Concurrent and Breakfast Session Tracks
These dynamic sessions feature organizations that provide
leading products and services to help with reform implementation. These sessions showcase innovations, strategies, and solutions for your business and operational challenges.
Tracks Include:
Consumer Engagement Strategies to Drive Sustainable Consumer Behavior Change | Leveraging Data, Information, and Analytics to Streamline Operational and Administrative Processes | New Technologies Transforming Health Care | Alternative Care Delivery and Payment Models that Promote Value, Efficiency, and Quality | Innovative Health Insurance Plan Strategies, Models and Products for a Post-Reform Environment | Compliance Track: Building Your Compliance Capabilities
Consumer
Engagement Strategies to Drive Sustainable Consumer Behavior Change |
- What is
the role of incentives in consumer engagement?
- How are
companies designing benefits that promote employee engagement and accountability?
- How can
companies create a consumer experience that enhances member satisfaction and
retention?
Reconciling the Great Healthcare Consumer
Paradox: Are Consumers Willing to Change to Get What They Want?
Presented by Accenture
Join Accenture and a leading health plan for a
discussion on the next generation of Consumerism and Consumer Engagement.
With an expanding ‘Retail’ health care marketplace, there is a greater
opportunity for health plans to develop innovative strategies to reach
consumers entering this marketplace for the first time. It will be critical for
plans to effectively engage these new consumers and assist them in making good
health care decisions. More than half of employers say that lack of engagement
is their biggest obstacle to changing their employees’ health habits. This
session will explore the approaches and barriers to effective engagement, and
discuss how one health plan has transformed to give consumers what they want.
- Steven C. Nelson, Senior Vice President, Health Services Strategy, Product, &
Marketing, Highmark
- Jean-Pierre Stephan, Senior Executive, Health CRM, Accenture
Incentive Tracking... A Health Plan Case Study
Presented by HealthTrio, LLC
Many health plans are using incentives to encourage consumers to participate in health management programs and alter unhealthy behaviors. An incentive tracking service can provide plans with a platform to track financial and non-financial rewards for members who have completed wellness, prevention or other designated activities. In this session, you will hear how an incentive tracking service has helped a leading health plan streamline its reward disbursement process.
- Bob Trombly, Deputy Chief Information Officer, Harvard Pilgrim Health Care
Redefining Healthcare Through Shared Decision
Making
Presented by Health Dialog Services
Corporation
With the shift towards patient centeredness and more accountable care, time and
resource-constrained doctors are embracing new models for delivering and
organizing care. In this session, hear how one of the country’s leading
non-profit health plans is redefining the doctor-patient relationship through
the practice of Shared Decision Making. By combining state-of-the-art patient
decision aids with focused discussion on treatment options and patient
preferences, quality of care improves, costs are reduced, and patients and
providers experience renewed satisfaction with the system.
- Paul Sherman,
MD, MHA,
Executive Medical Director for Health Plan Services & Medical Director
for Care Systems Development, Group Health
- Peter Goldbach,
MD,
Chief Medical Officer, Health Dialog
Driving
Toward Wellness: The Road to Success
Presented by Amylin
Pharmaceuticals
This
session will highlight a real-life example of a successful diabetes health care
program that addressed the problem of unsustainable health care costs and
disengaged consumers. Learn from the decisions made by multiple stakeholders
who worked together to achieve their most important common goal: the well-being
of patients and consumers. You will leave with a better understanding of how
consumers can reduce their health care costs, and what steps companies can take
to help them.
- Gary L. Moffitt, MD, Owner, Arkansas Occupational Health Clinic
- David W. McKinney, MD, MPH, Chief Executive Officer, California Occupational
Medical Professionals
- Richard Kersch, President, Human Factors Analytics, Inc.
