how to address barriers to engagement and ROI, whether your wellness program is up and running or in the planning stage.
Included in this session:
- How to perform a quick wellness program quality check
- Key components of a successful wellness program
- Experience the fun side of wellness, as a participant
SESSION 105 – The Evolving Relationship between Broker and Employer and How to Benefit the most from a Partnership
Four of the nation’s top brokers and advisors share a five-to-seven minute update on the ever-changing market and how they are evolving to meet those changes as well as their clients’ needs – impact of exchanges; involvement with ‘population health’; emergence of tools to help ‘consumers/employees’ such as ‘transparency solutions’; health care consumerism which embraces all of this. An interactive discussion with the attendees and panelists will conclude theSESSION.
Moderator: Bill Gibson, Vice President, National Sales, New Benefits
Panelists: Don Cooper, President, TriFlex Corporation, Scott Wood, Principal, Benefit Commerce Group, Donna Joseph, CEO and co-founder, Rhodes-Joseph & Tobiason Advisors, and Jim Skinner, President, JMS Benefit Solutions, L.P.
SESSION 106 – Empowering Employees to Shop for Healthcare Services
As employees pay a higher percentage of their own healthcare and desire to become more informed decision-makers, employers are clamoring for better healthcare shopping and transparency tools. In fact, in a poll conducted during a HealthSparq webinar, 100% of Health Insurance executives attending the event stated that they feel pressure from employers to provide better transparency tools to their employees. This session explores how to create a partnership between Health Plans and Employers to bring innovative solutions to employees. You will leave with a deep understanding of healthcare transparency, the priorities for both Health Plans and Employers, and a checklist of what to look for in transparency solutions to empower healthcare shopping.
Speaker: Scott Decker, President, HealthSparq
Track # 2 – Workshops
Thursday, December 5, 2013 • 2:30 p.m. – 3:30 p.m.
LEARN SESSION 201 – What Happens When the Peeps Have the Keys?
Your first night out as a teenager was nerve wracking for your parents, but guess what… you came home safely and the car was still in mint condition. Employers have become paternalistic in their efforts to control population health. But these days, people are taking control of their own healthy behaviors. And they’re doing it for themselves, not for their boss or HR director. Employers need to learn to “hand over the keys” of wellness to their employees for maximum results, understanding that individuals are ready to handle their own health decisions. At this workshop, hear what it takes for an employer to bring about a culture of health led by employees, not from the top down, and learn about the benefits they see when the employees own their solutions and successes.
Moderator: Brian Berchtold, Director of Business Development, hubbub
Panelists: Rod Reasen, President, Healthiest Employer®, LLC
LEARN SESSION 202 – Online Benefits Marketplaces – More Than Just Health Insurance!
As many private benefit marketplaces (exchanges) move into their second and third years of operation, what products and services are they offering to their members? In this session, attendees will learn what benefit marketplaces are designing for launch in 2014/15. Hear about how integrating enrollment and administration services with elements designed to drive behavioral change are being deployed to improve transparency in healthcare costs, advance the healthcare consumerism trend, and drive consumer value.
CONNECT SESSION 203 – It’s Not Cost – Why Care Transparency Matters More!!!
Cost transparency is necessary but not sufficient to drive consumerism! Unnecessary or ineffective care purchased at the best price doesn’t impact health or financial outcomes. This session will help you understand how leading companies are promoting "care" transparency and helping employees evaluate and choose effective care/treatments for their situation. You will learn how to integrate cost information into care transparency tools and help employees have educated conversations with their providers about effective care/treatment options.
CONNECT SESSION 204 – At the 10th Anniversary of HSAs, Here’s What’s Ahead! – Panel Discussion
This session will take a retrospective look at the evolution of consumer-driven health care as we near the 10th anniversary of Health Savings Accounts from some of the early players in the industry. The panel will discuss lessons learned and provide perspective on barriers to future growth and maturity of the consumer-driven market.
Moderator: Roy Ramthun, Founder, HSA Consulting Services, LLC and "Mr. HSA"; Former Senior Health Policy Advisor to President George W. Bush
Panelists: John Young, CEO, Consumerdriven, Mike Parkinson, Principal, P3 Health LLC ("Prevention, Performance, Productivity") and William J. West Jr., M.D., Senior Vice President, Business Development, HealthEquity
SESSION 205 – Health Care Access: When You Want It, How You Want It
Our evolving U.S. health care system poses new challenges for access to quality and affordable care, when such care is most needed. This is particularly true for those suffering from – or at risk for – chronic disease. While an era of “Obamacare” in theory offers much promise for Americans in need of health care, those who are in immediate need, those who are chronically ill and those living in areas where health care professional shortages exist are likely to face new barriers to access appropriate and timely care, given current and emerging market dynamics and trends.
