Precision Reimbursement Approaches for Managing High Cost Therapies
Dr. Ronald Potts, Chief Medical Officer, 6 Degrees Health | Mark Trusheim, Founder & President, Co-Bio Consulting
NEWDIGS (New Drug Development Paradigms Initiative) Biomedical Think-and-Do Tank from Tufts Medical Center will discuss the “Precision Reimbursement” of directed therapies, platforms for building real-world evidence, disease-oriented learning systems, and more.
Our guest speakers will include NEWDIGS Senior Advisor and 6 Degrees Health Chief Medical Officer Ron Potts, MD, and Strategic Director for NEWDIGS, Mark Trusheim. They will have a conversation with our team about how self-insured employers can prepare for the portfolio impact of cell and gene therapies, how partnering with patients can ensure that Precision Medicine targets what matters, payer perspectives on value-based reimbursements, and other related topics of interest to our audience.
Previous Fireside Chats
The Challenges of High Dollar Claims
Robert Page, Epic Reinsurance | Kristy Swailes, Swiss Re America Holding Corporation | Dr. Christine Hale, Lockton Dunning Benefits | 6 Degrees Health: Katy Brant, Jodi Hammer, Staci Branham
In this Fireside Chat the expert panelists defined and differentiated high dollar vs. complex claims and discussed how to manage these kinds of claims through extensive review, payment, resolution and appeals activities. They examined the headwinds and challenges of complex and high dollar claims from the self-funded lens and highlighted why Clean Claim Reviews are so important. They further discussed solutions and strategies to intervene, and the role of vendors in these kinds of claims.
Stop-loss Pricing in Traditional and Alternative Risk Financing Strategies
Join 6 Degrees Health and our guest Joshua McGee, a 20+ year industry veteran who has experience as a broker with a large regional agency, and former Director of Underwriting and Strategic Pricing at Blue Cross NC. We will discuss how pricing strategies in a dynamic and increasingly unpredictable stop-loss market requires employers and consultants to take an “all of the above” approach to market options. During this Fireside Chat, we will highlight stop-loss options available, and define some best practices and creative approaches to underwriting, contract terms, and financing strategies.