Don’t Forget About Direct: Building a Best in Class Telesales Capability
Presented by Deloitte Consulting, LLP
Health Insurance Exchanges are a critical marketplace for many health plans’ future growth strategies, but telesales will continue to be an important direct distribution channel long after 2014. This session will present a model for the telesales organization of the future, one that has the capabilities and scale to support the complex and varying demands of customers in the individual marketplace. Content will focus on executable best practices for developing or enhancing a telesales organization and will include talent, incentives, flexible work arrangements, and alternative delivery models; processes, operating models, and performance management; technology platforms and data integration; and multi-channel considerations.
The
New Era of Customer Communications – The Journey Begins Here
Presented by Thunderhead.com
Supporting the customer journey within health insurance
is complex, competitive, and becoming much more regulated. As health insurance
plans evolve from what was once a primary business-to-business sales model,
with a transactional claims adjudication focus, to a personalized
consumer-oriented sales and service model, the need to meet or exceed customer
expectations will become more critical. This presentation will provide insights
on the key trends, issues, and implications for payer communications
approaches, and a look at the payer best practices that are yielding the
biggest impact to customer experience. The speakers will also discuss
opportunities to positively impact both customer satisfaction and
administrative costs by changing approaches to member communications.
- Dean Heckman, Solution Architect, Thunderhead.com
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Leveraging Data, Information, and
Analytics to Streamline Operational and Administrative Processes |
- How are companies aligning health IT initiatives,
business strategies, and reform priorities?
- What are strategies for leveraging disparate data
sources for clinical analytics, risk management, and driving business
decisions?
- What are strategies for improving timeliness, transparency
and accuracy in claims processing?
Real Data, Real Impact: Claims Processing and the Business Case for Improving Adjudication
Presented by OpenConnect
This session will highlight the results of a recent survey examining claims processing and provide insights on market solutions that can improve efficiencies in key metrics. The panel will use the survey data as the basis for a business case discussion that also demonstrates the benefits of claims adjudication for the consumer. A sample of the data points surveyed include: electronic vs. paper claims; claims processing and receipt times; adjudicated claims, and audited claims.
- Jeff Lemieux, Senior Vice President, Center for Policy and Research, AHIP
- Edward Peters, Chief Executive Officer, OpenConnect
Risk
Adjustment Strategies for Health Insurance Exchanges
Presented by Inovalon
Risk adjustment has been used
for years in managed care for reimbursement. With the arrival of health
insurance exchanges, risk-based contracting requires the implementation of risk
adjustment programs. There will be similarities and differences in the models
and strategies for achieving risk score accuracy. Best practices from years of
experience in risk adjustment may be applied with modifications for the unique
requirements of the health insurance exchanges.
Care
is the New Core. Population Health Strategies Drive Better Care Coordination
and Better Member Outcomes
Presented by DST Health
Solutions
In today’s continually evolving healthcare landscape,
health plans must be proactive in their efforts to dramatically improve
coordination and quality of care. Imagine if a health officer had access to
real-time information on the health status and care patterns by neighborhood or
by leveraging EHRs linked to smart devices, a medical director could identify,
monitor and improve the care of tens of thousands of persons with chronic
diseases. This is a new era in population health. Join this insightful and
relevant panel discussion where industry experts share trends and best practice
approaches to population health management that are enhancing care
collaboration in the community they serve.
Industry Survey Offers Insights for 2013
Planning
Presented
by Emdeon
Each year leading researchers assess the top priorities
and challenges for health plans in the coming year through an annual survey
initiative. The results of this research contribute a health plan voice to the
public health care dialogue, the industry's dynamic challenges and enable
payers to benchmark their organizations against the industry as a whole. This
session will offer insights into this year’s
survey results with a focus on the dynamics of this unique period of time for
the health care industry. Learn about the ongoing shifts in health plan
priorities and operational challenges; the response and perspectives on the
Supreme Court ruling and recent elections; perspectives on ACOs and other
payment reform initiatives; and updated insights on how Health Information
Exchanges and Health Insurance Exchanges could impact health plans business.
