Health Care Management Conference

The prescription drug landscape is in a constant state of change. Recently developed, high-priced therapies are being introduced at an accelerated rate. This new environment is forcing plan stakeholders to meet the evolving needs of their participants while controlling plan costs. A comprehensive strategy is needed to balance these needs and create sustainable plan design. This session will cover:

• What’s coming down the pipeline
• Cost-management strategies(formularies, biosimilars and more)
• Pharmacogenomics updates
• Formulary development and more.

Historically, organizations have offered a number of health, wellness and safety initiatives to ensure worker health and improve productivity. However, few offer a holistic approach to worker well-being. To fill this gap, the National Institute for Occupational Safety and Health (NIOSH) created the Total Worker Health (TWH) program. What lessons can be learned from a comprehensive framework? Are there other useful approaches to explore? Session topics include:

• The importance of connecting health, safety and well-being initiatives
• Impact of recent research findings
• Implementing these strategies into a trust fund environment
• Case study examples.

Providing high-quality care while containing escalating costs is the primary goal of plan trustees and administrators. Through effective design, plans can address existing cost-drivers such as chronic conditions and specialty drug costs as well as more recent sources such as inflation, labor shortages and delayed preventive care. How can this be achieved? Topics covered in this session include:

• Navigating an inflationary environment
• Identifying your negative and positive cost-drivers
• Evolving from sick care to worker well-being
• Driving participant behavior to the most efficient outcomes
• Measurement strategies.

As plan memberships become more diverse, the need for work/life balance becomes even more imperative. A growing number of employers are offering family-friendly benefits such as fertility services, paid leave and flexible scheduling to accommodate employees in today’s competitive labor market. What offerings should your organization consider? This session will cover:

• Child-care considerations
• Paid and unpaid leave offerings—Maternity, paternity, surrogacy, adoption, miscarriage and more
• Fertility benefit offerings—IVF, genetic testing, egg freezing and more
• Other offerings you may not have considered
• Implementing offerings as a DEI initiative.

According to the CDC, six in ten U.S. adults have a chronic disease, and four in ten have two or more. These conditions are the leading causes of death and disability as well as one of the primary drivers of the country’s $4.1 trillion annual health care spend. What actions can be taken to combat these conditions at a plan level? Which will have the greatest impact? The session will address:

• Identifying and addressing causes of these conditions
• Identifying your high-risk participants
• Impact of preventive care
• Effective disease management initiatives
• Reducing/eliminating barriers to appropriate care.

About one in 36 children has been identified with autism spectrum disorder. This figure has increased drastically over the past 20 years, leading to an increasing number of workers providing care for dependents on the autism spectrum. Those workers may struggle with anxiety, depression and a lack of work-life balance, impacting productivity via absenteeism, presenteeism and turnover. What can be done at a plan level to design the most appropriate benefits? This session will cover:

• Identifying and diagnosing disorders
• Plan design and coverage options
• Mental health parity considerations
• Considering appropriateness of care.

This session will cover elements of the rapidly changing legal and legislative environment, including:

• Transparency guidance
• Mental health parity disclosures
• Surprise medical billing guidance
• Post-Dobbs implications
• Cybersecurity issues.

A defining characteristic of the COVID-19 pandemic was an increased emphasis on the mental health of plan participants. This took the form of increased utilization of EAP/MAP programs as well as the use use of telehealth for initiative delivery. Plan sponsors can continue this momentum and evolve their initiatives to better address the needs of their incumbent workers while attracting workers for the future. What does this evolution look like? What are the next steps? This session will cover:

• Lessons learned from the pandemic
• Impact of substance use—Alcohol, opioids and more
• Impact of gun violence
• Connection to physical safety initiatives
• Directions to consider—Peer support models, recovery-friendly workplaces and more.

Health care point solutions are designed to address specific conditions in your plan population, often through the use of technology. These solutions are varied and commonly address fertility, diabetes, musculoskeletal conditions and mental health. To make the best of use these capabilities, plan sponsors must have knowledge of this exceedingly complex landscape. What factors should you look for in a partner? What should you avoid? This session will address:

• Point solutions: How do they work?
• Using your data to drive plan design
• Avoiding silos—Integrating your other benefit offerings
• The role of artificial intelligence
• Case study examples.

A panel of experts will discuss a number of emerging trends in the health care arena. Attendees will have the opportunity to vote on which topics will be discussed. Potential subject areas include:

• Coverage for weight-loss drugs and bariatric care
• Navigating HSA/HRA implementation
• Cost impacts of delayed care
• Utilizing quality indicators
• Identifying and reducing fraud/abuse
• Cybersecurity initiatives
• Impact of legalized marijuana
• Coverage for gender-affirming care.

Last year, more people died by suicide than ever before, making it the second leading cause of death for people ages 20-34. The impact of suicide reaches well beyond the loss of life. A recent study noted that, on average, 135 people are impacted by the suicide of one individual, having an untold impact on medical costs, worker productivity and quality of life. What can be done to address this alarming trend? What are the roles of your stakeholders? This session will cover topics such as:

• What are the key causes? Digging into trends data
• Impact of gun violence
• Teaching resilience/coping skills
• Prevention, intervention and postvention strategies
• Coverage considerations for members and their beneficiaries.

A recent study noted that cancer was the top driver of health care costs in 2023. To combat these escalating costs, plan sponsors must provide access to coverage that is quality, comprehensive and integrated. This wide-ranging discussion will address:

• Catching cancer early (conventional screenings and next-gen tests)
• The power of data for patient navigation
• The impact on worker mental health
• Plan design considerations (specialty networks, high-quality providers and more)
• Specialty drug considerations
• Avoiding silos—Using an integrated approach
• Case study examples of success.