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8:30 -10:15 AM

OPENING SESSION: Employer Coverage & the Era of Exchanges Caroline Pearson, Avalere HCR Professional Sales & Marketing Relations Countdown to Pediatric Dental Developing a Private Exchange Launch-Coverage & the Exchange Strategy FFM's Mike Adelberg Potential for Abuse-- Scott Carver, Plan and Devon Trolley (via Craig Kasten, Scion Source & Akshay Live Video) Dental Kapur, Booz & Company Luncheon: Dentistry at a Crossroads Marko Vujicic, PhD, ADA Health Policy Resources Center

10:30 to 11:45 AM

Noon to 1:30

1:45 to 3 PM

Nevada: One State’s Silver Road to an Exchange--John Hager, Director Nevada Dental Exchange

Examining Important PPO Network Trends -- Aaron Groffman, The Ignition Group

Building a Measurable Social Media Strategy -Nichole Kelly, Social Media Explorer

3:15-4:15 PM

Understanding the Impact of Loss Ratios on Dental Coverage-Joanne Fontana, Milliman

The DSO Role in the Future of Dental Benefits--Panel TBA

Products & Tools for Consumer Engagement and Cost Transparancy--Robin Gelburd, FAIR Health

4:15 -5:30 PM




10:15 to 11:30 AM

8:30 -10:15 AM

1:30-2:45 PM

2:45 – 3:30 PM

3:30 -4:30 PM

4:45 – 5:45 PM


How to Win an Unfair Fight Garrison Wynn, Author of Real Truth About Success Sponsored by Coastal Dental HCR The Landscape for Dental Plan Quality & Measurement -- Drs. Amundson, Horowitz, Lepsky and Preble, Moderator Timothy Brown LUNCHEON:

Professional Relations Alternative Care Delivery & Benefit Models –Drs. Allen Finkelstein, Paul Glassman and John Luther

Sales & Marketing Business Intelligence: The New Dental Benefits Imperative Dr. John Reed and Will Hinde

Professional Relations Provider Credentialing Challenges and Solutions -- Christy CAQH, Kasten and Tom Mort, Moderator Brian Flynn

Sales & Marketing E-Commerce: Maximize your Market Presence – Kristin Irving & William Hinde, West Monroe Partners & Ted Novak,

(No speaker)

HCR Sales Channels for Public Exchanges-Sarah Rodehorst of Connecture

Clique Studios

EXHIBIT HALL BREAK Sponsored by Aspen Dental HCR The Consumer Mindset in a Post Exchange World-- Marc Pierce, Stonegate Advisors

Professional Relations

Sales & Marketing Measuring Social Media ROI-- Nichole Kelly, Social Media Explorer


Open to All Members




ACA and Dental Benefits: The Path Ahead Health Care Reform and Exchange Task Forces CLOSING SESSION: Become a Brain Athlete Ron White, Ron White Training



Employer Coverage and the Era of Exchanges Caroline Pearson, Avalere Make sure your organization is prepared for the new business environment under health care reform with insights from CONVERGE keynote Caroline Pearson of Avalere. Pearson has received a 100% rating from CONVERGE attendees for the past two years making her the top industry presenter in the history of NADP. Caroline Pearson is Vice President, Health Reform at Avalere. Her clients have included large and small pharmaceutical and biotechnology companies, national and local health insurers, hospital systems, third-party administrators, and a range of foundations and not-for-profits. With a background in both state and federal policy, Caroline is uniquely positioned to understand the complexity of implementing the Affordable Care Act (ACA) at the state level.

About Caroline Pearson Caroline Pearson is Vice President, Health Reform at Avalere. Her particular areas of expertise include insurance exchanges, insurance market regulation, premium subsidies, and individual mandates. With a background in both state and federal policy, Caroline is uniquely positioned to understand the complexity of implementing the Affordable Care Act (ACA) at the state level. She graduated Magna Cum Laude from Harvard University with a B.A. in Government.



