The Journey
into Risk
The New Health Care
Marketplace and the
Impact of the
Affordable Care Act
SWAT VII: STRATEGIES, WEAPONS, AND TACTICS
DECEMBER 5 AND 6, 2013
DOUBLETREE HOTEL
Education Credits
Program participants are eligible for
8.75 Category II non-American College
of Healthcare Executives Continuing
Education credits. Program participants
are eligible for 6.25 Certified Public
Accountancy Continuing Education
credits.
Program Fee
$395
Register Online
Visit www.hanys.org/events to
register. Registration must be
completed by December 2.
Payment by credit card is
due immediately.
Overnight Accommodations
DoubleTree Hotel, Tarrytown
455 South Broadway, Tarrytown, New York Telephone: (914) 631-5700
A block of rooms at the DoubleTree Hotel has been reserved for
SWAT attendees. Please reserve your room by November 13 to
receive a discounted nightly rate of $149.
The group code is HTC.
To Reserve Online:
Please visit www.tarrytown.doubletree.com
To Reserve by Telephone:
Please call the DoubleTree Hotel at (800) 474-4260
What to Wear
The atmosphere throughout
the event is relaxed and we
suggest that participants
make themselves
comfort-able. Dress is business
casual. Participants should
bring a sweater to the meeting
room as it tends to be cool.
Cancellations
Registrations cancelled after
November 26 are subject to a
$50 administrative charge.
Registration fees for those
cancelling on the day of the
program or failing to attend
are forfeited. Substitutions
are permitted and
encour-aged, but should be indicated
either before or at the event.
Questions?
Registration questions: Christopher Guyon, Registration and
Technical Support Coordinator, at (518) 431-7834 or at
[email protected].
For questions about the SWAT program, please contact HANYS’
managed care staff.
HANYS’ Managed Care Team
Jeffrey Gold, Esq.
Vice President, Managed Care and Special Counsel (518) 431-7730 or at [email protected]
Cara Henley
Associate Director (518) 431-7827 or at [email protected]Jennifer Lee
Policy Specialist (518) 431-7871 or at [email protected]Anne-Marie Mull
Executive Assistant (518) 431-7890 or at [email protected]HANYS’ acclaimed SWAT program provides you with the tools and strategies you
need in the evolving managed care marketplace. SWAT is designed to help you
understand the changing health care environment and how to position your
organization to meet its challenges and opportunities.
This year’s SWAT program will focus on the
journey into risk, the new health care marketplace,
and the impact of the Affordable Care Act.
Experts will discuss issues emerging in the
evolving health care environment, and
representatives from integrated health
systems from around the country will
share the core skills and approaches
necessary to build and sustain successful
health care delivery models.
8 - 9 A.M.
Breakfast and Registration
9 - 9:30 A.M.
Journey into Risk: Strategies for
Developing Core Competencies
Jeffrey Gold, Esq.
Vice President, Managed Care and Special Counsel, Healthcare Association of New York State
9:30 - 10:45 A.M.
The Future of Private Exchanges
and Their Role in the Changing Market
Andrew Werts
Senior Marketing Manager, Liazon
A growing trend, private exchanges are proving to be attractive to many employers. Recently Walgreens, IBM, and Time Warner have joined several other large employ-ers in the move toward private exchanges. Andrew Werts will provide a detailed discussion of the private exchange marketplace, the driving force behind its appeal, and how it will complement and compete with the state-based exchange.
11 A.M. - 12:15 P.M.
Ready or Not: Exchange-Related
Issues on the Horizon
Jim Donohue
Senior Manager, ECG Management Consultants, Inc.
Jim Donohue will discuss how affordability, cost-sharing, provider networks, adverse selection, and population shifts will affect provider networking and contract strate-gies in the new exchange marketplace.
12:15 - 1:15 P.M.
Lunch
1:15 - 2:30 P.M.
Integrated Health Systems: Serving Patients
as a Provider and as a Health Plan
Todd Sandman
Vice President, Strategy and Customer Engagement, Presbyterian Healthcare Services, Albuquerque, New Mexico
Hospitals and other health care providers are discovering new models to more efficiently deliver quality care while reducing costs. Presbyterian Healthcare Services is the largest private, non-profit health system in New Mexico, operating as a hospital, medical group, and as one of the largest health plans in the state. Todd Sandman will discuss Presbyterian’s success and how its integration as a service provider and health plan facilitates quality and improvement activities.
