Large Claims (Medical/Specialty Pharmacy) Management Workshop

Date: June 28, 2018

Time: 12:00 pm - 2:00 pm

Location: Employers Health Meeting Center | 4771 Fulton Drive NW | Canton, Ohio 44718

Join Employers Health for a discussion of large medical and specialty pharmacy claims management strategies.

Dr. Christine Hale, president of clinical consulting and Christian Moreno, vice president, at Lockton, will present a unique large claims management program that Employers Health anticipates rolling out to a subgroup of interested employers. Dr. Hale will discuss a targeted and clinical approach to claims management, which is focused on reducing high cost claims, waste, fraud and abuse, while optimizing care channel delivery and minimizing employer cost exposure.

At the end of the program, those interested in collaborating on a large claims management initiative will be asked to attend a subsequent meeting in late July 2018 in which we will discuss a more granular and tactical approach to a joint employer initiative.

Factors that will be discussed:

  • Just 0.6 percent of members drive 30 percent of health plan costs.
  • Large claims are a significant contributor to overall trend, spur claims volatility and cause budget variance.
  • Stop loss carrier and plan sponsor loss ratios are at historical highs, resulting in aggressive renewal underwriting, claim reviews and contract interpretation.
  • Traditional approaches to large claim management and risk transfer have become ineffective. The strategy of simply purchasing stop-loss insurance to transfer the large claims risk is no longer sufficient.

12-12:30 – Lunch
12:30-2:00 – Program promptly begins

Webinar available only to those outside of northeast Ohio; we want employer input from a live group of intended stakeholders! However, those employers who are not geographically located in northeast Ohio will enjoy the same benefits of participation should they choose to move forward after hearing this strategy.

*Employer member only event