See What’s New at MMCC 2015

The Medicaid Managed Care Congress is in its 23rd year, and there is a reason why we have been around so long—we consistently provide the newest and freshest insights on the topics that matter most to you and your business. For the 2015 event taking place on May 20-22 in Baltimore.

Here is a sneak peek of what’s new:

8+ New Health Plan Case Studies
Evaluate opportunities to grow membership, increase quality and decrease costs by learning from victories (and lessons learned) from speakers who haven’t presented in the past, including representation from Humana, Community Health Choice, Molina Healthcare executives on a national and regional level, plus many more.

Dual Eligibles Summit
It’s not just a few sessions anymore; we now have an entire day focused on increasing revenue by successfully navigating the very complex but extremely lucrative duals market.

A 360º view
The popular Medicaid Managed Care 101 pre-conference summit has been reformatted to give you multiple perspectives on the areas that have the highest impact on your bottom line. A unique 360º view from health plans, government officials, solution providers and other perspectives for a well-rounded understanding of the topics that will grow your skill set, such as ACA implementation, improving quality, the long-term industry outlook and more.

Customize your Agenda (coming soon!)
Create a personal agenda to select which sessions will increase your ROI the most. Prepare your networking strategy in advance to optimize your time at the event and coordinate attendance with colleagues to ensure you get maximum expertise. Stay tuned as we will make this feature available in the coming weeks!

Download the preliminary agenda for more details.

Register now and save $400! Use code XU2026BLOG - Register here.

mhpa2014, Medicaid Health Plans of America’s event for the Medicaid managed care industry

mhpa2014, the annual conference of Medicaid Health Plans of America and a must-attend for Medicaid MCOs, is on October 26-28 in Washington, DC.

mhpa2014’s sessions, expert insights, and networking receptions will provide health plan attendees all they need to succeed in the new age heralded by the ACA. 

Meet health plan executives, policy experts, state and federal Medicaid officials, and business leaders to discuss the latest in Medicaid managed care.

Speakers include CMS’s Barbara Edwards, CMO Dr. Steve Miller of Express Scripts, and John Lovelace, president of UPMC for You.

mhpa2014 also features Thomas Duncan, CEO of Trusted Health Plan, William S. George, CEO of Health Partners Plans, and Karen Clark, President, Horizon NJ Health, fielding questions from Forbes writer Bruce Japsen.

mhpa2014 will close with a discussion with Medicaid Directors from Kentucky, Louisiana, Tennessee, and Virginia.

For details, visit http://bit.ly/mhpa2014 
 
Questions? Contact Sarah Swango at 202-857-5772

Specialty Drug Distributor 'Diplomat Pharmacy' Sets Terms for $200M IPO

Via NASDAQ

Operating as the fourth largest specialty pharmacy in the US – Diplomat Pharmacy has announced terms for its IPO on Monday. The company plans to offer 13.3 million shares at a price range of $14-$16.

Diplomat distributes drugs that require coordinated regimens by patients with complex chronic diseases. On top of distributing these drugs, they also provide support services to health systems related to the complexity of administering the treatments. The company has a national distribution network with one main facility and seven regional locations.

In terms of other specialty pharmacies, Diplomat hangs behind the likes of multinational pharmacies like Express Scripts, Walgreens, and CVS Caremark – but they are the largest independent specialty pharmacy in the US.

With a majority of specialty pharmacy revenue coming from government programs including Medicare and Medicaid, can the high cost of these specialty drugs be changed? For example, the high price and extraordinary demand for Gilead’s Sovaldi has prompted calls from insurers and other health care stakeholders for action on the specialty drug pricing model. What is the potential public policy response?

Join us at FDA/CMS Summit for Payers this December in Washington D.C. to learn the answers to these questions and many more. Hear from the FDA, CMS, Health Plans, and other industry game changers all under one roof, as they discussion the challenges facing payers and pharma. Download the updated agenda here and register with the code XP1917BLOG to save $100 off the current rate - $300 in total savings!

