San Francisco
Opening Discussion Topic for May 11:
So, how does Kaiser set its prices anyway?
As you can imagine: very carefully – particularly when your rates impact 12.5 million members – the employees of large and small groups of employers, individuals, Medicare and Medicaid beneficiaries. Add in the complexity of market pricing in eight states, plus D.C., not to mention 19 different regional Pricing Areas within California.
Other elements include the need to set prices competitively to encourage growth, yet still maintain the margin needed to cover operations. Factor in what’s happening in the broader economy, and the potential for “Black Swans,” like COVID.
As the Executive Director, Strategic Market Planning & Execution at Kaiser Permanente Health Plan, Marcos Vasconcelos is responsible for leading cross-functional teams in developing pricing and market strategy recommendations for senior leaders. His accountabilities include leading the National rate setting and membership forecasting teams, as well as the Channel and Strategic Projects market strategy teams; he also co-leads the important Equity, Diversity and Inclusion work for the Health Plan.
Of course, we’ll also look to hear “What’s Up?” in your “post-acute phase of COVID” world.
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UPCOMING San Francisco MEETING DATES:
May 11……Jun 8……Jul 13……Aug 10……Sep 14……Oct 12……Nov 9……Dec 14
Our San Francisco Healthcare Round Table meets on the 2nd Wednesday of each month – either via Zoom or sometimes with an In-Person option (*unless a holiday or special event alters the date).
Oakland
Opening Discussion Topic for May 19:
Overcoming Healthcare Career Obstacles
Chances are excellent that in your healthcare career you’ve had a few obstacles thrown in your way: a challenging board, government bureaucrats, dissident employees, or a “Plan A” that didn’t work. During our Members Go-Round, we’ll look to hear about the most challenging obstacle you’ve faced in your business career, and the steps you took to overcome it.
No doubt for thousands of healthcare executives, dealing with the past two+ yeas of COVID has been the largest career obstacle they dealt with – and increasingly, their last, as execs take early retirement and others leave the field entirely.
During the second half of our Table, in addition to hearing “What’s Up?” in your healthcare world, we’ll look to hear how you’re dealing with the INFLATION’s IMPACT ON HEALTHCARE. As a reflection of the significance of this topic, our Member John Dao, Principal with Wipfli, suggested a Fierce Healthcare article entitled, “AHA: Federal funds needed to offset 20% per patient increase in hospital expenses since 2019.” Of course, the major culprit has been mushrooming labor costs, which for hospitals was “36.9% higher than pre-pandemic levels and increased to 57% at the height of the omicron surge in January 2022.” The net result for hospitals has been that 33% are operating on negative margins.”
So what to do? Many in the ZOOM will remember the belt tightening of just the 21st century: the popping of the Internet bubble followed by the post 9/11 attack recession, the Great Recession of 2008-09, and even the “2020 COVID Recession,” when unemployment jumped to 14.7% and over 20 million jobs were cut. What approaches have you experienced that worked best to safeguard margins, even when the revenue line sank beneath the expense line?
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UPCOMING Oakland MEETING DATES:
May 19……Jun 16……Jul 21……Aug 18……Sep 15……Oct 20……Nov 17……Dec 7
Our Oakland Healthcare Round Table meets on the 3rd Thursday of each month – either via Zoom or sometimes with an In-Person option (*unless a holiday or special event alters the date).
Past Round Table Topics
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"ABL gives me an opportunity to get input from a cross section of healthcare leaders. Knowledge and ideas are shared across the spectrum."
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"ABL is like being in an Executive MBA class at Wharton, except it’s a little bit better, because it’s really just all the professors talking about the problem."
"Every meeting fills in another blind spot in my knowledge about the healthcare industry. There is no forum that brings together the broad spectrum of perspectives on health policy so well."
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"ABL provides exposure to relationships with a “brain trust” of knowledgeable, thoughtful & innovative leaders in the healthcare world.
"ABL provides exposure to relationships with a “brain trust” of knowledgeable, thoughtful & innovative leaders in the healthcare world."
"I love everything about the ABL meetings. Being able to see and hear what is on other's minds is invaluable."