It’s no secret, the current healthcare system is flawed and rising costs continue to extract value from employers and local communities each and every year, oftentimes at the expense of investments to improve social determinants of health such as education, nutrition, housing, and more.

In this conversation with Dave Chase, co-founder and CEO of Health Rosetta, you will witness a powerful vision for restoring community-based health and practical steps for creating employer-optimized health plans.

Speaker: Dave Chase
Gibson Facilitator: Ray Korson

Preferred provider networks have traditionally been favored by employers for providing broad provider access to members across large geographies. However, provider networks are not necessarily built to manage costs and quality given fee-for-service reimbursement arrangements and the inability to steer to high quality providers in the network. Innovative purchasers focused on driving higher quality and lower costs in their health plans are actively seeking ways change how providers and hospitals are paid to ensure that incentives exist to lower costs and drive high quality patient outcomes.

Join us and special guest Lester Morales of Next Impact as we expose the reasons why traditional forms of healthcare purchasing are ineffective and may actually be contributing to higher plan costs. We’ll discuss alternative payment strategies that align incentives to promote greater value in the form of higher quality and lower costs for healthcare.

Arguably one of the greatest dysfunctions of the U.S. healthcare system is the demoted position of primary care. Unfortunately, primary care has been relegated as a sort of “loss leader” in the healthcare delivery system, designed to serve as a referral source to higher cost specialists or facilities rather than allowing doctors enough time to treat patients holistically on the front-end. The Affordable Care Act rightly promoted the importance of primary care by eliminating cost for preventive services, but this is not adequate by itself.

Join us as we explain the importance and value of primary care and outline strategies that promote its use through plan design and direct care arrangements.

Did you know that, for most health plans, a mere 6-8% of covered members account for 80% of total claims spend? One of the foundational strategies behind value-based purchasing is focusing on reducing the frequency and severity of high cost claims. In other words, focus on the 6% of your members driving the majority of your costs and claims volatility in your plan.

Join us as we expose this prevalent challenge and debunk the myth that employers are helpless when it comes to managing the risk of high cost outlier patients.

Recent scandals and public scrutiny have started to shine a bright light on the opaque business practices of big pharma manufacturers and pharmacy benefits managers. Despite this scrutiny, the cost of prescription medications continues to rise as manufacturers focus on developing high cost specialty medications and lack of regulation permits various players to arbitrarily inflate the cost of prescriptions year over year.

Join us as we shine a light into the “black box” of prescription medications. We’ll explain how prescription medications are sourced and procured, how PBMs get paid in oftentimes hidden ways, and how you can better manage your pharmacy spend.

Even the most innovative and best-in-class programs will fall short if individual healthcare consumers neglect to take advantage of these programs. Driving behavior change in how individuals access healthcare and engage with your plan should be a primary focal point of your benefits strategy.

Join us as we dive into the topic of care navigation and why it matters. We’ll outline the traditional methods insurers and purchasers have used to manage care and highlight best practices for ensuring that patients are taken care of and compassionately guided towards high quality, low cost providers.