Countdown to Exchange Launch – via Live Video Mike Adelberg and Devon Trolley, CCIIO Office of Exchanges Operations & Policy Mike Adelberg, Deputy Director for Exchange Policy and Operations for the Center of Consumer Information and Oversight (CCIIO), and Devon Trolley, CCIIO’s dental policy lead, will join us via video for an informative session related to dental offerings through the FFM. With less than a month to launch the latest guidance and steps for completion will be discussed. This presentation will be moderated by NADP HCR Task Force Chair Jon Seltenheim, United Concordia Companies, Inc.

Developing a Private Exchange Strategy Scott Carver, Plan Source, Akshay Kapur, Booz & Company Private exchanges are entering the market in droves. While most of the action is taking place in the large employer segment, it is the small and mid-sized employer segments that may see the most benefit in the exchange value proposition. As private exchanges proliferate, payors need to design strategies that consider the value to individual employer segments and factor in new players, new ways to play, and new risks. Booz & Company’s Akshay Kapur will examine the landscape of private exchanges and their potential while identifying key questions that need to be addressed for payor strategies in participation. Scott Carver, President of Plan Source will share his firm’s role in putting up exchanges for private vendors and their potential in connecting carriers and exchanges.

Pediatric Dental Coverage and the Potential for Abuse Craig Kasten, Scion Dental Craig Kasten of Scion Dental Wasteful spending on healthcare in the United States totals hundreds of millions of dollars each year. While the country spends more than $2 trillion on healthcare annually, it is estimated that at least 3%, or $68 billion, is lost to fraud. Many of the victims are those in greatest need; America’s adults and children supported through Medicaid dental programs. The speaker will highlight compelling advances the dental industry must take to detect and address fraudulent activity as a fundamental strategy to reduce dental care costs and manage the health of those most vulnerable. Distinctive global budgeting strategies, ultra-responsive provider profiling and incentive-based reimbursement approaches, all made available through state-of-the-art dental administration technology, will become primary course of action for dental plans to achieve greater value and effectiveness for every dollar spent.



Sponsored by United Concordia Companies, Inc.

Dentistry at a Crossroads, Exhibit Hall Marko Vujicic, PhD, ADA Health Policy Resources Center Dentistry is at a crossroads. Declining dental care utilization among adults, the rapid growth in larger dental service delivery groups, increased financial barriers to care among adults, and improvements in oral health status for most segments of the population are just a few of the factors bringing significant change to the profession. Overarching all of this, the U.S. health care system is on the verge of unprecedented change due to the Affordable Care Act (ACA).

About Marko Vujicic Dr. Marko Vujicic is Managing Vice President, Health Policy Resources Center at the American Dental Association where he is responsible for overseeing all of the Association’s policy research activities. Prior to joining the American Dental Association, he was Senior Economist with The World Bank in Washington D.C. where he directed the global health workforce policy program, which focuses on addressing the numerous human resources for health challenges in developing countries. Previously, he was Health Economist with the World Health Organization in Geneva, Switzerland. Dr. Vujicic is the lead author of the book, Working in Health, which examines the effect of fiscal policy on the health workforce.



Building a Measurable Social Media Strategy Nichole Kelly of Social Media Explorer When creating a social media strategy, the first question you have to answer is, “what am I trying to accomplish with social media?” In this session, you will evaluate options for generating brand awareness, increasing revenue and improving customer retention against your core business goals so you can determine which goal is right for your organization. Then you will then dive into how to create strategies that are designed to be measured. You’ll evaluate key performance metrics for each social media goal and be provided with a framework for evaluating strategies against the level of effort, risk and impact. Already have a strategy in place? This session will help you evaluate your strategy and improve its ability to deliver results. Just getting started in social media? You’ll learn how to create a strategy that is designed to deliver the kind of results that create careers.

Does Network Size Matter? Examining important PPO network trends Aaron Groffman, The Ignition Group PPO Network Trends  Get a handle on PPO network trends and how they impact your decision-making:  Are networks still growing? At what pace?  Is there still room for growth or has a saturation point been reached?  What’s going on with network leasing?  Are providers “maxed out”, or are they still joining networks?  Are all listed providers actively practicing at all locations?  How does your network grade out versus your competitors?

