2018 Agenda

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Breakout Sessions

Supply Side Reorganization - Total Cost of Care: Can a Member Truly Be a Consumer?

12:00 pm - 12:50 pm Oct 29, 2018

Room 305 AB

Speakers
Description

The last 20 years of wellness, engagement and cost transparency tools has failed corporate America by most measures. Not for lack of effort - but rather due to structural realities in the health care supply chain- and the financing mechanisms behind it. Clear, demonstrable, longitudinal data sets show the history of these failures and the multiple iterations of various vendor/trends that have attempted to stem the health care cost tide. This session will highlight the flaws behind many of the historical missteps and how we may be at the precipice of real health care change due to "big data"; and the organization of care around this data. TPA's, insurance carriers and consultants have access to data that can demonstrate the "total cost of care" for a population and more specifically, which health systems are more effective in treating/keeping patients healthy. For the first time since the days of the HMO, the "supply side" of the health economics equation is getting in the mix. Moreover, the data/technology, and incentive structure may align to give these organizations a real shot at success. The data is being used currently to create high performance/narrow networks across the United States. Employer sponsored health plans/HR Executives will be faced with tout questions about access vs. costs for their employee populations Ð as these new networks tout significant savings while sacrificing some choice/freedom from the typical PPO style network. The emergence of high performance/narrow networks in the last few years shows a completely different approach to disease/clinical risk management. Further, as these networks begin to take actual financial risk via performance based reimbursement payments, there appears to be a large shift in the risk mix in health care financing. This will likely trigger a complete rethinking of employer vendor mix in the wellness/engagement space as the clinical side begins to take ownership of these areas. We will use data and case studies to quickly demonstrate the "edge" of this trend and how employers need to prepare themselves in the coming years.

Tag

  • Complexity
Intermediate
  • Continuing Education
Self Insurance Certification Specialist®
  • Industry Niche
Self-Funding
  • Session Type
Breakout Sessions