13.30 – 15.30 Section 2 
CONSUMER CONTROL OVER HEALTH CARE SPENDING ON THE HEALTH INSURANCE MARKET
Section partner – ACHMEA

Nominal premiums in Netherlands: case study Achmea
Tamara Pieterse 
(Achmea, Netherlands)

 Presentation (password needed)

CV
Tamara Pieterse is a Senior Manager Product Management at Achmea division Health, former Manager Commercial Development & Innovation
& Manager Product Management ad interim at Achmea division Health and McKinsey. She is the graduate of the Vrije Universiteit Amsterdam.
Post-graduate trainings and studies at the Vlerick Leuven Ghent Management School and the University Maastricht.

Summary
The first part of the presentation was an introduction of the Dutch Healthcare system. After this part you were familiar with the characteristic of the Dutch System. For example: mandatory basic insurance, risk equalization fund and thresholds like deductibles.
The second part of the presentation has explained a best practice: Zilveren Kruis Achmea. In 2011 Zilveren Kruis Achmea succeeded in offering differentiated propositions in a market, which can be seen as a commodity. Zilveren Kruis Achmea puts the consumer in the driver seat.
The third part of the presentation have focused on the future: what are the challenges of the Dutch Healthcare system? Is this system (financially) sustainable and what is the role of consumerism? Tamara told us more about key issues in The Netherlands, and specific within Achmea, regarding the sustainability of the system.

How to design a disease management program
Daniel D. Cave 
(President and CEO, Nurtur, USA)


CV
Daniel serves as Chief Executive Officer and President of Nurtur Health, Inc. (Cardium Health Services Corp). Mr. Cave served as President and Co-Chief Operations Officer of AirLogix, Inc. He has more than 25 years experience in key leadership roles in the disease management, service, and device segments of the health care industry. His knowledge and expertise, particularly in delivering health care cost reduction strategies for employers with proven clinical and financial outcomes, has earned Cardium Health recognition as the leading disease management company in the self-insured employer market. Mr. Cave served as Chief Operating Officer of CIGNA Pharmacy Management, including pharmaceutical manufacturer management, retail pharmacy network, customer and provider services, claim and account installation, and national operational leadership for field-based clinical staff. He also served as President, Specialty Health, for Prudential HealthCare responsible for a national staff of 1,200 clinical and non-clinical professionals. Additionally, Mr. Cave also held a variety of positions during an 11-year tenure at Travelers Insurance Company. He co-founded Cardiovascular Outcome Management, Inc. and served as its Senior Vice President.

Summary
The presentation has focused on the growing burden of chronic disease across the globe and in Europe in particular.  Despite governmental and geographic differences in how health care is financed, health is a universal element of the human experience. Traditional disease management techniques from the United States have been discussed. The attendee has been learned about consumer-centric techniques that are being used to identify and engage individuals with chronic conditions in state-of-the art health behavior improvement programs  and how such programs are working to lower costs and improve quality outcomes. 
The role of new paradigms in health management related to behavioral economics and behavior change science have been presented. Also clinical and economic outcomes resulting from programs operating in the United States have been reviewed.
Lastly, the attendee has been provided a glimpse into the future, including the output from new predictive modeling techniques based on epidemiologic and biometric measures, and a view of the extraordinary potential burden from disease that may be in our future due to lifestyle factors.  

Case study from Poland: Private Health Insurance in Poland
Adam Kozierkiewicz
(Poland)
 Presentation (password needed)

CV
Adam Kozierkiewicz MD., PhD, a graduate of Faculty of Medicine at the Jagiellonian University in Krakow (1992), and School of Public Health at the same University, as well as post-graduate trainings and studies at the Harvard University, Boston, MA and the Semmelweis University, Budapest, as well as the Warsaw School of Economics.
Adam had been working for the Jagiellonian University Medical College, as a research and lecturer since the beginning of 1990-ties, until 2008. In 1998 he was appointed vice Director, and later a Director of Health Information Department, at the Ministry of Health, Republic of Poland. After restructuring the Ministry, he became a first director of the Centre of Health Information Systems, which inherited competences of the Department, combining them with data collections and analysis. In 2001 he left the Ministry, returned to the University and worked as a consultant on a free-lance basis. He has served as a consultant for governments and NGO’s in such countries like Bulgaria, Romania, Bosnia and Herzegovina, Ukraine and Kazakhstan. The scope of the consultancy covered hospital payment and performance measure, organization of public health insurance scheme, System of Health Accounts, public health statistics/ reporting, and anticorruption measures in health care. In 2003 he established a company dealing with health information (WRM sp. Z o.o.), which was sold to sector investor in 2008. Since 2008 he is working for the European Investment Bank, firstly as a senior health economist, based in Luxembourg, and later as a Knowledge Economy Specialist, based in Warsaw. The recent position is placed in the JASPERS, the joint initiative of the European Investment Bank, the European Commission and the European Bank of Reconstruction and Development.

Summary
The healthcare system in Poland is financed through social insurance contributions with a signle National Health Fund. However, a rapid increase of private providers‘ sector is one of the major trends in the country within this sector.
Private health insurance is part of the health sector (0,6% of total health expenditures), but it only has a limited progress. It is below the expected potentials of the sector due to the limited demand.  Major advantages of private health insurance in Poland are: (1) an increased focus on consumers assistance, (2) reinsurance that covers unexpected expenditures, (3) more control over providers activities (Utilization, Quality) and (4) the opportunity to shape products to consumers preferences.

Panel Discussion with Speakers led by Jim A. Rice
(Management Sciences for Health, USA)


Strategic Scenarios 2020 – Film N°3: Fairy Julie

15.30 – 16.00 Coffee break

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