This workshop offers the opportunity to discuss access barriers and innovative solutions to the challenges we face in quality, affordable and timely health care access. It also provides insight into novel and strategic ways employers and employees can approach health care in a more individualized, cost-effective and efficient manner, putting the consumer of health care back in the driver’s seat.
Moderator: Ron Bachman, Chairman, Editorial Advisory Board, The Institute for HealthCare Consumerism
Panelists: Alan Roga, M.D., FACEP, Founder and Chief Executive Officer, Stat Health Services, Sunil S. Budhrani MD, MPH, MBA, CEO, CareClix Telemedicine, Ling Shao SVP Strategic Solutions, American Well
SESSION 206 – How to Engage Employees to Become Better Consumers of Healthcare
Your company may have the most efficient health care plan, technology or innovative wellness strategy. But if your employee engagement rate is at or below 10 percent does it really matter? In this SHARE session, top thought leaders around the country will showcase tools, best practices and communication strategies guaranteed to help employees make better, more informed health care choices that reduce costs and improve the quality of care. Active interaction between the panelists and attendees is encouraged.
Moderator: Ben Sommers, Regional Vice President, Castlight Health
Panelists: Diana M. Andersen, SVP, Director of Corporate HR Benefits, Zions Bancorporation, Charity Trujillo, Manager of Benefits and Compensation, Allegiant Travel Company, Sam Shallenberger, Chief Financial Officer, RJ Young Company, and Jennifer Forster, HR Director, Buffalo Exchange
Track # 3 – Workshops
Thursday, December 5th, 2013 • 3:45 p.m. – 4:45 p.m.
LEARN SESSION 301 – Consumer Engagement: The Key to a Successful Exchange
Public and private insurance exchanges are new and evolving. Though it remains to be seen what shape they will ultimately take, it is clear that consumers moving onto any type of exchange will require a range of tools to support their healthcare decision-making. Whether provided by the plan sponsor or carrier, the following tools are critical for consumers as they take on more responsibility for their care:
- A comparison tool that makes it easy for consumers to understand and compare benefit plan designs
- A treatment cost calculator that provides out of pocket cost estimates for anticipated services, procedures, and preventive care for chronic conditions
- A multi-channel personalized messaging solution to help consumers be proactive in finding ways to save money, manage their chronic conditions, and stay healthy
LEARN SESSION 302 – Ingenuity to the Rescue. Employers Seize Control.
Accountable care, bundled payments, consumerism, disease management, transparency, cost-shifting — the solutions proposed to fix health care are deceptively ineffective and will not achieve employers’ healthcare goals. Employers who want health improvement, higher productivity and lower costs must seize control – NOW. And PPACA provides the way!
- Business productivity is declining. Employers starting to take over healthcare; seeing productivity increases
- While healthcare is essential, caring about health is ecstasy. An employer blueprint for a fresh focus on wellness.
- Surreptitious solutions that employers desperately need, and PPACA has made possible!
Speaker: R. John Kaegi, Chief Corporate Strategist, Healthstat, Inc.
CONNECT SESSION 303 – Beyond 2014: Defining Your “Whole Workforce” Under Obamacare
As the key tenets of the Affordable Care Act become reality, the way people get benefits will evolve — whether slowly or quickly is yet to be seen. What is certain is that the way employers view their employee benefit programs will need to evolve as well. From new eligibility requirements to managing benefits for retirees, employer considerations will become more complex. But with the advent of private exchanges, many are hopeful that advances in technology will simplify the processes required for managing more complex benefit programs. Join Shan Fowler, Director of Marketplaces at Benefitfocus, to learn how private exchange interfaces combined with public exchange connectivity can create a whole workforce solution for employers offering a multitude of benefits across all segments of their employee populations.
Speaker: Shan Fowler, Director of Marketplaces, Benefitfocus
CONNECT SESSION 304 – ACA Compliance & Strategies Update – Open Discussion
This session’s goal is to give attendees additional time to get their many questions answered on “Health Care Reform and Compliance Issues”. Following his participation as a key panelist from the General Session under the same title, Alston + Bird LLP legal expert John Hickman will field your questions and give you an inside look at the implications of PPACA’s impact on consumer directed health. He will be offering practical, actionable strategies your company can use immediately to be compliant with ACA regulations. The discussion will be directed toward health care reform and compliance issues relevant to attendees. Bring your questions!!!
