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The 2nd Annual Health Insurance Exchanges Summit
 

The 2nd Annual Health Insurance Exchanges Summit

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    The 2nd Annual Health Insurance Exchanges Summit The 2nd Annual Health Insurance Exchanges Summit Document Transcript

    • PRESENTS The 2nd Annual Health Insurance Exchange Summit Practical Marketing, Risk Adjustment, & Operational Strategies for Success November 18-19, 2013 * * The Aria ** Las Vegas, Nevada Health Insurance Exchange Summit Advisory Board 2013 Shana Alex Lavarreda, PhD, MPP, Director of Health Insurance Studies, Research Scientist, UCLA Center for Health Policy Research Alan Byrnes, Director, Risk Adjustment, Blue Cross and Blue Shield of Michigan Gregory Franklin, Assistant Secretary, Health Information Technology, California Technology Agency Anna Lau, Director of Healthcare Economics, United Health Care Patricia MacTaggart, Lead Research Scientist/Lecturer, George Washington University Health Policy Department Michael Marchand, Director, Washington Health Benefit Exchange Brian Melanson, Director Distribution & Ancillary Strategy, Premera Blue Cross David Meyer, Vice President Revenue and Quality, InnovaCare Health Services Compliance Provider Networks & Contracts Technology & Operations Risk Adjustment Marketing & Distribution Pricing & Rate Revisions Health Insurance Exchange
    • Michael Nolin, Executive Director, The Hilltop Institute, University of Maryland, Baltimore County Confidential Working Agenda DAY ONE: Monday, November 18, 2013 8:00 – 8:35 Exhibits Set-Up & Continental Breakfast 8:35 –8:45 Chair’s Opening Remarks: 8:45 –9:30 Market Analysis: Who’s Actually Entering the Health Insurance Exchange Marketplace?  What are the demographics and socioeconomic predictions?  How will the population for the exchange marketplaces continue to evolve?  How will Medicaid expansion and churn disrupt population forecasts?  Education and outreach challenges for reaching this population Shana Alex Lavarreda, PhD, MPP, Director of Health Insurance Studies, Research Scientist UCLA Center for Health Policy Research 9:30 – 10:30 A Fire Side Chat: State vs. Federal Perspective:  Where are we now and what do we need to do before 2014?  What have we learned from those states in the trenches?  Mechanics of the marketplaces  Facilitating private involvement  Success stories & biggest obstacles  What are the challenges moving forward? Moderator: Patricia MacTaggart, Lead Research Scientist/Lecturer George Washington University Health Policy Department Panelists: Honorable Thomas B. Considine, Chief Operating Officer MagnaCare Former Commissioner of Banking & Insurance State of New Jersey John Barela, Implementation Manager Connect for Health Colorado Michael Marchand, Director Washington Health Benefit Exchange Rosemarie Day, President Day Health Strategies
    • 10:30 –10:45 Morning Break 10:45-11:30 Provider Network Contracts & Management Building, Managing, & Monitoring Physician Networks  How are plans managing their networks?  What types of programs are in place to monitor physician networks?  Leveraging real-time data  What are the processes in place for network performance evaluation?  Effective strategies for network development  Provider contracting strategies to ensure network adequacy  Honorable Thomas B. Considine, Chief Operating Officer MagnaCare Former Commissioner of Banking & Insurance State of New Jersey Patrick Holland, Director Wakely Consulting Group 11:30-12:00 Rhode Island Case Study: From IT Solutions to Contract Negotiations – Hear How Rhode Island is Paving the “Rhode” to Success  Examining the collaboration, opportunities, and alignments between Medicaid and the Exchange  Streamlining eligibility ad enrollment  Integration & alignment between policy, operations, and technology – A well-oiled machine  Who will the Rhode Island Exchange cover?  Delivery system and payment reform  Lessons learned to date Deborah J. Florio, Administrator, Center for Child and Family Health Rhode Island Executive Office of Health & Human Services Angela Sherwin, Assistant Director Health Benefits Exchange, Office of the Governor, State of Rhode Island 12:00 – 1:15 Luncheon for all attendees & speakers Track A: Market Place Marketing & Distribution Track B: Risk Adjustment 1:15 –2:00 Open Enrollment Report Card: What Have We Learned About Open Enrollment so Far?  How’s it going so far?  What have we learned?  Problems and proposed solutions  Is the population what you expected?  What is the enrollment process from a consumer perspective? Risk Adjustment in the Market Place: How to Implement the Federal Risk Adjustment Model  How will plans conduct risk adjustment on the Exchange?  How will a plan manage risk adjustment across multiple states?  Risk score calculations and its impact on risk adjustment: A moving target