- Alan
Abramson, Senior Vice President of IS&T and
Chief Information Officer, HealthPartners
- Kathleen
Bennett, Chief Information Officer, Geisinger
Health Plan
- Tom
Carleton, Director of Strategic Development, Blue
Cross Blue Shield of North Carolina
- Ferris
Taylor, Director, Managed Care Executive Group
(MCEG)
- Nancy
Wise, Vice President of Strategy, HTMS, an Emdeon company
Leveraging Advanced Analytics to Understand and Influence Member Behavior
Presented by SAS
As the health care landscape evolves, health plans should consider managing their operations by employing methods from other successful consumer-focused industries. These industries utilize a myriad of consumer data along with advanced analytics to understand customer preferences, attributes and behaviors. Health plans could achieve this same level of sophistication while adhering to HIPAA and other health-care specific guidelines by incorporating non-traditional member data along with similar advanced analytics solutions. This session will explore the benefits to health plans of engaging continuous-learning software and refreshed data to refine their business proposition, predict and guide member behavior, and further understand and manage risk.
- Arjun Aggarwal, Managing Director, Healthscape Advisors LLC
- John Steele, Managing Director, Healthscape Advisors LLC
- Dipti Patel-Misra, Senior Manager, SAS’ Center for Health Analytics & Insights
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New Technologies Transforming Health
Care |
- How are mobile monitoring technologies improving care
for individuals with chronic conditions?
- How is social media transforming the patient experience
and increasing consumer engagement?
- What new apps and gaming strategies are enhancing the
care continuum?
- What are strategies for leveraging modern technology
platforms to meet 21stcentury business goals?
Fad or Tipping Point: The Impact of Exchanges on Employer-Based Health Plans
Presented by bswift
In this session, you'll learn about the forces driving employer interest in private exchanges, predictions about the long term staying power of exchanges, and which types of exchanges are most likely to succeed. The panel will compare and contrast different exchange approaches, and weigh the issues that carriers must consider when determining which and how many exchanges to engage.
- Vince Ashton, CEO, HealthPass New York
- Craig Hasday, COO, Frenkel & Company, International Insurance Brokers
- Paul Wingle, Head of Exchange Strategy and Implementation, Aetna
Provider/Patient Texting: The Promise and the Peril
Presented by 3pTALK
Text
messaging is a dominant form of communication that most providers and many
patients, especially the younger demographic, are increasingly familiar with.
On the one hand it provides us with a powerful new communication tool to
supplement provider portals,
email and social media. Yet, several barriers exist to actually using it for
communications between providers and patients or between providers. Are texts
taken as seriously as more formal forms of communication? Can it be made secure
and HIPAA compliant? Do providers really want ability to let patients text them
indiscriminately? Are payors willing to underwrite the time and communication
expenses? Join panelists representing
the various constituencies for a lively debate on the promises and perils.
- Ravi Ganesan, Founder, 3pTALK (Moderator)
Creating
Optimal Customer Service Programs, Post-Reform
Presented
by Sykes Enterprises, Inc.
This session
will explore the full range of customer care programs from sales, enrollment,
general customer service, provider care and telehealth and discuss how to adapt
customer service for the post-reform environment. The discussion will provide
insight into customer care delivery strategies for each type of care that will
accomplish the goals of creating outstanding customer service experiences. You
will learn what individual plan members and providers can expect from their
customer service experience, when to consider outsourcing customer service, and
how virtual service models can be applied.
- Mike Clarkin, Senior Vice President of Marketing, Global
Contact Centers, SYKES Enterprises
Beyond Accountable Care
Organizations: Creating the Accountable Care Consumer
Presented
by Dell
Health care reform to date has focused on providers,
health plans, and funders of care, but only incremental attention has been paid
to the stakeholder at the center of care—the individual consumer. This
session will focus on the future of the consumer, including how data can be
leveraged to accelerate genetic analysis and identify targeted treatments for
individual patients. The speakers will also examine how health insurers are
embracing incentives, data analytics, social media, and mobile health
applications, to engage consumers and build a broader partnership for
accountable care.
- Robert Teague,
MD, Physician Advisor, Dell Services Healthcare &
Life Sciences
- Andy Arends,
Practice Leader, Dell Services Healthcare & Life Sciences
Connecting to State and Federal Health Insurance Exchanges - Opportunities and
Challenges
Presented
by hCentive, Inc.
