Agenda

8.00 Registration and coffee

8.45 Welcome and speed networking session

8.50 Opening remarks from the Chair

9.00 Health insurance after COAG 2011 and the May 2011 Budget: Leadership challenges

• The political and economic landscape for private health insurance after COAG 2011 and the May 2011 Budget
  
• PHI: Does the public understand the value case for the P bit?
  
• Equity and efficiency are impaired by co-pays: The policy alternatives require real leadership
  
• Payment reform beyond activity-based funding of hospitals: Paying for coordination and IT
  
• Intelligent care planning for chronic conditions: new models, data linkages and public trust are needed

Dr Paul Gross, Director, Institute of Health Economics and Technology Assessment in Australia and Greater China

9.50 KEYNOTE ADDRESS
Future structure of the PHI industry

• With recent mergers, acquisitions and exits from the industry, what will this mean for the future of PHI?
  
• With private health insurers offering new services by expanding into chronic disease management and direct provision of health services, will this; reduce overall benefit outlay, attract new members to PHI and retain existing ones?
  
• Will the effect of possible changes in the government policy around health care and health delivery pose a threat to the health insurance industry or create opportunities?

Mathew Moore, CEO, RT Healthfund

10.30 Morning tea

10.45 PHI regulations

• PHIAC wrap-up on the 2011 premium round
  
• Current regulatory initiatives
  
• PHI Industry outlook and PHIACs regulatory stance

Shaun Gath, CEO, Private Health Insurance Administration Council - PHIAC

11.25 The National Health Reform Agreement

• What changes will the new agreement bring to Australia's health system?
  
• How will it affect health services and, particularly, the health insurance sector?
  
• What will the National Partnership Agreement on Improving Public Hospital Services mean to patients?
  
• How will changing the source and proportion of funding, impact change at the patient level?
  
• Will further investment in the healthcare sector equate to providing clinical care?

12.05 Lunch

1.05 Demographic factors affecting health insurance and what they mean for your PHI business

• Demographic and morbidity trends that make PHI ever more challenging
  
• What does these mean for community rating and a far too over-regulated industry?
  
• Does who has or doesnt have PHI really matter these days?
  
• Why should community rating reward peoples stupidity in this day and age? Isnt that what the public system is for?
  
• Why cant we truly reward those who minimise the costs of risk borne by others with lower premiums and other benefits?
  
• Do this government and its partners really understand PHI?

Terry Barnes, Principal, Cormorant Policy Advice

1.35 PANEL DISCUSSION
The current and future shape of Activity Based Funding (ABF)

• Identifying the pros and cons of activity based funding and assessing what needs to happen to successfully implement ABF in Australia?
  
• Who assumes responsibility for drawing up the performance indicators within ABF?
  
• How would the health insurance industry be affected by ABF?
  
• Is Australia ready to fully embrace activity based funding?

2.30 Afternoon tea

2.45 E-health interoperability and the Personally Controlled EHR

• E-health and the PCEHR - Critical elements in modernising the Australian health system
  
• Reducing the costs of medical errors and increasing process efficiency via a patient-centric interoperable e-health system
  
• Case Studies: The PCEHR & the "Health Book", a personal EHR for insurance members and their healthcare providers

Klaus Veil, Adj. Assoc. Professor - University of Western Sydney, President, Australasian College of Health Informatics

3.25 Australias ageing population: A question of sustainability

• Assessing the growing pressure of an ageing population and its impact on the healthcare system
  
• Have the costs to the healthcare system of an ageing population been exaggerated?
  
• Will Australias younger generation pay more in health insurance to subsidise Australias ageing population and can they afford to do so?
  
• Key trends in health insurance payouts amongst older members

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

4.05 Health consumers and informed financial consent

• The importance of informed financial consent for consumers
  
• The context - Rising out-of-pocket costs
  
• Restrictions, exclusions and informed financial consent
  
• Changes to the Prostheses List Making sure consumers understand their options

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

4.45 PHI sustainability & profits

• Sustainability
  
• Trends in profit margins
  
• Membership changes relation to premium increases
  
• Factors driving benefit change
  
• Profit margin
  
• The relationship between underwriting profit & fund size

David King, CEO, Australian Health Service Alliance - AHSA

5.25 Closing remarks from the Chair

5.30 Networking drinks

6.00 End of day one

CONFERENCE DAY TWO Wednesday 27th July 2011

DAY ONE | DAY TWO

8.30 Coffee and networking

8.45 Welcome and speed networking session

8.50 Opening remarks from the Chair

9.00 Chronic disease management and prevention
Prevention is our business, Prevention is your business: Lets work together

• Why does preventing ill health matter?
  
