The Phoenician, Scottsdale, AZ September 17 19, 2014

Transcription

1 The Phoenician, Scottsdale, AZ September 17 19, 2014 Charles Kennedy, MD Chief Executive Officer, Accountable Care Solutions Aetna Captain Chesley B. (Sully) Sullenberger, III Aviation and Safety Expert, Best-Selling Author William Winkenwerder, Jr., MD Recognized Health Industry Leader; Former, President and Chief Executive Officer of Highmark Health T. Colin Campbell, MS, PhD Best-Selling Author, The China Study and WHOLE Peter Wickersham Senior Vice President, Integrated Care and Specialty Prime Therapeutics ManagedMarketsSummit.com

2 MANAGED MARKETS SUMMIT SPEAKERS AT-A-GLANCE Jennifer Allen, RN, BSN, MBA Senior Program Manager UBC An Express Scripts Company Bill Barre Vice President, Business Development MedImpact Healthcare Systems, Inc. Charles Bell Director, New Business Development UBC An Express Scripts Company Eric Cannon, PharmD, FAMCP Chief of Pharmacy SelectHealth Brian Corvino Head of Commercial Strategy, Insights and Training Decision Resources Group Kirby Eng, RPh Executive Director, Clinical Oncology Management Services Onco360 Patrick Finnerty PWF Consulting Alice Ganzar Director, Business Development UBC An Express Scripts Company Matthew Gibbs, PharmD Chief Commercial Officer Envision Rx Options Martin Hickey, MD Chief Executive Officer New Mexico Health Connections Jennifer Hinkel Partner McGivney Global Advisors 2 MANAGED MARKETS SUMMIT FALL 2014 Brigham Hyde Vice President, Data Science Decision Resources Group Atheer Kaddis, PharmD Senior Vice President, Sales and Business Development Diplomat Specialty Pharmacy James Kenney, Jr., RPh, MBA Pharmacy Operations Manager Harvard Pilgrim Health Care, Inc. Randall Krakauer, MD, FACP, FACR Vice President, National Medical Director, Medical Strategy Aetna Chronis Manolis Vice President of Pharmacy Services UPMC Health System (Pennsylvania) Bill Melville Senior Analyst Decision Resources Group Peter M. Mikhail, PharmD, MBA Associate Vice President, Procurement Services, Enterprise Supply Chain Services Geisinger Health System Neil Minkoff, MD Founder FountainHead HealthCare Jeff M. Myers President and CEO Medicaid Health Plans of America Kathleen Oestreic Chief Executive Officer Meritus Health Partners Cynthia Pigg, BSMT, PharmBS, MHA, FAMCP Senior Vice President, Pharmacy MagellanRx Management David A. Pizzi Director, Political and External Relations Florida Blue Gary Rice, RPh, MS, MBA, CSP Vice President, Clinical Services Diplomat Specialty Pharmacy Marc Richmond, MD, MMM Regional Medical Director Blue Shield of California Bruce Sherman, MD, FCCP, FACOEM Medical Director Employers Health Coalition John Thornton, MS, RPh President JB Pharmaceuticals Kimberly Tuck, RN, MHA President and Chief Executive Officer NurseWise, a subsidiary of the Centene Corporation F. Randy Vogenberg, PhD, RPh Principal Institute for Integrated Healthcare Laurie Wesolowicz, PharmD Director, Pharmacy Services Clinical Blue Cross Blue Shield of Michigan (BCBSM) Heather Lee Whipple Vice President, Government/Payer Relations Practice Decision Resources Group Michael White, PharmD, CSP Director, Clinical Pharmacy BlueCross BlueShield of Tennessee Joseph Zavalishin Executive Vice President, Strategic Contracting & Payer Relations AxelaCare Health Solutions

