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Tuesday May 24, 2005
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8:00 am
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8:00 am
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9:15 am
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Cost increases are eroding employer sponsored benefits and causing retirees to seek options that provide limited out of pocket expenses and extensive prescription drug coverage. Do these options exist? This panel will explore current reactions to the changes in the Medicare Modernization Act and projections for future retiree plans.
In this session you will:
- Identify methods for mitigating cost of retiree benefits, Part D and the value proposition for maintaining product offerings for the Medicare population
- See how employers are 'filling in the gap' in prescription drug offerings
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Mary Grealy
President
Healthcare Leadership Council
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John Rother
Director of Policy and Strategy
AARP
 View Biography
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10:00 am
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Dual eligibles, those people whose care is provided through both Medicare and Medicaid, are often those people most in need of comprehensive, consumer-focused high quality health care. The Medicare Modernization Act recognizes this group's needs through new Special Needs Plans. States, which have the primary responsibility for long term care, and private sector health plans are working in a variety of ways to provide integrated health care through waivers, fully integrated plans and soon, through Special Needs plans.
In this session you will:
- Assess the challenges and opportunities in projects currently underway or planned in Florida, Texas, Massachusetts and Washington State to make Medicare work for this population
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Mary Kennedy
Vice President, Business Development
Evercare, A UnitedHealth Group Company
Former Director of Medicaid
State of Minnesota
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10:45 am
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In this session you will:
- Assess competitive bidding structures
- Analyze how plans are developing competitive and viable Medicare Advantage product offerings, the processes that PPO demonstration projects are using to maintain or eliminate their regional PPO status how this effects competitive plans
- Explore the implications of regional designations on access to care — Can local and regional plans respond to the infiltration of national plans?
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Karen Wintringham
Vice President of Medicare Strategy and Operations
Excellus Blue Cross Blue Shield
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11:15 am
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11:45 am
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Delivering disease management to a Medicare population presents some unique challenges. As with all disease management programs, the overall goal is to increase compliance with established care guidelines to improve health outcomes and decrease costs. Medicare recipients require a program that addresses the needs of a high risk population, and understands the challenges in engaging them in a plan that ensures a favorable clinical result.
In this session you will:
- Examine lessons learned in dealing with a Medicare Advantage population
- Uncover methods for determining the special needs of a geriatric population
- Learn the significant clinical and financial outcomes achieved through the partnership between Aetna and LifeMasters
- Consider issues such as engagement, eligibility, data exchange issues, and physician engagement
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Randall S. Krakauer MD, MBA
National Medical Director, Retiree Markets
Aetna
View Biography
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Christobel Selecky
President
Disease Management Association of America
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1:15 pm
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In this session you will:
- Determine the characteristics of elderly and disabled Medicare beneficiaries
- Consider the challenges that these characteristics create for educating Medicare beneficiaries under the Medicare Modernization Act
- Distinguish the kinds of support needed to help beneficiaries negotiate choice
- Figure out how these needs translate into unique product needs and opportunities in Medicare Advantage
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Marsha R. Gold Sc.D.
Senior Fellow
Mathematica Policy Research
View Biography
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2:00 pm
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In this session you will:
- Hear updates from those chosen for the Chronic Care Improvement Program, and evaluate their strategies over the coming year
- Evaluate the Visiting Nurse Service of NY/UnitedHealth Group Approach including:
- Establishing joint ventures
- Building on core competencies and experiences of each organization
- Blend of "High Touch" and "Low Touch" models dependent upon risk level
- Deliberate the benefits of collaborative model
- Analyze the challenges of CCIP pilot including:
- Achieving minimum participation rates
- Ongoing engagement of physicians and other providers
- Influence model — ability to achieve clinical outcomes and financial savings
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3:00 pm
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