Speaker: John Hickman, Partner, Alston + Bird LLP
SESSION 305 – Healthcare Transparency – Our Journey or Just Some Far-Off Destination?
In July 2009, Paul B. Ginsburg and Nicole M. Kemper wrote in an article for Health System Change that:
“Greater transparency in health care reflects the confluence of two major trends. One is a development throughout society that institutions need to operate in a more open and accountable manner. The other is the health care consumerism movement, which envisions consumers assuming more responsibility for and control over their health and health care. To move from the vision of health care consumerism to reality will require credible and accessible information on……. dimensions of cost and quality.”
Health care transparency means providing consumers with the reliable cost and quality information necessary to choose health care providers based on value. Reliable information empowers consumer choice; Consumer choice creates competition and incentives at all levels, and motivates the entire system to provide better care for less money. Those involved in America’s health system are embracing Consumerism and Transparency; ………And by doing so, we are creating a powerful force for change. But how will we know when we have arrived?
More recently, in a study done by the Deloitte Center for Health Solutions, their executive director, Paul H. Keckley, PhD, said “About 53% of consumers are oblivious to costs and tend to go along with whatever is suggested.”
Come hear from leading Employers on what they are doing and SHARE your thoughts on healthcare cost and quality transparency!
Moderator: Doug Field, CEO, The Institute for HealthCare Consumerism
Panelists: Torben Nielsen, General Manager, HealthSparq, Dr. Scott Conard, Chief Medical Officer, Compass Care Engineering, Compass Professional Health Services, Clayton Nicholas, VP, Strategy and Marketing, Change Healthcare Corporation, and Donna Smith, Executive Director of Business Development, FAIR Health
SESSION 306 – Pharmacy Benefit Management – The Value to Employees / Consumers Can Be Significant!!!
The transition is nearly complete – prescription drugs that use to be insignificant in cost and paid for straight from the patient’s own pocket are now paid for by third parties, almost exclusively. The reason – Rx accounts for more than 20% of total health care costs, and is rising. With the almost simultaneous transition to an age of healthcare consumerism, employees / consumers are now responsible for at least a portion of this expense and they are now exposed to a rising personal expense.
Pharmacy Benefit Managers, or PBMs, act as intermediaries between payors, usually insurance companies or large corporations, and everyone else in the health care system. They generally make money through service fees from large customer contracts for processing claims for prescriptions, operating mail-order pharmacies, and negotiating discounts and rebates with pharmacies and drug makers. Until recently, the value of PBMs has been to help their larger clients 1) control and cut pharmacy costs and 2) increase the efficiency of operations, including claims processing and reimbursement management.
PBMs have evolved from processing prescriptions at pharmacies to taking over the entire drug benefit portion of health plans. Today approaching 90% of all Americans get their pharmacy benefits through a PBM. As part of their evolution, the larger PBMs are moving beyond being just administrators and are working to offer new services, such as utilization and disease management, to help clients’ employees manage spending.
Join us and share your thoughts!
Moderator: Michael Showalter, Chief Marketing Officer, Prime Therapeutics
Panelists: Susan Hayes, Principal, Pharmacy Outcomes Specialists, Zachary French, Executive Vice President, Sales & Marketing, Citizens Rx, LLC, Chuck Gamsu, R.PH, MBA, Vice President, Envision Rx Options, Hilary Hanson, Supervisor of Health Management, Hormel Employee Benefits, Hormel
Track # 4 – Workshops
Friday, December 6th, 2013 • 10:30 a.m. – 11:30 a.m.
LEARN SESSION 401 – Saving Employers Money – One Back Surgery at a Time
One of the end goals of healthcare transformation is cost savings. According to the World Health Organization, musculoskeletal conditions rank as the number one burden of disease worldwide due to prevalence and cost. However, mounting evidence documents that when the first line of treatment is non-invasive care, the cost of care can be significantly lowered.
Known for its non-drug and non-invasive approach to care as the first step toward optimal spinal health, chiropractic care has been reported to reduce the likeliness of surgery by 28 percent, when used as the first line of treatment for musculoskeletal conditions. Furthermore, in a cost analysis, patients under chiropractic care experienced 40 percent lower costs per episode versus those under medical care.