The upcoming state health insurance exchanges
present a new channel for health plans to market their products on a grand
scale. However, integrating internal IT systems with disparate state and
federal insurance exchange systems is likely to be challenging. The ability to
deliver a seamless online insurance shopping experience to millions of
consumers will require a reliable solution that can facilitate health plan
integration with state and federal exchanges. This session will highlight key
requirements for enabling effective collaboration among insurers and different
state/federal agencies. The speakers will discuss the scope and magnitude of
technology integration tasks necessary to operate in the new Exchange model.
You will hear about business strategies and solutions that address the
challenges of adequately interacting with state/federal exchanges and minimize
the impact of federal rulings to your existing services and technical
infrastructure.
The
Next Wave: Five-Steps for Adapting to Constant Change
Presented by HealthEdge
The payor industry is currently in the midst of an era of
unprecedented upheaval. While this level of change is generally tied to new
industry regulations (ICD-10, HIPPA 5010) and the adoption of next-generation
healthcare business models (HIEs, P4P, ACOs), it is now clear that this is just
the beginning. Payors that want to be successful in the new healthcare economy
will need to find ways to leverage modern technology platforms to meet their 21st
century business goals. Business as usual is no longer a viable option.
Even if an organization is not currently planning on engaging in
next-generation business models, it is not immune from the need to evolve. How
do you prepare? This session will explore the reality of constant change, and
provide a five-step roadmap that payors can use to ensure that they are ready
for the new normal.
- Ray Desrochers, Executive Vice
President, HealthEdge
Strategic
Solutions for Health Plans: Technologies
that Drive Cost Efficiencies, Consumer Satisfaction, and Improved Health
Outcomes
Presented by Hewlett-Packard
In
this ever-changing health care environment, health plans must confront evolving
and still-uncertain regulatory requirements, tough new competition, tighter
controls on administrative costs, and the continued dramatic shift towards the
empowerment of healthcare consumers. Surviving and succeeding in this dynamic
environment requires health plans to undertake rigorous evaluation and adoption
of new business models, new processes, and a promising array of next-generation
technologies. This session will address the crucial role technology can and
will play in how health plans adapt and succeed, and how next-generation cloud
computing and mobility solutions are one promising solution to better engage
consumers. These new technologies can help health plans gain efficiencies to
provide anywhere/anytime connectivity across their value chain.
- Paul
Thompson,
Commercial Healthcare Strategy Director, U.S. Health & Life Sciences
Industry, Hewlett-Packard
- Larry
Schmidt,
Chief Technologist, Americas Health & Life Sciences Industry, Hewlett-Packard
Leveraging Technology and Designing Financial Incentives to Drive Sustainable Behavior Change
Presented by Walgreens
This session will explain how technology can increase patient access to vital specialty and infusion services while enabling patient health care decisions that improve clinical outcomes and decrease treatment costs. The discussion will primarily focus on how technology is shaping the specialty and infusion pharmacy landscape. The speaker will address how information systems integration across retail and specialty pharmacies can lead to better patient outcomes. The speaker will also highlight how advancements in data analytic techniques can be used to discover savings opportunities benefiting both patient and payer within health plan medical claims. Attendees will also learn how technology enables specialty utilization management programs to influence physician prescribing decisions.
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Alternative Care Delivery and
Payment Models that Promote Value, Efficiency, and Quality |
- How are data analytics being utilized to support
payment reform initiatives?
- What technologies enable companies to maximize
population health strategies for better care coordination and member
outcomes?
- What are critical operational considerations for
implementing payment reform strategies that improve care for Medicaid
populations?
Optimizing Your Network to Improve Clinical
and Cost Performance
Presented by Optum
Provider networks are a critical driver of health plan
efforts to improve clinical and cost performance. By developing optimized
networks, plans can help physicians and other practitioners move from volume to
value and contribute to higher standards of care for their patients. This
session will outline the components of an optimized network and demonstrate
best practices in narrow network management.
