This session will focus on three cost drivers in health care, including the rising costs and complexity in the management of specialty drugs, the challenges of administering laboratory benefits specific to genetic testing and personalized (or precision) medicine, and the rising costs related to emergency department utilization. Attendees will learn about new solutions to bend these trends while decreasing the complexity of administering benefits in these categories.

The CMS Interoperability and Patient Access Final Rule created challenges that health insurance providers have struggled to efficiently operationalize, with more to be done after the July 1, 2021 deadline. This session will outline the three key phases that payers need to establish an effective interoperability infrastructure, both as purveyors and as consumers of data. The session will incorporate market research and proven cross-industry best practices.

The well-being landscape has changed, especially for health insurance providers attempting to engage their members, employer groups and local communities. Backed by an emphasis on inclusivity, social determinants of health and mental health, one payer is meeting well-being needs and boosting immunity for all. In this session, speakers will discuss how to partner with local communities to address diversity, COVID-19, and create more access to emotional health programs.

Health insurance still lags in industry rankings for consumer experience (CX), and there is no question of the consequences for health plan growth. But health insurance CX is not retail CX; the type of CX that works for Amazon may not work for payers and third-party administrators (TPAs). Speakers in this session will discuss how to make CX work effectively for health insurance providers, sharing insights from the wins and pitfalls of more than 200 payers and TPAs.

This session will provide actionable insights on how health insurance providers can foster collaborative relationships that benefit both providers and members. Attendees will learn how timely, transparent, and fair reporting can enhance value-based care initiatives, increase provider engagement, and drive proactive partnerships.

A focus on Social Determinants of Health (SDOH), which drives up to 80% of health outcomes, has compelled many payers to move toward a whole-person model of care and address health-related social needs. Speakers in this session will review the design, implementation, and evaluation of SDOH pilot programs, which can inform effective benefit design and clinical programming. Speakers will also review a pilot program using home-delivered meals to support members facing diabetes and food insecurity.