2:45 - 4 P.M.
How Aggressive Can Providers Be About
Waiving Costs or Providing Discounts as
Strategies to Attract Patients?
Fredrick I. Miller
Partner/Director, Garfunkel Wild, P.C.
Fredrick Miller will discuss the complex set of issues and choices related to a hospital’s ability to discount or waive costs for patients who qualify and how to meet financial assistance guidelines.
5 - 7 P.M.
Cocktail Reception
9:30 - 10:45 A.M.
What Does Wall Street Think? A Health Plan
Financial Performance Forecast
Carl McDonald, C.F.A.
Director and Senior Analyst, Managed Care, Citi Research
With health care reform, health plans are being asked to run their businesses in a very different way. Carl McDonald will provide a health plan outlook beyond January and discuss how performance and profitability will be impacted by the exchanges in 2014. He will discuss the number of changes coming, what to look for, and how reform will impact industry margins.
11 A.M. - 12:15 P.M.
Narrow and Tiered Networks: An Emerging
Trend
Brandon Edwards President, ReviveHealth
Brandon Edwards will discuss the resurgence of narrow and tiered networks in the health care market with premi-ums that are substantially below traditional offerings. Mr. Edwards will discuss why these plans are being embraced, the implications of these types of benefit plans, and how these networks are impacted by the emergence of the exchange marketplaces.
12:15 - 1:15 P.M.
Lunch
1:15 - 2:30 P.M.
Integrated Health Systems: Piedmont-WellStar
Collaboration
Jim Sams, M.D.
Chief Medical Officer, The Piedmont Clinic, Atlanta, Georgia
Debi Hueter
Vice President, Managed Care, Piedmont Healthcare, Atlanta, Georgia
Piedmont Healthcare and WellStar Health System, two of Atlanta’s largest health systems, have formed a partner-ship to develop a new health system-based insurance plan. The joint venture creates a provider-owned vehicle to offer health insurance to serve the greater Atlanta market. Dr. Jim Sams and Debi Hueter will discuss how this suc-cessful partnership has created opportunities to drive innovation, take on more risk, and deliver a better product to the market in terms of cost and quality.
2:30 - 3 P.M.
Concluding Remarks
Jeffrey Gold, Esq.
DAY ONE: Thursday, December 5
DAY TWO: Friday, December 6
8 - 9 A.M.
Breakfast and Registration
9 - 9:30 A.M.
Journey into Risk: Strategies for
Developing Core Competencies
Jeffrey Gold, Esq.
Vice President, Managed Care and Special Counsel, Healthcare Association of New York State
9:30 - 10:45 A.M.
The Future of Private Exchanges
and Their Role in the Changing Market
Andrew Werts
Senior Marketing Manager, Liazon
A growing trend, private exchanges are proving to be attractive to many employers. Recently Walgreens, IBM, and Time Warner have joined several other large employ-ers in the move toward private exchanges. Andrew Werts will provide a detailed discussion of the private exchange marketplace, the driving force behind its appeal, and how it will complement and compete with the state-based exchange.
11 A.M. - 12:15 P.M.
Ready or Not: Exchange-Related
Issues on the Horizon
Jim Donohue
Senior Manager, ECG Management Consultants, Inc.
Jim Donohue will discuss how affordability, cost-sharing, provider networks, adverse selection, and population shifts will affect provider networking and contract strate-gies in the new exchange marketplace.
12:15 - 1:15 P.M.
Lunch
1:15 - 2:30 P.M.
Integrated Health Systems: Serving Patients
as a Provider and as a Health Plan
Todd Sandman
Vice President, Strategy and Customer Engagement, Presbyterian Healthcare Services, Albuquerque, New Mexico
Hospitals and other health care providers are discovering new models to more efficiently deliver quality care while reducing costs. Presbyterian Healthcare Services is the largest private, non-profit health system in New Mexico, operating as a hospital, medical group, and as one of the largest health plans in the state. Todd Sandman will discuss Presbyterian’s success and how its integration as a service provider and health plan facilitates quality and improvement activities.