Nevada: One State’s Silver Road to an Exchange Jon Hager, Silver State Health Insurance Exchange Jon Hager, Executive Director of the Silver State Health Insurance Exchange, will provide an overview of Nevada Health Link, Nevada’s state-based Exchange. Nevada is quietly surpassing many of the original ‘pace car’ state Exchanges, particularly with regard to incorporation of pediatric dental and vision Essential Health Benefits. Mr. Hager’s presentation will focus on how Nevada Health Link is handling complex issues including pediatric dental plan offerings and provide insight on how Exchanges may impact the marketplace. Key dental issues addressed in this session: the incorporation of dental into the Shop and Compare consumer tool, decisions on mandatory purchase and dental product types, i.e. bundled/embedded/stand-alone.



The DSO Role in the Future of Dental Benefits Amy Marko, Aspen Dental; Michael Cole, Dental Care Alliance; Dr. Dan Croley, Delta Dental of CA, PA & Affiliates, and Jeanne Hensel, Humana Dentistry is at a crossroads. Dental Service Organizations are cited by the ADA as the fastest growing segment of dentistry. The panel of both DSO and carrier representatives will explore the factors fueling the growth of DSOs and how they can partner with the insurance carriers and contribute to the expansion of dental benefits as well as support and enhance the efficient and effective delivery of dental care.

Products and Tools for Consumer Engagement and Cost Transparency Robin Gelburd, FAIR Health At this time of rapid change in the insurance industry, Robin Gelburd, President of FAIR Health, will address the critical need for rich data to inform strategic planning, fee schedule development, provider networking strategies and, importantly, consumer engagement. In particular, she will discuss how this new era of consumer engagement calls for effective cost transparency and educational solutions to support plan selection and plan management. She will likewise discuss how these consumer tools need to be complemented with internal “dashboards” and custom analytics to advance sound decision-making by employers, dental plan managers, administrators, brokers, actuaries and other stakeholders in this time of churning reform. Her presentation will include concrete examples of consumer engagement and internal management solutions.

Understanding the Impact of Loss Ratios on Dental Coverage Joanne Fontana of Milliman California bill AB18 aims to impose a 75% minimum loss ratio on all individual and small group pediatric dental policies sold in the state. Using this bill as a case study, we will discuss how loss ratio regulations affect dental carriers differently than medical carriers, and we will compare loss ratio calculations to other commonly used indicators of consumer value such as Actuarial Value.



How to Win an Unfair Fight: What the most influential leaders do differently Garrison Wynn, Author of Real Truth About Success Sponsored by Coastal Dental This entertaining research-based keynote reveals how top performers harness the power of their advantages, even when the odds are not in their favor. Business relationship expert and bestselling author Garrison Wynn delivers a high-impact program that answers two monumental questions: How do you get people to do what you want them to do? And how can you get better results from the difficult people you encounter along the way? With an emphasis on what you can actually walk out of the session with and achieve tomorrow; this program shows you how to weather the perfect storm while still looking really good in a raincoat! Garrison Wynn helps people learn how to make the jump from being great at what they do to understanding and developing the qualities it takes to be chosen for the job. He gets them to understand why their products, services, or leadership styles-- or those of their competitors -- are selected. As he says, "If the world agreed on what's best, everybody would choose the best and nothing else would be considered. Decision making doesn't work that way."

About Garrison Wynn Garrison Wynn is a nationally known speaker, trainer, and consultant. He is the author of The Real Truth About Success and president and founder of Wynn Solutions, a company specializing in turning talent into performance. He helps people learn how to make the jump from being great at what they do to understanding and developing the qualities it takes to be chosen for the job. Garrison has worked with some of the world's most effective corporate leaders and business developers, from multibillion-dollar manufacturers to top New York Stock Exchange wire houses.



