Creating a Health Plan for Dual Eligibles

Dual Eligible Health Plans will have to meet the same requirements as those outlined by CMS for Special Needs Plans

• How do health plans meet the Medicare Advantage Requirements of a Special Needs Plan required for dual eligible operations?
• Fulfilling quality requirements, grievances and appeals
• What elements need to be considered in planning, strategy and product development
• Discuss Medicaid and Medicare Advantage Contracting
• Explore Home and Community Based Waivers- what do they look like?

• Debate the recent arguments presented on health reform in March and the outcome of the recent ruling.
• What are the implications of the 2012 Presidential candidates and the election?
• Discuss the implications of the Supreme Court decision and what it means for the industry

• The key concerns facing plans for 2013 and how to overcome them
• New marketing guidelines
• Political and financial impacts and how to prepare for them
• Strategies for creating meaningful partnerships with providers for better outcomes

• Pioneer ACO panel discussion on lessons learned
• Making reductions a reality
• Establishing success and growth benchmarks
• Impact on pharma utilization and price negotiations
• ACO/Pharma partnerships

• Acquisitions and partnerships by Health Plans to improve their star ratings
• Meaningful use of Health IT in boosting ratings
• Quality measure improvement strategies
• Member impact
• Marketing Perspective: communicating star ratings and what they mean to beneficiaries