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2016 TPA Summit Schedule




 

 Schedule at a Glance as of 6/23/16

speakers and topics subject to change


Wednesday, July 13th, 2016

11:00am - 5:30pm - Registration - Grand Ballroom foyer 

1:00pm - 1:45pm - Conference Opening

Welcome, Opening Remarks, Conference Overview
Carol Berry, CEO and Tim Callender, Emcee

Award to Outgoing President, Additional Introductions & Notices
Steve Rasnick, HCAA Board President and Julie Wohlstein, HCAA Immediate Past President


1:45pm - 2:45pm - Opening Session - Mike Ferguson, SIIA

Positioning the Self-Insurance Industry as a More Effective Advocacy Force

This session will highlight current initiatives in the areas of media outreach, political contributions, lobbying, litigation and grassroots mobilization designed to position the self-insurance industry as a more effective advocacy force at both the federal and state levels.  Updates will also be provided on timely legislative, regulatory and litigation developments affecting TPAs and other companies involved in the self-insurance marketplace.

 
2:45pm - 3:15pm - The State of HCAA - presented by Steve Rasnick, HCAA Board President

 

 







3:15pm - 3:30pm - BREAK


3:30pm - 5:00pm - Session Paths


Leadership and Marketing/Sales Paths

Selling Your Brand - Lost Opportunities to Tell Your Story

panel presentation by: Rich Mousty of Unified Group Services, Bruce Flunker of Employee Benefit Solutions and Juli Barcelona of Barcelona Creative



In an age where online and digital forms of communication seem to have taken over, continuing to establish your TPA brand has never been more important. It’s easy to dismiss traditional forms of marketing your organization, as well as ways to improve and enhance the experience that existing and prospective clients and broker partners may have with your brand. Your ability to provide effective marketing tools before, during and even after the sales process can mean increased opportunities for your TPA and better relationships with clients and partners.


Operations Path

Discovering Stop Loss Policy Pitfalls Before They Become Your Problem - presented by Bruce Carlson, CP Consultants, LLC and Kurt Ridder, Spectrum Underwriting Managers, Inc.





A high percentage of stop loss challenges are the result of misinterpreted policy obligations and risk characteristics at the group level.  As stop loss advances into the future, we can expect regulators to further expand oversight of stop loss policies.  As a result, insurance companies will more tightly define their exposure to risk through changes in underwriting and policy provisions.  While this evolution will create a variety of new reinsurance options including shared corridors, fixed-cost reimbursement schedules, and captive utilization, it will also require additional expertise from brokers and TPAs.  In this session, you will gain an understanding of the items reference above from an industry expert witness and consultant.  These insights will help you maximize your clients’ self-funded plan performance. 
 

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

 

Thursday, July 14th, 2016

7:30am - 5:30pm - Registration - Grand Ballroom foyer

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

8:30am - 8:45am - Welcome and Notices - Tim Callender, Emcee

8:45am - 10:15am - Keynote - Connie Podesta, Connie Podesta Presents, LLC

Lead Like You Mean It!

Successful people are great influencers. They know how to get consensus, ownership and buy-in from the people who count–without manipulation, intimidation, sacrificing relationships, or stepping on toes. Bottom line: Getting the job done the right way hinges on your ability to “sell” yourself, your products, your services, and your ideas in such a trusting and positive way that people will CHOOSE to: Follow your lead. Cooperate with you. Learn from you. Buy from you. Partner with you. And…SUPPORT you so you can get the job done right! With a rare blend of laugh-out-loud humor, uncanny insight into human nature, interactive delivery style and killer persuasive strategies, Human Relations expert and author, Connie Podesta, will take you right inside the minds of the people you need to influence and impress. You will learn how to negotiate differences, influence behaviors, change attitudes, overcome objections, and “close the deal” so you can create an amazing network of PEOPLE who have one common goal: to willingly help you provide the best service possible! This session is guaranteed to make your life easier and your customers happier. Now that’s a win-win for everyone!!

  

10:15am - 10:30am - BREAK

10:30am - 12:00pm: General Session - Connie Podesta, Connie Podesta Presents, LLC

The Power of Personality and Communication to Increase Engagement 

Imagine what you could accomplish if you could decode the mystery of human behavior and truly understand what makes people do what they do and say what they say (including yourself!) Research shows that the #1 key to SUCCESS is the ability to get along with other people. At work and at home.

Bottom line: how you choose to relate to, communicate with, be accountable to, resolve conflict with and garner respect from other people will directly impact your ability to attract and sustain healthy relationships so you can lead, manage, sell, produce, collaborate, work as a team, enjoy life, stay healthy, be happy and....experience success that you desire.


 
12:00pm - 1:30pm - Lunch and HCAA Business Meeting - City View - Steve Rasnick, HCAA Board President

 

1:30pm - 2:30pm: Session Paths


 

Leadership and Marketing/Sales Paths


Medicare Bundled Payments and the Commercial Marketplace - 
presented by Paul T. Gallese, PT, MBA, and Dr. Bill Bithoney MD, FAAP, The BDO Center for Healthcare Excellence & Innovation

CMS has recently introduced a new method of reimbursement for certain orthopedic procedures where providers will be reimbursed based on the longitudinal cost of care and outcomes, rather than on a unit cost basis.  This type of provider reimbursement is also being promoted by some commercial insurers, but has not yet become mainstream in the TPA space.

This session will provide the basics of the concept and what is required in order to reimburse based upon quality rather than pure cost.  It is designed not only to educate TPA’s but also to stimulate a thought process about how their current Population Health tools could be used to facilitate a Value Based Reimbursement approach.



Operations Path

New Cracks in an Unstable Wall - the Impact of Health Care Reform on Fraud & Abuse - presented by Karen Schwabacher, Schwabacher Health Insurance Consulting, Inc.


