Speaking

Total Cost of Care—a new financial analysis tool available to consultants and employers—will usher in a new era of clarity around the true cost and performance of health care providers and institutions. Broad PPO network that include 85% of all physicians and 92% of all hospital beds in the US will be under pressure as the new analytics and narrow/high performance networks highlight the inefficiencies and savings opportunity. The shifting tectonic plates will likely trigger a change in value propositions for broad PPO networks as they struggle to keep pace with the cost savings of high performance networks and more effective/selective insurance carrier networks. Lessons learned from the historical shifts in networks and financing of care apply to the coming changes, which are triggered by the increasing transparency of costs and quality.

Audience:Health Care & Coalition Audiences

Measurable improvement over obesity prevalence—and the associated co-morbidities—for employer workforces has been illusory for mid to large-sized employers. Years of expenditures on wellness programs, weight loss programs, and a variety of physical activity tracking devices—these were all pushed with monetary (or other) incentives. But does the data tell us what these herculean efforts—and massive expenditures—have produced? Compare and contrast the successful performance of recent obesity treatment protocols (i.e. Obesity Rx and Bariatric Surgery) against the traditional wellness programs. And learn the necessary benefit design to include these emerging and effective treatment protocols.

Audience:Health Care & Coalition Audiences

Since the HMO’s fall from grace in the late 1990’s, employer focus on health plan cost management has leaned towards the “Demand-side” of the equation. Wellness programs, incentives, and increasing engagement are themes that have all dominated employer discussions within benefit design and strategy meetings. However, the “Supply-side” of the equation is gaining an audience—quickly. The question employers are asking is: “Do my employees really need 90% of all health care providers in a network – and what is the cost of that freedom?” The increasing transparency of health care costs and quality is quickening the pace of this rebalancing of the equation. Over the next few years, employers will integrate wellness program into their health provider network—narrowing access to a subset of existing networks. Health care providers and networks must adapt or risk obsolescence.

Audience:Health Care & Coalition Audiences