Alternatives in Care Delivery and Benefits- Public and Private Allen Finkelstein, Managed Health Care Systems of NY, Dr. Paul Glassman, and Dr. John Luther, DentaQuest Dental care consumes only x% of the overall health dollars. But when you compare dental to the dollars spent on particular diseases, dental actually fares well in expenditures. With competition for health dollars increasing, are there ways that dental carriers operating in both public and private coverage can change the spending paradigm to improve care and stretch the funds that are available to cover more enrollees? Could these and changes like them move dental benefits out of the pattern that has been followed for decades? Do the changes in coverage under the ACA for pediatric dental provide opportunities to innovate? Our panel members provide insights into new methods of care.

Business Intelligence: The New Dental Benefits Imperative Dr. John Reed, The Concept Group & Will Hinde, West Monroe Partners Our industry is changing beyond our expectations. Health care reform, public and private exchanges, the disintegration of the small groups market and the emerging individual market are changing the rules as it relates to how we define and analyze new market opportunities. Our predominant focus on the group market has required nominal investments in sophisticated marketing methods and tools that are commonly applied in other more consumer centric industries. We must now catch up. It is now imperative to build a business intelligence capability that includes competitive intelligence, market analytics and new agile product development capabilities as we define new markets and products to supplement our increasingly risky group business. These skills and practices must be supplemented by modern technology tools that help us make substantive investment decisions that are more than just “intuitive judgments.” The Concept Group and West Monroe Partners are co-presenting this session that will combine their deep expertise in business intelligence and technology respectively, to provide an overview of methods and tools that can be applied to our increasingly dynamic industry.

The Landscape for Dental Plan Quality and Measurement, Monet 2-4 Dr. Craig Amundson, HealthPartners; Timothy L. Brown, NADP; Drs. Fred Horowitz, Nevada Dental Benefits; Stephanie Lepsky, OptumInsight and David Preble, ADA With implementation of HIPAA/ACA and Federally Funded Marketplaces (FFMs), there’s substantial chatter around dental quality measurement. What is the current status? What is coming next? Join a distinguished expert panel of NADP members and ADA staff engaged in the development of dental quality measures and diagnosis codes. Get quickly up to speed on recent actions and participate in an interactive conversation about why it matters to dental plans along with the near and long term actions and outcomes.



E-Commerce: How to Maximize Your Market Presence William Hinde & Kristin Irving, West Monroe Partners & Ted Novak of Clique Studios This session will provide industry expertise and project experience and insight on why enabling e-Commerce capabilities is critical as Payer organizations transform themselves to respond to the changes brought forward by Healthcare Reform. Payers are challenged to think and operate differently with the shift to B2C and a customer centric market strategy and execution. Topics will include:  Define the need and purpose of an E-Commerce solution and how it also enables health insurance marketplace readiness  Present the E-Commerce Maturity Model (including examples from the Payer Industry)  Outline the capabilities required to support the purchase of insurance products on-line  Overviews of Integrated Digital Marketing, Search Engine Optimization and Search Engine Marketing Expected results from enabling an E-Commerce solution  Examples / Lessons learned from our projects  Next steps for your organization based on where you are in the Maturity Model

Provider Credential Challenges and Solutions Brian Flynn, NADP, Craig Kasten, Wonderbox, Tom Mort, DentalXChange, Christine Stroup, CAQH With the continued evolution of technology in the Dental Benefits arena, Provider Credentialing is quickly moving to an electronic platform and multi-payer solution. Dental credentialing is a process of assessing, reassessing and validating the qualifications and practice history of a dental provider. Attend this session to learn more about the challenges involved with Provider Credentialing and solutions in the market that save time and money both to the providers and payers. Our panel of experts includes representatives from a healthcare administration technology vendor, Dental clearinghouse and CAQH who will share their perspectives on the current changes and future trends for Provider Credentialing.

Sales Channels for Public Exchanges Sarah Rodehorst, Connecture Increasing enrollment in health insurance is one of the primary goals of the health reform law. CMS has created two alternative avenues for marketplace enrollment, i.e. direct enrollment from carrier websites and enrollment through web-based insurance brokerage firms. These additional portals will help enroll Americans in the insurance exchanges in the 35 states where the federal government is involved with state exchanges. Both avenues will be able to determine if individuals are eligible for subsidies through connections with the federal data hub but each will approach enrollment differently. Learn more about these avenues to enrollment, what choices and options you have to work with, and whether they provide additional opportunities for dental sales from a leader in technology advances for health insurance.