2:45 - 4 P.M.
How Aggressive Can Providers Be About
Waiving Costs or Providing Discounts as
Strategies to Attract Patients?
Fredrick I. Miller
Partner/Director, Garfunkel Wild, P.C.
Fredrick Miller will discuss the complex set of issues and choices related to a hospital’s ability to discount or waive costs for patients who qualify and how to meet financial assistance guidelines.
5 - 7 P.M.
Cocktail Reception
9:30 - 10:45 A.M.
What Does Wall Street Think? A Health Plan
Financial Performance Forecast
Carl McDonald, C.F.A.
Director and Senior Analyst, Managed Care, Citi Research
With health care reform, health plans are being asked to run their businesses in a very different way. Carl McDonald will provide a health plan outlook beyond January and discuss how performance and profitability will be impacted by the exchanges in 2014. He will discuss the number of changes coming, what to look for, and how reform will impact industry margins.
11 A.M. - 12:15 P.M.
Narrow and Tiered Networks: An Emerging
Trend
Brandon Edwards President, ReviveHealth
Brandon Edwards will discuss the resurgence of narrow and tiered networks in the health care market with premi-ums that are substantially below traditional offerings. Mr. Edwards will discuss why these plans are being embraced, the implications of these types of benefit plans, and how these networks are impacted by the emergence of the exchange marketplaces.
12:15 - 1:15 P.M.
Lunch
1:15 - 2:30 P.M.
Integrated Health Systems: Piedmont-WellStar
Collaboration
Jim Sams, M.D.
Chief Medical Officer, The Piedmont Clinic, Atlanta, Georgia
Debi Hueter
Vice President, Managed Care, Piedmont Healthcare, Atlanta, Georgia
Piedmont Healthcare and WellStar Health System, two of Atlanta’s largest health systems, have formed a partner-ship to develop a new health system-based insurance plan. The joint venture creates a provider-owned vehicle to offer health insurance to serve the greater Atlanta market. Dr. Jim Sams and Debi Hueter will discuss how this suc-cessful partnership has created opportunities to drive innovation, take on more risk, and deliver a better product to the market in terms of cost and quality.
2:30 - 3 P.M.
Concluding Remarks
Jeffrey Gold, Esq.
DAY ONE: Thursday, December 5
DAY TWO: Friday, December 6
Education Credits
Program participants are eligible for
8.75 Category II non-American College
of Healthcare Executives Continuing
Education credits. Program participants
are eligible for 6.25 Certified Public
Accountancy Continuing Education
credits.
Program Fee
$395
Register Online
Visit www.hanys.org/events to
register. Registration must be
completed by December 2.
Payment by credit card is
due immediately.
Overnight Accommodations
DoubleTree Hotel, Tarrytown
455 South Broadway, Tarrytown, New York Telephone: (914) 631-5700
A block of rooms at the DoubleTree Hotel has been reserved for
SWAT attendees. Please reserve your room by November 13 to
receive a discounted nightly rate of $149.
The group code is HTC.
To Reserve Online:
Please visit www.tarrytown.doubletree.com
To Reserve by Telephone:
Please call the DoubleTree Hotel at (800) 474-4260
What to Wear
The atmosphere throughout
the event is relaxed and we
suggest that participants
make themselves
comfort-able. Dress is business
casual. Participants should
bring a sweater to the meeting
room as it tends to be cool.
Cancellations
Registrations cancelled after
November 26 are subject to a
$50 administrative charge.
Registration fees for those
cancelling on the day of the
program or failing to attend
are forfeited. Substitutions
are permitted and
encour-aged, but should be indicated
either before or at the event.
Questions?
Registration questions: Christopher Guyon, Registration and
Technical Support Coordinator, at (518) 431-7834 or at
[email protected].
For questions about the SWAT program, please contact HANYS’
managed care staff.
HANYS’ Managed Care Team
Jeffrey Gold, Esq.
Vice President, Managed Care and Special Counsel (518) 431-7730 or at [email protected]