Latest Conference Content

The Academy of Managed Care Pharmacy's (AMCP) 2012 Educational Conference will take place in Cincinnati, OH, October 3-5 at the Duke Energy Convention Center.

Len Nichols, PhD, Professor of Health Policy and Director, GMU Center for Health Policy Research and Ethics, College of Health and Human Services, George Mason University, says that if states do not expand their Medicaid programs half of the uninsured will continue without coverage. States will continue to pay for healthcare inefficiently while patients receive suboptimal care.

Although there are contentions regarding its mechanisms, health policy and managed care authorities agree that the ultimate goal of healthcare reform is to increase access, improve quality, decrease costs, and measure progress. The initiative of further integrating digital health systems and implementing health information technology continues to receive substantial support and growth in a positive direction.

Peter Cunningham, PhD, Senior Fellow and Director of Quantitative Research, Center for Studying Health System Change, says that delivery systems should be moved more towards care management in order to deal with the high levels of wasteful care and emergency room use associated with Medicaid.

Robert Berenson, MD, FACP, Institute Fellow, Health Policy Center, Urban Institute, thinks that new healthcare delivery models are inevitable due to the behavior of physicians and providers who have abused fee-for-service. Dr. Berenson says that there has been unacceptable growth in the bias of fee-for-service activities, and new delivery models are necessary to improve quality and costs in healthcare.

The current movement toward healthcare reform is a multifaceted initiative that attempts to increase healthcare access and improve quality across the nation while balancing budgets and reducing current fiscal deficits. One health program that is a major component in the movement is Medicaid, and in this article, 2 health policy experts share their insight on the impact and future direction of Medicaid reforms.

Juliette Cubanski, PhD, Associate Director, Program on Medicare Policy, Kaiser Family Foundation, believes that the Medicare program overall has as much at stake in the 2012 election. Specifically, Dr. Cubanski says increasing private plan participation in Medicare and whether Medicare should move towards privatization will be some of the greatest challenges moving forward.

With healthcare and Medicare reform initiatives set in motion and garnering substantial momentum, mechanisms and programs for assessing improvement and determining quality measures have gained increased attention. In today's featured presentation, 2 health policy experts shared their insight on the current and future movement of performance and quality measurement.

Joseph Antos, PhD, Wilson H. Taylor Scholar in Healthcare and Retirement Policy, American Enterprise Institute, says people need to accept and understand that Medicare will not pay for all healthcare expenses after the age of 65. It is necessary to realistically look at other payment alternatives.

Farzad Mostashari, MD, ScM, National Coordinator for Health Information Technology, US Department of Health and Human Services, says that meaningful use sets a foundation for new models to deliver care to an entire population.

As the search continues for effective cost-containment strategies in a landscape of substantial healthcare expenditures, policy authorities are looking at Medicare reform and the Part D model for opportunities and direction. In this discussion, 2 policy experts share their insights on the progress, trends, and possibilities of Medicare Part D.

Mark McClellan, MD, PhD, Director, Engelberg Center for Health Care Reform, Leonard D. Schaeffer Chair in Health Policy Studies, Brookings Institution, talks about how to better inform providers regarding regulations and quality measures that are part of new delivery care models.

Although delivery systems are seemingly designed with beneficial intentions and streamlined utilization, a number of current practices and policies have been the subject of criticism and controversy. Two leaders in health policy shared their insights regarding these concerns and discussed the necessary steps to further improve an antiquated delivery system during changing times.

Karen Ignagni, President and Chief Executive Officer, AHIP, feels Medicare is right to take on the challenge of hospital readmissions. Ms. Ignagni also discusses how the Medicare Advantage plans have done a better job with traditional fee-for-services programs and tackling high hospital readmission rates.

The hotly debated proposition of premium support comes during a time of healthcare improvements through the Affordable Care Act and Medicare reform, which aim to combat the rising costs and substantial budget deficits resulting from an aging population and increased healthcare utilization.

Innovation in healthcare is becoming more important as the environment continues to evolve. There are a couple key components to increasing the adoption rate of new technologies and ideas in healthcare, according to Burns.

Many organizations would like to get consumers more engaged in their health. However, many programs miss the mark by lacking key features that have the potential to improve participation rates.

Barry Kinzbrunner, MD, Executive Vice President, Chief Medical Officer, VITAS Corporation, states that hospice and palliative care programs are important in the coordination of care for patients.

Much of the focus at AHIP Institute 2012 has naturally been on the issues that affect health plans and payers. However, one session in particular focused on some of the barriers and issues that providers face in today's complex healthcare environment.

"The problem is that incentives are still not aligned. Health plans need to align incentives so that hospitals are not losing and not being counterproductive of the goals they are striving for, says Jan Berger, MD, MJ, President & CEO, Health Intelligence Partners and Editor-in-Chief, The American Journal of Pharmacy Benefits.

The lunchtime general session at AHIP Institute 2012 on Thursday featured a couple of big name speakers: Paul Begala and Ari Fleischer, both of whom are political analysts for CNN. They spoke to a packed ballroom about the hot topics in healthcare reform and how they see the 2012 Presidential election shaping up.

In a heavily regulated market, it is becoming increasingly important for health plans to rely on innovative ideas. In order to do so, health insurers must create an organizational culture that places emphasis on flexibility and new ideas. In this session, presenters discuss some of the ways their organizations continue to break the mold in order to stay ahead of the curve.

Robert Margolis, MD, Managing Partner and CEO, HealthCare Partners, states that physicians and hospitals need to understand how to assess health and insurance risks in order to provide better care.

Karen Ignagni, President and CEO, America's Health Insurance Plans, spoke on Wednesday about the looming Supreme Court decision and how it will impact insurers.

One of the featured workshops at the America's Health Insurance Plans Institute 2012 on Wednesday was the Health Reform Advanced Studies Workshop, which was an interactive session that touched on a number of healthcare issues. Here are some of the highlights.

A focus at the America's Health Insurance Plans Institute 2012 is health insurance exchanges (HIX). With 30 million newly insured lives entering HIX in 2014, insurers face considerable risk. To assist insurers with managing this risk, the Centers for Medicare & Medicaid Services have developed 3 methods-reinsurance, risk adjustment, and risk corridors.

Sarah Thomas, Vice President, Public Policy and Communications, NCQA, states that there are 3 significant pieces of quality improvement strategies for health insurance exchanges.

In this video, Margaret Powers, PhD, talks about obesity's impact on the management of chronic illnesses. Dr. Powers also talks about the benefits of obese patients losing 5% to 7% of body weight and working out 150 minutes a week to lower their risk of developing diabetes and other chronic conditions.