Institute for International Research

Obtain Best Practices on Lessons Learned in 2006 on Implementing Special Needs Plans & the Integration of Tactics to Reduce the Operational Kinks

This workshop draws on lessons learned from 2006, analyzing how we performed as an industry creating and implementing SNPs that improved care integration and coordination, enhanced accountability for quality of care, and improved the quality of care delivered to beneficiaries. In addition to drawing on lessons learned, this workshop helps established SNPs focus their marketing tactics and organizational structure to better understand the critical capabilities needed for success.

Workshop Leaders:

Steve Pearse, Medicare Product Manager, FAMILYCARE HEALTH PLANS, INC.

Keith Vollberg, Vice President of Medicare Products, UNISON HEALTH PLAN

Robb Cohen, Vice President, Government Affairs, XLHEALTH /CARE IMPROVEMENT PLUS

George M. Louie, MD, Senior Medical Director, HEALTH NET OF CALIFORNIA

P4P-101- Understanding the Basics Behind Pay-For- Performance and Its Impact on the Future of Medicare

Known as Pay-Per-Performance (P4P), these plans are designed to reward health care providers for the accurate care of beneficiaries. While these plans seem to optimize quality of care in a private setting, in the Medicare arena they are regarded as experimental. In this session, our presenter highlights the mechanics behind P4P plans and how they would work with Medicare's patient population and size. In addition, our speaker discusses the basic, practical implementation of these plans and gives the audience the latest updates in P4P concepts and practice. More specifically:

• How does P4P differ from other plans?
• How do we measure quality of providers, while not overpaying?
• The various challenges of integrating P4P into your system of healthplans
• Motivating physicians to work under P4P
• What is the mechanism behind preparing and validating risk?
• What items and structures are examined during the regulatory process?

Workshop Leaders:

Murray N. Ross, PhD, Director, Health Policy Analysis and Research, KAISER PERMANENTE INSTITUTE FOR HEALTH POLICY

Joel V. Brill, MD, Chief Medical Officer, PREDICTIVE HEALTH, LLC

How to Segment your Dual Eligibles into a Special Needs Plan to Ensure Adequate Healthcare while Maintaining Costs

Creating a Special Needs Plan from your dual eligible population is an opportunity too straightforward to pass up. This workshop will identify:

• Making the decision: What is the minimum number of enrolled members needed in a SNP to ensure success? What expertise do you need to build? What is your strategy for working with state Medicaid agencies/Medicaid health plans?
• Product Development and Marketing: Which supplemental benefits will attract duals? How will benefit structure impact providers? What are the demographics of the dual population, and what marketing tactics will be most effective?
• Education: How do you help members understand your plan? How do you educate and engage network providers?
• Compliance: How will you meet CMS compliance standards and work with states?
• Care Management Challenges: Update on guidelines for coordination of care between Medicare and Medicaid. State carve-out impacts on your model. Behavioral health challenges.
• Member retention

Workshop Leaders:

Rodney C. Armstead, MD, FACP, Chief Executive Officer, APIPA

Carmen Alexander, Vice President, Medicare, APIPA

Prepare the Market for 2008 Open Enrollment – Implementing Lessons Learned & New Ideas on Pre-Heating the Market

2006 saw the healthcare community living through a monumental change with the implementation of Medicare Part D and participating in open enrollment and lock-in of beneficiaries to their plans. Despite the fact that the first enrollment period is behind us, there are still many unanswered questions and challenges that healthcare companies must face:

Effective Sales Strategies under Medicare Lock-In

• What is "lock in" and who does it impact? Who doesn't it impact?
• What is Open Enrollment and how does it lengthen the sales cycle?
• What are Special Election periods and related sales opportunities?
• Who are dual eligibles and what are their coverage options?

Gretchen Mills, Medicare Regional Product Head, AETNA

It's All About Leverage: Brand, Brand Direct and Experiential Marketing for Acquisition and Retention

As we move into a more mature Medicare marketplace, smart marketers will need to address a whole new set of issues. Customer retention and growth through open enrollment will become critical while acquisition programs must be retooled for a changing market landscape. In this informative session, we'll take a look at successful tactics from Medicare Part D and Advantage launches, and how they can be leveraged in the future. Plus, we'll discuss the three keys that all health care marketers should be focused on when branding their respective identities in the modern Medicare landscape:

• Branding and why it's a bottom line issue in Medicare
• Brand direct strategies that drive top line growth
• Creating the optimal customer brand experience for your health plan

Sherman Rogers, President & CEO, FINELIGHT