3 WHAT'S NEW AT FALL MMS FALL 2014 WHAT S NEW AT FALL MMS 5TH KEYNOTE PRESENTATION MMS now features 5 keynote presentations with the addition of Peter Wickersham of Prime Therapeutics, who will present on Friday, September 19th at 8:00 am. COMPLIMENTARY MORNING YOGA All MMS speakers and attendees are welcome to take a morning outdoor yoga class before the conference begins. We provide mats and a beautiful morning sunrise, all you need to do is show up! MMS COUNTRY BASH On the last evening of the conference, we ve decided to throw one heck of a networking event with the MMS Country Bash. Enjoy some of the Southwest s finest edibles and drinks while mingling with speakers and attendees. KEYNOTE SPEAKER BOOK GIVEAWAY Each attendee will receive a complimentary copy of keynote speaker T. Colin Campbell s best-selling book, The China Study: The Most Comprehensive Study of Nutrition Ever Conducted and the Startling Implications for Diet, Weight Loss and Long-Term Health. MAKE SCOTTSDALE YOUR WEEKEND DESTINATION Enjoy one or two relaxing days before or after MMS by taking advantage of the discounted attendee rate at The Phoenician three days before or after the event based on availability. MMS attendees also receive a 10% discount on spa services and golf fees at the resort's championship course! For event updates and registration, visit ManagedMarketsSummit.com. SEPTEMBER SCOTTSDALE, AZ 3

4 MANAGED MARKETS SUMMIT KEYNOTES FALL 2014 WEDNESDAY SEPT. 17 MORNING 8:00 am 9:15 am Creating a Sustainable Health Care Future AFTERNOON 1:00 pm 2:15 pm Preparing for Excellence: Leading Your Team to Success Charles Kennedy, MD Chief Executive Officer Accountable Care Solutions Aetna Captain Chesley B. (Sully) Sullenberger, III Aviation and Safety Expert, Best-Selling Author With government reimbursements declining at the same time the industry is moving away from fee-for-service to a value-based model, how do we ensure a sustainable future for health care providers in this new world? Dr. Charles Kennedy will talk about the environmental factors necessitating a business model change, the economic pressures facing providers and purchasers, and consumer expectations for health care value and a better experience. He will share how accountable care models are helping to address the necessary changes in how health care is delivered, including Aetna s work to help providers succeed through effective payer-provider collaborations. How you prepare, train and lead makes all the difference when you are confronted with a challenge. While many know about Captain Chesley B. Sully Sullenberger's heroic actions on January 15, 2009, few have an understanding of the depth of Sully s preparation, as lives depended on his training every day. From his early career as a fighter pilot in the U.S. Air Force, to his ongoing work in commercial aviation as a pilot and safety trainer, Sully s life-long pursuit of learning and investing in himself shows the importance of education and preparedness, and illustrates that true leaders must always lead by example. Straightforward and humble, Sully s story shows the positive outcomes of having a daily devotion to duty. Sully will challenge and inspire teams to establish a foundation of passion for their work, build trust in each other, and commit to always reaching for the highest standards. 4 MANAGED MARKETS SUMMIT FALL 2014

5 KEYNOTES FALL 2014 THURSDAY FRIDAY SEPT. 18 SEPT. 19 MORNING 8:00 am 9:15 am Surviving the Health Care Crisis: A Road Map for Employers AFTERNOON 1:00 pm 2:15 pm Nutrition: The Forgotten Medical Science MORNING 8:00 am 9:15 am Solving America s Drug Problem William Winkenwerder, Jr., MD Recognized Health Industry Leader; Former, President and Chief Executive Officer of Highmark Health As one of the country s most influential health care leaders, whose experience includes being on both the provider and business sides of the debate and who has worked directly with major employers, Dr. Winkenwerder speaks candidly about the difficult choices that lie ahead for corporate America and the government in both the long and short terms. Audiences will benefit from his recommendations for companies to evaluate their long-term health care programs as well as his advice on: How preventive health care can provide substantial long-term savings How reforms involving new regulations, possible tax credits, and a national health exchange may play out in the future What corporate managers should consider in adjusting benefit designs and new services to more fully engage employees in healthy behaviors and reduce health care costs T. Colin Campbell, PhD Jacob Gould Schurman Professor Emeritus of Nutritional Biochemistry (Cornell) Best-Selling Author, The China Study and WHOLE Nutrition, when properly done, has an amazing but little known capacity to maintain health, repair health gone bad, and prevent future health problems all with the same dietary protocol, better known as dietary lifestyle. In short, this kind of nutrition not only prevents future disease (domain of preventive medicine) but also treats existing disease while restoring health. When sustained, it is a protocol that is relatively free of side effects. This kind of nutrition is provided by a diet of whole plant-based foods with little or no added fat/ oil, refined carbohydrates and salt (the taste-enhancing ingredients of highly processed fast foods ). Its nutritional composition approximates 80% carbohydrate, 10% fat and 10% protein. Although its biological activities within our bodies are infinitely complex, its application in the kitchen is surprisingly simple and user friendly. Its application also is far-reaching, including especially notable decreases in health care costs and environmental benefits. Peter Wickersham Senior Vice President Integrated Care and Specialty Prime Therapeutics Discuss prescription drug use in the U.S. over the past 2 decades and assess its overall impact on public health Address the greatest challenges and problems related to prescription drugs Outline several steps to increase patient safety and access while maintaining sustainable cost growth into the future SEPTEMBER SCOTTSDALE, AZ 5

