Speaker: Hank Kearney, MHP, RHU
President, PHM International

Benefits: Advanced understanding of the construct of US managed care and it’s role as an export to the UK and Europe.

Course: Targeted to attendees with prior exposure to the workings and types of managed care, this program concentrates on the unique aspect of this line of cover. From network management, to why claims administration is different from private cover in the UK, attendees will gain a detailed look at managed care in the US.

Course Level: Advanced ● Course Length: 3 hours ● Course Style: Lecture

Who Should Attend: Anyone working in private cover or anyone looking to gain insight of this growing export from the USA.

Course Outline

1. Introduction
   A. Governance and Management Structure
   
2. Why Managed Health Care is Different From Insurance
   A. Members vs. Insureds
   
3. Operational Issues
   A. Benefits
   B. Underwriting
   C. Rating
   D. Claims Administration
   
4. Network Management
   A. Physicians
   B. Hospitals
   C. Ancillary & Complimentary Providers
   D. Accreditation
   
5. Ethical Issues
   A. Managed Care as US Export: Impact on NHS and Private Cover in the UK