Moving
from Volume to Value: Smart, Point-of-Care Decision Support to Align Payers and
Providers
Presented by McKesson Health
Solutions
As the healthcare industry continues the transition to
care delivery and reimbursement strategies that recognize value over volume,
payers and providers are collaborating in new ways to move discussions into
action. Taking a fresh look at how decision support tools used at the
point-of-care can open up new avenues for the payer-provider partnership. These
tools are now blending an array of clinical and financial information to inform
decisions that better position providers to manage risk for patient
populations, while aligning care delivery and care reimbursement in the pursuit
of true healthcare value. This session will outline various approaches to
enabling point-of-care decision support while defining their underlying
technologies.
- Matthew Zubiller, Vice
President, Decision Management, McKesson Health Solutions
Analytics to Support and Evaluate Payment Reform Initiatives
Presented by
Truven Health Analytics
This isn’t the first time around for payment reform. New data and analytic tools now available will improve the
opportunity for successfully changing the delivery system. This session will
examine
how simple models based on robust data can provide a baseline for monitoring,
measuring and improving ACO and Bundled Payment performance. You will learn
about the tremendous variation in patterns of post
acute care following bundle anchor events, including the differences in
patterns between commercial and Medicare populations. Also important is
the system-to-system variation in readmission rates and use rates of Skilled
Nursing Facility, Home Health and Inpatient Rehab services for selected acute
payment bundles among peer hospitals. The speakers in the session will also
provide insight into emerging methods used to support real-time point-of-care
decisions, proactive patient care interventions and retrospective process and
system-of-care performance improvement.
- Bob Kelley,
Senior Vice President, Center for Healthcare Analytics, Truven Health Analytics
Member-Centric Optimization: The Missing Link to Successful Returns on Case & Disease Management
Engagement
Presented by SDLC
Partners, LLP
Learn how to maximize your investment in member outreach
and care management capabilities by further refining populations based on
unique member health risk, their motivations to change and preferred
intervention programs that return the most
value. This session will provide insight into the missing link regarding
case and condition management by going beyond gaps-in-care and cost triggers to
include consumer behavioral/preference, outreach effectiveness, and
volume/capacity data to augment care plan compliance using the most efficient
and effective means necessary (e.g. web/fulfillment, nurse, integrated voice
response, etc.). The speakers will provide real-world, practice applications of
how to take your health risk data and do another round of automated,
member-centric stratification to feed your care management platforms, increase
outreach effectiveness and reduce care management cycle times.
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Innovative Health Insurance Plan
Strategies, Models and Products for a Post-Reform Environment |
- What are next generation benefits that lower premiums
and demonstrate value?
- How do companies make the transition from wholesale to
retail?
- How can companies succeed in the new state-based,
private marketplace?
How the Medicare Advantage Risk Adjustment Experience Can
Help Your Commercial and Medicaid Business
Presented byMatrix Medical Network
Organizations that are able to get the most out of
prospective assessments are able to achieve substantial value for risk
adjustment initiatives and increase care optimization. This session explores
the inner workings of this vital part of maintaining any well run health plan
and how to gain the most value out of your assessments.
• Improve care coordination
• Reduce medical costs
• Increase member retention
• Enhance overall revenue management
- Christopher
Vojta, MD, MBA, MSCE, Managing Partner, Vojta and
Associates
5 Fundaments of HealthCare
Economy – Making Commerce Conversational
Presented
by PaySpan, Inc.
As the industry shifts to
quality-based reimbursement, payers will need to be able to assemble claims
across multiple providers into episodes of care. Payments will be delivered
based on the efficacy of patient care quality and desired outcomes, as opposed
to the conclusion of a care event. Payers must engage providers in a dialogue
about financial and clinical interactions to generate richer data sets and
smarter business processes to support conversational commerce. This session
will provide deeper insight into the economic rewards of efficient and
effective care, value in the funding and reimbursement flow, and sustainability
of the benefits that members depend upon.
- Bill Nordmark,
Senior Vice President, Sales and Marketing, PaySpan. Inc.
