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2015 Executive Forum Schedule


 Schedule at a Glance

speakers and topics subject to change

Monday, February 9th, 2015

12:00pm - 5:00pm - Registration - Encore Ballroom foyer 

5:30pm - 7:00pm - Welcome Reception - Encore Ballroom


Tuesday, February 10th, 2015

7:30am - 5:30pm - Registration - Encore Ballroom Foyer

8:00am - 8:30am - Breakfast & Networking - Encore Ballroom

8:30am - 9:00am - Welcome and Opening Remarks

9:00am - 10:30am: Keynote 

A Physician-Senator's Look Into the Crystal Ball of Healthcare Reform

presented by: Hon. William Frist 

In this presentation, Senator Bill Frist, M.D. will take a look into the crystal ball of health care reform. What will happen over the next six months…and the next five years?  From Appeals Court rulings impacting exchanges, to employer mandates to changes in the reimbursement system, Senator Frist has been in the forefront of those willing to address the controversial decisions and to propose solutions.

10:30am - 10:45am - BREAK

10:45am - 11:40am: Session 

ACA Requirements and Actionable Data

presented by: John Barlament, Quarles & Brady, LLP

Is your head spinning from trying to keep track of all the latest legal rules (much less, all the prior ones) for health plans and TPAs?  Join us for this informative session where John Barlament will go over the 2015 “Calendar”, hit the hot buttons that you need to on top of and go over where we are today and where we have come from.   You can take your copy out of your conference bag and follow along as we describes how 2015 will affect you, and your clients.

11:40am - Noon - HCAA sponsor service and product updates

Noon - 1:00pm - Lunch

1:05pm - 2:05pm: Session 

Will the Long Term Impact of ACA Expand or Shrink Self Funding?

presented by: Tim Jost, Law Professor and Commentator

The primary goal of Congress in enacting the Affordable Care Act was to extend health insurance coverage by reforming the individual and small group markets.  The ACA will also, however, profoundly affect the large group market, which is largely self-funded. The employer mandate, for example, may increase large group coverage, but access of employees to public exchanges or the 2018 Cadillac coverage tax may cause large group coverage contraction.  Growth in private exchanges, an indirect effect of the ACA, may encourage insured rather than self-funded coverage.  The ACA could, on the other hand, encourage self-funded coverage among small employers, as self-funded small groups face fewer regulatory requirements than insured groups.  This presentation will explore the many and varied effects that the continued implementation of the ACA may have on expanding or shrinking self-funding of group health plans.

2:05pm - 2:35pm - HCAA sponsor service and product updates

2:35pm - 3:30pm: Session 

Applying Alternative Risk Strategies to Stop Loss Underwriting Solutions

presented by: Gary Hudgins, Prodigy Health Insurance, Doug Thomas, Northwind, John Youngs, Prodigy Health Insurance, Barbara Tomlin, RGA Reinsurance

Learn tools and techniques for tackling stop loss underwriting challenges and improving your Client’s health plan policy performance.  Identify exposures created by ACA and Plan document language which if not aligned with the stop loss policy will negatively impact the client’s health plan performance.  Gain a greater grasp of new proven underwriting techniques and alternative risk strategy solutions that can help you more effectively manage your client’s risk tolerance.  

3:30pm - 4:00pm - BREAK

4:00pm - 5:00pm - Breakout Sessions

A: Medicare Reference Based Benefits Plans - "What a Difference a Year Makes, or Does it?"

presented by: Jim Farley,  J.P. Farley and Steve Rasnick, Self Insured Plans, LLC

2013 was a watershed year for the emergence of medical benefit plans where reimbursements were predicated upon a percentage of Medicare rather than a PPO schedule. Although similar plans were in existence for many years, in 2013:
The demand for price transparency increased.
Third party vendors providing patient advocacy and legal defense matured and began to proliferate the marketplace;
Employers demanded more cost effective benefit plans, and
The interest in self funding exploded, due in great part to its ability to implement and sustain creative new programs like Medicare Reference.

B: Emerging Technology Implications for the Improvement of Population Health Outcomes

presented by: Dr. Ashish Abraham, Altruista Health

Technology is now a catalyst for forever altering the magnitude of population health management effectiveness.  Historically, care management has been fragmented, utilizing a retrospective approach with older technical tools to drive population health initiatives. With the integration of electronic medical records, biometrics, clinical episode criteria, claims payment platforms and the internet – not to overlook the impact of mobile phones -- payers can be fundamentally light years ahead of the way care management programs have ever been administered before.

5:00pm - 5:30pm - Attendee free time

5:30pm - 7:00pm - Reception and Membership Longevity Awards


Wednesday, February 11th, 2015

7:30am - Noon - Registration - Encore Ballroom Foyer 

8:00am - 8:30am - Breakfast & Networking - Encore Ballroom

8:30am - 8:40am - Welcome and Opening Remarks - Encore Ballroom

8:40am - 9:35am - Session

How Strategic Planning Blends Passion, Achievement & Wealth

presented by: Ernie Clevenger, CareHere, LLC

Strategy can be planned (i.e. NASA) or be emergent (i.e. Russian Space Program).  This session explores the merits of each by looking at why it takes 10,000 hours to be the ‘best’, un-corking creativity, understanding the end of ‘competitive advantage’ … and foremost, remembering that passion drives and relationships are precious.

9:35am - 9:55am - BREAK

9:55am - 10:50am - Session

How to Boost Your Brand

presented by: Russ Krueger, Ocozzio

Never has competition for TPAs been more challenging than today. How does one differentiate themselves from competitors?  A TPA can't claim we have better service ... we care more ... we pay claims faster ... etc. A TPA must demonstrate they have the means and tools to assist a health plan in accomplishing its goals.  Everyone wants to reduce or control their “spend” while improving the overall health of their population. How does a TPA convince a health plan they can do this? Job one is to have a clearly stated point of difference.  Most TPAs are trading on the same strategy and tactics they began with years ago. There is a better, more effective way.

10:50am - 11:45am - Session

Affordable Care Organizations and Third Party Administrators - Changing the Future Landscape of Healthcare

presented by: Jack Hill, Accountable Care Solutions Group and Dan Holets, Consultant

Are Accountable Care Organizations creating concerns over account retention?  Have they figured out “the secret sauce” for controlling health care costs?  As this delivery model expands it is creating a significant opportunity for Third party Administrators.  If we remove the ACO label and focus on capabilities, then most TPAs are already equipped to deliver these services today.  At the Forum, experts from the TPA and managed care fields will demonstrate how TPAs are already applying many of these principles.  As attendees, you will gain insight into creating immediate opportunities along with resources to help get you started.

11:45am - 12:15pm - Prize Drawings (must be present to win)

12:15pm - 12:25pm - Closing Remarks and Adjourn








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