The Consumer Mindset in a Post Exchange World Marc Pierce, Stonegate Advisors, LLC Are consumers ready for health insurance exchanges? The shift in our industry from a wholesale to retail market has a monumental impact on every aspect of the consumer value chain, from how we educate, communicate, market and sell, to how we transact, engage, and service consumers on an ongoing basis. Learn how consumers will shop in a post exchange environment, not only for health benefits, but also for products and services not typically covered by core health insurance. Beyond insurance, an average individual spends nearly $1800 a year out-of-pocket; a family spends close to $4,000. Consumers are now looking to stretch their healthcare dollars and find the right balance. In this session, we will discuss how and where consumers will shop both on and off the exchange, and learn what they are really looking for.

Measuring Social Media's ROI Nicole Kelly, Social Media Explorer Build on the principles presented in yesterday’s session, Building a Measurable Social Media Strategy. In this session, you will learn more about how to create strategies that are designed to be measured. You’ll evaluate key performance metrics for each social media goal and be provided with a framework for evaluating strategies against the level of effort, risk and impact.



ACA and Dental Benefits: The Path Ahead Health Care Reform and Exchange Task Forces Jon Seltenheim, Chair of the Task Force along with members Chris Swanker, Kirk Andrews, Jeff Album and Gail Garcia and Rick Lantz of NADP’s State Exchange Task Force will participate in an interactive panel discussion on the policy and operational issues ahead as the era of exchanges advances. Regulatory decisions and guidance, based on the imperfect incorporation of the Stabenow amendment into the statute, have created multiple controversies over the offer of pediatric dental coverage both on and off Exchanges. Key issues that will be in the forefront for both regulatory and Congressional action as ACA implementation is adjusted in the coming years include  the separate dental out-of-pocket maximum,  dental’s exclusion from cost sharing reductions for low income consumers,  partial application of market reforms to pediatric dental coverage,  limited tax subsidies for pediatric dental  the offer, but not required purchase, of pediatric dental in Exchanges,  dental portion of ACA insurer assessment and Exchange fees, and  reasonable assurance and Exchange certified for dental products outside the Exchanges As well, operational issues in Exchanges—both federal and state-- will continue to impact the dental benefits market as states move from federal to state-based Exchanges. Get valuable insight into these issues, the policy positions advocated by NADP and other stakeholders and the road ahead for the dental benefits industry and NADP as our representative.



Become a Brain Athlete Ron White Ron White is without question the nation’s #1 Memory Expert and is one of the top in the world. He is a two-time national memory champion winning the USA Memory Championship in 2009 and 2010. He held the record for the fastest to memorize a deck of shuffled cards in only 1 minute and 27 seconds for two years. He has memorized the names of 200 people in 15 minutes even more times than he can remember. His desire is not that you see him as the person with the best trained memory but that he teaches YOU to have the best trained memory! Ron has spoken to audiences across the globe, been a guest on more than 200 radio programs and authored more than a dozen CD albums and books.

About Ron White Ron has given his talk all over the world in countries including Singapore, Indonesia, Ireland, Kenya, Sout h Africa, Mauritius, Zimbabwe, Nigeria, Ghana, England, Italy, Germany, Spain, Australia, Thailand, Malaysia, Canada, The Bahamas, Puerto Rico, Belgium and even Nebraska. He has appeared on Good Morning America, Martha Stewart Show, FOX and Friends, the CBS Evening News, CBS Early Show, FOX, NBC and newspapers across the country from the New York post to the Dallas Morning News. He is a part of the History Channel show Stan Lee’s Super Humans as the memory guy. You may have also seen him on the National Geographic Channel show ‘Brain Games’. He has been the guest on over 200 radio programs and is the author of over a dozen CD albums and books. In every talk Ron shares that he is no different from anyone and everyone can learn how to improve their memory.