Medicare Congress: Agenda: Day Two

Pre-Conference

Day One

Day Two

Agenda: Medicare Congress Day II Wednesday, November 2, 2005
8:00 a.m.	Medicare Congress Morning Plenary Session Nancy-Ann DeParle Senior Advisor, JPMorgan Partners Former Administrator, Health Care Financing Administration Washington, DC (Co-Chair)
8:30 a.m.	Congressional Intent Regarding the Implementation of the New Medicare Prescription Drug Program Senator Chuck Grassley (R/IA) Chairman of the Senate Finance Committee United States Senate Washington, DC
9:00 a.m.	Enhancing Quality of Care Through the New Medicare Part D Carolyn Clancy, MD Director, Agency for Healthcare Research and Quality Rockville, MD
9:45 a.m.	The Role of Health Information Technology in the Implementation of Medicare Part D David Brailer, MD, Ph.D. National Health Information Technology Coordinator Department of Health and Human Services Washington, DC
10:30 a.m.	MMA's Implications for Drug Pricing Dan Mendelson President and Founder, Avalere Health Former Associate Director for Health Office of Management and Budget Washington, DC Presentation Material (Acrobat) Presentation Material (Powerpoint)
11:00 a.m.	Break
11:15 a.m.	Concurrent Sessions IV
	4.01 MMA Implementation: Congressional Intent vs. Market Reality The legislative process is rife with compromise, but what happens when those compromises have the potential to alter health care for 41 million Americans covered by Medicare, as well as have a significant impact on the health insurance and pharmaceutical industries? This session will provide insight from policymakers close to the process, including details of how the legislation was developed and what their perceptions are of how the provisions have played out in the marketplace. Jonathan Blum Director of the Medicaid Practice, Avalere Health Former Democratic Staff, Senate Finance Committee Washington, DC Patrick Morrisey, Esq. Partner, Sidley Austin Brown & Wood Former Deputy Staff Director and Chief Health Counsel Energy and Commerce Committee United States House of Representatives Washington, DC
	4.02 MMA, Private Plans and Competition: Integrating Data and Integrating Care The creation of the Part D prescription drug benefit fills an obvious hole in the health coverage provided for Medicare beneficiaries, and in doing so creates an unprecedented opportunity to analyze the impact of pharmaceutical care on overall health outcomes. This session will focus on CMS' claims data initiative, as well as one health plan's recent examination of its own data sources looking at the impact of pharmaceutical care on other treatment outcomes. Kelly Cronin Centers for Medicare and Medicaid Services Washington, DC Jeffrey Kang, MD, MPH Senior Vice President Medical Strategy and Policy Cigna Health Plans Bloomfield, CT Presentation Material (Acrobat) Presentation Material (Powerpoint)
	4.03 Medicaid and MMA Administrative Challenges: State Pharmaceutical Assistance Program (SPAP) Activities State Pharmaceutical Assistance Programs offer a ready pool of potential enrollees in Part D, but state governments face challenging issues in transitioning beneficiaries to the new drug program. In addition, several large states-including New York and Pennsylvania-are considering ways to maintain their programs for beneficiaries who may find the state coverage more attractive than Part D. This session will feature the very latest information on how key states are thinking about the transition. Sean M. Dougherty Senior Director, Medicare Strategy Patient Assistance Programs AstraZeneca Wilmington, DE Presentation Material (Acrobat) Presentation Material (Powerpoint) Tom Snedden Director, Pennsylvania PACE/PACENet Programs Harrisburg, PA Presentation Material (Acrobat) Presentation Material (Powerpoint)
	4.04 Marketing Part D Plans: Industry Role in Educating Beneficiaries Enrollment is the critical challenge that will determine the success of Medicare Part D. This session will focus on efforts by manufacturers and Part D plans to ensure that beneficiaries learn about the new benefit. This session will include discussion of the early experiences of the outreach effort for 2006. James Carey Executive Director, Health Policy Novartis Pharmaceuticals East Hanover, NJ Terri Swanson General Manager, Part D Cigna Hartford, CT
	4.05 Fee for Service Trends: Evidence-Based Medicine in Part B This session will take an in-depth look at use of new standards of evidence under Medicare Part B, including recent applications by CMS of the national coverage decision process. Shamiram Feinglass Senior Medical Officer, CMS Baltimore, MD Kevin A. Schulman, MD Professor of Medicine and Business Administration Director, Center for Clinical and Genetic Economics Vice Chair for Business Affairs, Department of Medicine Duke University Medical Center Durham, NC Presentation Material (Acrobat) Presentation Material (Powerpoint) Tanisha Carino, Ph.D. Manager, Avalere Health Washington, DC (Moderator)
	4.06 Quality, Evidence, and Drug Safety: Part D and eRx, Friends or Foes Part D data implementation is exclusively focused on administrative data for coverage and reimbursement. The MMA eRx program will have established pilot program eRx standards in September 2005 and pilot projects to test these standards will take place in 2006. As a follow on to the Part D data implementation session, this session will look at the overlap of these two activities, the implications of bringing together these two significant information initiatives, and how the quality, evidence and drug safety landscape could change. Reed Liggin Director, e-Prescribing Strategy McKesson Clinical Solutions Phillip A. Rothermich Vice President, Business Development ExpressScripts Inc. Maryland Heights, MO Jeff Smith Assistant Vice President, Physicians Connectivity Caremark Nashville, TN