• What will the challenges be in preventing ill health in the future
  
• Public and community services role in preventing ill health
  
• What new models of service delivery will be required to prevent ill health
  
• Why preventing ill health is both good for business and a business opportunity

Dr Brendan Goodger, Branch Manager, State Wide Major Project Branch, Centre for Health Advancement Department of Health NSW

9.30 Preventative healthcare and the PHI

• How will taking a preventative approach alleviate the pressure off the health system and therefore, the private health insurance sector and reduce long- term financial costs?
  
• How will telephonic health coaching for lifestyle and self management of chronic conditions take the pressure off the hospital system and decrease cost?

Cindy Shay, Group General Manager, Provider Relations, Medibank Private

10.00 Morning tea

10.20 Pathology: The regulatory environment of pathology funding and its impact on private health insurance

• Impact of 2011 budget outcomes
  
• Current state of the pathology sector
  
• Pathology and the PCeHR
  
• Decision support for pathology requesting

Katherine McGrath, CEO, Australian Association of Pathology Practices - AAPP

10.50 Community care services: Understanding role of this sector as an integral part of the healthcare system

• Will changes in responsibilities for Home and Community Care Services (HACC) recognise the importance of maintaining existing service delivery strengths?
  
• Acknowledging the role of community care service providers within primary healthcare
  
• The sustainability of community care

Robyn Batten, Executive Director, Blue Care

11.20 Medical Genomics - The challenge for the health system

• Pharmacogenomics: Ensuring more targeted and cost-effective healthcare into the future of personalised medicine to improve patient care and disease prevention
  
• The importance of testing to rule out individual disease susceptibility amongst increased risk family members, reducing the need for costly and invasive screening and preventative therapy
  
• Realising commercial potential of personalised medicine

Professor Warwick Anderson, CEO, National Health & Medical Research Council - NHMRC

12.00 Lunch

1.00 Medical technologies and innovation

• Is the medical technology industry in Australia underrated when it comes to low levels of funding for medical technology research?
  
• Capitalising on innovation gaps in the medical technologies market, the push towards the emphasis on innovation and IP strategies to maintain competitiveness in an international market
  
• Future trends of the Australian Medical technologies

Katie Barwell, Account Director, Atlantis Healthcare

1.30 The Health Technology Assessment (HTA) review

• Highlighting the achievements and implementation since the release of the HTA review
  
• What will the impact of the HTA reform have on payers?
  
• Supporting better health care for all Australians and reducing unnecessary regulatory burdens while providing timely access to new and improved technologies and treatment modalities

2.00 Benefits management: System controls, claims adjudication, leakage and fraud

• Developing effective claims leakage and fraud prevention strategies to manage costs without degrading the customer value proposition
  
• How organisational silos can adversely affect benefits management
  
• Enhancing technologies and approaches to fraud analytics
  
• Fraud patterns
  
• ROI

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

2.30 Does complaining do any good?

• Consumers of private health insurance
  
• The operations of the PHIO
  
• The private health insurance industry complaint trends into the future

Samantha Gavel, Ombudsman, Private Health Insurance Ombudsman

3.00 Afternoon tea

3.20 Integrating information across the healthcare 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
  
• Embracing the shift towards a more patient-centric healthcare system through IT
  
• What will this mean for health funds, hospitals, the public sectors and the patients?

3.50 Pharmaceuticals

• Assessing the crucial role between PHI and the pharmaceutical industry
  
• Integrating hospitals and community pharmacy services
  
• Cohesive patient care at the hospital-community interface and improving the capacity of individuals for self-care and independent living following acute hospital episodes
  
• Workforce challenges impacting the pharmaceutical industry and its effect on PHII

4.30 Closing remarks from the Chair

4.35 End of conference