6 MANAGED MARKETS SUMMIT AGENDA FALL 2014 TUESDAY WEDNESDAY SEPT. 16 SEPT. 17 Registration Opens 4:00 pm 8:00 pm Registration Opens 7:00 am Lunch 11:45 am 1:00 pm Wine & Cheese Reception 6:30 pm 8:00 pm Morning and afternoon sessions run 60 minutes, then repeat. There is a 15-minute break between sessions. Just added to Wednesday morning! Trends in Opioid Abuse in Patients with Non-Cancer Pain John Thornton, MS, RPh President JB Pharmaceuticals Utilizing a Specialty Pharmacy Drug Pipeline Database to Optimize Patient Care Gary Rice, RPh, MS, MBA, CSP Vice President, Clinical Services Diplomat Specialty Pharmacy Breakfast 7:00 am 8:00 am Keynote Presentation Charles Kennedy, MD 8:00 am 9:15 am MORNING SESSIONS 9:30 am 11:45 am The Role of Employers Using the ACO/Provider Collaboration Model for Enhanced Pharmacy Management Including Quality and Cost Medicaid From Afterthought, to Top of Mind, to Driving the Future Trends in Opioid Abuse in Patients with Non-Cancer Pain Specialty Pharmacy Contracting Utilizing a Specialty Pharmacy Drug Pipeline Database to Optimize Patient Care Benefit Designs in the Specialty Drug Era (2016 and Beyond) Utilizing a Specialty Pharmacy Drug Pipeline Database to Optimize Patient Care Keynote Presentation Captain Chesley B. (Sully) Sullenberger, III 1:00 pm 2:15 pm AFTERNOON SESSIONS 2:30 pm 4:45 pm The Future of Drug Fulfillment for the Payer and Consumer Evolving Oncology Drug Management Strategies Update on Biosimilars 2014 Opportunities and Challenges Patient Engagement through Adherence and Compliance Programs Fresh Opportunities, Continuing Challenges: Health Exchanges Roll Into 2015 Government Markets: Driving Systemic Transformation of the U.S. Healthcare System A Spanish Soirée 5:00 pm 7:00 pm 6 MANAGED MARKETS SUMMIT FALL 2014

7 AGENDA FALL 2014 THURSDAY FRIDAY SEPT. 18 SEPT. 19 Registration Opens 7:00 am Lunch 11:45 am 1:00 pm Registration Opens 7:00 am Breakfast 7:00 am 8:00 am Keynote Presentation William Winkenwerder, Jr., MD 8:00 am 9:15 am MORNING SESSIONS 9:30 am 11:45 am The State of Health Policy: PPACA and Emerging Legislative Issues New Specialty Pharmacy Distribution Channels An Evolution in the Specialty Pharmacy Industry Employers in the Post-ACA Marketplace: Risk, Rx Benefits and Specialty Futurescape Biopharma Beyond ACA: A Look at Key Trends that will Impact the Industry over the Next 3-5 Years Health Plan Marketplace Formulary Strategy: Challenges and Opportunities How Providers Outside of an Integrated Delivery Network Can Favorably Bend the Outcomes Curve Rates Up Rates Down: The Role of the Exchange / Travelocity Changing Trends in Specialty Keynote Presentation T. Colin Campbell, PhD 1:00 pm 2:15 pm AFTERNOON SESSIONS 2:30 pm 4:45 pm Collaboration for Impact on Quality and Cost Patient Reported Outcomes: The Next Wave of Rx Data Innovative Models in Cancer Care: Oncology Practices of the Future Hospital Consolidation and Growth: Understanding the Impact of 340B and Site of Care Shift Managing Traditional & Specialty Pharmaceuticals in the Era of the 4 E's: Where Evidence, Economics, Ethics & Emotion Collide The Need for Reimbursement Solutions to be Provided as an Integrated Offering MMS Country Bash 5:00 pm 7:00 pm Breakfast 7:00 am 8:00 am Keynote Presentation Peter Wickersham 8:00 am 9:15 am MORNING SESSIONS 9:30 am 11:45 am Medicaid: How It s Changed One-Year Post ACA Human Resources Transformation: Recognizing the Business Value of a Healthy Workforce Managing Pharmacy Benefits in an Ever Changing Marketplace Managing an MCO Specialty Pharmacy Benefit: Integration, Utilization Management & Benefit Design Contracting with Integrated Delivery Systems & ACOs SEPTEMBER SCOTTSDALE, AZ 7