12:15 p.m.	Networking Luncheon
1:15 p.m.	Closing Plenary Session: The Future of Medicare Congresswoman Nancy L. Johnson (R - CT) (Invited) Chairwoman, Health Subcommittee Ways and Means Committee United States House of Representatives Washington, DC Congressman Pete Stark (D-CA) Ranking Democrat, Health Subcommittee Ways and Means Committee United States House of Representatives Washington, DC
2:30 p.m.	Concurrent Sessions V
	5.01 MMA Implementation: MMA Part D Long Term Care Implementation: A New Institutional Bias? This session will discuss Medicare Part D's dramatic effect on the delivery and organization of long-term care services and the effect on institutionalized beneficiaries. It also addresses the challenges to educating institutionalized populations and the associated changes with the long-term care pharmacy delivery system. Mark McCullough President, Kindred Pharmacy Services Louisville, KY Presentation Material (Acrobat) Presentation Material (Powerpoint) Alexis Ahlstrom Manager, Avalere Health Washington, DC
	5.02 MMA, Private Plans, and Competition: The Future of Medicare Advantage The MMA created two types of Medicare Advantage managed care plans - regional and local - with the initiation of regional health plans scheduled to coincide with the start of the new Medicare drug benefit plan in January 2006. Once implemented, plan payments will be based on a newly conceived competitive bidding process, a major departure in how Medicare pays providers and plans. This session will explore how participants expect the MA program to evolve. Francis Soistman President, Health Plans Coventry Health Care Inc. Bethesda, MD Janet Newport Vice President of Public Policy Programs PacifiCare Health Systems, Inc. Cypress, CA Presentation Material (Acrobat) Presentation Material (Powerpoint)
	5.03 Medicaid and MMA Administrative Challenges: Special Needs Plans By authorizing Medicare Advantage plans to specialize in serving dual eligibles, nursing facility residents, and other beneficiaries with severe or disabling chronic conditions, the MMA provides important new opportunities for plans to integrate the new Medicare Part D drug benefit with other acute and long-term Medicare and Medicaid services. This session will explore the policy and regulatory challenges facing SNPs. Sandra Bastinelli Acting Director, Division of Special Programs, Center for Beneficiary Choices Centers for Medicare and Medicaid Services Baltimore, MD Presentation Material (Acrobat) Presentation Material (Powerpoint) James M. Verdier, JD Senior Fellow, Mathematica Policy Research, Inc. Washington, DC Presentation Material (Acrobat) Presentation Material (Powerpoint)
	5.04 Marketing Part D Plans: Provider/Pharmacy Session This session will focus on the role of pharmacies and other providers in the roll out of the Part D benefit. Brian Bruen Director, Policy Studies and Research National Association of Chain Drug Stores Alexandria, VA Sunyil Iyengar Senior Editor, Medicare Drug Focus, FDC Reports Chevy Chase, MD (Moderator)
	5.05 Fee for Service Trends: Pay for Performance Pay for performance is the emerging approach for moving the health care agenda from cost savings to value by linking financial incentives to high quality processes and outcomes of care. This session will describe the rationale for and experience with pay for performance structures, including the government's initiatives in this area. Colette Desmarais Staff of the Finance Committee United States Senate Washington, DC Diana Birkett Staff of the Finance Committee United States Senate Washington, DC Donald R. Ryan President and Chief Executive Officer, CareCore National Wappingers Falls, NY Presentation Material (Acrobat) Presentation Material (Powerpoint)
	5.06 Quality, Evidence, and Drug Safety: Round Table Panelists and attendees will discuss the implications of the trends and activities previously covered in track 6. For example, given all of the federal quality and health information initiatives, what are some of the significant changes we are likely to see in the next 1 to 2 years? Is the Pharmaceutical industry anticipating what these changes will mean for drug development, approval and reimbursement? What does a truly outcomes oriented healthcare delivery system look like? This session is intended to give conference participants an opportunity to discuss their thoughts and concerns with each other and some of the speakers. Panelists from prior track 6 sessions Shannah Koss Director, Avalere Health (Facilitator)
3:30 p.m.	What's Next: A Vision of Medicare in 2008 Nancy-Ann DeParle Senior Advisor, JPMorgan Partners Former Administrator, Health Care Financing Administration Washington, DC John Glaudemans Managing Director, Avalere Health Washington DC Presentation Material (Acrobat) Presentation Material (Powerpoint) Thomas A. Scully, Esq. Senior Counsel, Alston & Bird Senior Advisor, Welsh, Carson, Anderson and Stowe Former Administrator, Centers for Medicare and Medicaid Services Washington, DC John K. Iglehart Founding Editor, Health Affairs National Correspondent, New England Journal of Medicine Washington, DC (Moderator)
4:30 p.m.	Medicare Congress Adjournment

top of page