Attention All Health Plans | Buy One, Get One Free to the Specialty Pharmacy Collaboration Summit

 

Attention Health Plans! Join us at the Specialty Pharmacy Collaboration Summit and for a limited-time only, we're offering a Buy One, Get One offer*! 

Expiring this Friday, July 25th, purchase one pass and have a colleague attend for free! Be sure to use code: XP1968BOGO. To register, call Roxana Siu at 646-895-7452 or email rsiu@iirusa.com.


*Free Delegate Pass Eligibility Rules and Regulations:
1. Offer applies only to Health Plan executives
2. If the paying delegate cancels, the free delegate will receive an invoice for the amount of the paying delegate.
3. Tiered pricing is valid through expiration date. New pricing takes effect at specific dates indicated. All fees must be paid in full by expiration date or your price will increase to the next level tier.
4. Offer cannot be applied retroactively to confirmed paying registrants.
5. Offer cannot be combined with any other discounts or promotions.
6. All BOGO registrants and guests are subject to IIR approval.

360 Perspective from BCBS, Boston Medical Center, Tufts Health Plan, Denver Health Plan and more!

 

This Friday, July 25th is your last chance to save up to $500!

Use Code: XP1968BLOG 

Register Now

Due to increasing healthcare costs brought on by health care reforms and the ACA, payers need to partner with specialty pharmacies to help fill the oversight gap in compliance and to manage costs and reimbursements. Specialty Pharmacies offer their product management and patient adherence services to help fill the gaps of the payers, while meeting the needs of reduced costs.

IIR's all-new Specialty Pharmacy Collaboration Summit is the only event in the space offering you the opportunity to partner directly with all the key stakeholders in the specialty pharmacy value chain to increase patient adherence, expand distribution and improve bottom line. Learn how health plans successfully partner with specialty pharmacies and leading pharmaceutical companies and discover the impact of specialty pharmacies on bottom line profits and costs from the below experts:

The True Value of Specialty Pharmacy: A Direct Impact on Bottom Line Revenue and Profits

• Reed Melton, Executive Director, Center for Clinical Practices, Blue Cross and Blue Shield Association
• Bhavesh Shah RPh, BCOP, Clinical Pharmacy Manager, Hematology-Oncology, Coordinator - Patient Assistance Programs, Specialty Pharmacy Manager, Boston Medical Center

Payer Panel: Specialty Pharmacy Management in Commercial Health Plans

• Michelle Beozzo, PharmD, Director of Pharmacy Services, Managed Care, Denver Health Medical Plan
• David Brumley, MD, MBA, Senior Medical Director, Tufts Health Plan

Roundtables: The Specialty Pharmacy Space-Niche No More?

• Independent Retail Community Pharmacies
Nick Calla, VP Industry Relations, Community Specialty Pharmacy Network
• Regional and National Chains Launching Specialty at Retail Programs
Christopher Benz, Business Development Director, Armada Health Care
Brian Burke, Vice President, National Accounts, Armada Health Care
• Private, Independent Specialty Pharmacies
Rebecca M. Shanahan, Esq. Chief Executive Officer, Avella Specialty Pharmacy

Download the updated brochure for the full agenda and speaker details.

Don't miss out! This Friday, July 25th is your last chance to save up to $500! Click here to register or call 888-670-8200 to register. Be sure to use code: XP1968BLOG

Announcing IIR’s All New Specialty Pharmacy Collaboration Summit

IIR is proud to introduce the all-new Specialty Pharmacy Collaboration Summit taking place September 15-17, 2014 in Boston, MA.

This collaborative summit is designed to facilitate networking and integration between all key stakeholders in the evolving specialty pharmacy value chain, including the leading pharmaceutical manufacturers, health plans, and specialty pharmacies.

Register now to save $600! Plus take an EXTRA $100 off with the code: XP1968BLOG - That is $700 in total savings! Register today!    

To see how you can expand distribution, increase patient adherence and improve your bottom line, download the brochure.

Develop consistency and clarity around the integration of all specialty pharmacy stakeholders through:

• Never-Before-Heard Case Studies on accountable care Impact on payer provider relations from:
• Aetna
• BCBS
• Tufts Health Plan
• Denver Health Medical Plan
• And more!

