Sponsored by The Robert Wood Johnson Foundation's State Coverage Initiatives Program
Conducted by AcademyHealth

Thursday, July 18, 2002

7:30 - 8:30 a.m.
Registration and Continental Breakfast

8:30 - 8:40 a.m.

Welcome and Conference Overview

Presenters:
Pamela S. Dickson
Senior Program Officer
The Robert Wood Johnson Foundation

Vickie S. Gates
Vice President
AcademyHealth

8:40 - 9:40 a.m.

What's Driving Health Care Costs? Perspectives on Public and Private Expenditure Growth

Facilitator:
W. David Helms
President and CEO
AcademyHealth

Presenters:
Vernon Smith
Principal
Health Management Associates
SLIDES: What's Driving Health Care Costs? The Medicaid Budget Outlook

Brad Strunk
Research Analyst
Center for Studying Health System Change
SLIDES: Private Health Care Cost Trends and Their Drivers

Additional Resources:

• Slide: Annual Increase in State General Fund Revenues and Medicaid Costs
• The Economic Downturn and Its Impact on Seniors: Stretching Limited Dollars in Medicaid, Health and Senior Services, Testimony of Vernon K. Smith, Ph.D. for the Special Committee on Aging, The United State Senate, March 14, 2002.
• Tracking Health Care Costs: Hospital Care Key Cost Driver in 2000, Data Bulletin: Results from HSC Research, Center for Studying Health System Change, September 2001.
• Slide: Community Tracking Study Sites, Center for Studying Health System Change

9:40 - 10:45 a.m.

Facilitated Discussion: How Premium Increases are Impacting States and the Private Sector

Facilitator/Presenter:
Alan Weil
Director, Assessing the New Federalism
The Urban Institute

10:45 - 11:00 a.m.
Break

11:00 - 12:15 p.m.

Strategies for Controlling State Health Expenditures

Facilitator:
Ben Wheatley
Senior Associate
AcademyHealth

Presenters:
Kala Ladenheim
Program Manager
National Conference of State Legislatures
SLIDES: State Cost Control Strategies: Overview

Carol Isaacs
Deputy Director, Health Legislation and Policy Development
Michigan Department of Community Health
SLIDES: Michigan Pharmaceutical Best Practices Initiative

Kevin Concannon
Commissioner
Maine Department of Human Services
SLIDES: Maine Medicaid Program Drug Benefit

• Overview of state cost control strategies
• Efforts to contain pharmaceutical costs and other Medicaid expenditures
• Disease management strategies

Additional Resources:

• Medicaid Cost Containment: A Legislator's Tool Kit, Chapter 4, Cost Cutting Strategies, National Conference of State Legislatures, March 2002.
  
• NCSL Reports On-Line
• Pharmaceutical Purchasing Pools, Issue Brief, National Governors Association, October 24, 2001.
  

12:15 - 1:30 p.m.
Lunch

1:30 - 2:45 p.m.

Strategies for Controlling State Health Expenditures (continued)

Facilitator:
Jeremy Alberga
Senior Associate
AcademyHealth

Presenters:
Rod Betit
Executive Director
Utah Department of Health
SLIDES: Covering the Uninsured: An 1115 Approach in Utah

John Santa
Administrator
Office for Oregon Health Policy and Research
SLIDES: Strategies for Controlling State Health Expenditures

Allen Feezor
Administrator
California Public Employees’ Retirement System
SLIDES: CalPERS Health: New Directions?

• Benefit reductions and cost-sharing increases
  
• Impact on state expenditures and quality of care
  
• Consequences for other parts of the health care system
  
• Public employee purchasing strategies

Additional Resources:

• Background on Utah's New Medicaid Waiver, Rod L. Betit, Executive Director, Utah Department of Health, May 2, 2002.
• Comparison of Benefits and Cost-Sharing in Oregon's and Washington's Basic Benefit Plans, March 2002.
• Significant Line Changes to Prioritized List of Health Services for 2003-05
• The Evidence Based Process Applied to Prescription Drugs in Oregon (Draft), John Santa, MD, Office of Health Policy and Research.
• CalPERS Facts at a Glance: General
• Links to Federal Waiver Texts On-Line

2:45 - 3:00 p.m.
Break

3:00 - 4:30 p.m.

Lessons from the Private Sector

Facilitator:
Anne Gauthier
Vice President
AcademyHealth

Presenters:
Michael Bailit
President
Bailit Health Purchasing
SLIDES: Containing Costs to Preserve Coverage: Lessons from the Private Sector

Louise Probst
Executive Director
Gateway Purchasers for Health
SLIDES: Containing Costs to Preserve Coverage: One Coalition's Response

John Bertko
Vice President and Chief Actuary
Humana, Inc.
SLIDES: Consumer-Directed Health Plans: A New Vision of Health Benefits

• What employers are doing to reduce health care expenditures
  
• Lessons transferable to public programs

Additional resource:

• Four Fortune 500 Companies Join Empire Blue Cross and Blue Shield to Recognize and Reward Hospitals that Achieve Leapfrog Safety Standards, Press Release, October 18, 2002.
  

4:30 - 5:30 p.m.
Break

5:30 - 6:30 p.m.
Reception and Light Buffet

Friday, July 19, 2002

7:30 - 8:30 a.m.
Continental Breakfast

8:30 - 10:00 a.m.

Regulation vs. Competition in Health Insurance Markets: Where are States Heading?

Facilitator:
Deborah Chollet
Senior Fellow
Mathematica Policy Research, Inc.
SLIDES: Regulation vs."Competition in Health Insurance" Markets: Where are States Heading?"

Presenters:
Bill Daley
Deputy Commissioner for Policy
Washington Office of the Insurance Commissioner
SLIDES: Market Reform in Washington State

Ana Smith-Daley
Deputy Commissioner
Life/Health Division
Texas Department of Insurance
SLIDES: Regulation vs.Competition in Health Insurance Markets

Bill Lindsay III
President
Benefit Management and Design, Inc.
SLIDES: Regulation vs. Competition

• Insurance market regulations and the push for more competitive markets
  
• Health plan benefit mandates

Additional Resources:

• Mapping State Health Insurance Markets: Structure and Change in the States' Group and Individual Health Insurance Markets, 1995-1997, Executive Summary, Deborah J. Chollet, Adele M. Kirk, Marc E. Chow, December 2000.
• Health Insurance Regulation in Texas, The Impact of Mandated Health Benefits, Executive Summary, Texas Department of Insurance, Report to the Texas Legislature, December 1998.
• Cost Impact Study of Mandated Benefits in Texas, Report #1, Executive Summary, Milliman & Robertson, Inc., July 21, 2000 with August 30, 2000 revisions.
• Cost Impact Study of Mandated Benefits in Texas, Report #2, Executive Summary, Milliman & Robertson, Inc., September 2000.
• Colorado's Small Group Market Shrinks Significantly, Colorado Division of Insurance, April 30, 2002.
  

10:00 - 10:15 a.m.
Break

10:15 - 11:40 p.m.

Small-Group Discussions

• Federal flexibility on benefit design
  
• Managing insurance market challenges
  
• Controlling pharmaceutical costs
  
• Lessons from private sector innovations

11:45 - 12:00 p.m.
Closing Remarks and Next Steps for SCI

Presenter:
Vickie S. Gates

12:00 p.m.
Adjournment (box lunches available upon request)

If you have any questions about this workshop, please feel free to contact Ben Wheatley, Senior Associate, at 202.292.6724, or Isabel Friedenzohn, Associate, at 202.292.6706.