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Home > Disease Management
Tiered Networks in Healthcare: The Impact on Quality Improvement, Cost Reduction and Customer Satisfaction
Tiered Networks in Healthcare: The Impact on Quality Improvement, Cost Reduction and Customer Satisfaction
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Tiered Networks in Healthcare: The Impact on Quality Improvement, Cost Reduction and Customer Satisfaction, a November 9, 2005 audio conference on CD-ROM, examines case studies of health plans that have implemented tiered network products and the impact that it has had on price, quality and customer satisfaction.

In an attempt to control costs, a number of health plans have implemented tiered-provider networks, which seek to steer patients to higher quality healthcare providers.

During this 90-minute audio conference on CD-ROM, your expert panel of speakers, Julie Bunde, product development manager, HealthPartners, Bill Banks, vice president of provider contracting and network operations, Humana, and Pat Dunks, principal and consulting actuary with Milliman Inc., provide inside details on how tiered networks are impacting health plan cost and quality. You will get details:

  • Overcoming provider and consumer resistance;
  • Achieving cost savings from tiered products;
  • Structuring quality improvement initiatives under tiered products;
  • Determining price tiers;
  • Negotiating with providers on tier placement; and
  • Developing the next generation of tiered network products.

Here's what participants said about the live program:

"This conference has practical lessons and accessible content," according to Cynthia Schlough, manager of strategic connections, The Alliance--Employer Health Care Alliance Cooperative.

"This program provides good information, knowledgeable experts, and a good discussion," according to Robert Berie, manager, analysis and information management, Excellus Bluecross Blueshield.

You can "attend" this program right in your office and enjoy significant savings – no travel time or hassle; no hotel expenses. It’s so convenient! Invite your staff members to listen in.

WHO WILL BENEFIT FROM THIS AUDIO CONFERENCE?

Health plan CEOs, medical directors, strategic planners, network managers, product development and marketing, executives and financial managers, directors of managed care contracting for providers and benefit executives at employers

ABOUT OUR PANELISTS:

Bill Banks

William Banks currently serves as vice president, provider contracting and network operations for Humana in Ohio and Indiana. In his role, Banks oversees provider relations and contract negotiations with Humana’s extensive network of hospitals and physicians.

Banks previously served as director, market financial analysis for Humana.

Prior to joining Humana in 2002, Banks was network manager for Anthem BC/BS in Cincinnati. He holds a master of arts in applied economics from University of Cincinnati and a master of health administration and bachelor of arts in political science from Xavier University. Banks has also served in the Ohio National Guard and the Medical Service Corps of the U.S. Army.

Julie Bunde

Julie Bunde is HealthPartners' product development manager in charge of developing HealthPartners’ suite of Empowersm consumer directed health plans, including HRA, FSA and HSA plans. HealthPartners is a family of nonprofit Minnesota healthcare organizations focused on improving the health of its members, its patients and the community. HealthPartners and its related organizations provide healthcare services, insurance and HMO coverage to nearly 700,000 members.

Before assuming this role, Bunde served the organization in a variety of finance and business development roles, primarily within the HealthPartners medical group and clinics - a 580-physician multi-specialty practice in 50 clinics across Minnesota and Western Wisconsin.

From 2000-2003 Bunde provided management consulting services in the areas of business development and project management. This work led Bunde back to HealthPartners and into the Product Development arena. Most recent projects include the development and implementation of HealthPartners Empowersm HRA, FSA and HSA plans.

Bunde is a graduate of the University of Illinois with a Bachelor of Arts in Economics, and is nearing completion of a Master of Business Administration in Marketing.

Pat Dunks

Patrick J. Dunks is a principal and consulting actuary with the Milwaukee office of Milliman. He joined the firm in 1985.

Dunk’s area of expertise is in managed healthcare. He has assisted clients with Medicare contracting, medical cost estimates and projections, provider reimbursement strategies, product development, risk-sharing arrangements, provider negotiations, experience analysis, trend analysis, liability estimation, Medicaid contracting, and managed workers’ compensation programs. Dunk’s has advised HMOs, PPOs, hospitals, medical groups, PHOs, Blue Cross/Blue Shield plans, and insurance companies.

Dunk’s is a frequent speaker at managed care industry meetings. He is a fellow with the Society of Actuaries and a member of the American Academy of Actuaries.

Dunk’s reveived his Bachelor of Arts in Mathematics from Saint Norbert College in DePere, Wisconsin. He received his Master of Science in Mathematics from Purdue University.


Publication Date: November 9, 2005
Number of Pages: 90 minutes of audio on CD-ROM
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