Health Care Management Conference

Using Plan Data to Improve Outcomes

Health plan stakeholders have access to an extensive amount of plan data. Plans are increasingly dedicating time and money to identify trends, and they are finding value in the process. How can fiduciaries utilize this data to better design their plans and drive informed health decisions? This session will:

• Discuss whether plan metrics are improving
• Highlight new metrics that should be tracked
• Review methods for requesting data from your professionals
• Identify how to find data patterns among your membership
• Summarize action steps based on your findings.

Cost Containment—Who Are You Paying, and What Are You Paying For?

Health plan fiduciaries have the legal obligation to monitor service providers and pay reasonable expenses for services. This can become increasingly difficult in a rapidly evolving provider landscape. This session will aim to:

• Illustrate steps to demystify your health plan spend
• Summarize the provider landscape update—Who are your professionals?
• Identify your fiduciary duties
• Review best practices in fulfilling your fiduciary duties.

Navigating Health Claim Denials

A recent study noted that about one in five in-network health care claims is denied. This interactive session will allow participants to ask questions about the approval process and work through case study examples. This session will:

• Describe the key reason that claims are denied
• Highlight when claims should and should not be denied
• Identify the steps involved in the appeals process
• Explore the legal ramifications of a claim denial
• Illustrate the importance of an advocate in the fund office.

Hot Topics in Health—Speaker Debates

A panel of experts will discuss a number of emerging trends in the health space and debate their merits. Attendees will have the opportunity to vote on which topics will be discussed. Potential topics include:

• The use of artificial intelligence in health plans
• Coverage for weight-loss drugs, bariatric care and more
• Coverage for psychedelic treatments.

Preventive Services—Accessing Vital Information

Recent estimates have stated that as many as half of premature deaths are preventable, driven by behavioral factors such as physical inactivity, poor diet and tobacco use. This makes quality, well-researched information on preventive services an imperative part of your plan communication efforts. This wide-ranging session will:

• Highlight the importance of disease management initiatives
• Discuss women’s health initiatives in the preventive space
• Review lessons from the international health community
• Identify the importance of participant education and advocacy
• Examine methods for steering your participants to appropriate resources
• Explain effective communication initiatives for your participants.

Advancements in Care—Success Stories

Health headlines overwhelmingly focus on negative trends, citing increasing costs and decreasing levels of quality. However, recent industry advancements have taken steps to reverse this slide. This finale session will:

• Examine the evolution of common conditions
• Identify changes in participant engagement levels
• Review scientific advancements (gene therapies, vaccines and more)
• Review technological advancements (self-service patient portals, wearable technology, 3D printing and more)
• Discuss potential success stories on the horizon
• Highlight the impact on plans and participants.