Agenda

Conference Day One: Wednesday 30th June 2010

DAY ONE | DAY TWO

8.00 Registration and coffee

8.45 Welcome and speed networking session

8.50 Opening remarks from the Chair
Craig Bosworth, Director of Strategy, Healthways Australia

POLICY BASED INITIATIVES

9.00 Keynote Address: Examining the Federal Government’s policy on PHI

• Reviewing the government’s policy on health insurance: rebate incentives, Lifetime Health Cover and the Medicare Levy Surcharge
• What are the future directions for industry reform?
• What is the future of the PHI rebate?

The Hon. Mark Butler MP, Parliamentary Secretary for Health

HOSPITAL REFORM

9.30 State Keynote Address: Hospital funding in the mixed public and private system: Getting the balance right

• The case for health care funding reform
• The mixed public and private healthcare system
• Challenges in funding public hospital services

Professor Michael Cleary,Deputy Director General, Queensland Health

10.00 Morning tea

PHI REGULATION

10.30 Regulating the PHI industry and recent legislative changes on health insurers

• The regulatory environment in an economic crisis
• The legislative changes on what health funds can cover
• The next premium requirements and approval processes
• Working within a regulatory framework that supports insurers

Paul Groenewegen, Acting CEO and General Manager, Prudential Supervision, Prudential Supervision, Private Health Insurance Administration Council

CHRONIC DISEASE MANAGEMENT

11.00 Increasing healthcare expenditure and the high cost of chronic disease in Australia

• The cost of rising chronic disease
• Future projections of chronic conditions e.g. type 2 diabetes, cardiovascular disease and cancer
• The implications for health insurance products and services

Richard Juckes, Head of Expenditure and Economics, Australian Institute of Health and Welfare

LEGISLATION

11.30 Assessing competitive strategies employed in the PHI market

• How can a marketing strategy end with a jail term (or why you need to be careful with discounting/promotions/commissions)?
• What shouldn't my ad say?
• How product differentiation can go badly wrong
• How can I avoid a fine (or worse)?

Robyn Baker, Partner - Health and Aged Care, Clayton Utz

12.00 Lunch

PHI INDUSTRY

1.00 Improving chronic disease management through electronic management systems

• Background of My Health Guardian
• What are the valued added features?
• How the system aids in CDM

Dr. Christopher Wallace, General Manager Benefits Management, HCF

1.30 Fund mergers and new growth strategies

• Business transformation and synergy realisation
• Employing growth strategies through M&As
• Challenges and lessons learnt so far

Gideon Perrott, Executive General Manager, Sales and Service,Medibank Private

2.00 Bringing valuable competition to the PHI industry and building corporate relationships

• Corporate structure – for-profit and not-for-profit
• Creating strategic corporate relationships
• The value of financial investment markets
• Benefits to consumers and shareholders

Mark Fitzgibbon, CEO, Nib Health Funds

PANEL DISCUSSION

2.30 The future shape of the private health insurance industry

• How PHI funds view Medicare Select
• How PHI works alongside the “health and hospital plans”
• How will reform impact the PHI industry?
• What is the likely cost impact for health funds?
• What is the likely impact on the scope of services?

Moderator: Terry Barnes, Principal, Cormorant Policy Advice
Glenn Campbell, CEO, rthealth fundbr
Dr. Christopher Wallace, General Manager Benefits Management, HCF
Gideon Perrott, Executive General Manager, Sales and Service, Medibank Private
Mark Fitzgibbon, CEO, Nib Health Funds

3.00 Afternoon Tea

FINANCIAL MARKETS

3.20 Analysing market change and the impact on PHI

• Financing the health fund in tough economic times
• Overcoming changes to major investments
• Strategic business models for market success and investor satisfaction

Stuart Rodger, Partner & Health Practice Leader, Deloitte Actuaries & Consultants

PERFORMANCE STANDARDS

3.50 Monitoring PHI performance and service delivery

• The use of performance benchmarks in all areas
• Managing and improving accountability for performance
• The Australian Health Care Agreements and impact on PHI
  - Private Patient Election in public hospitals
  - The provision of high cost drugs to overseas visitors and students

Samantha Gavel, Ombudsman, Private Health Insurance Ombudsman

CONSUMER NEEDS ANALYSIS

4.20 Affording to be privately insured in a world of rising costs

• Health inflation and high costs for health care
• Impact on consumers of the growth in costs
• Implications of PHI premium rise
• Prioritising consumer health needs

