2. Agenda The New Issue: Cooperatives The Kennedy Factor The Future of Healthcare The Legislative Process: A Reminder & What We’ll See Resources For Staying Engaged
3. Cooperatives “If not a Public Plan, then let’s build Cooperatives” Version 1: Senator Kent Conrad’s Description Version 2: House Bill Language Version 3: Real-World Examples The Growing Discussion
4. Cooperatives: Senator Kent Conrad’s Description Cooperative Plan An insurance option sold within Exchange(s) Democratically controlled by members; governed by an elected Board. Surpluses retuned to members or reinvested Non-profit Funding Initial seed $: Government & Others Then self-sustaining Considerations? Individuals? Groups? State Law Conversion of existing Insurance Plan? Elected Board Exchange $ $ $ $6B ? ?
5. Cooperatives: House Bill Language Cooperative Plan Not for profit, member-run Sold through Exchange(s) Once established, Co-op is at risk Can be regional; state has acceptance authority Funding $5 Billion, for 36 mo. disbursement Gov’t: Gift $ for Reserves Gov’t: Loan $ for startup Administration Priority for Funds: Integrated, Statewide & Non-Gov’t support Qualifications for Funds Has to be a new entity Can’t be a Carrier or Gov’t subsidiary Elected Board Exchange $ $ $5B
6. Cooperatives: Real-World Examples Most Applicable Existing Models Group Health Cooperative & HealthPartners Sell through Brokers GHC: 2/3 in-house Drs/Facilities HP: 1/3 in-house Drs/Facilities Act just like other Insurance Companies Large HMOs Members identify more with HMO philosophy than with membership Tremendous information Efficiency? Yes & No Decisions of members often very similar to decisions of owners Elected Board $ Broker
7. Cooperatives: The Growing Discussion Examples That Don’t Apply Health Insurance Purchasing Cooperatives (HIPCs) Population-Specific Business Cooperatives Market Implications More Insurance Companies Will Brokers be Able to Sell Cooperative Products? How Can We Drive the Discussion? How will they improve competition? Why will they be more honest than Insurance Carriers? Where is proof they’re more efficient?
8. Future of Healthcare Forum Highlights From New World of Healthcare Forum Future of Products? Future of Carriers? Future of Brokers? Future of Broker Commissions? How Can We Affect Change?
9. Future of Products? Transparency Individualized by Patient Rankings by Price / Quality Behavior Change: Fun Horse Power Challenge Incentives & Rewards Work New Approaches Virtual Health Records Social Networks by Disease Make it Fun Mike McCallister President & CEO, Humana
10. Future of Carriers? Merge Small Group / Individual New Pricing In-Migration of High Risk Members? COBRA Members Uninsured (Mixed) Multi-Line Products by Carriers Bigger Market for Specialty Carrier Consolidation Growth of Individual Brian Sassi President & CEO , WellPoint Consumer Business
11. Future of Brokers? What Makes a Top Firm? Engaged Leadership Clearly Articulate Differentiator A Plan Best Players Training & Performance Mgmt Sell Themselves, Not a Product Value Added Differentiation Protect Relationships! Ken Fasola Former CEO, Secure Horizons
12. Future of Brokers, In Light of Exchanges? Limit the Exchange A Regulatory Agency Defining the Plans Monitoring Body Set to Replace Brokers Explaining Role of Broker Exchange Would Cost Billions Use Infrastructure in Place BenefitMall Lobbyists at Work Launching Online Community For Brokers / Carriers to Communicate & Participate Bernie DiFiore CEO, BenefitMall
13. Future of Broker Commissions? Not Fundamentally Change Probably Not Always Tied to Medical Inflation Work Still Needs to be Done Work Needs to be Paid For Will Still Vary By Carrier Mike McCallister
14. Future of Broker Commissions? Physician/Hospital Comp Will Change Brokers’ Probably Will, Too If Comp Reduced, Doesn’t Mean We Can’t Generate Income Time Is Not Our Ally Have Your Voice Heard Ken Fasola
15. How Can We Affect Change? Media Usage? Best: “Un-Earned Media” TV Radio Talk Shows Op-Eds Letter to Editor Quoted in Articles Value: Volume of Hits Read Local Editorials Respond: Short Letter to Editor Member of Congress Reads Daily Janet Trautwein CEO, National Association of Health Underwriters
16. The Legislative Process A Reminder of the Process Road Map to a Health Reform Law What We’ll See This Fall Building Blocks of 2009 Reforms
17. Road Map to a Health Reform Law Senate House Harry Reid Nancy Pelosi Finance Committee Health Education Labor & Pension (HELP) Committee Education & Labor Committee Energy & Commerce Committee Ways & Means Committee Henry Waxman George Miller Charles Rangel Max Baucus Ted Kennedy Finance Bill HELP Bill Senate Passes House Passes Bill Combined Bill via Rules Committee House Bill Senate Bill Bipartisan Work to Combine Bills Conference Committee Sets Rules for Debate & Votes Combined Bill Debate & Passage Debate & Passage In Senate In House Final Bill
18. Building Blocks of 2009 Reforms Employer Mandate Large Fund-Raising Mechanisms Public Insurance Plan Cost Containment Strategies Cooperative Individuals Employers Connector / Exchange Government Subsidies Individual Mandate
19. Staying Engaged On Reform www.HealthcareExchange.com Subscribe to the Site Register For NAHU Membership Cooperative Report Q&A: Follow Up Answers Blog: Give Your Input!