8 MANAGED MARKETS SUMMIT WEDNESDAY, SEPT. 17 SESSIONS MORNING SESSIONS Sessions are 60 minutes beginning at 9:30 am 10:30 am and repeated again at 10:45 am 11:45 am. The Role of Employers Matthew Gibbs, PharmD Chief Commercial Officer Envision Rx Options Overview of pricing structures and the role of Fair Market Value assessments PANEL DISCUSSION Benefit Designs in the Specialty Drug Era (2016 and Beyond) James Kenney, Jr., RPh, MBA (Moderator) Pharmacy Operations Manager Harvard Pilgrim Health Care, Inc. Understanding the advantages/disadvantages of selffunded commercial plans vs. private/public exchanges and retiree solutions from subsidy to Employer Group Waiver Programs (EGWP) Options to managing the cost inflation of specialty medications Using the ACO/Provider Collaboration Model for Enhanced Pharmacy Management Including Quality and Cost Chronis Manolis Vice President of Pharmacy Services UPMC Health System (Pennsylvania) Using pharmacists in the medical home is it effective and for which areas of focus? P&T optimization for enhanced decision support Using physician risk models to enhance drug management Kirby Eng, RPh Executive Director, Clinical Oncology Management Services Onco360 Atheer Kaddis, PharmD Senior Vice President, Sales and Business Development Diplomat Specialty Pharmacy Marc Richmond, MD, MMM Regional Medical Director Blue Shield of California The challenge of the anticipated increased cost of specialty drugs to over 50% of drug spend The impact of legislation at the state and federal level that limits or restricts the pharmacy benefits The increased use of closed formularies, creative benefit designs, and utilization management to control drug costs Rationing of medications based on severity of disease Specialty Pharmacy Contracting Charles Bell Director, New Business Development UBC An Express Scripts Company Detailed review of the key components of a contract between a specialty pharmacy and a manufacturer Discussion of best practices during the contracting process including timelines, internal coordination and general preparedness 8 MANAGED MARKETS SUMMIT FALL 2014 Medicaid From Afterthought, to Top of Mind, to Driving the Future Jeff M. Myers President and CEO Medicaid Health Plans of America Growth of Medicaid since 65 Impact of ACA Future impact of high cost meds and-insurance tax Changes to Medicaid population and impact to future health system

9 BREAKOUT SESSIONS WEDNESDAY, SEPTEMBER 17 AFTERNOON SESSIONS Sessions are sixty minutes beginning at 2:30 pm 3:30 pm and repeated again at 3:45 pm 4:45 pm. The Future of Drug Fulfillment for the Payer and the Consumer Emerging Trends in Patient Engagement through Adherence and Compliance Programs Jennifer Allen, RN, BSN, MBA Senior Program Manager UBC An Express Scripts Company Bill Barre Vice President, Business Development MedImpact Healthcare Systems, Inc. What are the dynamics influencing retail network fulfillment with the various payer types? What is the current state and future opportunities for mail service distribution? What factors are effecting specialty fulfillment distribution in the market? How do all stakeholders including: payers, patients, pharmaceutical manufacturers, and others align to optimize drug fulfillment selection? Evolving Oncology Drug Management Strategies Kirby Eng, RPh Executive Director, Clinical Oncology Management Services Onco360 Role of Oncology Pharmacy and key differentiators with existing models Pharmacy and medical benefit design unification approaches and its impact on utilization Clinical support and interventions that address key management challenges Update on Biosimilars 2014 Opportunities and Challenges Examine current trends in the delivery and design of patient engagement programs across various channels How patient engagement impacts strategic planning and identifying effective strategies that increase engagement Utilizing patient engagement across multiple channels to appeal to patient preference The role of patient activists in gaining engagement Maximizing the patient experience at each touch point Fresh Opportunities, Continuing Challenges: Health Exchanges Roll Into 2015 Bill Melville Senior Analyst Decision Resources Group Review how competition has increased in various states The impact of UnitedHealth s major exchange push Understanding the importance of network size and proper pricing Does state vs. federal exchange operation matter What threats remain to exchanges PANEL DISCUSSION Government Markets: Driving Systemic Transformation of the US Healthcare System James Kenney, Jr., RPh, MBA Pharmacy Operations Manager Harvard Pilgrim Health Care, Inc. Heather Lee Whipple (Moderator) Vice President, Strategic Consulting Decision Resources Group Define the biosimilar product category Discuss recent FDA guidance on biosimilar products Review state legislation on biosimilars Assess the role of benefit design on formulary coverage decisions for biosimilars Provide a managed care perspective on the biosimilar value proposition David A. Pizzi Director, Political and External Relations Florida Blue Jeff Myers President and CEO Medicaid Health Plans of America To better understand how healthcare reform is transforming care delivery and quality in nearly all markets SEPTEMBER SCOTTSDALE, AZ 9

