HC21 - 14th Annual Forum

Attendees began the morning with Brian Haile, Insurance Exchange Planning Initiative Director, State of Tennessee, Department of Finance & Administration. Haile spoke about the state health exchange and the potential impact to Tennessee employers. It is hoped that exchanges will help consumers make informed decisions about their health care and apply for premium assistance and public programs. Exchanges should also help small employers comply with PPACA and avoid penalties. Haile noted that health plans would have to qualify to be listed on the exchange and ways to evaluate plans would need to be created. Some reasons given for TN to operate its own exchange rather than letting the federal goverment do so, is that it would allow TN to retain control of TennCare and allow for regional customization.

Haile's complete presentation can be found here: "Insurance Exchanges: What Makes Sense for Tennessee?"

James Winkler, Managing Principal, US Health & Benefits, AON Hewitt shared opportunities that health reform presents for employers, including new paths that redefine what it means for an employer to be 'in' or 'out' of health benefits. He noted that over the course of the last year, many employers had a 'wait and see' approach because of the uncertainties of health care reform. He asked employers to form a plan and be ready for the opportunities and the potholes. Winkler covered four approaches for the future (please see slides). He suggested that health care change would be similar to the change American companies made when converting from pension funds to 401k accounts. He also reiterated that no matter what your path of change, the goal is a healthy and productive workforce, which is critical for business success. Winkler introduced the AON Hewitt Corporate Exchange concept that plans to launch as early as 2012 and suggested this exchange would have better risk and less variability than state-based exchanges.

Winkler's complete presentation can be found here: "Post-Reform: New Paths, New Approaches"

Anton Gunn, Regional Director, Department of Health & Human Services discussed HHS's vision of future health care in the US as a result of the Affordable Care Act (ACA). He reported that Tennessee received $168.9 million in federal grant funding as part of the ACA. This money is designated for several programs, among them the Medicare Part D rebate program, Early Retiree Reinsurance, Consumer Assistance, Health Insurance Exchange, Community Health Center improvements, Prevention and public health, Maternal and child health, Medicaid improvements and Prenatal assistance programs. Gunn expressed that the major themes of the ACA are to expand coverage, offer consumer protection and consumer choices, make health care more affordable, improve quality and improve prevention and public health. Implementation of the ACA began in 2010 and complete roll out is expected by the end of 2014.

J. Martin Storey, Director of Benefits, Michelin North America and Johnna Reed, VP, Heart & Vascular Services, Bon Secours St. Francis Health System, offered the story of their collaboration; Diabetes Integrated Practice Unit Pilot Project. Michelin and Bon Secours teamed with UnitedHealthcare, Medco & Porter, Tiesberg and Wallace to address chronic disease among their employees, specifically, diabetes. Michelin and Bon Secours are located in South Carolina where demographics for diabetes and obesity are high; 5th in the country for obesity and 3rd in the country for adults with diabetes. Their program integrated employer-paid Basic Care Requirements, learning labs, social networks and peer coaching. Benefits seen included patients who were able to stop insulin therapy, decreases in HgAIc's, weight loss and decreases in high blood pressure. This project created great partnerships and viewed healthcare not as an expense, but as an investment.

Their presentation can be found here: "Improving Diabetes Care at Michelin North America"

Jerry Reeves, MD, Chief Medical Officer, Health Innovations, presented a case study on how Health Innovations and Greenspun achieved consumer and provider accountability simultaneously. Dr. Reeves demonstrated variations in care received from different sites, hospitals and physicians. He showed that care also varies based on patient engagement and value. These variations helped to increase out-of-pocket costs by 84% since 2001. Dr. Reeves noted that a value based benefit design has the potential to drive us to better choices. He elaborated on the Patient Centered Medical Home Network and its incentives to provide better clinical, financial and satisfaction outcomes for all parties; patient, physician and plan sponsor.

Dr. Reeves' presentation can be found here: "Total Engagement: The New Look of Employee Health"