- Glendon Schuster,
Senior Vice President and Chief Information Officer, Centene Corporation
Are You Ready?
Considerations for Success in a New Era of Consumerism and Exchanges
Presented
by The TriZetto® Group, Inc
A
new era of consumerism is upon us, and it brings new challenges for health
plans to maintain efficiencies while meeting new requirements for health
insurance exchanges and sales channel fragmentation. During this session, you
will hear three key considerations for success: meeting new exchange requirements,
accommodating fragmented sales channels, and focusing on automation to gain
efficiencies.
- Eric Grossman, Vice President, Enterprise Strategy, TriZetto
A Vision for U.S.
Healthcare’s Radical Makeover
Presented by
Cognizant Technologies
Just as the publishing and music industries were
disrupted and rebuilt by powerful transformative levers, the healthcare
industry is on the verge of a similar disruptive change that will significantly
reshape our experiences and reorient our expectations across the provider and
payer value chain. Redistributed accountability and risk, the adoption of
Accountable Care Organizations and Patient-Centered Medical Homes, the
“retailization” of healthcare, cloud technology, mobility and ‘big data’ – the
health care environment is in a state of flux. Despite the momentum behind these
market forces, these initiatives alone cannot transform healthcare’s business
model, and will generate only incremental improvements in cost reduction,
quality and efficiency. Creating a truly sustainable foundation for healthcare
will require the industry to eliminate substantial costs, embrace new ways of
delivering care and improve the quality of that care. Success in this
rapidly changing world will depend on how well your organization understands
where it will fit in the new health ecosystem and how it will achieve that
position. Join us for a discussion on rethinking healthcare and the powerful
levers that are enabling the reinvention of the industry’s business model.
- Patricia
(Trish) Birch, Vice President and
Healthcare Consulting Practice Leader, Cognizant Technology Solutions
- Bill Shea,
Partner, Healthcare Business Consulting
Emerging Trends in Specialty
Pharmaceuticals
Presented by GSK
The U.S. health care system continues
to experience growth in innovation across areas of high unmet medical need. As
such, specialty pharmaceuticals play an increasingly important role in how
health plans manage their patient populations. In this session, a panel of
health plan executives will explore strategic and operational trends in
optimizing patient outcomes, cost, and quality with specialty
pharmaceuticals. The speakers will also discuss the current landscape and
future market dynamics for specialty pharmaceuticals, and health plan
operational considerations with regards to specialty pharmaceuticals.
Moderator:
- Tejal Vishalpura, PharmD, Field
Vice President, Specialty in the Payer, Policy & Vaccines Unit,
GlaxoSmithKline
Retail Consumer Strategies – Making the
Shift from B2B to B2C
With product
standardization, new regulatory constraints, and price transparency leveling
the playing field, health plans need to refresh their approach to customer
outreach and retention. What was once a marketplace anchored in employer-based
group health coverage is rapidly moving to an environment driven by individual
decision making. The retailization of healthcare means
consumers are in control – purchasing health benefits, navigating care
delivery, and determining brand preference. The transition from a
business-to-business to a business-to-consumer focus can’t wait. This is
particularly true in the most reformed market segments – small group,
individual medical, and Medicaid. It means quantifying risks and identifying
opportunities using a sequenced, well-calculated strategic approach. This
session will highlight three critical success factors of an actionable,
knowledge-based consumer strategy.
- Lindsay Resnick, Chief Marketing Officer, KBM
Group: Health Services
Winning in the New Reality: Health Plan Strategies for 2013 and Beyond
Presented by Infosys Public Services
Health plans have been investing in health care reform over the last few years. As the outcome of elections sets the tone for the next four years, how should health plans transform for 2013 and beyond? Health plans need to go beyond business-as-usual actions and realize game-changing innovation to transform health care while optimizing operational costs. Health care reform and the opening of individual markets offer new opportunities but require focused strategies for exchanges, consumer engagement, provider collaboration and integrated care management. Leveraging advances in technologies such as analytics, mobility and social media can help build differentiated capabilities to support these strategies. Join us as health plan executives and industry experts examine these initiatives and share practical experiences to navigate the new reality.