10 MANAGED MARKETS SUMMIT THURSDAY, SEPT. 18 SESSIONS MORNING SESSIONS Sessions are 60 minutes beginning at 9:30 am 10:30 am and repeated again at 10:45 am 11:45 am. The State of Health Policy: PPACA and Emerging Legislative Issues David A. Pizzi Director, Political and External Relations Florida Blue How insurers are responding to the new health care world New business opportunities created by federal health reform Emerging legislative issues that will impact the system New Specialty Pharmacy Distribution Channels An Evolution in the Specialty Pharmacy Industry Atheer Kaddis, PharmD Senior Vice President, Sales and Business Development Diplomat Specialty Pharmacy Specialty pharmacy spend is expected to account for over 50% of total pharmacy spend for payers over the next five years. Common specialty pharmaceutical distribution channels today include specialty pharmacies, wholesalers and physician offices. Overview of how the specialty pharmacy industry is evolving to include new distribution channels such as retail pharmacies and hospital outpatient pharmacies. Employers in the Post-ACA Marketplace: Risk, Rx Benefits and Specialty Futurescape F. Randy Vogenberg, PhD, RPh Principal Institute for Integrated Healthcare Identify what is risk in commercial insurance and why it is driving benefit coverage decisions across stakeholders. Why the insurance market is predictable yet seemingly chaotic. Determine where and why pharmaceutical benefits fit into group health benefits and decision making in the commercial sector. How the difference does become important today versus public sector, and who is pharmas future customer. Compare and contrast the coverage positions of specialty and biologic products today versus the future market landscape. Will this evolving marketplace be good or bad for pharma? Biopharma Beyond ACA: A Look at Key Trends that will Impact the Industry over the Next 3-5 Years Brian Corvino Head of Commercial Strategy, Insights and Training Decision Resources Group Discuss the key macrotrends impacting the biopharmaceutical industry Evaluate how these trends will evolve and impact the industry over the next 3-5 years Discuss implications and strategic considerations Hotel discounts are available through August 25th. Book now for lowest rates! 10 MANAGED MARKETS SUMMIT FALL 2014

11 BREAKOUT SESSIONS THURSDAY, SEPTEMBER 18 Health Plan Marketplace Formulary Strategy: Challenges and Opportunities Laurie Wesolowicz, PharmD Director, Pharmacy Services Clinical Blue Cross Blue Shield of Michigan (BCBSM) PANEL DISCUSSION Changing Trends in Specialty Neil Minkoff, MD (Moderator) Founder FountainHead HealthCare Describe the health plan strategy and desired outcomes for developing a Qualified Health Plan (QHP) Marketplace formulary Identify the regulatory requirements and challenges for maintaining a QHP Marketplace formulary Discuss collaborative opportunities to improve patient and financial outcomes Charles Bell Director, New Business Development UBC An Express Scripts Company Kirby Eng, RPh Executive Director, Clinical Oncology Management Services Onco360 How Providers Outside of an Integrated Delivery Network Can Favorably Bend the Outcomes Curve James Kenney, Jr., RPh, MBA Pharmacy Operations Manager Harvard Pilgrim Healthcare, Inc. Joseph Zavalishin Executive Vice President, Strategic Contracting & Payer Relations AxelaCare Health Solutions Collecting real clinical data can affect care and outcomes versus reporting on services and usage Creating common goals and breaking the rewards for spending paradigm Case examples: tailing the curve on expensive specialty therapy, managing expensive patient crashes, and affecting the top line through managing most costly frequent patients Rates Up Rates Down: The Role of the Exchange / Travelocity Martin Hickey Chief Executive Officer New Mexico Health Connections Basics of the Exchange and choice What goes into building actuarial rates and how can it be manipulated The role of the Metal levels If we build it, they will come: the role of Primary care, deductibles, networks, etc. How medical benefit and oral products are changing the SPP offering New ways to manage costs through innovation around dose and site of service Outlook for pricing of new products Integration of benefit with plan and employer AFTERNOON SESSIONS Sessions are 60 minutes beginning at 2:30 pm 3:30 pm and repeated again at 3:45 pm 4:45 pm. Collaboration for Impact on Quality and Cost Randall Krakauer, MD, FACP, FACR Vice President, National Medical Director, Medical Strategy Office of the Chief Medical Officer, Aetna Provider Collaboration: are incentives the end or the beginning? Expanding on the potential of collaboration further impact at the intersection of quality and cost SEPTEMBER SCOTTSDALE, AZ 11