• URAC Accreditation Workshop to improve operations and enhance compliance.
• Facilitate more face-to-face meetings to foster meaningful engagement and build relationships across 3 days than in your entire year with partnering360.

Remember, to save an EXTRA $100 off the current rate, use the code: XP1968BLOG when registering.
  _______________________________________

Connect with Potential Partners and Clients

To learn more about how to sponsor or exhibit, please contact Patricia Rose at 508-614-1406 or prose@iirusa.com.

A Call For Papers: HIX Reloaded

We are pleased to announce HIX Reloaded (formerly the Health Insurance Exchange Congress), taking place the week of November 11 in Baltimore. We’re playing in a dynamic marketplace, where seemingly every day there’s new information, guidance and regulations when it comes to healthcare reform, and more specifically, health insurance marketplaces. In a marketplace laced with uncertainty, constant change, and unclear guidelines, HIX Reloaded brings together early HIX adopters and entrants to share their lessons, discuss anticipated challenges ahead. When attendees register, they will be asked to vote on the topics that matter most to them, thus ensuring a timely, relevant agenda.

The agenda is currently under development, and I am currently looking for health plan and state government speakers who have first-hand experience on in the following areas:

-budget neutral risk adjustment

-network development & expansion

-state/health plan collaboration

-case studies on marketing your plan to grow membership

-training Navigators

-strategies to maintain continuity of care

-setting and negotiating provider rates

For information about last year’s agenda visit our website.

If you are interested in speaking on any of these topics, or would like to suggest another topic, please email SGordon@iirusa.com, the Program Director for the event.

If you would like to get in front of our audience of health plan executives working on exchanges, please contact Sarah Scarry at SScarry@iirusa.com for sponsorship and exhibition opportunities.

We look forward to hearing from you soon!

Cheers,
The HIX Reloaded Team

Meg Murray on if there are specific areas where health plans need to expand their networks?

Recently, Meg Murray,CEO, Association for Community, Affiliated Health Plans, sat down with Medicaid Managed Care Congress director Sarah Gordon to discuss some of the biggest topics in the industry. 

Today, we feature Meg's answer to this question:

In general, are there specific areas where health plans need to expand their networks?

Her response:

We continue to hear about problems with the pediatric specialists. Dermatology is also one we often hear about. Of course the dental issues. I think everyone is very aware of the dental. As we move into the expansion population, a lot of this population coming on board are going to be people with significant mental health and substance abuse problems. That has continued to be a current concern of getting enough providers with those specialties. So, our plans are now actively looking at how they can enhance the network for adults, one. And then also for people with mental health issues.

Download the full interview at the MMCC Resource page.  Meg will be the moderator for the Health Plan CEO Panel: Ensure Member Access through Robust Provider Networks at this year's Medicaid Managed Care Congress taking place April 30-May 2.  For more information on the event, download the brochure.  If you'd like to attend, mention code XP1726BLOG when you register to save 25% off the standard rate!

High quality care rules to change in 2013

On Friday afternoon, The Medicare Agency released a detailed system to encourage the pay-per-performance to encourage better care in hospitals as proposed by the Democratic Healthcare Bill. The Hill commented that with the value-based purchasing system will look at both the quality of care and experience provided to the patient.

Centers for Medicare and Medicaid Services (CMS) Administrator Donald Berwick said in a recent statement, "Today's proposal is a huge leap forward in improving the quality and safety of America’s hospitals for both Medicare beneficiaries and all Americans. The hospital value-based purchasing program will reward hospitals for improving patients' experiences of care, while making care safer by reducing medical mistakes."

Health Plans will be joining to discuss end-of-life care issues at the upcoming Medicare Congress Jan 24-26, 2011 in Scottsdale. For more information on Health Plans session, and the entire agenda, download the brochure.