    •  What can consumer choices and assumptions teach us and how do we adjust our strategy? Jon M. Hager, Executive Director Silver State Health Insurance Exchange Jean Klingle, Director of Education & Outreach Kentucky Health Benefit Exchange Robert Fox. Vice President for Individual Business Coventry Health Care Inc. John Barela, Implementation Manager Connect for Health Colorado  Understanding the zero-sum risk adjustment  Using risk adjustment as a lever for other objectives in your plan 2:00-2:45 Impact of Exchanges on Traditional & Emerging Distribution Models  How are producers adapting?  What new players are emerging— retailers, tax advisors, etc.? o How are consumers responding to these models? o How are exchanges, carriers and producers responding to emerging entrants? o Moving beyond sales: Are new care delivery models coming to light?  How is the selling infrastructure holding up to new demands? Brian Melanson, Director Distribution & Ancillary Strategy Premera Blue Cross Robert Fox. Vice President for Individual Business Coventry Health Care Inc. What Can Health Plans Learn about Risk Adjustment from Medicare Advantage Plans?  Lessons learned and landmines to avoid  Helpful tips for claims data & chart review  Driving revenue through quality of care and member selection  New policies that Medicare Advantage plans need to implement David Meyer, Vice President Revenue and Quality InnovaCare Health Services 2:45-3:30 New Customers are Great, but Retention is Key for Success!  Retention and its effect on your bottom line  Keeping enrollees informed and engaged  Why do members leave and what can you do to combat that?  Evaluating the cost of getting a new member vs. keeping existing one  What does it take to keep members happy? Putting Risk Corridors & Reinsurance Front & Center  Taking a closer look at risk corridors & reinsurance and their impact on revenue  Crunching the numbers for risk corrdidors and reinsurance  Pricing products on the exchange  Lessons learned from Part D
    •  Practical outreach & communication strategies Chris Kelly, Senior Advisor, Marketing & Outreach Covered California Diane R. Boyle, Vice President, Federal Government Relations National Association of Insurance and Financial Advisors Jessica Self, Compliance Coordinator Vantage Health Plan, Inc. Rosemarie Day, President Day Health Strategies 3:30 – 3:45 Afternoon Break Afternoon Break 3:45-4:30 Managing & Training Navigators & Assistors  Effectively attracting members to the marketplaces  Engage navigators appropriately  Gaging performance  What do these new distribution channels mean to current brokers?  Should navigators acting as brokers/agents?  Navigators’ activities beyond 2-3 years? Jon M. Hager, Executive Director Silver State Health Insurance Exchange Danielle Davis, Director, Communications, Outreach & Training Maryland Health Connection Jean Klingle, Director of Education & Outreach Kentucky Health Benefit Exchange Sandra Cook, Consumer Assistance Specialist, Arkansas Insurance Department Arkansas Health Benefits Exchange Partnership Risk Adjustment Data, Claims, Collections & Submission  What is the infrastructure plans need to have for adequate data review & submission?  Coding and compliance  Getting to the nitty-gritty of encounter submissions Patricia MacTaggart, Lead Research Scientist/Lecturer George Washington University Health Policy Department 4:30 – 5:15 Cultural & Language Obstacles for Marketing in the Market Place  How can you improve your outreach efforts to the population on the Marketplaces?  What are the cultural obstacles RADV Looking at the evolving role of revenue- oriented audits  What’s the latest from CMS and where is the industry headed?  Looking at the emerging role of
    • holding you back?  What have you learned so far and what will you change?  Securing the right staff to break through language barriers  How are the needs of each market segment different and how are you responding to their needs? Danielle Davis, Director, Communications, Outreach & Training Maryland Health Connection Sandra Cook, Consumer Assistance Specialist, Arkansas Insurance Department Arkansas Health Benefits Exchange Partnership Michael Marchand, Director Washington Health Benefit Exchange vendors for risk mitigation and conducting audits  Comparing RADV for the Exchanges audits vs. Medicare Advantage RADV audits David Meyer, Vice President Revenue and Quality InnovaCare Health Services 5:15 End of Day One Cocktail Reception End of Day One Cocktail Reception Cocktail Reception Immediately Following Sponsored by: XXXXXXX 5:00-6:00 Contact Jennifer Clemence for more information on our sponsorship opportunities at jclemence@healthcare- conferences.com or 704-341-2438 DAY TWO: Tuesday, November 19, 2013 8:00-8:45 Continental Breakfast 8:45 – 9:00 Recap of Day One 9:00 – 10:00
    • Policy & Compliance Update: Reading the Tea Leaves  TBA  TBA  TBA  TBA  TBA Track A: Products & Pricing in the Market Place Track B: Operations & Technology 10:00 –10:45 Product Design in the Market Place  Designing products on the exchanges  Is product doing what you thought it would do?  Any consumer backlash? Jessica Self, Compliance Coordinator Vantage Health Plan, Inc. Troubleshooting & Interfacing with the Federal Hub  Information technology set up with edge server  Which edge server issues are causing the most grief and why?  What are the interfacing challenges to date?  Data logistics with the edge server  What are the differences between state and federal exchanges? 10:45 – 11:00 Morning Break Morning Break 11:00-12:00 A Retrospective Look at Your Pricing Strategy on the Exchanges: How Should Plans Modify their Current Rates?  Pricing products: Flying a plane while you’re building it  How do you strategically price to maximize enrollment?  Taking a closer look at pricing mechanics  Figuring out the mistakes made  How can you improve your pricing strategy? Enrollmet & Reconcilliation: Strategies to Streamline the Process and Minimize Errors  Findng the enrollment cracks  Practical tips for enhancing your reconcilliation process  How much it can cost you if you get it wrong  Implementing a strong safety net for errors  Making the most of the reconcilliation process  What’s the latest with Section 1402 & 1412 – Cost sharing reduction (CSRs)? 12:00 – 1:15 Luncheon for All Attendees 1:15 –2:00 2:00 –3:00 TBA 3:00 End of Summit