12 MANAGED MARKETS SUMMIT THURSDAY, SEPT. 18 SESSIONS Patient Reported Outcomes: The Next Wave of Rx Data Neil Minkoff, MD Founder FountainHead HealthCare Develop greater understanding of how Patient Reported Outcome data can be used to help payers understand new products Determine which other data sets can be used in connection with PROs See how traditional barriers to PRO collection can be addressed through technology Innovative Models in Cancer Care: Oncology Practices of the Future Marc Richmond, MD, MMM Regional Medical Director Blue Shield of California Whole person patient centered care and shared decision making resources Technology enabled Oncology Care and clinical decision support systems Design thinking overview as it applies to the physician work environment and office setting Pharmaceutical manufacturers opportunities to partner with ACOs for value added services Explore proposed policy changes for 340B and how these might impact the hospital and pharma/biotech industries Discuss site of care cost differentials and what payers are doing, or considering, to influence site of care Recognize the interplay between 340B, site of care shift, hospital economics, pricing, and biosimilar competition Managing Traditional & Specialty Pharmaceuticals in the Era of the 4 E s: Where Evidence, Economics, Ethics & Emotion Collide Cynthia Pigg, BSMT, PharmBS, MHA, FAMCP Senior Vice President, Pharmacy MagellanRx Management The evolving pharmaceutical management model Payer support in the era of the 4 E s Consumer engagement Emerging talent needs The Need for Reimbursement Solutions to be Provided as an Integrated Offering Alice Ganzar Director, Business Development UBC An Express Scripts Company Hospital Growth and Consolidation: Impact and Implications of 340B and Site of Care Shift Jennifer Hinkel Partner McGivney Global Advisors How reimbursement hubs benefit multiple stakeholders patients, physicians, pharmaceutical manufacturers and pharmacy Leveraging technology to maximize reimbursement services The value of adherence programs for pharma sponsored programs Understand which hospitals are eligible for 340B discounts and the impact on hospital economics Examine how hospital consolidation impacts pharmaceutical pricing and reimbursement 12 MANAGED MARKETS SUMMIT FALL 2014

13 BREAKOUT SESSIONS FRIDAY, SEPTEMBER 19 FRIDAY, SEPT. 19 SESSIONS MORNING SESSIONS Sessions are 60 minutes beginning at 9:30 am 10:30 am and repeated again at 10:45 am - 11:45 am. Medicaid: How It s Changed One-Year Post ACA Patrick Finnerty PWF Consulting Medicaid Expansion: the numbers and characteristics of new enrollees State programmatic changes being implemented to handle expansion population Reform priorities beyond the ACA State actions focusing on prescription drug policies Human Resources Transformation: Recognizing the Business Value of a Healthy Workforce Managing Pharmacy Benefits in an Ever Changing Marketplace Eric Cannon, PharmD, FAMCP Chief of Pharmacy SelectHealth Review current challenges faced by those managing pharmacy benefits across multiple lines of business Review marketplace changes and their impacts by line of business. (i.e., Commercial, Managed Medicaid, Medicare, Exchange) Identify opportunities for improved outcomes, through optimal pharmacy benefit management Managing an MCO Specialty Pharmacy Benefit: Integration, Utilization Management & Benefit Design Michael White, PharmD, CSP Director, Clinical Pharmacy BlueCross BlueShield of Tennessee Bruce Sherman, MD, FCCP, FACOEM Medical Director Employers Health Coalition Employers' cost-focused efforts at health care cost containment have not been particularly successful Workforce human capital is best managed as a strategic organizational asset, not simply a cost center Accordingly, investments in workforce health and well-being can have measurable business impact Employers and health plans can expand their measurement strategy to incorporate a broader array of metrics in assessing the value of specific health benefits Several ways that health plans can integrate their medical and pharmacy benefits and offer enhanced specialty pharmacy programs Utilization management techniques that are typically used to contain specialty pharmacy costs Key considerations involving specialty pharmacy medications when benefit packages are being created or amended Contracting with Integrated Delivery Systems & ACOs Peter Mikhail Associate Vice President, Procurement Services, Enterprise Supply Chain Services Geisinger Health System Current class of trade model challenges & thinking differently Contracting across payer & provider 340B SEPTEMBER SCOTTSDALE, AZ 13