Compliance Track: Building Your
Compliance Capabilities |
- How can companies develop and design new products that
meet the operational and compliance challenges?
- How do you manage compliance issues for the small
group, large group and self-insured markets?
- How can companies plan for compliance issues inside and
outside Exchanges?
Fraud, Waste and Abuse: The
Transformative Potential of Data and Collaboration
The
U.S. Department of Health and Human Services (HHS) and the U.S. Department of
Justice (DOJ) recently announced a new and innovative partnership among federal
agencies, private entities and state organizations to detect and prevent health
care fraud on a national scale. This new initiative holds many new
opportunities for health insurance plans. This session will provide an overview
of the collaboration and discuss how federal and state agencies intend to
leverage private market efforts to combat fraud. In addition, health insurance plans will gain new insights into how data
will begin to be shared between public and private organizations for effective
detection and enforcement activities. Any health insurance professional who
work in an Antifraud, Special Investigations Unit (SIU), Internal Audit,
Compliance, or Legal department should not miss this session.
- Ted Doolittle, Deputy Director of Center for Program Integrity, CMS
- Lou Saccoccio, Chief Executive Officer, National
Health Care Anti-Fraud Association
Leveraging Innovative Electronic Tools
for Detecting and Prosecuting Fraud, Waste and Abuse
This
session will provide an overview of the new public/private initiative in which
CMS will combine public and private claims data to root out fraud, waste and
abuse, and how innovative tools can be an integral part of these efforts. It
will also address how social network analytics can layer of information in
discovering collusion and crime. The speaker will examine the power reflected
in the volume of data being collected when payers choose to collaborate and share
information.
- Pam Jodock, Director
Commercial Business Development, Health Care Solutions, LexisNexis Risk
Solutions
Enterprise-Wide Security and Risk Management:
Protecting Health Insurance Plan Data
This
session will offer business strategies and system security techniques to
prevent data breaches, reduce potential liability for data-related losses,
provide sensible guidelines for mitigating data losses, and
comply with federal and state legal requirements in the event that personally
identifiable information is
compromised.
- Paul H. Luehr, Managing Director,
Stroz Friedberg
- Gerard Stegmaier, Wilson, Sonsini,
Goodrich & Rosati
Wellness Programs and Compliance
Considerations
The establishment of cost-saving programs for
wellness or preventive care requires compliance with a variety of existing
laws. This session will discuss the primary compliance-related items an
employer or plan sponsor must consider and comply with, including: the
Americans with Disabilities Act; Genetic Information Nondiscrimination Act;
Health Insurance Portability and Accountability Act; and state and local
disability discrimination and privacy laws.
- Jerry Noyce, President and Chief
Executive Officer, The Health Enhancement Research Organization
Social
Media and the Internet in Health Plan Operations
In
this digital age, consumers have become accustomed to – and dependent upon –
the use of the Internet and social media in their everyday lives. To meet
consumers’ expectations, health insurance companies have turned to social media
to increase individuals’ awareness and involvement in their own health care.
This session will focus on the new trends in health insurance plans’
interactions with consumers via social media and the Internet, potential
pitfalls to using social media in health insurance plan operations, and
practical compliance tips for managing employees’ use of social media for
business purposes.
- Timothy C. Zevnik, Privacy Official & Director, HIPAA Program, Molina Healthcare, Inc.
Inside/Outside:
Compliance Issues for the Exchange Environment
The
Affordable Care Act mandates the creation of health insurance exchanges and
several states are already in the process of building these cyber-marketplaces
for health insurance products. In 2014, health insurance exchanges will become
available to consumers, creating a new and unique online marketplace for purchasing
health insurance coverage. This session
will focus on what’s in, what’s out, and the compliance considerations for
selling insurance products in or out of the Exchange environments.
- Gary E. Bacher, Of Counsel, Mintz Levin & Senior Vice President, ML Strategies
- Teresa D. Miller, Acting Director, Office of Oversight, CCIIO, CMS, HHS
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