Success implementing transparent, value-based NextGen healthcare plans requires a financial, strategic conversation with the CEO and/or CFO. These top advisers will reveal how the C-Suite healthcare conversation is evolving, the importance of using C-Suite language with executives, effective messaging that drives change, and the importance of discovering what the CEO & CFO want.

• Hear perspectives on why employers must modify their approach to benefit program design to meet the needs of today’s workforce and retain talent
• Discuss the importance of implementing holistic health and well-being programs to drive healthy behavior change, improve productivity, and reduce healthcare costs
• Explore novel models to coordinate care, promote healthy lifestyles, and ensure timely access to resources and support for employees and their families

Whether it’s a BUCA fully insured plan or a BUCA administrative services only (ASO) arrangement in a self-funded plan, disintermediating (i.e., getting rid of the middleman) the BUCA carrier is necessary to take control of the healthcare spend. Experts will lay out the key considerations and potential landmines when building a NextGen replacement to the BUCA plan.

• Hear perspectives on recent innovations in employer-provider partnerships that prioritize quality and value
• Reexamine direct contracts and focus on arrangements that enhance patient experience and outcomes.
• Discuss cost control strategies for employers via alternative payment models in telehealth and virtual care
• Explore opportunities in advanced primary care specific arrangements to deliver appropriate care and eliminate waste

Even though most employers are eligible to move to a transparent, value-based NextGen health plan, not all owners and executives are ready to leave the mental comfort of a BUCA provider network or the perceived comfort of a BUCA logo on the insurance card. These experts will share NextGen strategies that bring value to the client while meeting them where they are.

This is a shared session with the Engagement and Experience Track at thINc360 – The Healthcare Innovation Congress also taking place from June 20-22, 2023, at the Grand Hyatt Hotel in Washington DC.

• Understand the impact of adverse childhood experiences, the pandemic, stigma, and other health risks on treating mental health issues
• Identify and treat trauma-related stressors through creative expression and mindfulness
• Gain insights into how employers and healthcare professionals can establish a framework to help individuals cope and heal
• Discuss the value and importance of taking a proactive approach to address mental health including improved health and well-being, increased productivity, and reduction in overall healthcare costs

Addressing the waste and abuse in prescription medications, and especially high-cost maintenance and specialty drugs, provide the highest ROI in terms of reduced spend vs. plan disruption and noise. This expert panel will share effective cost-containment strategies and case studies.

Employers feel the heat of health costs and it extends beyond rising costs of care.  The additional costs for point solutions, employee medical leaves, and Rx prices amplify cost pressures.

What can we do?  Use data to explore how basic strategies like preventative service utilization can be a powerful offset.

Join this roundtable and walk away with two things:

1. New insights, techniques, and resources to paint a more accurate cost picture for your organization
2. Hear what other employers are doing to reduce financial burden while providing robust benefits

The roundtable leaders will share data resources, studies, and analytic strategies you can apply to quantify a more accurate true-view of costs associated with delayed or deferred preventative care.  Then let’s hear from our roundtable participants –what’s working and what’s next?

Come ready to hear more about:

• Care utilization trends across medical, pharmacy, and leave (STD, LTD, FMLA) data
• New survey data that provides unexpected insights into why people are still avoiding care
• Social determinants of health indices used to measure inequities in utilization and health outcomes across sub-populations
• Analytic approaches that help quantify additional cost impacts of avoiding care – “sicker at first diagnosis”

We want you to depart feeling empowered with insights and ideas!

Managing an employer’s healthcare supply chain – i.e., the employees’ medical and pharmacy purchases – is how advisers can ensure the quality of care and reduce the frequency and severity of claims, which is the only way to reduce the cost of healthcare. These experts will address the opportunities and challenges of managing the healthcare supply chain.  

• Gain strategies to support individuals with chronic conditions every step of the way
• Discuss the role of digital tools and applications to proactively communicate with and engage individuals
• Implement a comprehensive chronic-care strategy by providing access to resources, health coaches, medication, and mental/behavioral health support
• Leverage medical and SDoH data to determine unique needs, tailor care, and sustain healthy behavior change

Advisers are controlling the cost of healthcare with proven strategies to supplant the misleading and meaningless BUCA network “discounts” – 50% off of…what? – with strategies that reprice the provider’s unreasonable prices. This expert panel will discuss using a cost-plus pricing model with providers or replacing the bad BUCA provider contract with a direct contract between the provider and the employer.

• Understand the alignment on drug pricing, the utility of NADAC, and the influences that drive costs of value-driven pharmacy  
• Examine optimal ways to eliminate wasteful spend, curb rising drug costs, and review the data requirements due to CAA accountability, while moving to personalized medicine 
• Consider if Digital Therapeutics (DTx) should be managed by your PBM 

Layers of standards and measures, mostly rooted in compliance, have mounted for decades — all in the name of advancing quality and safety. The result is an overburdened workforce that is tired of checking boxes and jumping through hoops and whose been left to believe that quality ‘didn’t work’ or is a ‘waste of time’.

Today’s opportunity is to shift from a compliance mindset to an excellence mindset where our workforce is inspired to do their best work, not just get through the motions. Join NAHQ’s CEO, Stephanie Mercado, as she explores a future led by transformational leadership strategies where we reset the definition of healthcare quality and align teams to achieve healthcare excellence.

Several lawsuits have been filed over the past few months against carriers by parties demanding access to their health plan’s claims data, and on February 23, 2023 the Department of Labor (DOL) issues further guidance on the removal of “gag” clauses, meant to facilitate such access, including where and how to file attestations and instructing plans to report carrier noncompliance to its enforcement division. Navigating your Healthcare Plan under the new requirements and transparency has opened the door for huge cost savings for the plan and the participants but ignored, there are significant liabilities.

The Consolidated Appropriations Act of 2021 (CAA) is the most significant compliance challenge employers have encountered since the 2009 enactment of the Affordable Care Act, aka Obamacare. Yet not many are talking about it. This course offers a comprehensive educational program consisting of a certification program for CEO, CFOs, business owners, benefits specialists or other employer fiduciaries tasked with oversight of the plan. Classroom session is hands-on, peer to peer inter-active and forward thinking, using subject experts to facilitate the discussions. The curriculum is informative and relevant, covering essential areas pertaining to the healthcare plan and the new fiduciary duties and responsibilities plan sponsors now have.

The storm is here, and employers, sick of paying more each year in exchange for less, are determined to get healthcare costs under control. The mission of this half day course is to establish a foundation for a prudent process that will reduce organizations liabilities by engaging in conversation of management and oversight of employer sponsored healthcare plan.

The prudent employers will be at the table and the imprudent are on the menu as litigation and enforcement ramp up.

In this Deep Dive Workshop, you will learn:
1. What employers are required to do under the CAA 2021.
2. How to run a Fiduciary Procurement Process on your healthcare plan
3. How to reduce your liabilities, implement cost containment and enhance benefits on your healthcare plan