Anna Wise, Senior Policy Manager, Consumers Health Forum of Australia

4.50 Closing remarks from the Chair

5.00 Networking drinks

Conference Day Two: Thursday 1st July 2010

DAY ONE | DAY TWO

8.30 Coffee and networking

8.45 Welcome and speed networking session

8.50 Opening remarks from the Chair

Jacinda de Witts, Partner, Minter Ellison Lawyers

HEALTHCARE BUDGETS

9.00 The interaction between private health policy and public health service delivery

• Changes to the Medicare Levy Surcharge legislation
• The independent review of the impact of changes to MLS thresholds on public hospitals

Richard Bartlett, Acting First Assistant Secretary, Medical Benefits Division, Department of Health & Ageing

9.40 The increasing strain on the healthcare budget

• The effects of an ageing population
• How should PHI respond to the IGR3?
• PHI rebate incentives
• The future shape of the PHI industry

Terry Barnes, Principal, Cormorant Policy Advice

10.10 The myth about hospital premium increases

• Is it ignorance or obsession that drives public commentary?
• Why do hospital premiums increase as much as they do?
• Why are premium increases less than per capita growth in health expenditure?
• The irrelevance of comparing premium increases to cost indices
• The importance of membership growth

David King, CEO, Australian Health Service Alliance

10.40 Morning tea

HEALTH SERVICES

11.00 Improving hospital and health services through the private sector

• Nurses and midwives in public and private practice
• The role of midwives and nurses in health service delivery
• Increasing contribution from the private health sector
• Collaboration to relieve pressure from hospital waiting lists

Pauline Ross, CNO, Queensland Health

E-HEALTH

11.30 Integrating information across the health care continuum and overcoming interoperability problems

• Interconnectivity between public and private providers
• Collaborative effort to enhance communication of health care
• Redesigning networks with improved health outcomes

David Roffe, CIO, St Vincents and Mater Health Sydney

12.00 Lunch

PATHOLOGY

1.00 Overcoming increasing costs in pathology services

• Negotiating costs for pathology services
• Changes to no-gap arrangements
• Future projections for services and charges

Katherine McGrath, CEO, Australian Association of Pathology Practices

MEDICAL INNOVATION

1.30 Outcomes of the Health Technology Assessment Review and implications for reimbursement of medical technology

• The Health Technology Assessment Review and implementation plan
• Issues surrounding the reimbursement arrangements of medical technology
• Improving health technology assessment techniques

Anne Trimmer, CEO, Medical Technology Association of Australia

PHARMACEUTICALS

2.00 Examining the relationship between PHI and the level of funding for pharmaceuticals

• Building relationships with PHIs to invest in the pharmaceutical industry
• Utilising PHI to fund innovative pharmaceuticals not receiving timely PBS listings
• The potential for medical cost savings and the health care budget

Dr. Brendan Shaw, CEO, Medicines Australia

ANCILLARY

2.30 Creating incentives to promote personal responsibility for health care

• What impacts the take-up of ancillary services?
• What is the scope for new PHI products?
• Broader health cover expansion by PHI
• Issues surrounding non-evidence based services

Ann O'Gorman-Skarratts, Manager of Benefits & Provider Relations, Australian Health Management

3.00 Afternoon tea

IT IN HEALTHCARE

3.20 The rise of the consumer in healthcare

Already doctors are noticing that patients come to consultations armed with information from the internet. Health forecasters predict that the power balance between health providers and patients will shift towards the patient. Health services will be designed so that integrated, coordinated care is delivered to patients (currently health services are largely designed to suit providers), health information will move, not patients. Patients will become better informed and more demanding. They will be more in control of health decision making. What will this mean for governments, health care providers and payers? How will this affect the big issues of healthcare today?

Dr. David Dembo, Leader of HealthVault, Microsoft’s Consumer Health Platform, Microsoft

CLAIMS AUTOMATION

3.50 Industry solutions to optimise service delivery and reduce costs

• Benefits of an industry solution
• Business Process Outsourcing versus Do It Yourself
• The vision for BPO Services
• Case Study

Peter Lavender, Business Manager, HEALTHStream

CLAIMS LEAKAGE

4.20 Managing claims leakage and fraud in private health insurance

• What is the magnitude of the issues and why overseas data cannot be transposed to Australia?
• Causes of claims leakage and fraud
• Detecting claims leakage and fraud – analytical techniques
• Prevention
• Staff skill sets required to be effective
• The role of State and Federal Government legislation and agencies
• ROI - measuring and tracking savings

Michael Douman, Head of Business & Clinical Analysis, BUPA Australia

4.50 Closing remarks from the Chair

5.00 End of conference

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