Benefit Design and Marketing for Individual Health Insurance Products: “Life Stage” Strategies for Health Plans; New HSA ‘Grab Bag’ Guidance: Bottom-Line Impact on Health Plans, Employers and Banks; Winning Strategies for MA Plans and PDPs Under the Mid-July Medicare Law


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Visit AISEducation.com for more news and strategic information for today's business leaders
 
Audio CD and written materials of
AIS's audioconference on
July 26, 2006
Debit and Credit Cards: How and When They Will Solve CDH/HSA Payment Problems

The success of consumer-directed health (CDH) plans — which now present considerable paperwork chores for consumers who need to be reimbursed — may be linked to the success of health debit cards and specialized lines of credit. The rapid convergence of health care providers, health insurers and financial services means health debit and credit cards will play an invaluable role in the adoption of account-based health plans. But there are complex questions related to the allowability of charges, real-time claims substantiation and adjudication, electronic verification of eligibility, and other issues. What steps are being taken to solve the remaining debit/credit card problems and to make CDH plans and HSAs significantly more attractive to consumers?

Sponsored by Atlantic Information Services, Inc., publisher of Inside Consumer-Directed Care, Managed Care Week and Consumer-Directed Health Care Facts, Trends and Data.

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Hear three industry gurus discuss the latest in credit- and debit-card technology and specific steps that remain for their successful integration into CDH plans and other high-deductible products.

First up, John Prince, CEO of UnitedHealth Group's Exante Bank, will tell you about a new line of advanced debit cards that will give providers the ability to transmit and receive claims data — in real time — without having to go through a claims clearinghouse. Exante now administers more than 200,000 HSAs and says about 90% of its HSA transactions are made via debit card.

Next, you'll hear from Chris Byrd, executive vice president of operations and development at Evolution Benefits, Inc., which has partnerships with four of the nation's largest HSA administrators: HSA Bank, Mellon Financial Services, Wells Fargo and BB&T, which collectively administer more than 300,000 HSAs. Mr.Byrd will discuss the importance of debit-card companies being able to simultaneously integrate with the HSA custodian and the health plan, and strategies for making this integration successful.

Finally, Craig Swanson, a founding partner of the Sequoi Group, a CDH consulting firm that works with health plans and banks, and co-founder of Definity Health in 1998, discusses the challenges that remain in order for debit cards to succeed.

You'll hear the latest on the rapidly evolving medical debit-card industry and valuable practical details about:

  • Paper receipts: A debit card at the point of service might not be any more convenient than paying cash if further substantiation is needed to verify charges. What needs to happen to make sure unqualified charges don't translate into complex headaches for card holders and health plans?
  • Physician education: Health plans must work with banks to make sure providers know how to use health debit and credit cards. What steps should be taken to make sure physicians embrace this technology ... and who will be left holding the bag if they don't?
  • Proprietary claims systems: Health plans and TPAs all have proprietary claims systems, and getting them to speak the same language to a provider's system is a difficult hurdle to overcome. How are these problems being solved?
  • Real-time adjudication: The ability of providers to submit information to insurers and present patients with bills before they leave is considered "the holy grail" of CDH. While real-time adjudication is fairly easy to do at the pharmacy, what is necessary to make it work at a hospital or doctor's office?
  • Claims substantiation: The owner of the HSA is solely responsible for the substantiation of claims. But what responsibility remains for the employer and the health plan?
  • Multi-purse cards: UnitedHealth Group plans to issue millions of cards this fall that will hold account information about FSAs, HRAs and HSAs. How are they solving significant challenges regarding which account is being tapped and when?

 

Speakers

JOHN PRINCE is CEO of Exante Financial Services (a division of UnitedHealth Group). Since joining United in December 2005, Prince has worked to establish Exante as the pre-eminent health services banking company. Prior to joining United, Prince was senior vice president and head of health care business strategy at JPMorgan Chase.

CHRIS BYRD is executive vice president at Evolution Benefits, a debit-card vendor that works with health plans and HSA administrators. His responsibilities include operations, product development and business development. Prior to co-founding Evolution, Byrd was senior vice president at Women's Health USA, a group that provides management services to physician practices.

CRAIG SWANSON is a founding partner of The Sequoi Group, a CDH consulting firm that works with some of the largest and most innovative health plans in the country. Swanson co-founded Definity Health in 1998 and ran the company's strategy and business development for seven years. He also served in a variety of other leadership roles until December 2004, when UnitedHealth Group acquired Definity. His responsibilities at Definity included creation of initial and annually modified business plans, vendor/supplier assessment (build/buy/borrow decisions), P&L and cash-flow management and health plan operations oversight.

Moderator: Steve Davis, managing editor of AIS's industry-leading biweekly newsletter, Inside Consumer-Directed Care.

 

Designed Especially For

  • Managed care and insurance company
    • CFOs
    • Product managers
    • Business development directors
    • Marketing VPs
    • Market research managers and analysts
  • Insurance brokers and sales staff
  • Third-party administrators
  • HSA administrators and other financial firms
  • Credit unions
  • Employer human resources VPs
  • Marketing directors at consumer-directed health (CDH) plans
  • CDH-related vendors
  • Executives at financial firms that work with HSAs
  • Attorneys and consultants
  • Actuaries

 

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