Course

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

View course outline

Day 1

  1. Health Care Influences and Trends: Where We've Been and What Is Changing
    1. Cost influencers and trends
    2. The impact of medical technology
      1. New and emerging technology
      2. Challenges and cost considerations (examples)
        1. Pharmacotechnology
        2. Genomic medicine
    3. The cost impact of prescription drugs
      1. Prescription drug cost drivers
      2. Cost-control opportunities
    4. Beyond the pandemic
    5. Predicting your health care trend
  2. The Importance of Your Data
    1. Data analysis
    2. Sources of health care data
      1. Medical claims
      2. Pharmacy and specialty pharmacy claims
      3. Enrollment/eligibility statistics
      4. Health risk assessments
    3. Prescription data
  3. Basic Strategies for Cost Control
    1. Basic plan elements
      1. Coverage
      2. Eligibility
      3. Contribution strategies
      4. Plan design
    2. Price and utilization management
      1. Basics of utilization management
      2. Price management
      3. Reference-based pricing
      4. Controlling drug costs
      5. Managing fraud and abuse
    3. Network designs
      1. PPO network design
      2. Direct contracting
      3. Work site clinics
      4. Non-traditional treatment settings
    4. The patient side of cost control
      1. Promoting health and reducing health risk
      2. Consumerism
      3. Health literacy

Day 2

  1. Expanding on Patient-Focused Care
    1. Evidence-based medicine
    2. Value-based health care
    3. Accountable care organizations
    4. Patient-centered medical homes
    5. Precision/personalized medicine
  2. Putting It All Together
    1. Opportunities for reducing costs or lowering trend
    2. What you decide to do will depend on who you are
    3. What you decide to do will also depend on where you are
    4. The levers to consider
    5. Longer term strategies to improve workforce health
  3. 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

Jul 2025 Oct 2025 Apr 2026 Sep 2026

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

Jul 2025 Oct 2025 Apr 2026 Sep 2026

Friday, July 18 - Saturday, July 19, 2025

Chicago, IL

Friday, October 10 - Saturday, October 11, 2025

Hilton Austin, Austin, TX

8:00 AM - 5:00 PM

Health Care Cost Management - Day 1

8:00 AM - 3:00 PM

Health Care Cost Management - Day 2

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.