Agenda

Registration & Coffee

Chairmans Opening Remarks

Terry Barnes, Principal, Cormorant Policy Advice

OPENING KEYNOTE ADDRESS | FUTURE LOOKING BRIGHT FOR PRIVATE HEALTH INSURANCE

• The necessity for more private funding
• Confronting the limitations of the current funding system
• Key principles for reform, short and long term actions
• Implications of a possible change in government

Mark Fitzgibbon, Chief Executive Officer, and Managing Director, nib

Private hospitals, doctors, health insurers and the patient: payment reform as a common goal

• The national health reform agenda in July 2012
• The dangers of leaving the IHPA strategy unchallenged
• The pricing of private hospitals in 2012/13 and the likely reactions of all payers
• Payment reform and transparent hospital quality: the debate about public report cards
• The private health sector and COAG: new seats at the policy reform table
• The next government and the private health sector: reasonable expectations

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

Private Health Insurance premium change process

• Examining the current process for approving increases in private health insurance premiums
• When examining public administration processes it is common practice to see how they perform in terms of the key characteristicsthat should be present with well-designed arrangements.
  Such characteristics include: Appropriateness, Transparency, Predictability, Confidence, Simplicity, Low compliance costs
• Suggested reforms

Dr David Charles, Director, Insight Economics

The future impact of consolidation on the market

Andrew Goodsall, Senior Healthcare Analyst, UBS Australia

Morning tea

The impact of the means test on private hospitals

• The concern for private hospitals is that the introduction of the health insurance rebate means test will encourage people to downgrade but not drop their insurance, leaving them without cover for surgery in private hospitals. By scaling back their coverage, they could still avoid waiting lists but have their surgery performed as private patients in public hospitals
• The impact on private hospitals

Cathy Ryan, Group Manager, Health Funds, St John of God Health Care

PANEL DISCUSSION | Forming effective relationships between funds and hospitals

• The relationship between private hospitals and health funds
• The relationship between health funds and doctors
• The private sectors role in the delivery of hospital services

Donal Byrne, Negotiator - Provider Relations, NIB

Cathy Ryan, Group Manager, Health Funds, St John of God Health Care

Please check www.healthinsurancesummit.com.au for panellist updates.

Lunch

PHI regulations

• Current regulatory initiatives
• Industry outlook
• Sustainability

Jacinda de Witts, Partner, Minter Ellison Lawyers

KEYNOTE ADDRESS | PHI code of conduct is government regulation always required to protect consumers?

• The PHI Code of Conduct history and purpose
• Experience under an industry-regulated Code
• Requirements under the new Code from July 2012

Robert Seljak, Chairperson, PHI Code Compliance Committee, and Chief Executive Officer, Teachers Union Health

PANEl DISCUSSION | regulatory compliance panel

• Compliance issues
• Legislative changes
• Working within a regulatory framework that supports insurers

Mei Ramsay, Group General Counsel, Medibank

Alison Choy Flannigan, Partner, Holman Webb Lawyers

Emma Zipper, General Counsel & Company Secretary, Bupa Australia

Bradley Russell, Partner, Freehills

Andrew Raiter, Group Legal Counsel, HBF Health Limited

Afternoon tea

Enhancing corporate governance and strategic direction

• Effective CG succeeds best when legal, institutional and ethical dimensions interact effectively
• Reviewing your governance structures

Shaun Gath, CEO, Private Health Insurance Administration Council

Risk equalisation Models and international experience

• Risk-equalisation (RE) is an essential mechanism required to support competitive health insurance markets, whether they be voluntary, as with private health insurance (PHI) in Australia, or mandatory, as in countries with comprehensive health insurance with consumer choice, such as the Netherlands
• It equalises the risk profiles of insurers to mitigate the adverse effects of risk selection as a competitive device
• Reviewing the conceptual issues involved with designing RE arrangements through examples from selected countries that have developed various risk equalisation schemes
• Considering the role of RE in the context of the range of government interventions implemented to maintain affordability of health insurance for high risk segments of the population

Francesco Paolucci, Fellow, Australian Centre for Economic Research on Health, Australian National University

Closing remarks from the Chair

Networking drinks

Registration and networking

Opening remarks from the Chair

KEYNOTE ADDRESS | PHI and Preventative Health

• Should prevention be a priority health strategy and what does this mean in economic terms?
• Do health prevention initiatives actually make a difference?
• What are health payors doing globally and what should the role of PHI and other health payors be in Australia?
• What is Medibanks strategy as a PHI and Health Solutions company to address the need for health prevention?

Dr Andrew Wilson, Group Executive Strategy and Innovation, Medibank

Fraud in the health sector

• The Health industry in context
• What are the fraud risks?
• Where does the threat come from?
• How can they be mitigated?

Frank OToole, Lead Partner, Deloitte Forensic

Private Health Insurance Claims leakage, Fraud prevention, Technology and Analytics in Australia

• What is fraud and claims leakage?
• Countervailing factors to fraud & claims leakage control
• Health insurance fraud in context - Australia & overseas
• Proactive claims leakage controls
• Technology for processing and analytics
• Retrospecive analytics - Patterns & techniques

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

Morning tea

Consumer needs analysis: Private Health Insurance rebate

• Health costs and affordability
• Making the health system more equitable
• Where should we invest in the health system?

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

KEYNOTE ADDRRESS | listening to the Consumer

• Regular complaints and observations from the consumer
• Learning from consumer complaints
• What do your members want?
• Changes to industry practice

Ms Samantha Gavel, Private Health Insurance Ombudsman

Lunch

Age, demographics and morbidity trends Implications for private health insurance in the future

• The ageing population and its impact on the healthcare system
• Key trends in health insurance payouts to older members
• The future shape of the Private Health Insurance industry

Terry Barnes, Principal, Cormorant Policy Advice

The modernisation challenge

• Insurance companies of all sizes are grappling with aging, complex systems that are costly to maintain and too inflexible to support new business initiatives
• This session will discuss the critical systems that insurers must address. It outlines the transformation process and explores best-practice approaches that IT organisations can use
  individually or in combination to achieve their modernisation goals.

Lisa Pettigrew, National Director & General Manager, Healthcare Group, CSC

Afternoon tea

Retaining your members How will administration of the means tested rebate affect your marketing?

• What communication will members see? Where from?
• What decisions will they be prompted to make? When? Who will do the prompting?
• Pain? Or painless? (for the customers, that is)
• Will member inertia be a thing of the past?

Stuart Rodger, Partner, Actuaries & Consultants, Deloitte Australia

Developing social media policies The role of social media in the modern healthcare industry

• How do you develop social media policy that allows staff to use tools effectively, while protecting your brand / organisation?
• What key issues (e.g. legal, professional) are relevant to social media in healthcare and the health insurance industry? How is this similar/different to other sectors?

Matthew Cox, Strategic Consultant, Dialogue Consulting

PANEl DISCUSSION | Marketing in the 21st century

• Marketing challenges in the industry
• Adapting to new marketing technologies
• Embracing online and mobile opportunities

Anita Mulrooney, GM Marketing & Communications, Peoplecare Health Insurance

Matthew Cox, Strategic Consultant, Dialogue Consulting

Closing remarks from the Chair

End of Conference