Educational Sessions

• The complete definition of population health analytics and what other data it should include.

• How employers can use this complete data to fully understand their populations’ health status, healthcare needs and the impact of their health benefit programs.

• How population health data can be used to define objective outcomes goals and performance guarantees for vendor partners.
• How having a complete grasp on population health allows an employer to improve its program offerings while remaining cost neutral.

• Hybrid fully insured Rx with self-funded option - The self-insured can transfer their Rx risk while keeping their self-insured medical plan in place. They pay a fixed premium to an Rx insurer that manages the risk, which often creates savings of 25% to 40% below the expected cash claims and it reduces the cost of stop-loss coverage as well.
• Rx advocacy programs - Employees and dependents that have high-cost brand drugs that may not be covered or have significant cost sharing can use access Rx programs that will cover the cost-sharing piece and/or provide the Rx for free, thereby shifting the high-cost drug exposure away from the employer’s risk.
• Data analytics for pharmacy cost containment.

• The pioneering work in Texas on drug formularies; results from other states with drug formularies
•  “B practices” for regulators in developing or adopting a formulary
• “B practices” for administrators in managing a state-mandated formulary
• Guidelines for opioid use and management
• Adopting evidence-based medical guidelines versus developing your own guidelines

• Identify the right team for the job.
• Clearly define the responsibilities of each team member.
• Understand the data resources at your disposal.
• Remain objective and put your injured employee first!

• Diagnose and triage COVID-19. Telehealth can screen patients with symptoms or those who have had encounters with infected individuals and refer them for testing.
• Treat patients who need other types of medical care. Remote doctor visits introduced patients to the telehealth experience making them more comfortable being treated by video or phone.
• Protect health care workers, lowering their chance of infection and enabling those at risk to work remotely and still perform patient care.
• Permanently change the way health care is delivered. Patients reported great satisfaction with their telehealth visits and the expectation is that treating patients with telehealth will remain a viable option for patient care in the future.

• Employers'' health care pain points
• What changes they would like to see in the health care system
• Gaps in care and information they want to see closed
• Their views on how payers, self-insured purchasers, their advisers and health care providers are – and are not – working toward solutions. Test your assumptions about what is really on the minds of your clients and prepare for a lively discussion.

• How to mine outcomes and cost data to identify the truly high-value, low-cost in-network specialists.
• How an episode-of-care approach to managing care improves outcomes and reduces specialist costs.
• About new products that stop-loss insurers are developing to better manage specialist care on behalf of seriously ill patients.

The broker-TPA relationship is critical to the successful establishment and ongoing management of self-insured group health plans. Given this importance, brokers/advisers need to fully understand the role of the TPA and how it interacts with plan sponsors, stop-loss carriers and cost management vendors. Particularly important on the front end is how brokers/advisers facilitate information flow between plan sponsors and TPAs. This session will feature top industry expertise who will explain what you really need to know to have a positive relationship with your TPA partners.