In the U.S. alone, annual costs associated with musculoskeletal conditions exceed $100 billion – with two-thirds citing a result of lost wages and productivity. Employers need a novel approach to better manage these troublesome conditions. This session will not only provide information and documentation of how to achieve cost savings but also validation of better outcomes and patient satisfaction.
Speaker: Dr. William Meeker, President, Palmer College of Chiropractic-West Campus
LEARN SESSION 402 – Modernizing Your Health Plan: Proven Solutions to Engage Employees with their Health through Programs & Tools
Today employers are taking steps to use their benefit plans and programs to achieve both improvements in health decisions and population-level engagement that reduce plan costs in ways CDHPs alone cannot achieve. These employers with modernized health plans have plan costs 25% lower than employers with traditional plans. Join us to hear how employers can modernize their health plans and how, when combined with effective communications and engaging consumer tools, drive significant changes in consumer decisions and plan costs.
Speaker: Craig Hankins, Vice President, Consumer Engagement Products, UnitedHealthcare
CONNECT SESSION 403 – Creating Connections that Last; Effective Financial Wellness Programming.
Effective wellness programs flourish in organizations grounded in a wellbeing culture and an environment rich in healthy opportunities. Most organizations do not start here or may not have adequate funding for the Cadillac of programs. So how does an organization learn to connect the essential dots?
It is important to understand what personal value and messaging will capture HR staff, connect employees, and drive individuals to action. Inherent in improved financial wellness rests intrinsic motivators such as savings accumulation, debt reduction, and an improved feeling of control. This reinforcement promotes sustainability, integral to the successful outcomes of a Financial Wellness Program.
One size does not fit all. Key to the program is the fostering of Champions, diversified offerings, dynamic marketing and program analysis. Maximizing precious staff resources and personalized counseling will create breadth and expand reach. Monitoring and analyzing your population’s responsiveness to marketing along with judicious use of interest and readiness assessments will aid in targeting early adopters. Join us for this dynamic class and learn how to create, analyze and sustain connections within your organization.
CONNECT SESSION 404 – Defined Contribution, Version 2014
It’s almost 2014 and, for benefits enrollment purposes, we’re there. As expected, Defined Contribution continues to be an immensely popular strategy for employers to establish control and predictability in their health care spending, engage employees in broader health considerations, and leverage private health insurance exchanges for more consumer flexibility and choice. The Defined Contribution strategies, theories and predictions we have discussed over the past few years are becoming real world experiences as we speak. What has been a great idea for future consideration and some limited early adopters is now being launched, tested, tweaked and applied to trend lines. ‘Mainstream adoption’ includes the full spectrum of employer sizes and types, and well proven is the fact that one size does not fit all. Let’s take a look at what we have learned so far from the employers, employees and various stakeholders in the Defined Contribution supply chain, and what we envision for ‘version 2015’ to come.
Speaker: Heather Andrews, Vice President of Enterprise Partner Development, Evolution1, Inc.
SESSION 405 – Exchanges or Marketplace? Whatever it’s Called, Get to Know it
Exchanges or Marketplaces are trending in health care. The ultimate in health care consumerism, private exchanges – group, individual, retiree – will be up and running in time for this year’s open enrollment. State- and federally-run exchanges begin Jan. 1, 2014. The exchanges will change the way Americans acquire health coverage and how employers offer coverage. ThisSESSION will focus on what exchanges are, their value and viability and how employers, brokers, advisors, TPAs, and consumers can benefit from exchanges. Active interaction between the panelists and attendees is encouraged.
Moderator: Doug Field, CEO, The Institute for HealthCare Consumerism
Panelists: Josh Hilgers, President, Health Partners America, Dr. John Reynolds, Chief Executive Officer, Cielostar, Shan Fowler, Director of Marketplaces, Benefitfocus and Terry McCorvie, President, WealthCare Marketplace Solutions, Alegeus Technologies
SESSION 406 – Building Better Consumers of Health Care and Health
Your employees are not children. They want to be treated like adults and make their own decision about their health care choices. However, if they do not have the proper education and decision-support tools they may not be able to make the best choices when it comes to getting care. In thisSESSION, some of the top thought leaders in the nation offer tips and provide tools on how to create better more educated consumers of health care. Active interaction between the panelists and attendees is encouraged.
Moderator: Sander Domaszewicz, Principal, Mercer