Health Care Cost Management
Rising health care costs, new technology, new drugs and changes in participants' health status have led to coverage challenges never faced before. This makes it even more critical to understand industry challenges and how to address them within plan documents. This two-day course explores the entire landscape of health care cost trends and cost-containment strategies, with special emphasis on today's emerging complexities. Gather with your peers and experts in the field to take a deep dive into the subjects and issues that affect health care plan costs and the evolving environment of health care management, plan design and coverage. Take the opportunity to network with and learn from others and exchange real-time ideas to implement in your organization.
Topics Covered
- Health care influences and trends
- Fundamentals of managing providers and patients
- The impact of technology on costs and health
- Prescription drug cost management
- Basic strategies for cost control
- Evolving health care management
- Strategies and decision points
- Case studies
Course Outline
Day 1
- Health Care Influences and Trends: Where We've Been and What Is Changing
- Cost influencers and trends
- The impact of medical technology
- New and emerging technology
- Challenges and cost considerations (examples)
- Pharmacotechnology
- Genomic medicine
- The cost impact of prescription drugs
- Prescription drug cost drivers
- Cost-control opportunities
- Beyond the pandemic
- Predicting your health care trend
- The Importance of Your Data
- Data analysis
- Sources of health care data
- Medical claims
- Pharmacy and specialty pharmacy claims
- Enrollment/eligibility statistics
- Health risk assessments
- Prescription data
- Basic Strategies for Cost Control
- Basic plan elements
- Coverage
- Eligibility
- Contribution strategies
- Plan design
- Price and utilization management
- Basics of utilization management
- Price management
- Reference-based pricing
- Controlling drug costs
- Managing fraud and abuse
- Network designs
- PPO network design
- Direct contracting
- Work site clinics
- Non-traditional treatment settings
- The patient side of cost control
- Promoting health and reducing health risk
- Consumerism
- Health literacy
Day 2
- Expanding on Patient-Focused Care
- Evidence-based medicine
- Value-based health care
- Accountable care organizations
- Patient-centered medical homes
- Precision/personalized medicine
- Putting It All Together
- Opportunities for reducing costs or lowering trend
- What you decide to do will depend on who you are
- What you decide to do will also depend on where you are
- The levers to consider
- Longer term strategies to improve workforce health
- Case Studies
Attendees will be divided into several groups to explore alternatives for controlling the costs of a hypothetical plan sponsor. In each of two breakout sessions, they will create a business plan that proposes both short- and longer term, broad-based solutions to the problem of rising costs through changes to the health care plan.
The hypothetical plan sponsors may be multiemployer, public sector or commercial, depending on the cross section of the attendees.
The case studies allow attendees to explore various topics from within the session and are wonderful opportunities to exchange real-time ideas.
Course Applies To
Pricing
July 18 - 19, 2025
Chicago, IL
Through June 2, 2025
US$1,400.00
Member
US$1,620.00
Nonmember
After June 2, 2025
US$1,700.00
Member
US$1,920.00
Nonmember
Pricing
October 10 - 11, 2025
Hilton Austin, Austin, TX
Through August 25, 2025
US$1,400.00
Member
US$1,620.00
Nonmember
After August 25, 2025
US$1,700.00
Member
US$1,920.00
Nonmember
Pricing
April 29 - 30, 2026
Scottsdale, AZ
Through March 16, 2026
US$1,495.00
Member
US$1,715.00
Nonmember
After March 16, 2026
US$1,795.00
Member
US$2,015.00
Nonmember
Pricing
September 28 - 29, 2026
Caribe Royale Orlando, Orlando, FL
Through August 17, 2026
US$1,495.00
Member
US$1,715.00
Nonmember
After August 17, 2026
US$1,795.00
Member
US$2,015.00
Nonmember
Continuing Education
Educational sessions at this program can qualify for CEBS Compliance credit. Visit www.cebs.org/compliance for more information.
Agenda
Friday, July 18 - Saturday, July 19, 2025
Chicago, IL
8:00 AM - 5:00 PM
8:00 AM - 3:00 PM
Friday, October 10 - Saturday, October 11, 2025
Hilton Austin, Austin, TX
8:00 AM - 5:00 PM
8:00 AM - 3:00 PM
Wednesday, April 29 - Thursday, April 30, 2026
Scottsdale, AZ
The selected event has no sessions.
Monday, September 28 - Tuesday, September 29, 2026
Caribe Royale Orlando, Orlando, FL
The selected event has no sessions.