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


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.


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