Convene at the health plan industry’s first congress of 2010

Join us at the start of the New Year for the health plan industry’s first congress of 2010. From operations and revenue drivers to marketing and competitive benchmarks, the 7th Annual Medicare Advantage Congress is your blueprint for optimizing the performance of your health plan. It’s a golden opportunity to interact with your colleagues, get insight into what your competitors are doing, and walk away with executable strategies for protecting profitability and driving growth.

This year’s program includes provocative Keynote Sessions delivered by the industry’s finest leaders:

Health Care Reform: Perspectives and Insights from Senator Tom Daschle and Dr. Mark McClellan:
• Tom Daschle, Former Senate Majority and Minority Leader
• Dr. Mark B. McClellan, Director of the Engelberg Center for Health Care Reform, BROOKINGS INSTITUTION

Creating an Accountable Medicare Managed Health Care System:
• Robert Berenson, MD, Institute Fellow, Urban Institute

Come together at The Medicare Congress to share the tools needed to improve quality, maximize revenue, ensure compliance, and improve operational efficiency in order to attract and retain members, protect and grow your organization’s Medicare market share, and improve clinical outcomes. With all the uncertainties coming our way, now is the time to prepare for what the future holds.

We look forward to seeing you in Washington, D.C. next January.

The current state of healthcare reform -- Are you ready?

Are you ready for the Healthcare reform?

If a bipartisan agreement is not reached by October 15th, a republican filibuster is not possible and healthcare reform is a done deal with 50 votes in the Senate. With the democrats holding 58 seats, it is irrational to think some level of reform will not happen this year. While it is difficult to predict what the final bill will look like, every reform proposal currently under consideration mandates individual coverage and ends barriers to coverage for people with preexisting medical conditions. If no other policy reforms are included in the final bill, the ramifications for the health insurance business are still tremendous.

How will Health Plans survive this direct hit on their current business model?

Through the vital restructuring of the healthcare delivery models they currently employ and the Next Generation Healthcare Delivery event, scheduled for October 26-27 in Washington, DC. This is your best opportunity to convene with other health plan leaders from across the nation to evaluate and integrate innovative healthcare delivery models to ensure sustainability and profitability in the years to come.

How will Health Plans expand coverage to previously uninsurable populations and maintain profitability?

Traditional medical management has been maxed out, if health plans want to survive, it is essential that they act now to incorporate value-based benefit design and outcomes driven provider structures that ensure that health and wellness are managed effectively and efficiently. At the Next Generation Healthcare Delivery join your industry colleagues at this critical crossroads and reshape your current provider model by taking simple steps to obtain measurable improvements in clinical outcomes.

• Utilize Shared-decision making and let patient choice lead to the use of less costly healthcare delivery options
• Incorporate Medical Home Models to support a better organization of care and gain ideas to make it more effective
• Implement value-based tools to manage risk and help members make better choices
• Leverage ways that e-visits can increase access to specialty care while maintaining lower cost structures
• Develop a value-based integrated health care delivery system for the future

The moment is now. Register for Next Generation Healthcare Delivery and evolve your business into a true partner in care delivery and improved health outcomes!

Healthplans must integrate these delivery models by redesigning their benefits and reimbursement structures. The Next Generation Healthcare Delivery event provides you with the tools you need to implement and integrate new delivery models into your program benefit design for better health outcomes, higher member satisfaction, and a greater competitive advantage.

Through pilot programs, case studies, panels and roundtable discussions, our expert speaking faculty shares best practices and RESULTS on new delivery models and how they can improve healthcare quality while maximizing ROI.

Register today!


To become more involved with other professionals working in the next generation healthcare delivery field, join our LinkedIn Group!

Medicaid Managed Care Congress: Will you be there?

What does the stimulus plan mean for your state program? How are your fellow state reps and health plans strategizing in this economy? The 17th Annual Medicaid Managed Care Congress provides you a forum to discuss these issues and bring home the best action plan. Join us this June 8-10, 2009 to hear best practices, next practices and the latest regulatory developments from CMS, State Medicaid officials and health plan executives on how to achieve quality care, comply with the latest legislation, and manage cost.


The lowest price of the year is available until March 13. For more information on the program and speakers, visit our website!