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They’re back! And with the return of new local PPOs to the Medicare market starting on Jan. 1, sponsors of both existing and new local PPOs, as well as those offering other Medicare products, need a quick and accurate assessment of what the end of this two-year moratorium will mean for them. PPOs and private-fee-for-service (PFFS) plans account for the lion’s share of new Medicare Advantage (MA) enrollment since Part D’s launch. Dozens more of these plans are expected to enter the market in 2008, combining to bring Medigap and Prescription Drug Plan (PDP) enrollment growth to a standstill.

Meanwhile, the new Democratic Congress has put MA firmly in its crosshairs. MA reimbursement cuts are expected, as are new legislative and regulatory requirements, after this fall’s Medicare debate. Sponsors of both existing and new MA products need a quick and accurate assessment of what these developments will mean for them, what the future Medicare market will look like, and whether and how to capitalize on emerging Medicare PPO product opportunities. They must do this while keeping in mind that the application deadline for 2009 entries is rapidly approaching.

Medicare PPO and PFFS plans — with their advantages of greater choice and flexibility for beneficiaries and potentially higher revenue streams for plans compared with HMOs — will work well for some market segments, but won’t work for others. You need tools that will help you to assess whether these products are a good strategic fit for your organization — and whether they’re viable long term. You and your partners also will need to know what your competitors are likely to do with these products.

Hear two of the nation’s top Medicare managed care experts outline the details of effective strategies in such areas as:

• Ways to determine how Medicare local PPOs and PFFS plans will fare in particular markets and in particular organizations.
• How to differentiate your Medicare products from others’ PFFS plans and local PPOs — and your PPO and PFFS plans from competitors’ products.
• How to diversify your current Medicare product mix for maximum results in a market that features new local PPOs and PFFS plans.
• Ways to segment your PPO/PFFS market and focus your marketing messages.
• Changes you may need in member services and retention strategies in light of the re-emergence of local PPOs and expanded PFFS offerings.

Speakers

JOHN GORMAN is president and CEO of Gorman Health Group, LLC, the leading consulting firm specializing in Medicare and Medicaid managed care and Part D. Before starting his company in 1996, Mr. Gorman served as assistant to the director of HCFA’s Office of Managed Care under two directors. Prior to that, he was staff director to U.S. Rep. John Conyers Jr., then chairman of the House Government Operations Committee. Mr. Gorman specializes in strategic planning and business development for the health care industry, with particular emphasis on federal programs and regulation.

TOM L. ANDERSON is an executive vice president of Gorman Health Group, LLC. He joined the company as a partner in 2001 after serving as head of the government programs division of United HealthCare. In this role, he built that business (now called Ovations) from $300 million in annual revenues to $2 billion in just five years, and grew membership from 50,000 to 500,000. Prior to that, he was at health plan operator FHP as senior vice president of marketing and later chief operating officer of health plans in Nevada.

Moderator: Jim Gutman, vice president and executive editor at Atlantic Information Services, Inc.

Designed Especially For

• Health plan CEOs, CFOs, chief operating officers, product development and marketing executives, pharmacy directors, government relations executives, and provider network and contracting managers.
• Directors of managed care contracting at provider organizations.
• Pharmaceutical company executives and marketers.
• Executives of pharmacy benefit management companies.
• Attorneys, actuaries, and consultants.

*Please note that shipping of CDs and materials will begin within three weeks of the conference.

Written Materials