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Rich Bailey FSA, MAAA, FCA Richmond, VA;Agenda;;Double-Digit Increase for Second Year in a RowPer employee costs in excess of $5,600 per year;Annual CPI Trend U.S. health care costs rise, despite continuing economic recession;Comparison of Overall Growth Cumulative medical care CPI 89% greater than overall CPI since 1967;Employers’ Cost Increases Out-Pace Other Indicators Largest increase since 1990 (all employers);Aggregate Health Care Spending (1980 – 2010) Government portion of payments increasing; total projected to be over $2 trillion by 2009;Medical Trends;Medical TrendsResponses from a group of 25 actuaries who had time to get their calculators;Legislation;Proposals to Increase Coverage Among Early RetireesFew government programs except for financially indigent;ADEA IssuesImpact on retiree medical coverage;Marketplace ChangesConsolidation of Major Health Care Carriers Employer options are greatly reduced, carriers have more clout;Marketplace Changes PBM consolidation continues; three major national PBMs remain;Population TrendsAging baby boomers will increase the elderly and near elderly populations;Negative Tidal Wave of Available Talent Pool of “prime workers” will be decreasing ;Impact of Demographics on Health Care Cost Cost increases with age;Health Deterioration A cause and a consequence ;Issues Facing Businesses The perfect storm ;Employer Outlook;Retiree Medical Coverage Employers continue to drop retiree medical coverage;;The Catch-22;;Paths Away from Traditional Delivery: Two Camps;Employers Becoming More Involved;Collective PurchasingUse employer and plan manager clout to negotiate favorable payment arrangements;What is a HPN? ;Rationale for HPNs ;High Performance Networks Network models;Direct Contracting ;Promote Consumer AccountabilityHelp patients be better consumers of health care;Efforts to Improve Quality of Care in Hospitals Leapfrog initiative ;Lobbying ;Preventive Care and Disease Management Across theHealth C