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P R O C E E D I N G S

Introduction, Opening Remarks

           DR. GINSBURG: I’d like to welcome you to HSC’s third and final conference of the year entitled "Defining Defined Contributions." In this meeting we’re attempting to get a better sense of whether defined contributions represents a future direction for employer-sponsored health benefits. We see this meeting of interest to benefits managers, to unions, to health plans, and to public policymakers.
           Whatever changes are made will reverberate through the health care system and affect the consumers that it serves.
           In June, at our annual "Wall Street Comes to Washington Meeting," I asked the analysts about what they had been reading in the trade press, and they characterized defined contributions as a key emerging trend and helped us make the decision to have this meeting. And in our site visits, we’ve been asking benefits consultants about this and have been told that it’s very much on the minds of employers, but that few concrete steps have been taken or even planned at this point.
           In today’s program we’re going to better define the various approaches that come under this category "defined contributions." We’re going to examine in-depth their feasibility, and we’re going to discuss the implications for consumers and for policy.
           Let me provide an update on the center. We’re currently collecting the third round of data from the Community Tracking Study. As you know, the Community Tracking Study involves biennial surveys of households, employers, and physicians in 60 communities across the United States, as well as site visits to 12 of these communities. The CTS is focused on identifying major changes in the nation’s health system and analyzing the effects of such changes on individuals.
           In February, we began releasing trend information from the first two rounds of the surveys and will be releasing many more such studies in the coming months. Next month, reports that chronicle changes from the intensive study sites will be released.
           To keep on top of these studies, I’d like to suggest that you register on our web site to receive e-mail alerts about these topics as they come out.
           Let me close by saying that this year is the fifth anniversary of HSC, and I want to take a moment to thank the Robert Wood Johnson Foundation for their continued support of HSC and also to acknowledge the contributions of Mathematica Policy Research, which whom we are affiliated.
           Let me introduce the speakers. Our first speaker is Sally Trude, and she will be followed by two separate panels. Sally Trude is a senior researcher at HSC who previously worked at MedPAC and Rand, and she’s the lead author of the defined contributions Issue Brief which we are releasing today and which is in all of your packets.
           Sally will start us off by presenting a framework that characterizes the various defined contribution approaches and which will help organize our discussions throughout the day.
           The first panel consists of three Internet entrepreneurs with distinct products that seek in various ways to support a movement to defined contributions. The panelists include Ray Herschman, who is CEO and founder of HealthSync, and previously held numerous senior positions at University Hospitals Health System of Cleveland and its QualChoice health plan; Dr. Lee Newcomer, who is executive vice president and chief medical officer of Vivius and held numerous senior positions at United HealthCare; and, finally, Steve Wiggins, who is chairman and CEO of HealthMarket, and who was previously the founder and CEO of Oxford Health Plans.
           Jon Christianson from the University of Minnesota will moderate this panel. John is a widely published economist who has worked extensively with HSC on its site visits going back to round one.
           The second panel includes an employer, a union representative, two health benefits consultants who have large employer clients, and Sally Trude.
           In the order in which they are sitting--I hope they are sitting, right?--Larry Atkins is the founder and president of Health Policy Analysts, where he advises Fortunate 100 companies, among other clients; David Blitzstein is the director of the Negotiated Benefits Department at the United Food and Commercial Workers International Union; Helen Darling is a senior consultant at Watson Wyatt & Company, where she assists purchasers with their health care and group benefits decisions; and Pam Krol is director of Health Programs and Benefits Administration for Lucent Technologies, where she is responsible for health care policy, strategy, administration, and performance management.
           Looking at the agenda, we’ll begin with Sally Trude giving a 15-minute overview of defined contributions, and this will be followed by the Internet panel. Each of these participants will provide a short description of their product and how it relates to defined contributions. Then Jon Christianson will ask follow-up questions. Then we will have questions from the floor. Then we’ll take a break, and the second panel I will moderate. This will be no presentations but just discussion, and then we’ll have a second opportunity for questions and answers from the audience after this panel discussion.
           Let me turn it over to Sally Trude.

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The Center for Studying Health System Change Ceased operation on Dec. 31, 2013.