14 MANAGED MARKETS SUMMIT WINE & CHEESE RECEPTION Tuesday, September 16th 6:30 pm to 8:00 pm Wednesday, September 17th 5:00 pm to 7:00 pm Stop by the Wine & Cheese Reception after checking in at MMS and enjoy two of life s culinary pleasures! This newly created networking event features a selection of Prosecco, fine wines, imported and domestic cheeses, fresh bread, crackers and crudités. A SPANISH SOIREE Join MMS attendees and speakers on the East Lawn for this Spanish-inspired networking event featuring a Sangria bar, Tapas and great music! Experience the excitement of our onsite cigar roller who will entertain you with all aspects of the cigar-making process! An event highlight that s not to be missed! Thursday, September 18th 5:00 pm to 7:00 pm MMS COUNTRY BASH Networking rises to another level at MMS with the Thursday evening Country Bash! Enjoy some of the Southwest s finest edibles and drinks while mingling with speakers and attendees. Set on the historic grounds of the Jokake Inn at The Phoenician, the MMS Country Bash will feature live music from Young Country and tethered, hot-air balloon rides offering the best view of an Arizona sunset!! 14 MANAGED MARKETS SUMMIT FALL 2014

15 REGISTRATION FALL 2014 REGISTRATION FALL 2014 INDIVIDUAL REGISTRATION Early Bird Fee: $2595 (Ends 8/29/14) Regular fee: $2795 Your registration fee includes: Keynote presentations Breakout sessions Three evening receptions, three full breakfasts, two lunches and all refreshment breaks A copy of keynote speaker T. Colin Campbell s The China Study Morning Yoga Wednesday, Thursday and Friday Registration Information The dress code for this meeting is business casual Please make all checks payable to DR/Decision Resources, LLC All payments must be received prior to the program All cancellations are subject to a $200 cancellation fee No refunds will be granted after August 15, 2014 Cancelled registrations or no-shows will not be carried over to future programs GROUP DISCOUNTS Register five or more colleagues and take advantage of special group pricing. Group Pricing Breakdown REGISTRANTS DISCOUNT PRICE/REGISTRANT 5 9 $100 $ $200 $ $300 $ $400 $2195 WHY BRING YOUR TEAM? Valuable training for your department Decades of experience funneled into three days Best practices and hands-on training Networking with colleagues and faculty Questions? Please direct questions regarding registration to events@dresourcesgroup.com. ACCOMMODATIONS The Phoenician Hotel Discount A discounted room rate of $229 per night through Monday, August 25, The group rate is available three days pre and three days post event based upon hotel availability. Reserve your room online at: ManagedMarketsSummit.com or call (480) About The Phoenician Nestled at the base of Camelback Mountain, near the burgeoning entertainment, shopping and cultural districts of Scottsdale, Arizona, the Phoenician is the place to be for a luxurious Scottsdale resort experience featuring hotel suites, golf, spa, pools, dining and more. The Phoenician offers unparalleled desert elegance with all hotel rooms featuring private balconies, desert views, high-speed internet access, and premium Italian bed linens. Register online at: ManagedMarketsSummit.com SEPTEMBER SCOTTSDALE, AZ 15

16 8 New England Executive Park Burlington, MA Presort Standard U.S. Postage PAID Holliston, MA Permit No. 20 Decision Resources Group is a cohesive portfolio of companies that offers best-in-class, high-value information and insights on important sectors of the healthcare industry