An engaging, enlightening and yet disturbing effect of the Affordable Care Act (ACA) is  that there are new opportunities for increased Health Care Fraud & Abuse.  This session will illuminate new ways that have been found that fraudsters can penetrate an already overburdened system.  We will provide and discuss pro-active solutions to avoid unnecessary payments and the litigation that ensues, when the absence or the inadequacy of claims investigation occurs; no one wins, except the attorneys.

You don’t want to create a cycle where you are defending a payment that has no defense! The identification of this phenomenon is essential in order to be postured proactively.  We will discuss specifics, including “live” cases, and provide attendees with not only identifiers, but guidelines and preventive tips.

 

2:30pm - 3:30pm: Session Paths


 

Leadership and Marketing/Sales Paths

Population Health & Data Analytics as a Sales & Renewal Tool
presented by Nancy Blough and Mike Goodman, American Health Data Institute


Historically, TPA’s have differentiated themselves from carriers based upon the efficacy of the self funded financing methodology and world class claims payment and customer service.  Today, however, self funding has universally grown in popularity because of the Affordable Care Act, so much so that carriers have introduced their own small group ASO products.  At the same time, world class service is expected of every credible payor and has become far less important to customers unless you screw it up, and then it becomes the most important service we provide; so we all work hard not to screw it up.  How, then, do we differentiate ourselves from our competition?  This session will explore these differentiators.

 
Operations Path

Improving TPA Operational Efficiencies through Better Use of Technology, Streamlined Processes, Increased Adjudication Quality and Better Risk Management

presented by Karen Schwabacher, Schwabacher Health Insurance Consulting and Rodney Gagne, National Underwriting Services

Third party administrators continue to be challenged with the improvement of their operations while simultaneously reducing costs, managing vendor relationships, managing data requirements, dealing with regulatory oversight, providing service for a higher volume of customer service calls, managing escalating costs of catastrophic claims, dealing with fraudulent claims activity and provider overreach with billing practices.  Operational managers are faced with prioritizing these difficult issues. These challenges impact each organization’s staffing and training needs. IT resources are a vital component for solving most issues faced by organizations today.  Ongoing decisions must be made regarding how to optimize internal IT resources and maximize vendor resources to offset programing costs.  Panelists will facilitate discussions between attendees of this session to ascertain which best practices can be utilized and the most effective strategies to tackle these problems. 

3:30pm - 3:45pm - BREAK

 

3:45pm - 5:00pm: Session Paths


 

Leadership and Marketing/Sales Paths

ACO Marketplace and Direct to Employer Provider Sponsored Community Health Plans

presented by Steve Rasnick, Self Insured Plans, LLC Jack Hill, Accountable Care Solutions Group and Dr. Allan Walls, Healthone80 

The current healthcare system positions the insurer and their offerings as the “product”. It also has the insurer as the “consumer” in its role of paying the medical provider for services provided to plan participants, based upon a provider reimbursement schedule that the carrier feels is “fair and equitable.” This historical model created a perverse economic purchasing model which has led to over utilization of medical services, increasing premiums and a total lack of transparency.
 
It is our belief that the true “product” is the medical provider and that the true consumer is both the plan participant and their employer. The business of healthcare delivery is a local business and provider sponsored “products” offered directly to the community will be a much more effective model. Purchasers of healthcare service desire a transparent process where quality is as important as price and only high quality, local healthcare providers can fulfill both requirements.



Leadership Path

Who Are You Becoming as a Leader? - presented by Jonathan Fanning, Jonathan Fanning Consulting

A year from today, will you be a better leader… or not?  The answer affects every aspect of our lives. Who are you BECOMING?  introduces the four pillars the greatest leaders all have in common and a simple formula for enhancing these pillars in your own life and organization.  Jonathan shares “The Simplest and Most Effective Leadership Development Plan”, borrowing powerful and practical lessons from the greatest people developers in all walks of life.  This program applies to you, whether you lead a company, non-profit, team, family, or just yourself.


 5:30pm - 7:00pm - Reception - City View

 

Friday, July 15th, 2016

7:30am - Noon - Registration - Grand Ballroom foyer
 

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

8:30am - 8:40am - Welcome and Notices - Tim Callender, Emcee

8:40am - 10:10am - General Session - Why Not a TPA?









 

panel presentation by: Tom Doney, Cypress Benefit Administrators; Ed Jacobson, Entrust, Inc., Dave Reynolds, Capitol Administrators, Larry Thompson, POMCO moderated by Joseph Hodges, INETICO, Inc.

The value proposition of a TPA over the years has been that they pay self-funded claims effectively and efficiently, provide world class customer service and are great marketing organizations.  Building on these core skills some TPA’s have greatly expanded their core value proposition and have become involved in much more than claims payment, while becoming enormously successful.

This session will pull together four industry visionaries that have built uniquely successful and multi-faceted TPA organizations who will share the “secret sauce” behind their success.
 

 
 10:10am - 10:30am - BREAK

10:30am - 11:30am - General Session - John Barlament, Quarles & Brady, LLP

Hot Legal Issues for TPAs and Employers

Join us for this informative session on the latest legal updates in the health and welfare plan area.  Third party administrators (TPAs) are primarily responsible for helping self-insured employers comply with numerous regulatory requirements.   This session will summarize key legislative/regulatory developments in 2016 that TPAs need to understand in order to effectively provide service to self-insured employers. 
 


11:30am - 12:00pm - Closing Remarks and Adjourn

Tim Callender, Emcee and Steve Rasnick, HCAA President

 

5353 Wayzata Blvd. Suite 350
Minneapolis, MN 55416

Phone: 888.637.1605
Fax: 952.252.8096
Email: hcaainfo@hcaa.org

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